Pregnancy complications

By Sally J. Hall

Hopefully you’re glowing yet sometimes you can get pregnancy niggles

We take a look at some of the more common pregnancy niggles and also a few (thankfully rare) complications to be aware of.

By Sally J. Hall

Many women sail through pregnancy with few set-backs, though most of us are prone to the more common pregnancy niggles such as morning sickness and swollen ankles. However, with so many strains on your body and the sheer work involved with growing a tiny human, it’s no wonder that a few problems turn up. We discuss some of the most common pregnancy complications and show you how to cope with them – and discuss a few more serious matters too.

Minor problems

Learn how to banish some of the more common pregnancy niggles and enjoy your happy, healthy pregnancy.

Constipation

Caused by changes in your hormones, you may find that it becomes more difficult to go to the loo. This usually happens in early pregnancy.

Solution: To counteract this, make sure you are eating plenty of foods high in fibre, such as fruit and vegetables, wholegrain breads and cereals plus pulses. Drinking plenty of water is indicated as well and you should avoid taking iron supplements, which can make constipation worse. You should also exercise regularly.

Cramps

Many women get cramps in their legs and feet during pregnancy and it’s
not really known why this happens. It usually strikes at night and can leave you hopping around the bedroom in agony.

Solution: To counteract it, pull your toes up and stretch the leg in the opposite direction to where the cramped muscles are and rub them vigorously. You may need to get your partner to help!

Fainting / Low Blood Pressure

If you aren’t getting enough blood and oxygen to the head, you can feel faint and may even pass out. This can be dangerous if you fall badly, so if you find yourself feeling light-headed, try to clench your leg and arm muscles (to get the blood flowing to the head) and sit or lie down. This affects some women but not others and can be quite worrying. It shouldn’t indicate a serious problem but if it happens a lot, you should see your doctor or midwife.

Solution: Do not lie flat on your back after 28 weeks of pregnancy – it can lead to a higher risk of stillbirth. Instead, lay on your left side with the support of a good pregnancy pillow.

Headaches

Whilst some women breeze through pregnancy without so much as a twinge in the head, others are prone to more headaches than usual. They tend to happen more in early pregnancy and should get better by the time you reach your second trimester. It’s doubly annoying, as there are fewer over-the- counter remedies that you can take for headaches during pregnancy.

Solution: You can try paracetamol, drinking more water and trying not to get stressed or a balm that you put on your temples. Perhaps you might need a couple of days off work if you feel that things are getting on top of you.

Headaches can be a symptom of pre-eclampsia, which is a more serious condition and one that you should not ignore. If you are having a bad headache, with blurred vision, flashing lights, feeling or being sick and suddenly finding your feet, ankles and hands are swelling, you should seek immediate medical help.

DVT

Deep vein thrombosis or DVT is where a blood clot develops in your body during pregnancy. It usually occurs in one of your legs and needs attention, as the clot could move in your bloodstream and cause a blockage in your lungs.

You’re more at risk if you are overweight, have had a previous clot or a family member has a history of blood clots, have had an injury such as a broken leg recently, have had fertility treatment, are carrying more than one baby, have varicose veins or are a smoker. It can be spotted if you have an ache in a leg, usually behind the knee or in the calf, a warm patch or a swelling or red skin.

Solution: If you have any of these symptoms, speak to your midwife or doctor immediately and call for an ambulance if you have difficulty breathing, are coughing up blood or have a tightness or pain in your chest or the upper part of your back.

What is a ‘Show?’

The neck of the cervix is plugged with a thick mucus-like substance in pregnancy. Before or during labour, it comes away and it can signal the start of labour.

What does it look like?

It is a jelly-like substance, sticky and sometimes a little pink-tinged, as it is mixed with a small amount of blood.

Does it all come away at once?

Sometimes the whole mucus plug comes away at once, though for other women it comes out gradually.

Will I notice it?

Because it may break up and come out in several smaller pieces, some women may not notice the plug come away. If your waters break, you probably won’t notice it either, as it’s mixed in the fluid. Some women actually see quite a noticeable clump of sticky mucus.

Rare problems

As with all common ailments, a small number of women can sometimes have symptoms of something a little more serious. Although extremely rare, they are always worth knowing about, so you know what signs to look out for.

Placenta Previa

This refers to a placenta that is very low in the womb, sometimes even covering the cervix. This will block your baby’s way out of the womb, so it can be a very dangerous complication if left undiagnosed. Usually this can be picked up at your ultrasound scan at between 18 and 21 weeks and the scan will be repeated at 32 weeks – most women will find that their placenta has moved up.

