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Medical problems in pregnancy
Pregnancy brings with it the most amazing
changes in your body. Most of them are quite normal -
and many can be exciting. But some of the changes your
body goes through can be warning signs. Some medical problems
are more common in pregnancy. Others only happen in pregnancy.
Knowing a little bit about the warning
signs of some of these conditions can help you to recognise
them and seek medical help early. It should also be able
to reassure you about some of the changes that aren't
anything to worry about!
Pre-eclampsia
Pre-eclampsia is a condition which only
happens in pregnancy. It almost never happens in the first
half of pregnancy. It causes a combination of raised blood
pressure, protein in your urine and often swelling of
your ankles.
One of the main problems with diagnosing pre-eclampsia
is that it doesn't give you symptoms until quite late.
You do get swelling of your ankles, but this is a common
problem in normal pregnancies too. It does mean that it
is important for you to have regular antenatal checks.
At the appointments, your blood pressure and urine can
be checked.
Pre-eclampsia can reduce the amount of blood getting to
your baby through your placenta. This can stop your baby
growing properly. In fact, pre-eclampsia is the most common
reason for your baby to be small if you don't have a multiple
pregnancy (twins, triplets etc).
Pre-eclampsia can, very rarely, go on to cause eclampsia
if it isn't treated. Eclampsia is a very serious condition
which causes fits and other problems to you and your baby.
You are more at risk of pre-eclampsia if:
- this is your first pregnancy
- this is your first pregnancy with this
partner
- other members of your family have had
it before
- you are under 5 feet tall
- you are under 20 or over 35 years old
- you have diabetes, high blood pressure
or kidney disease
- you have a multiple pregnancy
Warning signs include:
- headache
- pain at the top of your tummy
- vomiting
- blurred vision
- chest pain
If you have any of these symptoms for any length of time,
you should seek urgent medical help. While headache is
common in pregnancy, for instance, "normal"
headaches usually settle with paracetamol tablets.
If you have mild pre-eclampsia, your symptoms
can often be controlled with rest and/or tablets to lower
your blood pressure. If your condition gets worse, your
baby may need to be delivered urgently.
Diabetes
If you are already diabetic, it is very important to keep
your blood sugar tightly controlled while you are pregnant.
Sometimes, though diabetes develops for the first time
when you are pregnant. This is called gestational diabetes.
If you get gestational diabetes, your condition may go
away after you have your baby - but you will be at higher
risk of getting diabetes in the future.
You are more at risk of getting gestational diabetes if:
- you have sugar in your urine at more than one antenatal
check
- you are more than 20% over your ideal weight
- a close family member has had it
- you have had diabetes in past pregnancies
- you have had a previous unexplained stillbirth
- a previous baby has been born with abnormalities.
Symptoms of diabetes include:
- being very thirsty all the time
- passing water a lot
- getting a lot more infections than usual
- losing weight
- feeling excessively tired.
If you get any of these symptoms, you should seek medical
help.
If you are diabetic, or if you get diabetes
in pregnancy, your pregnancy will be monitored even more
carefully than usual. You will have to have regular blood
and urine tests. You will be given advice about your diet,
and you may have to take insulin injections. Tablets for
diabetes are not usually given in pregnancy.
If you have ever had diabetes in pregnancy, you will need
to be checked every year after you have your baby to make
sure you haven't got diabetes.
Urine infections
Urine infections are very common in pregnancy - much more
common than at other times. This is mostly because of
the hormone changes going on in your body. It is important
to drink plenty of fluids when you are pregnant. A good
fluid intake will reduce your risk of urine infections
and constipation.
Symptoms of urine infections include:
- burning or stinging when you pass water
- needing to pass water more often
- foul smelling or cloudy urine
- fever
- aching in your loin (the small of your back)
- feeling tired and generally unwell.
If you have any of these symptoms, you should seek medical
help. Having a urine infection usually doesn't cause you
problems. However, if it spreads to your kidneys, it could
increase your risk of going into labour too early. It
can also damage your kidneys if it is not treated.
Bleeding in pregnancy
Bleeding in the early stages of pregnancy is remarkably
common. In the first thirteen weeks of pregnancy - the
first trimester - it is known as a threatened miscarriage.
At least one in six pregnancies ends in miscarriage in
the first trimester. Resting will probably not affect
whether you have a miscarriage, but you may want to rest
to try and keep calm.
If you have bleeding in the first trimester, it is important
to get medical help. Very occasionally your pregnancy
can develop outside the womb. This is known as an ectopic
pregnancy. The first symptoms of ectopic pregnancy are
often slight vaginal bleeding, around the time your period
is due, and pain on one side of your tummy. This is a
medical emergency and you must get help straight away.
If you do not have any pain, ectopic pregnancy is unlikely.
Do contact your doctor, though - they will arrange to
see you and, if necessary, refer you for an ultrasound
scan.
Later in pregnancy, it is important to get medical help
straight away if you have bleeding. A common cause is
a low-lying placenta. This is called placenta praevia.
It is common for your placenta to be low in the middle
trimester, but it tends to move up in the last trimester.
If you have a low-lying placenta on your ultrasound scan,
you will be asked to return for regular scans and monitoring.
If you get bleeding from a placenta praevia, you may have
to go into hospital for bedrest.
The other serious cause of bleeding in the later stages
of pregnancy is called placental abruption. In this condition,
the placenta comes away from the wall of your womb. It
causes bleeding and can also cause severe tummy pain.
If you have any bleeding in pregnancy, whether painful
or not, you should seek immediate medical help.
Other warning signs
in pregnancy
You should contact your GP, midwife or hospital immediately
if you get:
- contractions before 37 weeks
- waters breaking or leaking
before 37 weeks
- blurring of your vision or
flashing lights
- no movement from your baby
for longer than usual
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