Risk of complications during pregnancy

Pregnancy Complecations

Complications can arise in pregnancies for many reasons. Sometimes a woman’s existing health conditions contribute to problems. Other times, new conditions arise because of hormonal and body changes that occur during pregnancy.
 

Always talk to your doctor if you have any concerns about your risk of complications during pregnancy. Some of the most common complications include the following.

Miscarriage

Miscarriage is the loss of a pregnancy in the first 20 weeks of pregnancy. The reasons for miscarriage are not always known. Most miscarriages occur in the first trimester, which is the first 13 weeks of pregnancy. Chromosomal abnormalities can prevent proper development of the fertilized egg. Or physical problems with a woman’s reproductive system can make it difficult for a healthy baby to grow.

Miscarriage is sometimes called spontaneous abortion, as the body rids itself of the fetus much like a procedural abortion. The most common sign of miscarriage is abnormal vaginal bleeding.


Other symptoms can include lower abdominal pain and cramping, and a disappearance of pregnancy symptoms, such as morning sickness.

Most miscarriages don’t require surgical intervention. When a miscarriage occurs under 12 weeks, the tissue will often dissolve or pass spontaneously without the need for further intervention. Some will require medicine or a minor procedure in the office or operating room to help with the passage of tissue.

Ectopic pregnancy

A fertilized egg implanted outside of the uterus is an ectopic pregnancy. The egg generally settles in one of the fallopian tubes. Because of the space limitations and the lack of nurturing tissues there, a fetus cannot properly grow. An ectopic pregnancy can cause severe pain and damage to a woman’s reproductive system, and is potentially life-threatening. As the fetus continues to grow, it can cause the fallopian tube to burst, leading to severe internal bleeding (hemorrhage).

The fetus will not survive in an ectopic pregnancy. Surgery and/or medication are necessary, as well as careful monitoring of a woman’s reproductive system by a gynecologist. Causes of ectopic pregnancy include a condition in which cell tissue that usually grows in the uterus grows elsewhere in the body (endometriosis), and scarring to the fallopian tubes from a previous sexually transmitted infection.

Gestational diabetes

Gestational diabetes is a form of diabetes that is diagnosed during pregnancy. It means that you are also at higher risk for diabetes after pregnancy. Like type 2 diabetes, gestational diabetes is caused by insulin resistance (your body doesn’t respond correctly to the hormone insulin). For most women, gestational diabetes doesn’t cause any noticeable symptoms.

While the majority of women with gestational diabetes give birth to healthy babies, the condition can increase the risk that the baby will have a larger-than-normal body.

Other health risks to the baby include:

jaundice
respiratory distress syndrome
abnormally low levels of minerals in the blood
hypoglycemia


Gestational diabetes is treated through changes in diet and close monitoring of blood sugar levels. Oral medication to lower glucose levels may also be necessary. The goal is to keep the mother’s sugar levels within a normal range for the remainder of the pregnancy.

Incompetent cervix

A growing baby puts continual pressure on a pregnant woman’s cervix. In rare cases, the pressure becomes too much for the cervix to handle. This will cause the cervix to open before the baby is ready to be born, which is called cervical insufficiency or an incompetent cervix. Women who have previously had a pregnancy complicated by cervical insufficiency or who have had surgery on their cervix are most susceptible.

Symptoms are often vague and nonspecific. Most women who have cervical insufficiency have no idea that their cervix is thinning or shortening. The hallmark of this condition is that it’s painless. However, some women do report a feeling of pressure or mild cramping.

Cervical insufficiency is diagnosed by measuring the length of the cervix with ultrasound. The treatment may include bed rest, vaginal suppositories of the hormone progesterone, or a procedure called cerclage. A cerclage is a minor surgery in which bands of strong thread are stitched around the cervix to reinforce it and hold it closed.

The treatment for cervical insufficiency will depend on many factors, including the length of your cervix, your gestational age, and the outcome in previous pregnancies if you have been pregnant before.

