Complications in pregnancy

Sometimes pregnancy can lead to medical conditions which may cause you or your baby harm. Signs and symptoms may vary, as may the treatment you receive.

Guidance for pregnant women and information on what is happening in their regional unit during the coronavirus (COVID-19) outbreak can be found on NI Maternity

Baby’s movements reduce or change

Most women first become aware of their baby moving when they are 18 to 20 weeks pregnant. Never go to sleep ignoring a change in your baby’s movements, such as reduced movement. Always seek professional help immediately. Do not rely on any home kits you may have for listening to your baby’s heartbeat.

Bleeding

Bleeding from the vagina at any time in pregnancy can be a dangerous sign. Some causes of bleeding are more serious than others, so it is important to find the cause straight away by contacting your midwife or doctor.

Deep vein thrombosis

Deep vein thrombosis is a serious condition where clots develop, often in the veins in your legs. It can be fatal if the clot travels to the lungs. The risk may increase if you are on a long-haul flight.

You will have an assessment carried out at booking to see if you have increased risk of developing clots.

Gestational diabetes

Diabetes which occurs during pregnancy is known as gestational diabetes. It occurs because the pancreas is not producing enough insulin, a hormone which regulates the body’s sugar, or glucose, levels.

Because women need higher insulin levels to keep their blood sugar down, some women may develop temporary diabetes during the second half of their pregnancy.

Risk factors include:

During pregnancy, your blood glucose levels will be tested. If you are diagnosed with gestational diabetes, you may be referred to a specialist clinic. This is to make sure your glucose control is regulated for the rest of the pregnancy.

Poor glucose control can result in macrosomic (fat) babies, who can have problems during delivery or develop other problems after birth, such as jaundice or breathing problems.

You are also at greater risk of stillbirth. Treatment will involve seeing a dietician and developing a plan of regular, gentle exercise.

Pre-eclampsia

Your blood pressure and urine will be checked at every antenatal appointment. A rise in blood pressure and protein in the urine can be the first sign of pre-eclampsia, which is brought on by pregnancy.

Pre-eclampsia occurs in around 10 per cent of pregnancies, usually in the final three months, and can be accompanied by a generalised swelling called oedema.

Symptoms of pre-eclampsia include:

  • bad headaches
  • blurred vision or lights flashing before your eyes
  • bad pain below the ribs
  • vomiting
  • swelling of the face, hands or feet

You can, however, have pre-eclampsia with no symptoms at all.

Pre-eclampsia can cause fits in the mother (called eclampsia) and affects the baby’s growth. It is life-threatening if left untreated, which is why routine antenatal checks are so important.

Pre-eclampsia usually happens towards the end of the pregnancy, but it may happen earlier. It can also happen after the birth. It is likely to be more severe if it starts earlier in pregnancy.

Treatment may start with rest at home, but some women need admission to hospital and medicines that lower blood pressure. Occasionally, pre-eclampsia is a reason to deliver the baby early, this may be by induction of labour or by caesarean section.

Severe itching and obstetric cholestasis

Severe itching can be a sign of a condition called obstetric cholestasis. This is a potentially dangerous liver disorder that seems to run in families, although it can occur even if there is no family history.

The main symptom is severe generalised itching without a rash, most commonly in the last four months of pregnancy.

Obstetric cholestasis can lead to premature birth, stillbirth or serious health problems for your baby. It can also increase the risk of maternal haemorrhage after the delivery.

Placenta praevia

Placenta praevia is when the placenta is attached in the lower part of the uterus, near to or covering the cervix.

If the position of your placenta is significantly low at your 18-21 week ultrasound, you will be offered an extra scan to check its position.

If the placenta is still low in the uterus, there is a higher chance you could bleed during your pregnancy or in labour. This bleeding can be very heavy and put you and your baby at risk.

You may be advised to go to hospital at the end of your pregnancy so emergency treatment can be given quickly if you do bleed. If the placenta is covering the cervix, the baby cannot get past and a caesarean section will be necessary.

Vasa praevia

Vasa praevia is a rare condition where the blood vessels of the umbilical cord run through the membranes covering the cervix.

When the membranes rupture and the waters break, these vessels may be torn, causing vaginal bleeding. The baby can lose a life-threatening amount of blood and die. It is difficult to diagnose but may be spotted by an ultrasound scan.

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