Becoming a mother and having a healthy child is a great happiness! However, complications during pregnancy can occur in any woman, even a completely healthy woman. That’s why it’s so important to see a good specialist from the earliest stages of pregnancy (see pregnancy management).
The following complications of pregnancy are distinguished:
- toxicosis;
- gestosis;
- ectopic pregnancy;
- premature birth;
- miscarriage (spontaneous abortion);
- frozen (non-developing pregnancy).
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Diagnosis of complications during pregnancy
2 Diagnosis of complications during pregnancy
3 Diagnosis of complications during pregnancy
Toxicoses
Toxicosis occurs in the first half of the term and is manifested by dyspeptic disorders and disorders of all types of metabolism.
In almost 90% of cases, early toxicosis in the first half of pregnancy is manifested by nausea and vomiting. If pregnancy is proceeding normally, then nausea or vomiting may occur no more than 2-3 times during the morning, more often on an empty stomach. These disorders do not require treatment and should go away on their own after 12-13 weeks.
Toxicosis is a condition in which nausea and vomiting occur at any time of the day, regardless of meals, and are accompanied by decreased appetite, exhaustion, weakness and weight loss.
Preeclampsia
Preeclampsia develops in the second half of pregnancy (after 20 weeks) and poses a great danger not only to the pregnancy itself, but also to the health of the woman and her child. Typically, gestosis is manifested by the occurrence of edema (hydropsis of the pregnant woman).
The next stage of gestosis - preeclampsia - is accompanied by increased blood pressure and the appearance of protein in the urine. This indicates changes in the biochemical composition of the blood, deterioration of blood circulation in the capillaries and small vessels (and in the placenta too). As gestosis progresses, eclampsia may occur with a critical decrease in cerebral circulation, cerebral ischemia and cytotoxic cerebral edema. Convulsions appear and coma is possible.
Preeclampsia ranks third among the causes of death in pregnant women, perinatal mortality with preeclampsia is 18-30%.
Therefore, it is so important for all pregnant women to be observed by an experienced obstetrician-gynecologist, who can promptly detect and prevent such complications during pregnancy.
What causes polycystic ovary syndrome?
- The level of hormones in the body is responsible for the process of puberty and the execution of reproductive activity. During endocrine changes, disruptions also occur in the functioning of the ovaries as an organ that is directly involved in the process of ovulation. Scientists call the source of the disorders an excessive amount of male sex hormones - androgens. A number of signs appear as external manifestations of hormonal imbalance: increased hair growth on the face and parts of the body, acne, increased oily skin, enlarged clitoris, deepening of the voice, and a decrease in the amount of menstrual flow.
- Genetic or hereditary factors may contribute to abnormalities in the structure of organs.
- Excess weight, leading to obesity, is the cause of the disease itself or as a consequence of other diseases, such as diabetes. The result is the same obstruction of the ovaries due to excess fat deposits.
With polycystic ovary syndrome, changes occur in the menstrual cycle. If changes are observed in the form of painful sensations, absence, untimeliness, scanty or, conversely, copious amounts of discharge, a diagnosis should be made. Based on this, appropriate effective treatment is prescribed.
Ectopic pregnancy
In an ectopic pregnancy, the fetus does not develop in the uterus, but in the cervical canal, fallopian tube, abdominal and pelvic cavities.
Normally, when an egg leaves the ovary, it enters the opening of the fallopian tube. Moving with the help of special cilia that cover the fallopian tube, after a few days the egg reaches the uterus. In normal cases, the process of fertilization of the egg occurs in the tube, then the cell appears in the uterus.
In the case of infectious obstruction of the tube or other pathology, the egg freezes in place or moves very slowly, never having time to reach the uterus. This is how an ectopic pregnancy occurs.
A blood test for hCG helps in establishing the diagnosis of ectopic pregnancy.
