Complications
Suggested articles for you
Low Amniotic Fluid (Oligohydramnios): Causes, Signs & Treatment
Amniotic fluid is a water-like fluid that surrounds the baby while it grows in the uterus and helps in his development. Amniotic fluid cushions the baby, allows the baby to move and prevents the umbilical cord from being compressed. It performs crucial functions that keep the foetus safe while it grows and develops. But sometimes, the amniotic fluid may be lower than expected for the baby’s gestational age, and it can be a cause of concern since it plays an important role in the baby’s development.
But Low amniotic fluid or oligohydramnios is a relatively common condition that your doctor may be able to detect and suggest treatment for. Read on to learn about its causes, symptoms, treatment, and more!
What is Amniotic Fluid?
During pregnancy, the foetus grows and develops inside a fluid-filled bag called the amniotic sac. This amniotic sac is filled with amniotic fluid. Amniotic fluid cushions the baby and protects it from all sorts of infections. It also protects the baby from getting hurt if the mother-to-be experiences a blow to her tummy. It keeps the temperature inside the womb constant and also helps in the development of the baby’s muscles, limbs, lungs and digestive system.
As your baby begins to breathe in the second trimester, he will start swallowing the amniotic fluid and later pass it as urine. That’s how a baby maintains the volume of amniotic fluid around himself.
What is Oligohydramnios?
Oligohydramnios is a condition where the volume of amniotic fluid inside the amniotic sac is too low for the baby’s gestational age. Doctors can measure the amount of amniotic fluid inside you through amniotic fluid index evaluation or deep pocket measurements. If the volume of liquid is less than 500ml in pregnant women during the 32nd to 36th week, then oligohydramnios is suspected.
Oligohydramnios is diagnosed when:
The amniotic fluid volume is less than 500 ml
The maximum vertical pocket is less than 2 cm
The amniotic fluid index is less than 5 cm.
How Common is Oligohydramnios?
The percentage of women suffering from oligohydramnios is close to 8%, and it can occur at any time during pregnancy, though it is most common during the last trimester. If you are 2 weeks from your due date of delivery, then there are high chances of your amniotic fluid becoming low. Around 12% of pregnancies that cross 41 weeks of gestation may encounter complications due to Oligohydramnios.
What Role Does Amniotic Fluid Play in the Development of the Baby?
Amniotic fluid performs several functions such as:
When the baby moves around freely in the amniotic fluid, it helps in bone and muscle development.
When the baby breathes the amniotic fluid in and out, it helps in the development of the lungs.
When the baby starts swallowing the fluid and peeing it out later, it helps in the development of the digestive system.
Amniotic fluid protects the umbilical cord from getting compressed. As a result, the flow of nutrition from the mother to the baby for its overall development is not compromised.
The amniotic fluid also acts as a lubricant and helps in the development of fragile body parts that grow together like fingers and toes.
How Much Amniotic Fluid is Normal When Pregnant?
The volume of amniotic fluid continues to increase until the 36th week of pregnancy, and it measures anywhere between 800 to 1000 ml, which is considered normal. After the 36th week of gestation, the volume of amniotic fluid starts to fall in preparation for birth. The amount of amniotic fluid goes down to 600 ml by the 40th-week gestation or at full term, and that too is normal.
Common Symptoms of Low Amniotic Fluid
During your regular check-ups, your doctor will keep a close watch on your belly. If your stomach is not growing the way it should, then your doctor may ask you to go for a scan to check the development or growth of the baby. Now, that’s one (and important) symptom. Other symptoms are:
Fluctuating blood pressure
First baby born with low birth weight or smaller in size
Constant leakage of fluid from the vagina
Both mother and child not gaining enough weight
Baby’s growth is prolonged
Causes of Low Amniotic Fluid
Low levels of amniotic fluid are most common during the third trimester. The causes for the same could be any of the following:
Water-breaking: If your amniotic sac tears off and fluid flows out, it is called water breaking. This usually happens in and around the time of delivery. If you haven’t quite reached the delivery time, then your doctor may give you antibiotics to protect you and your baby from infection while you wait for the delivery date to close in. If you have crossed 38th week of pregnancy, based on your condition, the doctor may also suggest inducing labour.
Health hazard: If your baby has some health issues, then the volume of amniotic fluid may become low. Especially during the second-trimester scan, babies are diagnosed with kidney, heart or chromosomal abnormality. This becomes obvious in the scan if your baby is passing very less urine. Your doctor may also suggest another test called amniocentesis, to be sure.
Issues with placenta: If you have diabetes, high blood pressure, lupus or preeclampsia, then your placenta may fail to supply enough blood and nutrition to your baby. In this case, the volume of amniotic fluid may decrease, and you may have to be under strict supervision.
Medication: Some medicines must be avoided during pregnancy as they cause low amniotic fluid. Drug for high blood pressure and an anti-inflammatory like ibuprofen are not prescribed during pregnancy.
Identical twins: If identical twins share a placenta, then sometimes there may be an issue of low amniotic fluid. In this case, the baby with extra blood will get access to the amniotic fluid while the other will not get enough.
If your doctor can rule out all the above causes, then there is nothing to worry about. Many a time it has been observed that low amniotic fluid level is due to dehydration during summers. So drinking plenty of water and taking enough rest will help.
Diagnosis Methods for Oligohydramnios
Following methods can be used to detect oligohydramnios.
Ultrasound Scans: The best and first diagnosis for oligohydramnios is an ultrasound scan. During the ultrasound, the amniotic fluid volume is measured in four various parts of your uterus, and then all the four values are put together to regulate the amniotic fluid index or the AFI. Also, the kidneys and bladder of the baby are assessed to look for any anomalies. The ultrasound diagnosis also includes the assessment of the baby’s growth which is done by measuring the abdominal circumference, head circumference, and the femur length.
Amniotic Fluid Index (AFI): AFI is measured through ultrasonography and is a widespread and safe test. This test helps your doctor to determine the volume of amniotic fluid in your uterus.
Sterile Speculum Examination: This test is performed by the doctors to check for a range of motion which is caused due to tear of the amniotic sac membrane, which in turn results in leakage of amniotic fluid.
Maximum Vertical Pocket: This test is used to check the volume of amniotic fluid in the thickest part of the uterus which doesn’t include a fetal portion and umbilical cord. An ultrasound is performed to check this.
Blood Tests: Blood tests like maternal serum screening can help in the detection of low amniotic fluid. It also allows the doctor to check if your baby has any congenital problems like Down’s Syndrome.
Amniotic Wrinkle: If you are carrying identical twins then you may have an amniotic wrinkle which is caused by the folding of the inter-twin membrane. By checking the amniotic line properly, doctors can detect if both babies are getting enough amniotic fluid or not.
If any of the above assessments point at oligohydramnios, then a team of experts need to manage your pregnancy and delivery.
Risk Factors of Oligohydramnios
Some women are at a higher risk of oligohydramnios than others. Risk factors include the following:
High blood pressure during pregnancy
Diabetes
Problems with placenta
Lupus
Obesity
If you are facing any of these issues in pregnancy, it is wise to get yourself checked for this pregnancy complication.
How Does Low Amniotic Fluid Affect Your Baby?
There are numerous and severe problems associated with low amniotic fluid if it is diagnosed during the first and second trimester. If the same is detected in the third trimester, then the situation can be brought under control as the doctors are well equipped for handling the complications at this stage. The problems associated with low amniotic fluid are as follows:
Your baby may be born with severe congenital disabilities like missing internal or external organs or malformation of bones like dysplasia or clubfoot.
It can also result in stillbirth or in-utero death of the baby after the 20th week of pregnancy. Some babies die soon after birth.
Miscarriage after the 20th week is also one of the complications associated with the low amniotic fluid.
The baby may be born prematurely, before the 37th week with low birth weight and underdeveloped organs.
If oligohydramnios is diagnosed during the third trimester, when a baby may be born with limited growth, compressed umbilical cord during labour, and caesarean delivery.
Complications of Low Amniotic Fluid
Some of the severe complications or oligohydramnios effects on the baby are listed below:
Foetal compression syndrome
Amniotic band syndrome
Pulmonary hypoplasia
Severe foetal infection
These complications pose a significant risk to your pregnancy and can adversely affect the baby.