Placental abruption

Placental abruption occurs when the placenta completely or partially separates from the uterus before a baby is born. This separation means a fetus cannot receive proper nutrients and oxygen. A placental abruption happens most commonly in the third trimester of pregnancy. Common symptoms include vaginal bleeding, contractions, and abdominal pain.

There is no definitive answer as to why abruptions occur. It’s thought that physical trauma can disrupt the placenta. High blood pressure can also damage the connection between the placenta and the uterus.

A number of factors can increase your risk for abruption. Pregnant women with high blood pressure are much more likely to have an abruption. This is true for blood pressure problems that are unrelated to pregnancy, like chronic hypertension, and pregnancy-related problems like toxemia (preeclampsia).

The likelihood of abruption is closely related to the number and nature of your previous pregnancies. The more babies you’ve had, the greater your risk of abruption. More importantly, if you’ve had one abruption in the past, you have about a 1 in 10 chance of having an abruption with your next pregnancy.

Low-lying placenta

Placenta previa is a rare pregnancy complication that occurs if the placenta attaches to the bottom part of a woman’s uterine wall, partially or completely covering the cervix. When it occurs, it usually happens during the second or third trimester.

Some women have a low-lying placenta in early pregnancy, however. A doctor will monitor the condition. But often the placenta moves to the appropriate place without any intervention.

Placenta previa becomes a more serious condition in the second or third trimesters. It can result in heavy vaginal bleeding. If left untreated, placenta previa can lead to bleeding heavily enough to cause maternal shock or even death. Luckily, most cases of the condition are recognized early on and treated appropriately.

Low or excess amniotic fluid

Amniotic fluid cushions the womb to keep a fetus safe from trauma. It also helps maintain the temperature inside the womb. Having too little amniotic fluid (oligohydramnios) or too much amniotic fluid (polyhydramnios) interferes with some of the normal functions of the womb.

Low amniotic fluid can prevent a baby from properly developing muscles, limbs, lungs, and affect the digestive system.

Most cases of excess amniotic fluid are mild and don’t cause problems. In rare cases, too much amniotic fluid can cause:

  • premature rupture of amniotic membranes

  • placental abruption

  • preterm labor and delivery

  • postpartum hemorrhage (bleeding after delivery)
     

An absence or excess of fluids is usually detected during the second trimester when the fetus begins to practice breathing and sucks in amniotic fluid. For those with too little amniotic fluid, saline solution may be pumped into the amniotic sac to help reduce the risk of compression or injury to the child’s organs during delivery.

For those with too much amniotic fluid, medication can be used to reduce fluid production. In some cases, a procedure to drain excess fluids (amnioreduction) may be required. In either case, if these treatments prove ineffective, an induced pregnancy or cesarean delivery may be required.

Preeclampsia

Preeclampsia is a condition marked by high blood pressure and high protein levels in a woman’s urine. Through it commonly develops in later pregnancy, after 20 weeks gestation, it can develop earlier in the pregnancy, or even postpartum. Doctors are not sure what causes preeclampsia, and it can range from mild to severe. In serious cases, symptoms may include:

  • severe headaches

  • blurred or temporary loss of vision

  • upper abdominal pain

  • nausea

  • vomiting

  • dizziness

  • decreased urine output

  • sudden weight gain

  • swelling in the face and hands
     

You should call your doctor or go to the emergency room immediately if you have severe headaches, blurred vision, or pain in your abdomen.

For most women, preeclampsia will not affect the health of the baby. However, some cases of preeclampsia can prevent the placenta from getting enough blood. Preeclampsia can cause serious complications in both mother and baby. Some complications include:
 

  • slow growth

  • low birth weight

  • preterm birth

  • breathing difficulties for the baby

  • placental abruption

  • HELLP syndrome

  • eclampsia, or seizures
     

The recommended treatment for preeclampsia is delivery of the baby and placenta to prevent the disease from progressing. Your doctor will discuss the risks and benefits regarding timing of delivery. Your doctor may advise waiting to deliver so that the baby can mature further. In this case, close monitoring would take place to ensure safety for you and baby.
 

