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Summary: In our society, pregnancy and delivering a baby is the very definition of womanhood. What happens when that seemingly straightforward process goes wrong? How do you know if your pregnancy is high-risk?Is there anything you can do to prevent complications? What are the top signs women can look out for in their pregnancy? Although the majority of pregnancies are uneventful, sometimes complications do occur.

Chenai Hove ( not her real name), a 28-year-old mother of one, was just over 26 weeks pregnant when she went into pre-term labour last month and delivered a premature baby. Doctors struggled to resuscitate the tiny baby, who weighed only 1.2kg.It lived for a day before succumbing.This was Chenai's second premature baby.The previous one had been a year ago and the early labour occurred at the same time.It was found that Chenai had an incompetent cervix due to injuries that occurred in her very first pregnancy and she would need a cervical stitch to be put in place for subsequent pregnancies.

Another mother,Elizabeth Katiku, a 36-year-old journalist, wrote to me: "I have suffered from a stillbirth due to umbilical cord andIhave also suffered from placenta previa and had an emergency c-section at 32 weeks with my daughter.There are just so many stories of women I know who have lost babies in pregnancy and this is something I would like you to bring light on because I find there is not enough available information."

These are just two of the many stories I hear everyday as a medical practitioner. My advice is that it is vital to see your doctor as soon as you fall pregnant. It is a good way to minimise complications. Dangers in pregnancy can happen before, during and after delivery, and it is important to know and look out for them.

The following are a few of the more common pregnancy complications that can occur and the signs to look out for:

Ectopic Pregnancy

In an ectopic pregnancy, the baby develops outside the uterus, in the uterine tubes, cervix, pelvis or even abdomen.The cause of an ectopic pregnancy is usually scar tissue in the fallopian tube from infection or disease.Ectopic pregnancies occur in about one out of 50 pregnancies and can be very dangerous to the mother.

What to look out for

Bleeding means different things throughout your pregnancy. "If you are bleeding heavily and have severe abdominal pain and menstrual-like cramps or feel like you are going to faint during first trimester, it could be a sign of an ectopic pregnancy," Peter Bernstein MD, ob-gyn professor at New York's Albert Einstein College of Medicine and Monte fiore Medical Center, says.The longer an ectopic pregnancy continues, the greater the likelihood that a fallopian tube will rupture and this may be life-threatening.Treatment of an ectopic pregnancy may include medication or surgical removal of the fetus.


A miscarriage is the loss of the fetus before 20 weeks. Miscarriages occur in about 15 to 20% of all pregnancies, usually by the 12th week of gestation, and are usually due to genetic or chromosomal abnormalities.

What to look out for

Miscarriages are usually preceded by bleeding and intense cramping, but light bleeding does not necessarily indicate a miscarriage. 30% of normal pregnancies have vaginal spotting.

To confirm a miscarriage, an ultrasound and blood tests may be performed.The fetus and contents of the uterus are often naturally expelled.If this process does not occur, a procedure called a dilation and curettage (D&C) may be necessary. This uses special instruments to remove the abnormal pregnancy.

Fetal loss in the second trimester may occur when the cervix is weak and opens too early.In some of these cases, a physician can help prevent pregnancy loss by suturing the cervix closed until delivery like Chenai's above.

Amniotic Fluid

Too much or too little amniotic fluid in the membranes surrounding the fetus may indicate a problem.Too much fluid can put excessive pressure on the mother's uterus, leading to pre-term labour.It can also cause pressure on the mother's diaphragm, leading to breathing difficulties.Fluids tend to build up in cases of uncontrolled diabetes, multiple pregnancy, incompatible blood types, or birth defects.Too little fluid may indicate birth defects, growth retardation, or stillbirth. What to look out for A belly bigger than expected for the date may indicate too much amniotic fluid.The only sure way to confirm this is by ultrasound.

Hypertensive disorders in pregnancy/ pre-eclampisa

Pre-eclampsia is thought to happen when the placenta isn't working properly.It can cause severe disease if not treated. Pre-eclampsia occurs in the second half of pregnancy.The diagnosis is made by tests during antenatal clinics which confirm high blood pressure and protein in urine.

What to look out for

* headaches

* burning epigastric (centre below ribs) pain

* blurred vision

* generalised body swelling

* decreased urine output

Early Labour

Contractions can be a sign of pre-term labour. "A lot of first-time moms may confuse true labour and false labour," DrRuddock of Florida Hospital says. False labour contractions are called Braxton-Hicks contractions.They're unpredictable, non-rhythmic, and do not increase in intensity.

"They will subside in an hour or with hydration," Dr Ruddock says. "Regular contractions are about 10 minutes apart or less and increase in intensity." If you're in your third trimester and think you're having contractions, call your doctor.If it is too early for the baby to be born, your doctor may be able to stop labour.


"Bleeding is always serious," women's health expert Donnica Moore MD says. Any bleeding during pregnancy needs immediate attention.Call your doctor or go to the emergency room.Bleeding in late pregnancy may be a sign of placental complications or a vaginal or cervical infection.Women who bleed in late pregnancy may be at greater risk of losing the fetus and hemorrhaging (excessive bleeding). n

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Publication:New African Woman
Date:Oct 1, 2013
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