Treatments for Oligohydramnios
If oligohydramnios is diagnosed in the third trimester, then the doctors are well equipped to handle it. Also, if the condition is mild, then it doesn’t require any treatment in the third trimester. The doctor will only prefer to keep you under observation for oligohydramnios management. But if oligohydramnios is diagnosed in the first or the second trimester, then the following treatments may be followed to deal with low amniotic fluid in your uterus.
Amnioinfusion: In this treatment, the doctor infuses sodium chloride in your amniotic sac through an intrauterine catheter, at room temperature.
Vesico-amniotic shunt: If the low amniotic fluid is due to your baby not being able to pass urine, then the doctor will try to divert your baby’s urine with the help of vesico-amniotic shunt. While this procedure will take care of the low amniotic fluid in your uterus, but it doesn’t ensure the effective functioning of your baby’s kidney or lungs.
Fluid Injections: This is a temporary method of treating oligohydramnios by injection fluid with the aid of amniocentesis.
Maternal Hydration: Here, the doctor advises you to drink lots of water and put you in IV and oral fluids to increase the volume of amniotic fluid. This is applicable if the cause of oligohydramnios is dehydration.
Bed rest: If you have mild oligohydramnios, then your doctor will keep you under observation and advise you complete bed rest. Proper hydration and complete bed rest can help to increase intravascular spaces, hence making more space for amniotic fluid.
Termination of pregnancy: The worst of all may be the medical termination of pregnancy due to severe oligohydramnios during the first trimester. But it is the best for you and the baby as the baby may be born with severe and multiple defects.
Your doctor will usually involve a specialist in maternal foetal medicine to treat oligohydramnios. This is to deal with severe complications that may occur in your baby due to low amniotic fluid, like hydrops foetalis and congenital malformations.
How Can You Prevent Oligohydramnios?
Preventing oligohydramnios entirely is not possible, and few precautions during pregnancy may reduce the chances of amniotic fluid becoming low during pregnancy.
Drink a lot of water and keep yourself hydrated. Many cases of oligohydramnios are due to dehydration.
Eat healthy food and listen to your doctor. Consult a nutritionist if necessary.
Do not take any medicines without speaking to your doctor; not even herbal supplements or vitamins.
Exercise regularly without exerting yourself. But walking periodically or prenatal yoga is beneficial during pregnancy.
Stop smoking. It affects your baby’s lungs directly.
Keep your prenatal check-up appointments without fail. Regular check-ups can help your doctor to determine any problem or abnormalities during pregnancy.
Oligohydramnios can be mild or severe. In both cases, your doctor would like to keep you under close supervision. Keep your appointments and consult your doctor in case of the slightest doubts. Be alert and watch your pregnancy carefully.
Also Read: How to Increase and Decrease Amniotic Fluid during Pregnancy Naturally
Read more
Pregnant With an IUD – Signs, Symptoms, and FAQ's
The intrauterine device (IUD) has become a favourite choice for many women because it’s simple, low-maintenance, and highly effective. Once placed in the uterus, it can work for 3 to 10 years, depending on the type used. With a success rate of more than 99%, it’s often considered one of the most dependable forms of birth control. But here’s the thing: no method is perfect. In rare cases, pregnancy can still occur with an IUD in place, and when it does, it may bring certain risks and complications for both mother and baby.
In this article, we’ll look at how pregnancy with an IUD happens, the risks involved, and what you should know if you ever face this situation, so keep reading to find out more.
Can You Get Pregnant With an IUD?
Although intrauterine devices are one of the most effective forms of birth control, their rate of being effective rate is about 98%. Therefore, there is a narrow margin, and it is observed that the odds of pregnancy with IUD are 3 cases out of 100. The American Congress of Obstetricians and Gynecologists (ACOG) says that the failure rate of IUDs during the first year of use is less than 1%, the same as sterilisation procedures like “tube tying” (1). In rare cases where pregnancies do occur, it’s usually caused by the device slipping partly or completely out of place. In fewer cases, the IUD may move and become embedded in the uterus and lose its effectiveness.
Signs & Symptoms of an IUD Pregnancy
Unlike the oral contraceptives, IUDs do not cause any changes in the body after it is put in place. Ovulation is not blocked, the endometrium continues to grow, and menstruation continues as normal (although, this depends on the type of IUD, which may cause bleeding to become much lighter or have it reduce altogether). The IUD only offers mechanical protection by not allowing the fertilised egg to implant in the uterine wall. In rare conditions, this protection can fail, and pregnancy proceeds as normal. Early pregnancy symptoms with the IUD is same as a normal pregnancy. These symptoms characterise it:
Delay in menstruation
Morning sickness and dizziness
Increase in the basal body temperature
Feeling tired, drowsy or fatigued
Lower abdominal pain
Loss of appetite in some women, conversely, excessive hunger
What to Do If You Suspect Pregnancy While Having an IUD?
It is not uncommon for women to worry about pregnancy when they are on an IUD. Many experience unusual bleeding for the first few months after the device is inserted. It is then normally followed by periods that are lighter and shorter; some even stop having periods entirely. Therefore, if you suspect that you are pregnant with IUD in place, follow these three steps (2):
1. Take a Pregnancy Test
If you feel symptoms of pregnancy and need to confirm it, the best way is to take a pregnancy test. A home pregnancy test is reliable. If you’re still in doubt, schedule a blood test for pregnancy with your doctor.
2. Visit Your Doctor
When you become pregnant, especially with an IUD in place, there’s a significant risk of an ectopic pregnancy (a pregnancy where the fertilised egg implants outside the uterus). Ectopic pregnancies are emergencies; therefore you need to visit your doctor immediately for a diagnosis.
3. Have the IUD Removed
If your pregnancy is viable and non-ectopic while the IUD is still in place, your doctor may recommend its removal (3). The doctor or a trained staff does this. It’s important not to try and remove it by yourself, as it is unsafe for the foetus.
Risks of IUD Pregnancy
IUDs are used to prevent pregnancies, so what happens if you get pregnant with an IUD? Knowing the risks of IUD and pregnancy can help you make better health decisions. Here are the main risks to be aware of (3) (4):
1. Miscarriage
A miscarriage is a significant risk when women get pregnant with an IUD. If the IUD is left in place during the pregnancy, the miscarriage rate goes up by 40-50 per cent. Removing it early on reduces the risk; however, it is still higher than normal women who got pregnant without an IUD (5).
2. Preterm Birth
Leaving the IUD in place during pregnancy also increases the chances of preterm birth along with miscarriage. It is seen that women who have an IUD in place during their pregnancy have five times more chances of giving birth prematurely than women who don’t. Removing the IUD early on lowers the risk of preterm birth.
3. Infection
Susceptibility to chorioamnionitis is high among pregnant women who have IUDs. It is an infection of the membranes surrounding the fetus and the amniotic fluid which can be potentially life-threatening (6). Removing the IUD early in pregnancy lowers the risk of the infection but does not remove it completely.
4. Placental Abruption
When the placenta separates from the uterine wall either before or during the delivery, it is called placental abruption. There could be a link between having the IUD in place and placental abruption (5).
5. Hormone Exposure
Hormonal IUDs pose a risk to the foetus as they slowly release progestin into the uterus. The long-term effects on babies are not fully understood. However, increased risk of congenital disabilities does not appear to be among the risks.
Is There an Instance Where a Doctor May Suggest ‘No IUD Removal’?
If you wish to continue your pregnancy, ideally the IUD should be removed. It is done if the strings are visible from the cervix and can be grasped. The pregnancy will then continue without complications, although there are slightly higher chances of miscarriage, infections and preterm labour. When the risk of removing the IUD outweighs the risk of leaving it in place, your doctor would suggest a ‘No IUD Removal’. There are instances where women have given birth to healthy babies even with the IUD. It usually so happens that as the baby grows; the IUD gets pushed out, somewhere around the middle of the term.
Possible Reasons for IUD Failure
Even though IUDs are one of the most effective birth control options available, they aren’t completely fail-proof. Here are some common reasons why an IUD might not work as intended:
Expulsion of the IUD: Sometimes the IUD can partially or completely slip out of the uterus, especially within the first few months of insertion. This reduces its effectiveness and may go unnoticed.
Improper Placement: If the IUD isn’t inserted correctly or shifts from its intended position, it may not provide full protection against pregnancy.
Using an Expired IUD: Each IUD has a lifespan of 3 to 10 years depending on the type. Using it beyond this timeframe increases the chances of failure.
Type of IUD and Timing of Insertion: Copper IUDs, such as Paragard, provide immediate protection once inserted. However, hormonal IUDs, like Mirena, can take up to 7 days to become fully effective.
