Maternal Health Issues During Pregnancy

Pregnant woman monitoring blood pressure

Safeguarding Your Health During Pregnancy

Many changes occur during pregnancy that can adversely affect maternal health. While most of these changes can be effectively monitored via a personal preconception plan devised with your practitioner, oftentimes pregnancy happens before women have opportunity to optimize their personal health, making them more susceptible to health issues while pregnant.

Your Capital Women’s Care team of women’s health professionals shares important information concerning these specific changes impacting maternal health, their subsequent symptoms and available treatments. This information can help protect you and your baby’s health throughout your pregnancy, so you not only experience a routine pregnancy and deliver a healthy baby, but also an uneventful birth without lingering post-partum health complications.

Maternal Health Issues During Pregnancy

There are several maternal health issues to be aware of once you become pregnant. While most pregnancy symptoms and complications range from mild and annoying discomforts, sometimes they may become severe and progress into life-threatening illnesses.

It can be difficult to determine which symptoms are normal and which are not, especially during a first pregnancy. These problems may include physical and mental conditions that affect your health or that of your baby and can be caused by or made worse by pregnancy. Many problems are mild and don’t progress; however, when they do, they may cause harm to you or your baby if not treated immediately.

Maternal health concerns that may arise during pregnancy include:

  • iron-deficiency anemia. Anemia occurs when red blood cell count (hemoglobin or hematocrit) is low. Iron deficiency anemia is the most common type of anemia. Iron within the hemoglobin allows blood to carry oxygen. Pregnant women need more iron than normal because of the increased amount of blood within their body and for their developing child.

    Symptoms of iron deficiency include feeling tired or weak, looking pale, feeling faint or experiencing shortness of breath.

    Taking prescribed iron and folic acid supplements as directed by your practitioner eliminates iron deficiency anemia risk throughout pregnancy.

  • high blood pressure. Gestational hypertension occurs when a woman who previously had normal blood pressure develops high blood pressure when 20+ weeks pregnant and her blood pressure returns to normal within 12 weeks after delivery. This problem usually occurs without other symptoms. In many cases, gestational hypertension doesn’t harm either mother or fetus.

    Severe gestational hypertension may be associated with preterm birth and infants who are deemed small at birth. Some women who have gestational hypertension later develop preeclampsia.

    In preeclampsia, the mother’s high blood pressure reduces the blood supply to the fetus, which may result in the fetus getting less oxygen and fewer nutrients. Telltale symptoms include increased swelling and protein in the urine. Other symptoms include stomach pain, dizziness, headaches and blurred vision.

    Eclampsia is when pregnant women with preeclampsia have severe symptoms affecting brain function, leading to maternal seizures, coma or increased risk of stroke.

    A serious complication of hypertensive disorders in pregnancy is HELLP syndrome, a situation in which a pregnant woman with preeclampsia or eclampsia suffers liver and blood cell damage:

    • hemolysis occurs when oxygen-carrying red blood cells break down
    • elevated liver enzymes, which indicates liver damage
    • low platelet count when cells responsible for stopping bleeding are low.

    Postpartum preeclampsia describes preeclampsia that develops in the woman after birth, usually between 48 hours and 6 weeks after delivery. Symptoms can include high blood pressure, severe headache, visual changes, upper abdominal pain and nausea or vomiting.  It can occur regardless of whether a woman had high blood pressure or preeclampsia during pregnancy.

    Adhering to your recommended prenatal checkup schedule and having your blood pressure monitored regularly reduces risk of developing high blood pressure and its subsequent health problems during pregnancy.

  • diabetes. Gestational diabetes occurs when blood sugar levels are too high during pregnancy.

    The condition is diagnosed with the glucose challenge screening test around 24 to 28 weeks of pregnancy followed by a diagnostic test (the oral glucose tolerance test.) Usually, there are no symptoms. Sometimes, extreme thirst, hunger or fatigue present.

    Gestational diabetes increases the risk of a baby that is too large (macrosomia), preeclampsia and cesarean birth, plus increase baby’s risk of low blood sugar, breathing problems and jaundice.

    Treatments include controlling blood sugar levels naturally via healthy diet and exercise plus medication if blood sugar values continue to be elevated.

  • hyperemesis gravidarum (HG). This condition is characterized by severe, persistent nausea and vomiting during pregnancy and is more extreme than morning sickness.

    Symptoms of HG include constant nausea, vomiting multiple times daily, weight loss, reduced appetite, dehydration and feeling faint or fainting.

    Treatment includes bland foods and fluids together initially. Sometimes, medicines are prescribed to combat nausea. Many women with HG are hospitalized so they can receive fluids and nutrients intravenously.