Solution: If your medical team feels the placenta is too low, they may decide to offer you an elective Caesarean; if you have painless bleeding during the last couple of months of pregnancy, you should contact you obstetrician at once.

Cord Prolapse

Sometimes the baby’s umbilical cord can slip down into the vagina during the process of labour and birth and this is known as cord prolapse. It’s rare, though extremely dangerous and can result in foetal distress or even the baby’s death if it is not managed, as the oxygen supply to the baby is compromised.

Solution: If you go into labour and there are no medical staff present and you have noticed the cord protruding from your vagina, you should get on your hands and knees. This can help take the pressure off the cord until help arrives. Your birth team will try to deliver your baby as quickly as possible if they spot a prolapsed cord, either with a Ventouse or forceps; if the baby is still high in the birth canal, you’ll have a Caesarean.

Pre-Eclampsia

This usually affects pregnant women in the second half of pregnancy, around the time of the birth or soon after. It can sometimes be spotted from symptoms you have, such as swollen hands, feet and face, a severe headache with visual disturbance or pain under the ribs. Medical staff may pick up problems when checking your blood pressure – it will become much higher – or finding protein when they test your urine.

The only way to resolve this serious condition is to deliver your baby, so your doctor will wait until you are around 37 to 38 weeks of pregnancy, monitoring you very closely and then delivery your baby, either by inducing you or with a planned Caesarean section.

Miscarriage

Sadly, miscarriage, or the loss of your baby before 23 weeks, is quite common, with around one in eight pregnancies ending in miscarriage. Women usually go on to have a successful pregnancy after this. It is usually signalled by heavy bleeding and cramps, plus pain in the lower abdomen. If you have some bleeding in early pregnancy, contact your midwife. Bear in mind that some light bleeding in early pregnancy is quite common and does not always end in miscarriage and that some women carry on having light ‘periods’ in pregnancy.

Many miscarriages are caused by genetic or developmental deficiencies and can’t be prevented – though you lower your risk of miscarriage if you are a healthy weight and don’t use drugs, or drink or smoke during pregnancy.

If a miscarriage is suspected, you will usually be given a scan to determine
if the pregnancy is viable. If the foetus has not made it, you will usually lose the foetus within a couple of weeks, or you may be offered a small procedure to help clear your womb.

Solution: A miscarriage is a sad and traumatic experience, even if you are in the very early stages of pregnancy, so you may want to explore having some counselling but do remember that usually, there’s no reason why you shouldn’t go on to have a healthy baby in the future.

Premature Labour and Birth

A premature birth is defined as one that takes place before 37 weeks of pregnancy (though babies from 24 weeks are considered ‘viable’). Though rare, one in eight babies will be born early, so you should contact your midwife or obstetrician if you are experiencing contractions, cramps, period-type pains, if your waters break, if you have an unusual backache or if you have a ‘show’.

You will be checked over and usually monitored to help work out if you are actually in labour or if it is the ‘practice contractions’ called Braxton Hicks.

Solution: If you are in labour, your medical team will discuss the various options and treatment you may be offered, depending on the cause of the early labour and how early it is. If your waters break early but labour has not started, you are at risk of getting an infection, so you may have to go into hospital; you will be given antibiotics and have blood and urine tests. If your waters haven’t broken but labour has started, you will be examined and your contractions timed. Medical staff will
ask you about pain, if you’ve had a ‘show’ and they will also take your blood pressure and temperature. They will ask about your baby’s movements over the past couple of days. If you are in labour before 36 weeks and it looks as if the baby is on the way, they will give you a corticosteroid injection to help strengthen your baby’s lungs and also magnesium sulphate if you are between 24 and 29 weeks to help protect your baby’s brain development.

Premature babies are at risk of a complicated list of problems and may have to spend some time in the neonatal, or special care baby unit.

Luckily, the majority of women have a wonderfully straightforward pregnancy, a problem-free birth and a happy, healthy baby at the end of it. So while it pays to be informed about the complications that might happen during pregnancy, chances are that you will sail through without so much as a stretch mark. So relax and enjoy your pregnancy!

Further Reading

We have more information on these pregnancy health problems: vomiting, heartburn, backache, piles, bleeding gums and stretchmarks. Head to this feature.

You can also find out how to avoid and cope with pregnancy incontinence here.