Tips to Protect Yourself From an Unwanted IUD Pregnancy
When used perfectly, IUDs are very effective at preventing pregnancies. Here are some steps to make sure that an unwanted pregnancy doesn’t occur with the IUD.
1. Visit Your Gynaecologist Regularly
Once a year, visit your gynaecologist and have an ultrasound scan of your uterus done. It can reveal any displacement of the IUD or even its loss. These two are the major causes of unwanted pregnancy when using an IUD.
2. Monitor the IUD Strings
Once a month, you can check if the device is properly in place by feeling for the strings attached to the device. They extend down from the cervix to the top of the vagina and can be felt with your fingers. An increase in their length would mean that the device has been displaced into the cervix. The disappearance of the strings mostly indicates a loss of the IUD. Both of these conditions mandate a visit to the gynaecologist and a pregnancy test if the device is missing.
3. Know the Expiration Date
All IUDs have an expiration date; 3-5 years on an average after which they must be removed or replaced with a new one. When left beyond their time, they may embed themselves into the uterus walls making it difficult to remove and increase the chances of infections.
When to Consult the Doctor
If you have an IUD, it’s important to reach out to your doctor if you:
Are planning to become pregnant or suspect you might be pregnant.
Think your IUD may have moved or slipped out of place.
Want to have your IUD removed or replaced.
You should also contact your doctor if you experience any unusual symptoms while using an IUD, such as:
Fever, chills, or other signs of infection.
Severe or persistent lower abdominal pain or cramps.
Unusual vaginal discharge or heavier than normal bleeding.
Pain or bleeding during sexual activity.
Most side effects of an IUD are minor and temporary, but in rare cases, serious complications can occur. These may include ectopic pregnancy, bacterial infection, or perforation of the uterus, which require immediate medical attention (3) (4).
FAQs
1. Does age affect the risk of IUD failure?
IUD effectiveness is generally high across all ages, but younger women may have slightly higher expulsion rates due to a more active uterus.
2. Can heavy periods affect IUD effectiveness?
Heavy menstrual bleeding doesn’t usually reduce effectiveness, but in some cases, copper IUDs can worsen bleeding, which may lead to removal or monitoring (4) (7).
Many women have questions about the odds of getting pregnant with an IUD. With proper usage, IUDs are very effective at preventing pregnancy. In the rare event that you do get pregnant with one in place, consult your doctor immediately.
Also Read:
Pregnancy Symptoms after IUI
Get Pregnant with Irregular Periods
Is It Possible to Get Pregnant after IUD Removal?
Read more
Preeclampsia in Pregnancy
Preeclampsia is a disease that affects pregnant women and has been known to cause issues such as poor liver function and fluid in the lungs. Apart from affecting the mother, it also has the potential to cause debilitating complications for the child such as cerebral palsy, blindness and deafness due to preterm birth.
What Is Preeclampsia?
Formerly called Toxemia Pregnancy, preeclampsia is a pregnancy complication that can start as early as 20 weeks of pregnancy, in the second trimester, or anytime up to six weeks post-delivery, and can lead to issues such as kidney damage and high blood pressure. Mothers-to-be may not display any symptoms if they are afflicted by preeclampsia, which is why most doctors insist on checking on your blood pressure during every visit to the clinic. If the blood pressure is high, they will suggest a urine test to check the protein levels in it.
Once detected, it needs immediate treatment as it could lead to other health problems like eclampsia and HELLP syndrome, where HELLP stands for Hemolysis, Elevated Liver enzymes, and Low Platelet count.
Causes of Preeclampsia
A reduced blood flow towards the placenta is one of the primary causes of preeclampsia, and there are no visible symptoms. This happens when the placenta does not place itself properly in the uterus lining, and the dilation of the arteries in that area is not enough. Diabetes and chronic hypertension prior to pregnancy could also be reasons for less blood flow to the placenta.
It has also been found that when there is a variation in the blood flow to the placenta, certain placental proteins are released into the bloodstream in large volumes. Because of this, the following reactions are triggered off in your body:
The blood vessel walls are damaged, which leads to swelling of the body and an increase in the level of protein in the urine.
Blood vessels constrict, thus leading to high blood pressure.
Preeclampsia can be also be caused due to other factors such as auto-immune disorders, genetic factors, diet and issues related to the blood vessels. Your immune system and its reaction to the pregnancy is also thought to be one of the causes of preeclampsia.
Signs and Symptoms of Preeclampsia
Preeclampsia may or may not display any noticeable symptoms, and even when it does, the symptoms may differ from one woman to another. People often get confused as preeclampsia has symptoms similar to the normal symptoms of pregnancy such as nausea, weight gain, and swelling. The early stages of preeclampsia may not be typically noticeable and thus need careful monitoring during visits to the doctor.
Speak to your doctor if you notice any unusual swelling in any part of your body as it could be related to preeclampsia swelling. Watch out for the following:
Swelling of hands and fingers.
Excessive swelling of feet and ankles.
Swelling of the face and neck or puffiness around the eyes.
Rapid increase of weight in a short period of a week or a fortnight.
It is to be noted that every pregnant woman who gains rapid weight or has swelling may not be affected by preeclampsia, and the causes for her condition could be different.
Many pregnant women who are affected by preeclampsia have also experienced symptoms like headaches that do not seem to subside, and altered vision. Your doctor may also advise urine and blood tests to check the protein level in urine, platelet level and any abnormality of liver enzymes.
Abdominal pain, slower reflexes, less or no urine, nausea and vomiting, and dizziness are also common symptoms associated with preeclampsia. You should ensure that your blood pressure remains in the range of 140/90 and any increase or decrease of these levels warrants a quick visit to the doctor. Regular checks of blood and urine should keep you updated on this.
The following signs are warning signs that could signal preeclampsia:
Difficulty in breathing.
Vomiting or nausea (especially when it happens in the 2nd or 3rd trimester).
Temporary vision loss, extreme light sensitivity, double vision or blurriness.
Pain in the upper abdomen.
Who Is at the Risk of Getting Preeclampsia?
Those who have had preeclampsia during their first pregnancy are more likely to develop it during subsequent pregnancies. The risk of developing preeclampsia is higher depending on the severity of the condition and when it appears during pregnancy. This could mean that if you have contracted preeclampsia prior to 29 weeks of your pregnancy, then there is a 40% higher chance of contracting it again in later pregnancy.
Though scientific evidence is lacking, Preeclampsia has a high incidence rate among pregnant teens. One study suggests that lack of prenatal care from unwanted pregnancies leaves pregnant teens vulnerable.
Preeclampsia is high among pregnant women above 40 as it puts excess strain on their bodies and may kickstart underlying medical conditions.
Generally, obese women with a Body Mass Index (BMI) of over 30 have an increased risk of preeclampsia as obesity aggravates blood pressure.
Diagnosis of Preeclampsia
During your scheduled appointments with the doctor, your blood pressure and urine will be under immense scrutiny. Elevated levels of blood pressure and protein in urine are likely to show the presence of preeclampsia. To be diagnosed with preeclampsia, you will need to have:
1. BP more than 140/90 or diastolic more than 90.
2. Proteinuria
Doctors are now aware that elevated blood pressure is a must for pregnant women to be diagnosed with preeclampsia.
If your doctor suspects preeclampsia, the following tests may be required:
1. Protein in Urine
Your doctor will ask for a urine test that can detect the presence of protein in your urine sample. If this initial test is positive, you will be advised to collect urine after 24 hours so that it can be sent for testing. This test is known as the most dependable and accurate test for preeclampsia. The presence of 300 mg and above of protein in the urine is a sure sign of preeclampsia.
2. Monitoring of Blood Pressure
If your systolic reading is higher than 140 or the diastolic reading is higher than 90, your blood pressure is higher than normal. Since blood pressure fluctuates as per the time of the day, your doctor will ask you to check it at different times to confirm that it is high. This is also a reliable pointer towards the diagnosis of preeclampsia for a pregnant woman.
3. Protein-Creatinine Ratio
Creatinine is a waste product of the body that is filtered out by the kidney along with other wastes. The Protein-Creatinine ratio is a urine test that checks the presence of this waste product, and hence the doctor can understand if the kidney functioning is normal. This test needs one random sample, which is better than collecting the 24-hour urine for the urine test. If your test shows the presence of 0.3 mg/dl, it can be concluded that you have been afflicted by preeclampsia.