Medications for high blood pressure (antihypertensives) are sometimes taken, and corticosteroids can be used to help mature a baby’s lungs to prepare for an early delivery. Antiseizure medication is taken in many cases. Seizures can be a common and serious complication for both mother and child.

Premature labor

Labor is considered preterm when it occurs after 20 weeks and before 37 weeks of pregnancy. Traditionally, the diagnosis is made when regular uterine contractions are associated with either opening (dilation) or thinning out (effacement) of the cervix.

The majority of premature labor and birth cases occur spontaneously. However, up to one-fourth are a result of an intentional decision. These cases are generally due to complications in either the mother or the baby. They are best treated by proceeding with delivery, despite the fact that the mother is not yet at her due date.

Preterm labor requires prompt medical attention. A woman who experiences symptoms of premature labor may be put on bed rest or be given medication to stop contractions. Many actually go on to deliver at term.

There are a host of risk factors associated with premature labor and delivery, including:

  • smoking

  • inadequate prenatal care

  • a history of multiple abortions

  • a history of preterm births

  • an incompetent cervix

  • uterine fibroids

  • urinary tract and other infections

Venous thrombosis

Venous thrombosis is a blood clot that normally develops in a vein in a leg. Women are susceptible to clots throughout pregnancy and delivery, and particularly afterward (postpartum). The body increases the blood’s clotting ability during childbirth, and sometimes the enlarged uterus makes it difficult for blood in the lower body to return to the heart. Clots near the surface are more common. Deep vein thrombosis is much more dangerous and far less common.

Women have a greater risk of developing clots if they:

  • have a family history of thrombosis

  • are over 30

  • have had three or more previous deliveries

  • have been confined to a bed

  • are overweight

  • have had a cesarean delivery in the past

  • smoke

Eclampsia

Eclampsia occurs when preeclampsia progresses and attacks the central nervous system, causing seizures. It’s a very serious condition. If left untreated, it can be fatal for both mother and baby. However, with proper prenatal care, it’s very rare for the more manageable preeclampsia to progress into eclampsia.

Molar pregnancy

A molar pregnancy is an abnormality of the placenta. It’s when an abnormal mass, instead of a normal embryo, forms inside the uterus after fertilization. Also called gestational trophoblastic disease, molar pregnancies are rare.

There are two types of molar pregnancies: complete and partial. Complete molar pregnancies occur when the sperm fertilizes an empty egg. The placenta grows and produces the pregnancy hormone hCG, but there is no fetus inside.

 

A partial molar pregnancy occurs when a mass forms that contains both the abnormal cells and an embryo that has severe defects. In this case, the fetus will quickly be overcome by the growing abnormal mass.

A molar pregnancy requires immediate dilation and curettage (D&C), and careful follow-up, as the molar tissue can start growing again and even develop into cancer.

HELLP syndrome

HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) is a condition characterized by liver and blood abnormalities. HELLP syndrome can occur on its own or in association with preeclampsia. Symptoms often include:

  • nausea

  • gastrointestinal pain

  • headaches

  • severe itching

Treatment of HELLP usually requires immediate delivery, as there is increased risk of serious health complications for the mother. Complications include permanent damage to her nervous system, lungs, and kidneys.

Fathima hospital, backed by specialists from multiple disciplines, specialises in handling high risk pregnancies. It is important to note that women, who are diagnosed with high-risk issues, mostly go on to have a normal pregnancy and a healthy delivery.

Fathima hospital offers pain relief programs that are globally applied to ease pain during labour. There are a number of options to ensure painless delivery, many of which pregnant women here are not aware of.

Fetal medicine focuses on the care of pregnant women where there is a need to monitor the health and wellbeing of the unborn child (fetus). This includes monitoring the rate of the baby’s growth, as well as diagnosing and managing fetal disorders and abnormalities using both invasive and non-invasive methods.

Our specialized fertility experts are highly experienced, and their technology and strict processes ensure high success rates. IVF (In-Vitro Fertilization) is a type of assisted reproductive technology which involves a series of procedures to treat fertility and assist with the conception of child.