HCG is human chorionic gonadotropin. HCG contains alpha and beta units. Using blood tests to detect an increase in hCG levels, the presence of pregnancy can be accurately determined. So, during a normal pregnancy, the hCG level increases by 65% every two days. But with an ectopic pregnancy, this dynamics is not obvious.
In a normal pregnancy, hCG rises until the 10th week, then begins to decline. Stopping the increase in hCG levels may be a consequence of a missed or undeveloped pregnancy.
What does polycystic ovary syndrome mean?
With some disorders in the body, the walls of the ovary thicken, as a result, a mature egg - a follicle - cannot leave it and enter the uterine cavity for fertilization. Remaining in the ovary and filling with fluid, the egg eventually turns into a small cyst.
Since this process is repeated many times, many such cysts are formed, and the phenomenon associated with this is called polycystic ovary syndrome. As a result, the maturation of eggs and the ovulation process are disrupted - the most common cause of infertility, which can be successfully treated and eliminated.
Miscarriage
Miscarriage is a spontaneous termination of pregnancy, independent of the woman’s will, at up to 22 weeks. The phenomenon is quite common. Every fifth pregnancy in women can end in spontaneous miscarriage.
The symptoms of miscarriage in the early stages (6-8 weeks) may not be very noticeable. There may be a delay in menstruation, a change in the nature of bleeding during menstruation, and moderate lower back pain. According to statistics, about 80% of all miscarriages occur before 12 weeks.
A miscarriage in late pregnancy is accompanied by symptoms such as nagging pain in the lower back, abdomen and sacral area, brown or scarlet spotting from the vagina. If treatment is not carried out, then the detachment of the fruiting body from the wall of the uterus and its expulsion begins. In this case, bleeding may increase and intense cramping pain may occur. A miscarriage can result in the release of the entire fruiting body or its parts getting stuck in the uterus (in such a case, medical intervention will be required).
A recurrent miscarriage is a spontaneous termination of pregnancy (up to 22 weeks), which is repeated with each pregnancy.
If a woman has had 2 or more spontaneous miscarriages, doctors can diagnose “recurrent miscarriage.”
1 Diagnosis of complications during pregnancy
2 Diagnosis of complications during pregnancy
3 Diagnosis of complications during pregnancy
Premature birth
Preterm labor is the onset of labor before 37 weeks. Premature birth can occur suddenly or follow an existing threat of miscarriage.
The process can begin with uterine hypertonicity, isolated contractions and moderate abdominal pain. Another scenario is rupture of the membranes and rupture of amniotic fluid. Sometimes premature labor can begin with bleeding. This happens with placenta previa or placenta abruption.
In any case, urgent hospitalization of the pregnant woman is necessary, in which all necessary measures will be taken to maintain the pregnancy.
In case of critical placental abruption and rupture of the amniotic sac, emergency delivery may be performed.
Frozen pregnancy
Frozen pregnancy (or non-developing pregnancy) is one of the types of miscarriage. We can talk about miscarriage in situations where the beginning of pregnancy complied with all medical standards, and then there was a complete stop in the development of the fetus and its death.
In addition, pregnancy failure can occur in the case of successful conception, when the egg is fertilized and has time to attach to the uterus, in the complete absence of embryo development. This is called an “empty fertilized sac” - all extra-embryonic organs are formed, but the embryo is missing from the egg.
Quite often, a non-developing pregnancy is diagnosed in the early stages of pregnancy.
Signs of a non-developing pregnancy may be erased. More often, scanty blood discharge from the genital tract occurs with or without nagging pain in the lower abdomen. In this case, an ultrasound scan is necessary. With a fertilized egg size of 20 mm, an embryo with a heartbeat should be visualized. If the period is shorter and the average internal diameter of the ovum is less than 20 mm, and there is no pain, then the doctor prescribes a control ultrasound after 7-10 days (based on the results of the study, the diagnosis of a non-developing or frozen pregnancy is finally established or refuted).