4. Foetal Ultrasound
This test is generally recommended to monitor your baby’s growth closely using the ultrasound method. In this manner, the doctor can estimate the foetal weight and gauge the level of amniotic fluid in the uterus.
5. Non-stress Test
This test involves a simple procedure that helps to check the baby’s heart rate and its reaction to movement.
6. Biophysical Profile
In this test, an ultrasound is conducted to measure the foetal breathing, movement, muscle tone and the amniotic fluid volume in the mother’s uterus.
Complications of Preeclampsia
Complications of preeclampsia are rare, but they can quickly develop into life-threatening problems, such as a low platelet count and a breakdown of red blood cells. Regular monitoring and quick diagnosis can ensure the complications do not grow, and the condition is arrested in time.
Let’s take a look at the complications this medical condition could possibly lead to in the mother and the child if it is left untreated.
1. Complications For the Mother
The following problems can affect the mother if she has been diagnosed with preeclampsia:
Eclampsia: This involves an involuntary contraction of the muscles and can be described as a fit or a convulsion that pregnant women can have. It can occur after the 20th week or immediately after delivery. During the fit, which lasts for less than a minute, the mother can experience repetitive movements of the arms, legs or neck, and she could also lose consciousness.
Stroke: When the blood supply to the brain is reduced due to high blood pressure, it can cause cerebral haemorrhage, commonly known as a stroke. In this case, the brain does not receive the necessary oxygen from the blood, causing the cells to die, and thus leading to brain damage or in certain cases, death.
Blood clotting: Medically known as Disseminated Intravascular Coagulation. In this condition, the mother’s blood clotting capacity is severely affected. Here, there is heavy bleeding since the protein level in the blood has drastically fallen, or there are a number of blood clots as the proteins have become highly active.
2. Complications For the Baby
If the mother is diagnosed with preeclampsia, the baby can face the following health issues:
Smaller Size of the Baby: Since there is a low supply of oxygen and nutrients to the baby during preeclampsia, such babies will be smaller in size. This is especially true if preeclampsia occurs prior to 37 weeks of pregnancy.
Breathing Difficulties in the Baby: In case the preeclampsia is diagnosed as severe, the doctor may take the decision to deliver the baby earlier. This can lead to breathing difficulties in the baby since the lungs are not fully developed.
Stillborn Baby: In some cases, the baby could be stillborn due to early delivery.
Earlier in this article, we spoke a little bit about HELLP syndrome; let’s take a look at it, too.
What Is HELLP Syndrome?
The HELLP syndrome is a rare blood clotting and liver disorder that is a severe version of pregnancy eclampsia. It is most likely to strike post-delivery, but cases have also been seen after 20 weeks, and sometimes, before 20 weeks, too. The acronym HELLP stands for each of the conditions:
H is for Haemolysis during which time the red blood cells in the bloodstream break down.
EL stands for Elevated Liver enzymes which is a sign of damage to the liver.
LP is for Low Platelet count which is responsible for clotting of blood.
Once the diagnosis is made, treatment should be given promptly for preeclampsia. Read on to know more.
Treatment for Preeclampsia When Pregnant
If you are 37 weeks pregnant or more, labour will be induced, especially when the cervix has dilated well. The doctor may also opt for a C-section if they feel that you or your baby will be unable to withstand the pressures of a normal delivery.
For the treatment of Severe Preeclampsia, you could be asked to remain at the hospital for regular monitoring if you are diagnosed with severe preeclampsia. A preeclampsia specialist could be assigned to you to give you special care and help in the management of the condition. Medication will be administered to lower the blood pressure along with an intravenous infusion of magnesium sulphate to help prevent seizures.
What If Preeclampsia Develops During Labour or After Labour?
If you are diagnosed with preeclampsia during or after labour, monitoring your condition will be of high priority. You will have to stay back at the hospital for a few more days to avoid any further complications that could develop if your blood pressure rises or you get seizures. You will be given magnesium sulphate for up to 24 hours after the delivery to avoid seizures. If you go home, you will have to report back with blood pressure checks conducted for at least a week.
Effects of Preeclampsia on Future Pregnancy
Preeclampsia or toxaemia in pregnancy is a serious condition. However, the mother continues to live with its effects, and the risk remains. The effects of preeclampsia on your organs may take at least six weeks to get resolved after delivery. Studies have also shown that there is also an increased risk of hypertension, Type 2 Diabetes, stroke and heart disease. The toxaemia in pregnancy affects the baby by limiting the supply of nutrients to the baby, which can change his structure and metabolism. This could lead to coronary heart disease and related disorders, including diabetes, stroke and hypertension.
How to Prevent Preeclampsia
Getting prenatal care and not missing on any of your appointments is the key to prevention of preeclampsia. You will have to keep a close watch on your blood pressure and the protein content in your urine to keep toxaemia health-related issues away. As soon as the first signs of preeclampsia are visible, alert your doctor so treatment can be started without any delay. Depending on the severity of the condition, the number of weeks and the baby’s condition, your doctor will decide the line of treatment. This will include numerous urine tests and blood pressure monitoring.
Preeclampsia is one of the foremost causes of maternal mortality and causes foetal mortality as well. However, close monitoring of health conditions of women with a history of high blood pressure and hypertension can be helpful in managing preeclampsia.
Also Read: Cramping During Pregnancy
Read more
Complications in the First Trimester of Pregnancy
It is often said that pregnancy is one of the most beautiful phases in a woman’s life. It involves pampering, indulgence, and immense support from one’s partner and family. Most pregnancies progress smoothly and without complications. However, understanding the possible complications of first trimester pregnancy is essential for every expectant mother. During the early stages of pregnancy, women undergo several tests, ultrasounds, and physical examinations so that doctors can rule out any complications or address concerns promptly.
An expectant mother is more susceptible to certain risks as the body undergoes tremendous changes to accommodate new life. Certain parts of the immune system become more active, while others are naturally suppressed to support these changes. Here is a look at some common early pregnancy problems and solutions every expecting mother should know about.
Pregnancy Complications in the First Trimester
There is a significant change in hormonal activity during the first trimester. This change is essential but brings with it complications like fatigue or nausea. While these are low risk and are more bothersome than dangerous, there are a few serious pregnancy problems in first trimester that you should be aware of. We have mentioned them below:
1. Miscarriage
It is unfortunate that about 10-15 per cent of pregnancies conclude in a miscarriage. Of these, it is reported that around 80% happen during the first trimester. Miscarriage during early pregnancy can be caused by infections, chromosomal abnormalities, clotting disorders, or anatomic problems with the uterus. Eating a balanced diet, appropriate exercise, avoiding alcohol and cigarettes should help sustain your pregnancy (1).
2. Ectopic Pregnancy
An ectopic pregnancy happens when a fertilised egg gets implanted outside the uterus. One in 50 of all pregnancies could be an ectopic one. Most ectopic pregnancies occur in the fallopian tube and may cause the tube to rupture. This can be fatal as it causes internal bleeding (2).
3. Constipation and Diarrhoea
Stomach problems during pregnancy first trimester are not uncommon. Usually, women experience mild to severe constipation due to changes in diet and incorporation of iron-rich foods. This may sometimes cause haemorrhoids and bloody stools (3). Diarrhoea that lasts more than 3-4 days should be reported to the doctor, or it could lead to dehydration and weakness. Continue to have a balanced diet and drink copious amounts of water. In rare cases, diarrhoea can be a result of food poisoning. It should be treated immediately if it doesn’t resolve within 24 hours (4).
4. Multiple and Twin Pregnancy Complications
30% of mums carrying twins or multiple foetuses are known to have vaginal bleeding. Twin pregnancy complications in the first trimester include vanishing twin, where one baby is lost to a miscarriage during the pregnancy. The embryo that is lost is usually reabsorbed into the uterine lining without any noticeable symptoms to the expectant mother (5). Up to 30 per cent of multiple pregnancies face the vanishing twin syndrome. It is detected because the mother has usually had early scans that showed dual embryos.
5. Vaginal Discharges or Itching
Vaginal discharge is a regularity in a woman’s life. Nothing is alarming about a little vaginal discharge unless it has an odour or is coloured yellowish. Additionally, if there is itching or redness, it could indicate an infection. A more serious concern is if the itching indicates an STD that could be transmitted to the baby (6).