Fathima Hospital has customized Antenatal programmes designed to make you feel safe, good and happy, these programmes educate you on the process of childbirth and the different stages of labour - in all, encouraging natural birthing as much as possible.

Postnatal exercises are important for you. They help you regain the strength of your abdominal muscles and help prevent lower back injury and other complications like abdominal organs from "drooping forward" due to lack of support. They also help you regain a flat stomach.

Our OB/GYN surgeons offer a variety of traditional and minimally invasive surgical procedures: Tubal ligation, removal of ovarian cysts, fibroids, growths from the cervix, Removal of the uterus (hysterectomy), ovaries, Hysteroscopy etc.  

Fetal medicine, which is an extension of the branch of Ultrasonography, treats the fetus as a patient in utero for any problems it might have. It comprises of Fetal scanning, Procedures such as Amniocentesis, chorionic villus sampling, and cord blood sampling, Screening tests and interpretation of the results.

When it comes to your little one’s health, you need to be extra sure. Hence, you want to know all the whys and when of vaccinations to be administered to your child from the time of birth. Keeping that in mind, we hand you over a vaccination schedule for your baby with all the mandatory and optional vaccines prescribed from the time of birth.

Pregnancy Care

Each pregnancy is unique and you have the right to be involved in all decisions affecting you and your baby. A good relationship with your maternity care provider can make a big difference in planning your pregnancy care. At Fathima hospital, Department of Obstetrics includes a team of expert gynaecologists, foetal medicine Specialist, physiotherapists, and trained and experienced nursing staff. Our hospital is equipped with advanced neonatal care team supported by state-of-the-art NICU infrastructure to ensure that complex and high-risk pregnancies can be managed including extremely premature birthings.

Pregnancy Trimesters

At Fathima Hospital, we provide comprehensive consultations, lab testing, ultrasound scan to provide the best possible care during your 1st Trimister to 3rd Trimister. A typical pregnancy lasts 40 weeks from the first day of your last menstrual period (LMP) to the birth of the baby. It is divided into three stages, called trimesters: first trimester, second trimester, and third trimester. The fetus undergoes many changes throughout maturation. A woman will experience many changes during the pregnancy like morning sickness, or nausea and vomiting due to pregnancy, at 6–8 weeks. A pregnant woman might also feel very tired and notice that she is more emotional than usual due to hormonal changes. 

Types of Delivery

Few things in life are more exciting than the birth of a new baby. This has been the case throughout human history, but childbirth options for new mothers have advanced to make the experience more safe. Fathima hospital offers comfortable maternity suites that convert into state of the art delivery rooms. An easy birth and a perfectly executed birth plan is ideal. But we know that even the most carefully planned birth can take twists and turns. In those cases, it's important to be prepared for alternative delivery methods. 

Pregnancy Scans

A range of tests is available if you are pregnant. These tests can confirm your pregnancy and also monitor your baby’s development in the womb. Regular check-ups with your gynecologist, fetal medicine specislists are an important part of pregnancy care, including information and advice about what tests you and your baby will need. Checking the general health of the mother and baby, the different kinds of tests available to pregnant women include: tests to confirm pregnancy, maternal health screening, routine screening tests (these tell you how likely it is that your baby has a certain health condition), diagnostic tests – for pregnancies at increased risk (these tell you more accurately if your baby has a certain health condition).

Pregnancy Complications

Complications can arise in pregnancies for many reasons. Sometimes a woman’s existing health conditions contribute to problems. Other times, new conditions arise because of hormonal and body changes that occur during pregnancy. They can involve the mother’s health, the baby’s health, or both. Some women have health problems that arise during pregnancy, and other women have health problems before they become pregnant that could lead to complications. It is very important for women to receive health care before and during pregnancy to decrease the risk of pregnancy complications. If you are receiving treatment for a health problem, your health care provider might want to change the way your health problem is managed.