1 Diagnosis of complications during pregnancy
2 Diagnosis of complications during pregnancy
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Abortion in 2 weeks
Early medical abortion can be done even on an outpatient basis, but always under the supervision of a doctor. Its advantage is the absence of any medical manipulations. Certain medications cause miscarriage. These drugs are not sold in pharmacies, even with a doctor’s prescription, but are dispensed only by the attending physician. The indication for premature termination of pregnancy, which is carried out for medical reasons, is the period of pregnancy. It can be carried out after 2 weeks, and the maximum period of pregnancy should not exceed 6 weeks. In this case, the size of the fertilized egg should not exceed 20 mm. In some cases, an early abortion done with medication may not be effective enough to completely remove the egg. In such situations, a full surgical abortion is additionally performed. Even a successful medical abortion significantly affects the woman’s hormonal state and requires the subsequent prescription of hormonal contraceptives.
Causes of miscarriage
The reasons for a non-developing pregnancy in the early stages are quite similar to the general situation when a woman cannot bear a child.
There are many reasons why a pregnant woman may lose her baby:
- the presence of infectious diseases (bacterial, fungal and viral diseases lead to inflammation of the endometrium, and this prevents the fetus from gaining a foothold in the uterus and developing);
- sexually transmitted infections (herpes, trichomoniasis, mycoplasmosis, toxoplasmosis, chlamydia);
- endocrine diseases, which can lead to hormonal imbalance and, as a result, miscarriage;
- mental, physical and emotional exhaustion;
- lack of female hormones, such as progesterone, which can lead to termination of pregnancy;
- chromosomal and other fetal abnormalities;
- congenital and acquired pathology of the uterus (for example, as a result of abortions and miscarriages in the past);
- Rh conflict (a negative Rh factor in the mother and a positive Rh factor in the father can lead to a conflict of antibodies, as a result of which the mother’s body perceives the fetus as a foreign body and tries to push it out of the body);
- the presence of bad habits in a pregnant woman (smoking, drinking alcohol, drugs, which leads to intoxication of the body;
- unfavorable environmental conditions, radiation.
1 Diagnosis of complications during pregnancy
2 Diagnosis of complications during pregnancy
3 Diagnosis of complications during pregnancy
Diagnosis of complications during pregnancy
Diagnosis of pregnancy or its complications begins with a visit to a gynecologist. The doctor pays attention to the woman’s complaints, which include weakness, malaise, delayed menstruation, the appearance of toxicosis, engorgement of the mammary glands, etc.
A home test for determining pregnancy based on the level of the hCG hormone in the urine is indicative (a study of the morning urine sample is especially informative).
A gynecological examination can reveal an enlarged uterus and other signs of pregnancy.
Ultrasound examination of the pelvic organs up to 10-11 weeks of pregnancy is carried out in cases where the attending physician needs to determine the location of pregnancy (uterine or ectopic) or exclude a frozen pregnancy.
Then tests are prescribed to determine the level of hCG in the blood, blood and urine tests for infections such as herpes simplex virus and type 2, chlamydia, toxoplasmosis, mycoplasmosis, cytomegalovirus, etc.
To prevent pregnancy complications, consultations are held with related specialists: ophthalmologist, therapist, ENT doctor, dentist, etc.
Early abortion: how to prevent
To avoid a situation where artificial termination of pregnancy is necessary, it is advisable to control the menstrual cycle, especially if pregnancy is undesirable at this stage. It is also important to use a reliable method of contraception. Your doctor will help you choose the most appropriate and effective method. If an unwanted pregnancy continues, you should consult a doctor as soon as possible to terminate it. The day after an early abortion, as with any other artificial termination of pregnancy, is the day of a new cycle, when the next pregnancy can already occur, so you should immediately choose the optimal method of contraception.
Some women mistakenly believe that it is not difficult to perform a premature abortion at home on their own. Such an event could cost the life of an unlucky mother or seriously harm her health. Under no circumstances should you try to induce a miscarriage, but you should always seek medical help.