6. Painful Urination
A urinary tract infection is a bane in every woman’s life. During pregnancy, a woman becomes highly susceptible to Urinary Tract Infection. The changes that pregnancy causes to the urinary tract makes it very easy for a pregnant woman to contract a UTI. Additionally, the pressure from the uterus prevents the bladder from completely draining and this causes infection. If you leave a UTI untreated, it can lead to kidney infection or early labour (7).
7. Difficulty Breathing
Increased levels of progesterone during the first trimester contribute to shortness of breath. Working slowly, sitting up straight, and sleeping on propped up pillows might help with easing breathing problems during the first trimester of pregnancy. Once you’re past the first trimester, the shortness of breath usually occurs around the third trimester when your uterus pushes up against the diaphragm and lungs, making it difficult to take a deep breath. If wheezing, palpitations, or coughing accompany shortness of breath, then you should let your doctor know immediately. They may be able to tell the difference between plain shortness of breath and other complications.
8. Spotting or Vaginal Bleeding
Implantation bleeding is common in pregnancy and is nothing to get alarmed about (8). There are, however, other reasons like cervical polyps that can lead to spotting and bleeding (9). Rupture of a tubal pregnancy, as in the case of an ectopic pregnancy, can also cause a fatal bleed.
9. Calf Pain & Headache
Calf pains during the first trimester are not very common. Hormonal changes combined with exhaustion can be credited with this. But pain on one side alone could be an indicator of a travelling blood clot. Pregnancy increases the chances of developing clots. A clot in the head could cause severe headaches. Clots that form in leg veins are known as Deep Vein Thrombosis. Staying active and improving blood circulation reduces the chances of blood clots and cramps (10).
10. Nausea & Vomiting
Morning sickness is the most common affliction that affects a pregnant woman during her first trimester. It affects different women differently. For some people, it could be extreme, and it increases the risk of dehydration. Some women cannot hold down anything that they eat. It may lead to reduced nutrition for the mother and foetus. Doctors may recommend some medication to regulate nausea and prevent dehydration in extreme cases (4).
11. Fatigue & Insomnia
Pregnant women, during the first trimester, experience a massive slump in the quality of sleep. Pregnancy sleep problems in the first trimester could be attributed to the fatigue and extreme exhaustion that women feel throughout the day. It could also be attributed to heartburn and bathroom breaks at night.
12. Temperature Above 101°F
A fever that crosses 101°F could be a sign of an underlying infection. This could invariably affect the foetus, and it should be checked. Fever accompanied by rash or joint pain could be parvovirus or Toxoplasma (11). There is also a minor chance that it could indicate cytomegalovirus which is a reason for congenital deafness (12). The chances of risk to the infant occur when a pregnant woman has recurrent CMV infection.
13. Swelling
After 20 weeks of pregnancy, swelling is considered to be normal in most women. This is caused by a change in blood volume and blood flow, allowing fluids to be trapped in the tissues around the extremities. But swelling in the first trimester, especially in the face and hands could be an indicator of preeclampsia (13). Always consult your doctor if in doubt about such things.
FAQs
1. How can women reduce the risk of early pregnancy problems?
Women can lower the risk of complications by eating a balanced diet, staying hydrated, taking prenatal vitamins, avoiding smoking and alcohol, managing stress, and attending regular prenatal checkups. Early medical guidance plays a key role in ensuring a healthy pregnancy for both mother and baby.
2. What are the signs of an unhealthy pregnancy in the first trimester?
Certain symptoms such as severe abdominal pain, persistent vomiting, high fever, heavy bleeding, dizziness, or sudden loss of pregnancy symptoms may indicate a problem during early pregnancy. While some discomfort is normal, any unusual or severe symptom should be discussed with a doctor immediately.
Pregnant women might face any number of discomforts ranging from slight dizziness to mild pelvic pain. Once past the 12 weeks mark, discomforts like nausea and vomiting will reduce or completely stop. Expectant mothers will now be asked to get scans and tests done in each trimester to rule out any other complication like Down’s syndrome in the foetus, preeclampsia, placenta previa, gestational diabetes, high blood pressure, or low amniotic fluid.
Bear in mind that although we have listed one too many 1st trimester pregnancy problems that mothers-to-be should watch out for, pregnancy is one of the most naturally beautiful phases in a woman’s life. There are many positives about being pregnant like hearing baby’s first heartbeat, feeling that first movement, the first kick, the glow and radiance of being pregnant, and the arrival of those tiny fingers and toes after 10 months. So, be watchful and heed any medical advice from your doctor but remember to relax and enjoy these months before your entire life becomes about your tiny tot.
Also Read:
Common Second Trimester Complications
Uterine Prolapse During Pregnancy
List of Pregnancy Problems and Their Solutions
Pregnancy Complications Every Woman Should Know
Read more
MTHFR in Pregnancy: Risks, Diagnosis & Treatment
Pregnancy can be a tough time for some women, especially for those who have tested positive for a mutated MTHFR gene. All humans have the MTHFR gene in their bodies, it is known as gene 5-methyltetrahydrofolate and is responsible for breaking folic-acid to create folate. Less folate or malfunctioning of the MTHFR gene can result in some disorders or health conditions, more so in pregnancy. In case the gene is mutated, it can increase the chances of miscarriage, preeclampsia, or birth defects in babies.
What Is Meant By MTHFR?
MTHFR or gene 5-methyltetrahydrofolate is a gene which is responsible for breaking down of folic acid to folate. It is found in every human and is the cause of how the body processes folate. Folate in everyone is responsible for making their DNA, repairing the DNA and producing RBCs (Red Blood cells) in the body. In some people MTHFR gene malfunctions and stops or slows down the breaking of folic acid. This condition is known as mutated MTHFR gene. Having a mutated MTHFR is not an uncommon condition and is generally harmless in most people; however, in a few people, it can create certain health issues. People with positive MTHFR mutation gene have Hyperhomocysteinemia.
Hyperhomocysteinemia is the condition in the human body when the homocysteine levels are elevated. In women, high homocysteine levels with low folic acid levels may create complications in reproduction and lead to MTHFR mutation pregnancy. Women with mutated MTHFR gene may face issues in reproduction and may have a higher risk of preeclampsia, baby born with a certain birth defect such as spina bifida or miscarriage. Most females who have a problem in conceiving or repeated miscarriages or stillbirth come to know that they have mutated MTHFR gene. In some cases, females with mutated MTHFR gene can have successful pregnancies and may come to know of this condition much later or after suffering from a loss of their baby.
Risk Factors of Positive Mutated MTHFR
A mutated positive MTHFR gene is a genetic issue. It passes from the parents (mother or father) to the child. No one can have positive mutated MTHFR after birth, as a baby is born with it. Simply nothing causes positive MTHFR gene, it was always there. A person who has genetically inherited the positive mutated MTHFR from both parents may have more issues than a person who inherited it from one parent. However, having positive mutated MTHFR doesn’t mean one will have any health problem or issues. It just increases the risk of having health issues. A few of the risk factors of positive mutated MTHFR are:
Homocystinuria– It is a disorder where the body is able to process homocysteine at a lesser pace. This may result in eye problems, skeletal abnormalities, abnormal blood clotting, and cognitive problems.
Spina bifida– It is the incomplete formation or development of bones surrounding the spinal cord.
Anencephaly-It is a birth defect which is characterised by incompletely or missing formed parts in the skull or brain.
Hearing loss due to age.
Heart disease
Hypertension
Stroke
Preeclampsia or high blood pressure during pregnancy.
Psychiatric disorders
Glaucoma
Certain types of cancer
What Are the Complications of Positive MTHFR During Pregnancy?
MTHFR gene can have many different mutations. These mutations may cause various health problems and affect various organs such as the heart. Some of the mutations affect pregnancy more than the other mutations. Though there is no accurate scientific evidence which proves a positive mutated MTHFR gene can cause recurrent miscarriage; however, women who had suffered multiple miscarriages often test positive for mutated MTHFR gene. A positive mutated MTHFR gene may several complications during pregnancy. A few of the complications caused by positive MTHFR during pregnancy are:
1. Spina Bifida
Spina bifida is a birth defect in a baby where the spinal cord is sticking out of the back. This creates nerve damage. Several children can have normal lives if the severity of the Spinal Bifida is low. Babies with high severity need full-time care.
2. Anencephaly
Anencephaly is a serious birth defect. Babies suffering from anencephaly are born with an underdeveloped brain or skull i.e. some parts of their brain or skull are missing. Babies suffering from this defect mostly don’t live past one week of their birth.
3. Preeclampsia
Preeclampsia is a health condition of high blood pressure in pregnant women.
