Medical Challenges in Pregnancy

Conditions such as diabetes, thyroid disease, and blood clotting disorders (known as thrombophilias) are cause for special concern during pregnancy because of the risk they pose to you and your baby. While most women with these types of conditions have uneventful pregnancies and healthy babies, they do require special monitoring and, in some cases, treatment during pregnancy.

Diabetes During Pregnancy

If you are diabetic and become pregnant, your health and your baby’s health can be at risk. The risk of having problems is greatest when your blood sugar levels are too high. By controlling your blood sugar levels during your pregnancy, you can reduce the risk of:

  • Macrosomia, which occurs when your blood sugar level is high. This allows too much sugar to go to your baby and can cause the baby to grow too large, making delivery difficult.
  • Preeclampsia, or high blood pressure during pregnancy, can pose severe health problems for you and your baby and may require your baby to be delivered early.
  • Polyhydramnios, which occurs when there is too much amniotic fluid in the sac that surrounds the baby. This can result in preterm labor and delivery.
  • Urinary tract infections, which may occur without symptoms. If the infection is not treated, it may spread from the bladder to your kidneys.
  • Respiratory distress syndrome, making it harder for your baby to breathe after birth.
  • Stillbirth delivery, when a baby has died before birth, occurs more often in babies of women whose diabetes was not well controlled during pregnancy.

By carefully monitoring blood sugar during pregnancy, most diabetic women can have healthy babies. Your doctor will closely monitor you through regular screenings to ensure early detection of any problems you or your baby may be having. You can also take the following steps to manage your diabetes during your pregnancy:

  • Eat a balanced diet consisting of several small meals and snacks throughout the day.
  • See your doctor regularly for checkups and tests.
  • Follow a moderate exercise program as prescribed by your doctor.
  • Check your glucose often each day to keep it at a normal level.
  • Take insulin injections or pills as prescribed by your doctor.

By working together, you and your doctor can control your glucose level to help ensure you have a safe pregnancy and a healthy baby.

In most cases, women with diabetes go into labor normally and have a normal vaginal delivery, with special monitoring of the glucose levels and the baby. If there are problems during pregnancy, labor may need to be induced early.

After birth, most babies do well. Some babies may need to spend time in a special care nursery due to problems such as:

  • Low glucose levels
  • Low blood calcium and magnesium levels
  • An excess of red blood cells
  • Neonatal jaundice (yellow discoloration of the skin)
  • Breathing problems

In most cases, these problems are not serious and are treated soon after birth. If your blood sugar levels are well controlled during pregnancy, your baby is less likely to have problems after birth. Women with diabetes can breastfeed their babies in most cases.

Thyroid Disease During Pregnancy

Thyroid disease can pose a risk to you and your baby during pregnancy. However, with close monitoring and proper medical treatment, you can reduce the risks and have a healthy baby.

Throughout your pregnancy, your doctor will regularly check the levels of the thyroid hormone in your body to be sure they are at healthy levels. Though many of the medications used to treat thyroid disease are safe for your unborn child, your doctor will also closely monitor your baby throughout your pregnancy.

If you have a history or symptoms of thyroid disease and are thinking of becoming pregnant or are pregnant already, it is important to talk to your doctor. The chance of problems is greatest when thyroid disease is not monitored, treated, and controlled during pregnancy.

Risks of Hypothyroidism

For Your Baby:

  • Smaller than normal birth weight
  • Preterm birth (born before 37 weeks of pregnancy)
  • Decreased mental ability

For You:

  • Preeclampsia
  • Placental abruption
Risks of Hyperthyroidism

For Your Baby:

  • Smaller than normal birth weight
  • Preterm birth (born before 37 weeks of pregnancy)
  • Possible death
  • Hyperthyroidism

For You:

  • An irregular heartbeat or heart failure
  • Thyroid storm
  • Preeclampsia
  • Placental abruption

Thrombophilias During Pregnancy

Thrombophilias refers to a group of disorders that promote blood clotting. If you have one of these disorders, your body tends to form blood clots easily. As many as one in five people in the United States have a thrombophilias, though many do not know because they have no symptoms.

Signs of thrombophilia are more common during pregnancy. Most women with a thrombophilia have healthy pregnancies; however, the condition can contribute to a number of pregnancy complications:

  • Fetal loss/miscarriage
  • Poor fetal growth
  • Placental abruption
  • Preeclampsia [link to preeclampsia page]
  • Venous thromboembolism, or VTE

 Most of the problems that occur during pregnancy are believed to result from blood clots in placental blood vessels that lead to placental changes and reduced blood flow to the baby.

The risk of blood clots or pregnancy complications due to thrombophilia appears to be less than one percent in women with no history or family history of blood clots. Your doctor may recommend a screening test if:

  • You have had any type of blood clot.
  • You have a family history of blood clots, pulmonary embolism, or strokes that occurred before age 60.
  • You have a history of pregnancy complications (i.e. several miscarriages).

If you test positive for thrombophilia and your doctor believes your risk of blood clots and pregnancy complications is strong enough, you may be treated with a blood-thinning drug called heparin. This drug is given by injection daily and is safe for your baby because it does not cross the placenta. However, most women with a thrombophilia disorder need only to be monitored closely throughout pregnancy.

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The providers of Capital Women's Care seek the highest quality medical and ethical standard in an environment that nurtures the spirit of caring for every woman.

 

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