    Women having HG often feel better by the 20th week of pregnancy; however, some women vomit and feel nauseated throughout the entire pregnancy.

  • mental health conditions. Depression, whether exhibiting extreme sadness during pregnancy or after birth, known as postpartum depression, is not uncommon during pregnancy.

    Symptoms may include intense sadness, helplessness and irritability; changes in appetite; and thoughts of harming self or baby.

    Treatments may incorporate one or a combination of options, including talk therapy, support groups or medications.

    If left untreated, maternal depression can adversely affect baby's development, so getting appropriate treatment is important.

  • placenta issues. The placenta may be affected or compromised during pregnancy, calling for immediate treatment and care.

    Placenta previa occurs when the placenta covers part or the entire opening of the cervix inside the uterus. It’s characterized by     painless vaginal bleeding during the 2nd or 3rd trimester or by no presentation of symptoms for some women.

    If diagnosed after the 20th week of pregnancy without bleeding, your doctor will advise to limit activity level and increase bed rest. If bleeding is heavy, hospitalization may be needed until mother and baby are stable. If bleeding stops or is light, continued bed rest is resumed until baby is ready for delivery. If bleeding doesn't stop or if preterm labor starts, baby is delivered via cesarean section.

    Placental abruption occurs when the placenta separates from the uterine wall before delivery, which may result in reduced oxygen sent to baby, thus endangering baby’s health and survival.

    Symptoms include vaginal bleeding, cramping, abdominal pain and uterine tenderness.

    With minor placental separation, bed rest for a few days usually stops bleeding. Moderate instances may require complete bed rest. Severe situations, resulting in more than 50% placental separation, require immediate medical attention and subsequent early delivery.

  • obesity and weight gain. Recent studies suggest the more unhealthy pounds a woman carries before she becomes pregnant, the greater her risk of developing a range of pregnancy complications, including preeclampsia and preterm delivery.

    Women who lose unhealthy pounds before pregnancy are likely to have healthier pregnancies. Lifestyle changes including healthy eating and physical activity decrease risk of pregnancy complications due to obesity.

  • infections, including those occurring with HIV, viral hepatitis B, sexually transmitted diseases (STDs) and tuberculosis (TB). These infections not only affect maternal health, but also that of your baby.

    In many instances, these infections can be passed directly to your baby or compromise you and your baby’s health and survival:

    • HIV can be transmitted to fetus or newborn during pregnancy, labor or delivery or by breastfeeding.

    • Newborns infected with viral hepatitis B have a 90% chance of developing lifelong infection, which can lead to liver damage and liver cancer.

    • STD infection can cause stillbirth, low birth weight and life-threatening infections and can also cause a woman's water to break too early or initiate preterm labor.

    • TB infection during pregnancy poses a substantial risk of morbidity to both mother and fetus if not diagnosed and treated in a timely manner.

Tips for a Healthy Pregnancy

There are several things you can do to maximize your chance of having a healthy pregnancy:

  • Establish a preconception health plan with your practitioner to optimize your health before becoming pregnant.

  • Get appropriate prenatal care throughout your pregnancy so health issues that arise during routine tests and exams may be immediately addressed, minimizing their impact on you and your baby’s health.

  • Gain control and effectively manage all pre-existing medical conditions as directed by your practitioner before becoming pregnant.

  • Devise a self-care plan to optimize your physical and mental health, including getting plenty of rest and sleep, adhering to proper nutrition and daily exercise and identifying and using personal strategies for relaxation and stress management.

  • Monitor symptoms throughout all stages of your pregnancy, as early treatment reduces health risks to you and your baby and gives you best opportunity for a safe, uneventful delivery and postpartum recovery should a health issue arise.

Your Capital Women’s Care team of professionals are here to address your concerns and answer your questions about maternal health issues during pregnancy or any women’s health issue. Our compassionate, knowledgeable team of women’s health experts prioritize quality, comprehensive care and treatment to ensure you enjoy optimal health and a long quality life.

Sources:

https://www.cdc.gov/nchhstp/pregnancy/default.htm
https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-co...
https://www.who.int/news-room/fact-sheets/detail/maternal-mortality
https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy
https://www.nichd.nih.gov/health/topics/preconceptioncare/conditioninfo/...
https://www.marchofdimes.org/complications/chronic-health-conditions-and...
https://www.npr.org/sections/health-shots/2019/01/24/686790727/fourth-tr...
https://www.bcbs.com/the-health-of-america/reports/trends-in-pregnancy-a...
https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/pregnancy...
https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/pregnancy...
https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/pregnancy...

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