4. Blood Clotting
A positive MTHFR mutation can cause blood clotting during pregnancy between the uterine wall and growing placenta. This area is known as ‘low flow maternal-placental interface’ and the blood clot prevents the nutrients to be transported to the baby. MTHFR blood clotting disorder can occur both during early or late in pregnancy. When occurring in early pregnancy, it can cause repeated miscarriage as the foetus is very vulnerable. When it occurs in advance pregnancy, it causes stillbirth as the blood clot is formed in the umbilical cord or placenta.
Diagnosis of a Mutated MTHFR
A positive mutated MTHFR cannot be (and is) not tested in every pregnant woman. The test is expensive and the mutated MTHFR affects only a few women, so it is done only on the advice of the doctor. The doctor generally orders a test to detect mutated MTHFR in pregnant women who have had multiple miscarriages or had a family history of positive mutated MTHFR gene or the women who had genetic issues in their other pregnancies. The test done to determine positive mutated MTHFR involves the following testing methods:
The doctor may ask to check different variants of the MTHFR gene to check for positive MTHFR mutation through a blood test. The blood test is done to determine the homocysteine levels of a person.
Genetic testing is also done to identify the MTHFR gene mutation.
There are two gene variants which are most commonly tested. They are – C677T and A1298C.
A person having elevated homocysteine levels will have two C677T genes variant or one A1298C and one C6771 variant.
Any person with elevated homocysteine levels will not have two A1298C gene variants. Though it is possible to have high homocysteine levels with a negative MTHFR gene mutation test.
Treatment for Positive Mutated MTHFR
There are many treatments prescribed by doctors to treat positive mutated MTHFR gene. Most treatments help prevent blood clots and increase folic acid levels in the body. Some popular treatments for positive mutated MTHFR are:
1. Lovenox or Heparin Injections
These injections assist in preventing blood clots formation between the uterine wall and the developing placenta. Most doctors prescribe this treatment for pregnant women in their early pregnancy. This is because then the mutated MTHFR gene is not able to form a blood clot anytime during pregnancy. The doctor can only determine for how long the injections need to be continued.
2. Aspirin
Many pregnant women having mutated MTHFR gene often ask their doctors if they should take aspirin for MTHFR as Aspirin also works as a blood thinner. Aspirin may prevent blood clotting but it should be taken only after checking with a doctor.
3. Prenatal Vitamin with L-Methyl Folate
Anaemia is common in pregnant women. Pregnant women having mutated MTHFR gene generally have low folic acid. So MTHFR and folic acid are co-related. L- methyl folate helps in decreasing the anaemia risk in pregnant women. MTHFR prenatal vitamins are different than normal prenatal vitamins as pregnant women with mutated MTHFR gene process folic differently, so they need different prenatal vitamins with L-methyl folate rather than synthetic folic acid. So prenatal vitamins with L-methyl folate are prescribed instead of folic acids by some doctors.
Is MTHFR Linked to Miscarriage?
There are several opinions about MTHFR and pregnancy. Some people believe that positive MTHFR gene and miscarriages are directly linked and some believe there is no correlation. Though the increased number of miscarriages is often linked with positive MTHFR gene mutation as the women had C677T MTHFR gene. It is proved that women having C677T mutation cannot effectively recycle homocysteine which results in the accumulation of blood. Accumulation of blood results in homocysteinemia which poses a risk for coronary artery disease or formation of blood clots. Blood clots prevent nutrients transportation to the placenta, causing starvation of the foetus and eventually spontaneous abortion.
MTHFR gene mutation may seem scary especially for pregnant women. However, it can be managed with medications and proper treatment. Moreover, many females with positive MTHFR gene have had normal pregnancies. So there is no reason to panic. In case of any issues, talk to your doctor and she can determine the effects of MTHFR on your pregnancy. Timely diagnosis and prompt treatment can increase your chances of a successful pregnancy.
Also Read:
Placenta In Pregnancy
Eclampsia While Pregnant
Ectopic Pregnancy
Read more
HIV or AIDS in pregnancy: Symptoms, Risks, & Treatment
Pregnancy is often a time filled with excitement, hope, and careful planning for your baby’s future. But for women living with HIV, pregnancy often comes with additional questions: Will my baby be safe? Can I have a healthy pregnancy? What steps can I take to reduce the risk of transmission? Fortunately, medical advances have transformed the outlook for mothers and babies, making it possible for many women with HIV to give birth to healthy, HIV-negative children.
Want to learn about the effects of HIV during pregnancy, the treatments available, and the best ways to protect your baby? Read the full article to find out all about HIV/AIDS and pregnancy.
What Is HIV/AIDS?
HIV (Human immunodeficiency virus) is an infamous virus known to cause AIDS (Acquired immunodeficiency syndrome). As the name suggests, it’s a virus that gradually breaks down the immune system making you prone to opportunistic infections and various other complications. One point of confusion amongst people is that they believe HIV and AIDS are similar when that is not the case. A person may be HIV infected for years without having AIDS. You are HIV positive from the moment the virus is detected in your blood (1). But only after the symptoms set in and the immune system breaks down the person is said to have AIDS. It usually takes several years to reach the last stage of HIV – that is AIDS (2).
How Does HIV Spread During Pregnancy?
Unlike viral flu, HIV does not spread by contact, breathing the same air or through food and water. HIV can be spread in ways similar to the Hepatitis B virus (3):
Sexual intercourse (most common)
Blood / blood-contaminated products / other body fluid / organ transplantation
Vertical transmission: From mother to child via the placenta or breast milk
The chance of transmission depends on the viral load, that is the number of viruses per ml of the blood. Also, during pregnancy, high levels of the hormone progesterone increase the level of virus receptors. This aids the entry of virus and increases the chance of transmission.
Symptoms of HIV & AIDS
Once the HIV virus gets into the blood, it begins to multiply and infect a specific type of white blood cell called the T lymphocytes. It usually takes 3 to 6 weeks for the symptoms to set in which last for less than 10 days. These symptoms include (4):
Fever and night sweats
Fatigue
Rash
Headache
Swelling in neck, armpits, groin
Sore throat
Body ache, joint pains
Nausea, vomiting, and diarrhoea
Thus, the symptoms of an HIV positive pregnancy are not different from flu during pregnancy. Later, after the symptoms are gone, the virus continues to multiply and attack the immune system silently, until it breaks down. It may take as long as 10 years for this to happen.
Various Problems That AIDS Can Cause
In cases where HIV progresses to AIDS, the risk of health complications increases for both the mother and the baby. To assess immune health, doctors often check the CD4 count; a type of white blood cell that plays a vital role in fighting infections (5). A low CD4 count is a key indicator of advanced HIV infection or AIDS. Some of the possible complications associated with AIDS during pregnancy include:
Infections: As the CD4 count falls, more serious and deadly infections set in, tuberculosis being the most common.
Cancer: Various forms of cancer are common in AIDS. Women may suffer from genital tumours which may be cancerous.
STDs: Other sexually transmitted infections in addition to HIV like syphilis may add to the problem for the mother and child.
Factors Which Increase the Risks Associated With Transmission of HIV
Some of the issues that increase the likelihood of the spreading of AIDS include:
Viral load: The most important factor that determines the transmission is the viral load in the mother (6). For example, the rate of transmission is 1% if the load of the HIV virus in the maternal blood is less than 400 copies/mL, but this increases drastically to more than 30% when maternal viral levels are more than 100,000 copies / mL. But viral load in the blood may differ from that in the genital secretions. So, the transmission through genital secretions may occur even before it is detectable in maternal blood in some cases.
Pre-term delivery: There is a four-fold increased risk of a baby being exposed to the HIV virus in pre-term delivery.
Breastfeeding: If you are breastfeeding your baby, there is a 30-40% chance that your baby will be infected by the virus (7).
Mode of transmission: The mode by which the mother acquired HIV also determines the rate of transmission. If it was a sexually transmitted infection, the rate of vertical transmission to the baby is higher.
Initiation of anti-HIV treatment: The period of gestation at which the anti-HIV treatment was initiated to the mother affects the transmission to the baby.
Medical intervention: Some medical procedures done during delivery like forceps application, artificial rupture of membranes, and invasive fetal monitoring increase the risk of transmitting the virus from the mother to the baby (7).
Should Pregnant Women Get Tested for HIV?
