Pregnancy Articles:

Look out for these problems in pregnancy Gestational diabetes and many more


Symptoms:Flu-like illness with fever, muscle aches, chills, and sometimes diarrhea or nausea that can progress to severe headache and stiff neck.

Potential Problem: Listeriosis (infection from the bacterium listeria monocytogenes, which can be found in soft cheeses and ready-to-eat deli meats).

Diagnosis: Blood test.

Treatment: Antibiotics (often prevent infection in the baby).

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Symptoms: Mild flu-like symptoms, or possibly no symptoms.

Potential Problem: Toxoplasmosis (parasitic infection that can be passed on to the baby, which can be contracted from cat feces or soil, or from eating raw or undercooked meat that contains the parasite).

Diagnosis: Blood test. If the mother is infected, the fetus can be tested through amniocentesis (a test on the fluid around the baby, to diagnose certain birth defects) and ultrasound.

Treatment: If fetus not yet infected, mother can be given an antibiotic, spiramycin (to help reduce severity of symptoms in the newborn). If the fetus is suspected of being infected, the mother can be given two medications, pyrimethamine and sulfadiazine. Infected babies are treated at birth and through the first year of life with these medications.

Symptoms: Extreme thirst, hunger, or fatigue (but usually no symptoms). Also, a blood sugar value of 140 mg/DL or greater on a diabetes test.

Potential Problem: Gestational diabetes (a form of diabetes that usually occurs in the second half of pregnancy).

Diagnosis: Blood test one hour after drinking a glucose (form of sugar) drink. Most women can control their blood sugar levels with diet and exercise.

Treatment: Some women with gestational diabetes or women who had diabetes before pregnancy need shots of insulin to keep blood sugar levels under control.

Placenta abruptio

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Placenta abruptio is the separation of the placenta (the organ that nourishes the fetus) from its attachment to the uterus wall before the baby is delivered.

Causes

The exact cause of a placental abruption may be hard to determine.

Direct causes are rare, but include:

  • Injury to the belly area (abdomen) from a fall, hit to the abdomen, or automobile accident
  • Sudden loss of uterine volume (can occur with rapid loss of amniotic fluid or after a first twin is delivered)

Risk factors include:

  • Blood clotting disorders (thrombophilias)
  • Cigarette smoking
  • Cocaine use
  • Diabetes
  • Drinking more than 14 alcoholic drinks per week during pregnancy
  • High blood pressure during pregnancy (about half of placental abruptions that lead to the baby's death are linked to high blood pressure)
  • History of placenta abruptio
  • Increased uterine distention (may occur with multiple pregnancies or very large volume of amniotic fluid)
  • Large number of past deliveries
  • Older mother
  • Premature rupture of membranes (the bag of water breaks before 37 weeks into the pregnancy)
  • Uterine fibroids

Placental abruption, which includes any amount of placental separation before delivery, occurs in about 1 out of 150 deliveries. The severe form, which can cause the baby to die, occurs only in about 1 out of 800 to 1,600 deliveries.

Symptoms

Exams and Tests

Tests may include:

Treatment

Treatment may include fluids through a vein (IV) and blood transfusions. The mother will be carefully monitored for symptoms of shock. The unborn baby will be watched for signs of distress, which includes an abnormal heart rate.

An emergency cesarean section may be needed. If the baby is very premature and there is only a small placental separation, the mother may be kept in the hospital for close observation. She may be released after several days if the condition does not get worse.

If the fetus is developed enough, vaginal delivery may be done if it is safe for the mother and child. Otherwise, a cesarean section may be done.

Outlook (Prognosis)

The mother does not usually die from this condition. However, all of the following increase the risk for death in both the mother and baby:

  • Closed cervix
  • Delayed diagnosis and treatment of placental abruption
  • Excessive blood loss, leading to shock
  • Hidden (concealed) uterine bleeding in pregnancy
  • No labor

Fetal distress occurs early in the condition in about half of all cases. Infants who live have a 40-50% chance of complications, which range from mild to severe.

Possible Complications

Excess blood loss may lead to shock and possible death in the mother or baby. If bleeding occurs after the delivery and blood loss cannot be controlled in other ways, the mother may need a hysterectomy (removal of the uterus).

When to Contact a Medical Professional

Call your health care provider if you are in an auto accident, even if the accident is minor.

Call your doctor right away if you have bleeding during pregnancy. See your health care provider right away, call your local emergency number (such as 911), or go to the emergency room if you are pregnant and have vaginal bleeding and severe abdominal pain or contractions during your pregnancy. Placental abruption can quickly become an emergency condition that threatens the life of both the mother and baby.

Prevention

Avoid drinking, smoking, or using recreational drugs during pregnancy. Get early and regular prenatal care.

Recognizing and managing conditions in the mother such as diabetes and high blood pressure also decrease the risk of placental abruption.

Alternative Names

Premature separation of placenta; Ablatio placentae; Abruptio placentae; Placental abruption

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