High Risk Pregnancy

A high-risk pregnancy is one that threatens the health or life of the mother or her fetus. It often requires specialized care from specially trained providers. Some pregnancies become high risk as they progress, while some women are at increased risk for complications even before they get pregnant for a variety of reasons. Early and regular prenatal care helps many women have healthy pregnancies and deliveries without complications. A high-risk pregnancy may be one that involves chronic health problems, such as diabetes or high blood pressure; infections; complications from a previous pregnancy; or other issues that might arise during pregnancy. Treatment for high-risk pregnancy depends on the risk factors and overall health of the mother and fetus.

Vaccination

Ideally, women of child bearing age should be immunized before becoming pregnant to protect their babies against various diseases. Pregnancy should not deter a woman from receiving vaccines that are safe and will protect both her health and that of her unborn child. Extreme care has to be taken to avoid those vaccines that harm the unborn baby. Pregnant women who aren’t up-to-date on their immunizations may be susceptible to diseases that can harm them or their unborn child. If you’re pregnant, talk to your doctor about which vaccines you may need and whether you should get them now or wait until after your child is born.  

Bad Obstetric History

Pregnancy loss is a frustrating and challenging problem for couples and clinicians alike. Miscarriage is often associated with guilt, embarrassment and depressive states. This is particularly true when the patient presents with subsequent pregnancy with added concerns of primary or secondary infertility, irregular menses, absent or irregular ovulation, a known history of uterine fibroids, a family history of miscarriage, advancing age, medical history and a prior history of pregnancy complications. It certainly warrants a detailed consultation and reassurance with a practitioner committed to pregnancy loss evaluation.

Ectopic / Tubal Pregnancy

Pregnancy begins with a fertilized egg. Normally, the fertilized egg attaches to the lining of the uterus. An ectopic pregnancy occurs when a fertilized egg implants and grows outside the main cavity of the uterus. An ectopic pregnancy most often occurs in a fallopian tube, which carries eggs from the ovaries to the uterus. This type of ectopic pregnancy is called a tubal pregnancy. Sometimes, an ectopic pregnancy occurs in other areas of the body, such as the ovary, abdominal cavity or the lower part of the uterus (cervix), which connects to the vagina. An ectopic pregnancy can't proceed normally. The fertilized egg can't survive, and the growing tissue may cause life-threatening bleeding, if left untreated.

Multiple Pregnancy

A multiple pregnancy occurs when one egg (ovum) splits before implanting or when separate eggs are each fertilized by a different sperm. Identical twins or triplets occur with the fertilization of a single egg that later divides into two or three identical embryos. Identical twins or triplets have the same genetic identity, are always the same sex, and look almost exactly the same. Fraternal multiples develop from separate eggs that are each fertilized by a different sperm. Fraternal twins might or might not be of the same sex and might not necessarily resemble each other any more than two siblings from the same parents might.

Pregnancy Care

Your pregnancy is one of the most exciting times of your life. At Fathima hospital, we will help you enjoy the journey with the support of our expert team, in modern private surroundings.

Families have trusted us for generations at this special time, and we have an enviable international reputation for private maternity care.

Our expertise enables us to safely look after you and your baby, whether it is your first child, your third child, you are expecting twins, or if you or your little one has additional health needs. Whatever your situation, we have the right team to support you. Our packages have been devised with you in mind, to give you the time and attention you need to make the birth of your child as special as possible.

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Fathima hopsital - Maternity care facilities Process Chart

​The best practices to ensure the that a mother gets utmost care during pregnancy and labor. Here is a list of our resources enabling to help you prepare for everything, from conception to delivery and beyond. Fathima hospital is fully equipped to comply with the maternity care Process chart. 

Treatments and Procedures

The Department of Obstetrics & Gynaecology has the capability and facilities to deal with a diverse range of cases and complexities in partnership with specialty services such as Foetal Medicine, Anaesthesia, Critical care, high risk, painless labour, Gynaecological surgeries for fibroid, prolapsed, endometriosis, ovarian cysts, Laparoscopic and hysteroscopic surgeries

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