It is mandatory for all pregnant women to undergo screening HIV test in some countries (opt-in approach) whereas in others the mother has the right to refuse after being counselled and informed about HIV (opt-out approach). Pregnant women who are injectable drug users, sex workers along with those who have HIV-infected sexual partners, multiple sexual partners or are diagnosed with an STD are recommended to repeat the test in the last trimester.
How Is HIV Testing Done?
HIV screening test is performed using an ELISA test (enzyme-linked immunoassay) (8).
If the test comes positive, it is confirmed with either a Western blot or Immunofluorescence assay (IFA) (9). A rapid detection using PCR can also be done.
Effects of HIV on the Mother’s and Baby’s Health
If the CD4 count is maintained high and the viral load is kept low it does not grossly affect the outcome of your pregnancy. All said and done, it is multifactorial and can manifest with variations. The real problems arise when HIV turns into full-blown AIDS.
1. Effect on Mother’s Health
The mother is at a high risk of various infections that can be life-threatening. Various cancers, both benign and malignant are common in AIDS which may affect the course of pregnancy. Some pregnancy-related complications like pre-term labour, hypertension, diabetes are common in HIV positive cases.
2. Effect on Baby’s Health
An HIV positive mother can also infect the baby. The infections acquired by the mother can be transmitted to the baby which can be life-threatening. It can potentially affect all the bodily functions of the baby (10).
Accuracy of HIV Test Result
HIV tests are highly accurate. The ELISA test has a sensitivity of more than 99.5%. This means that in more than 99.5 of 100 tests performed will pick up HIV if it is there. There is less than a 0.5% chance of missing HIV by ELISA. For further confirmation, the IFA and western blot have very high specificity. This means these tests very rarely will be a false-positive.
How Is HIV Transmitted From the Mother to the Child During Pregnancy?
The transmission that occurs from mother to child in the perinatal period is called vertical transmission. This transmission can be via the placenta and via breast milk.
1. Transmission in Early Pregnancy
Normally placenta forms a barrier between the mother’s and the baby’s blood. This forms a protective barrier for HIV transmission. But in very early pregnancy, while the fertilised egg is attaching to the uterus and the placenta is being formed, there is a chance of contact between their blood. Thus, HIV transmission can occur even before pregnancy is detected.
2. HIV and Labour: Transmission During Late Pregnancy
There is a high chance of transmission of HIV from mother to baby during the time of onset of labour. When the water bag ruptures, during the delivery process, and during placenta separation (10).
3. Transmission During Breastfeeding
It has been proven that the HIV virus is present in breast milk and babies who are breastfed are at an increased risk of being HIV positive.
Preventing Mother to Child Transmission of HIV & Its Challenges
Antiretroviral therapy (ART) is the anti-HIV medicines used as a remedial measure. ART plays a major role in preventing mother to child transmission of HIV (11). Being HIV positive and pregnant has a lot of challenges such as social stigma and non-medical hospital staff being hesitant to approach the patient. Many women suffer from anxiety in revealing that they have HIV may make them outcasts.
Here are some preventive measures which you need to keep in mind if you are trying to get pregnant (12):
Planning pregnancy: If you are planning to become pregnant, get yourself tested for HIV. If you test positive start right away with the antiretroviral therapy. This will not only reduce the viral load in the mother but also reduce the risk of transmission.
Post-exposure prophylaxis: If you are HIV negative but your partner has been diagnosed with HIV, you need to take the ART to prevent yourself from getting HIV.
Plan delivery: Planned c-section at 38 weeks is the preferred mode of delivery to minimise the risk of transmission of HIV.
Post-exposure prophylaxis for the baby: After birth, your baby will be given ART medicines to kill HIV virus if any has entered the baby’s blood from the mother.
Avoid breastfeeding: If good alternatives are available without compromising the baby’s nutrition, it is advised to avoid breastfeeding the baby.
With all these precautions taken the risk of transmission may be reduced to less than 1%.
Complications of HIV
HIV infection can add to the pregnancy-associated complications. These include (12):
Pre-term delivery
Low birth weight
Growth restriction of the baby
High blood pressure
Gestational diabetes
HIV Treatment
HIV treatment consists of antiretroviral therapy (ART). It consists of various regimens with different combinations of medicines either to be taken orally or injected. The regimen will be decided by your doctor based on the viral load, the CD4 count, previous treatments taken, the drug resistance pattern and the week of gestation. If you were on HIV treatment before conceiving, the treatment is usually continued.
Should Pregnant Women With HIV Take HIV Medicines?
The treatment of women infected with HIV should not be stopped because of pregnancy. Certain modifications in the regimen may be necessary as it may affect the development of the baby but the treatment needs to be continued throughout the pregnancy (10).
How Does HIV Affect Labor & Birth?
Usually, a C-section is advised at 38 weeks, but there is a high rate of preterm delivery and the associated complications in HIV infected mothers.
Some mothers may be given an injection of Zidovudine during labour which reduces the chance of transmission of HIV to the baby.
Certain procedures like artificial rupture of membranes to induce labour, using fetal scalp electrodes for fetal heart rate monitoring and delivery with vacuum or forceps are generally avoided given the potential of increased risk of transmission.
What If the Baby Tests HIV Positive?
All babies who test positive for HIV need to be given ART medicines. If the baby cannot tolerate oral medicines, then injectable medicines are given. It is a life-long treatment for the child. As with adults, there are different treatment regimens available for babies who test positive for HIV.
HIV Positive & Prenatal Care
As a protocol in hospitals, you will be treated like any other mother. Your healthcare professional will maintain professional secrecy. From counselling to appropriate treatment the healthcare professionals will take the necessary prenatal care required. As a pregnant woman with AIDS, the prenatal care responsibility that you have is to provide the doctor with all the information without maintaining any secrets.
Questions to Ask Your Doctor
If you have AIDS and you are pregnant, maintaining open communication with your doctor is essential for protecting your health and your baby’s well-being. Here are some important questions to discuss with your doctor:
1. How can I reduce the risk of transmitting HIV to my baby during pregnancy, labour, and delivery?
2. What medications will I need to take during pregnancy, and are they safe for my baby?
3. How often should my viral load and CD4 count be monitored throughout pregnancy?
4. Will HIV affect my pregnancy or increase the risk of complications?
5. What type of delivery is recommended for me based on my HIV status and viral load?
6. Can I breastfeed my baby, or should I consider alternative feeding options?
7. What follow-up care and testing will my baby need after birth to ensure they remain HIV-free?
FAQs
1. Does caesarean delivery reduce the risk of mother to child transmission of HIV?
There is only a 50% chance of the baby contracting the HIV virus if they are delivered via caesarean birth. In addition, the risk of transmission reduces by 87% when a caesarean section is combined with anti-HIV treatment.
2. Will my baby need treatment after birth?
Yes. Babies born to HIV positive mothers are given HIV treatment for 4-6 weeks after birth. This reduces the HIV multiplication if any, and protects the child.
3. Can an HIV positive mother breastfeed?
Breastfeeding is generally not recommended for mothers who are HIV positive as it significantly increases the risk of HIV transmission to the baby.
You can live a normal life with HIV. This includes becoming pregnant as well. Though there are complications involved, there is nothing stopping HIV positive women from getting pregnant. But you need to understand that despite all the precautions you may deliver HIV positive baby. As HIV reduces your immunity take extra precautions to keep yourself away from infections. Good hygiene, healthy food and exercise are key to a healthy pregnancy with HIV. With the advancements in HIV treatment, many babies born to HIV positive mothers test HIV negative.
Also Read:
CMV while Pregnant
Infections during Pregnancy
Trichomoniasis in Pregnancy
Sexually Transmitted Diseases in Pregnancy
Read more
Dilation & Evacuation (D and E) Surgical Procedure
Most women experience zero complications during pregnancy, and they go on to deliver and raise healthy babies. But for some women, things don’t go as expected, and they may have to end their pregnancies. It can be heartbreaking for a couple to make the difficult decision of ending their pregnancy, or it may result in a miscarriage. If a woman’s pregnancy needs to be terminated within the first thirteen weeks, a procedure called Dilation and Curettage is performed. However, if the pregnancy is further along, then Dilation and Evacuation (D&E) will be performed. In this article, we will explore everything about the D and E procedure, including how long it takes to complete, risks, complications, and more.
What Is Dilation and Evacuation?
Dilation and evacuation is a medical procedure that is performed in the second trimester of pregnancy to remove the remains of a fetus from the uterus. It combines dilation, vacuum aspiration and curettage. During D&E, suction and uterine forceps are used to aid in removing the remains of the foetus (1). While a D&E is usually done before the 15th week of pregnancy, women can also have a D&E at 20 weeks (2).
When Is D&E Abortion Done?
Women who need to end their pregnancies from the 13th week onwards can undergo the D&E procedure of abortion (3).
To Whom Is D&E Recommended?
There are various reasons why a woman may need to undergo a D&E procedure. A woman may be recommended D & E in the following cases:
When the baby dies in the womb. The baby will be stillborn, and the woman will be advised to have its remains removed, as it can sometimes lead to an infection.
If the baby is detected with extremely serious abnormalities, an abortion will be suggested.
If there is a premature rupture of the membranes, an immediate termination of the pregnancy may be prescribed.
In some cases, the woman’s health may be seriously compromised if she continues with the pregnancy. In such cases, she may be advised to terminate the pregnancy.
How Long Does It Take for the D & E Procedure?
The actual D&E (Dilation and Evacuation) procedure usually takes around 10 to 30 minutes, depending on the stage of pregnancy and the patient’s condition. However, the complete process may take longer because cervical preparation is often done several hours or even a day before the procedure (4).
After the procedure, the patient is typically monitored for a few hours before being discharged. Most women return home on the same day (5).
Tests Before The D&E Procedure
Before performing a D&E procedure, doctors may recommend several tests to ensure safety and reduce complications. These commonly include:
Ultrasound scan to confirm gestational age
Blood tests to check blood group and haemoglobin levels
Blood pressure and general health evaluation
Screening for infections if required
Review of medical history and current medications
These tests help the healthcare provider plan the safest treatment approach for the patient.
What Happens Before D&E?
Your doctor may write you an ultrasound to confirm the gestational age. Before the procedure, the cervix needs to be gently widened or softened to make the process safer. Doctors may use medications or special dilatants for cervical preparation.
The patient may also receive:
Medicine to soften and widen the cervix (given the night before the procedure)
Sedation or anaesthesia so that the patient doesn’t feel pain
Instructions about eating or drinking before the procedure
Antibiotics to lower infection risk
Counselling about recovery and aftercare
Healthcare providers usually explain the risks, possible side effects, and warning signs to watch for after the procedure. Emotional support and follow-up care are also important parts of the process.
Dilation and Evacuation Procedure Steps
Having to make the decision to terminate a pregnancy is very difficult for expectant couples. It can be very frightening for a woman to undergo such an experience, and not knowing what to expect can be helpful. Here is what to expect from D&E procedures (6):
Step 1: During the Surgery
Dilatants for abortion at this stage are necessary. The cervix is prepared around one or two days before the actual procedure is to be performed. This often requires the use of either seaweed or hydrogel rods. These absorb the moisture from the cervix and then expand it.
Another method that can be used to expand the cervix is through medication, but this is not preferred unless it is earlier in the 13th week.
Antibiotics are administered to prevent infection. General anaesthesia is administered before anything is done.
Once the anaesthesia has set in, the foetus and the placenta are removed from the uterus through the use of suctioning, curettage and forceps.
Step 2: After the Surgery
You will need to rest to allow your body to heal properly.
You will be put on antibiotics and other medications that help with shrinking the uterus.
Spotting or bleeding for two weeks after the procedure is normal. Use pads for this and avoid anything that needs to be inserted into the vagina. This is all to prevent abstaining from sex at this time.
Cramping is to be expected. The uterus will shrink back to its original size. This cramping may last for a few days, or it could be only for several hours. It depends on the individual.
Risks and Complications
While most procedures go off without a hitch, there are some occasions when you might face a few complications that will require serious medical attention.
Risks Associated With D&E Surgery
Here are some of the risks that are associated with the D&E procedure (7):
Injury can be caused in the lining of the uterus or the cervix.
Although rare, a hole can form in the lining of the uterus. This is called a uterine perforation. It usually forms during the dilation stage.
The uterus may not contract back into its non-pregnant size
Tissue can sometimes remain in the uterus.
Complications That Can Occur Later
Sometimes complications associated with the D&E procedure can arise at a later date. These complications include:
If you have developed a body infection as a result, you may experience muscle aches, headaches and dizziness. You could also go through a general feeling of unease or illness. Not all infections result in a fever as a symptom.
Severe bleeding, different from your regular menstrual bleeding, can occur. This bleeding can be excessive, and you may have to go through at least two large pads in an hour or less.
Fever or hot flashes that last for over four hours.
Swelling of the abdomen.
Vomiting that continues for over four hours.
Increased heart rate.
Swelling, pain or redness occurring in or around the genitals.
Increased vaginal discharge or discharge with a bad odour.
D&E Abortion – Cost
Dilation and evacuation abortion is an expensive procedure and can cost from around $500 to $3000 or sometimes, much more.
Taking Care After Undergoing a D&E Procedure
Having an abortion so late in the pregnancy can be very difficult for a woman. But if it is inevitable, you will have to go through it. There are a few things you should keep in mind to take care of yourself after undergoing a D&E procedure for your speedy recovery:
Remember that, as you have just gone through a very difficult procedure related to your reproduction, you will need to abstain from having sexual intercourse until your doctor says it is all right. Even when you get a go-ahead from your doctor, it is advisable that you ask your spouse to use a condom to lower the chances of infections. Birth control is another thing you will need to consider. Getting pregnant again so soon will not allow your body to heal as well as it should after going through something so traumatic.
For those who have had to undergo a D&E procedure, it is best that they visit a counsellor if they are unable to recover emotionally. You can even visit your therapist if you already have one. It is very important to speak to a professional, as there could be many factors that can lead to depression. Depression can also be a result of the changes in pregnancy hormones. Some of the most notable symptoms of depression are a change in your appetite or sleep, fatigue, constant sorrow, anxiety, emptiness and irritability. If these persist for more than two weeks, you should definitely seek counselling.
After the procedure, you will be kept under observation for about an hour or so. Once the observation period is over, your nurse will give you all the instructions you need to follow to recover physically.
Whether you undergo a D&E procedure due to a complication or a miscarriage, it can take a toll on your health. Your physical and mental health will suffer, but it is important that you speak to your doctor and open up to your loved ones to heal completely.
When to Consult a Doctor?
If you experience any of the following symptoms, it is advised to consult a doctor immediately:
Stomach pain that only gets worse
Swelling of your belly
Fluid from the vagina that increases or smells bad
Fast heart rate
Vomiting
Fever of 100.4°F (38°C) or higher
Feeling achy or unwell
New weird symptoms that get worse
Signs of depression that last for 2 weeks or more
FAQs
1. Is the D&E procedure painful?
The procedure is usually done under sedation or anaesthesia, so most women feel little to no pain during it. Mild cramping and bleeding afterwards are common.
2. How safe is a D&E abortion in the second trimester?
D&E is considered one of the safest and most commonly used methods for second-trimester abortion when performed by an experienced healthcare provider.
3. Will a D&E procedure affect future fertility?
In most cases, a properly performed D&E does not affect future fertility or the ability to get pregnant again.
4. How long does recovery take after a D&E procedure?
Many women recover physically within a few days, though light bleeding and cramps may continue for one to two weeks.
5. Is hospital admission required for a D&E procedure?
Most D&E procedures are done as outpatient procedures, meaning the patient can usually go home the same day unless complications arise.
Don’t keep your feelings bottled up. Speak to your gynaecologist about what you can do for a speedy recovery. Remember, undergoing a D&E procedure does not mean that you won’t be able to have a baby again. The D&E procedure does not affect a woman’s fertility. So give yourself enough time to heal; once you’re ready to have a baby, you can always try for another child if there are no health risks!
Also Read:
Nonstress Test
Medical Abortion
Surgical Abortion
Chances of Pregnancy after Abortion
Read more
Home Remedies UTI During Pregnancy – Natural Relief Tips
A urinary tract infection can be treated with home remedies for UTI during pregnancy, but where to start and where to look is a question among many pregnant women. A woman’s urinary tract can be a breeding ground for bacteria, more so during pregnancy. Since pregnant women are at an increased risk of UTIs between the 6th and 24th week of pregnancy, it is imperative you know what to do if you face one. Doctors usually suggest a urinalysis or urine culture to detect UTI during pregnancy (1). If the test results are positive, obviously you will worry because it requires immediate treatment or else it might damage the kidneys. Consulting a doctor is a must, but you can also try some home remedial measures to get rid of this infection. There are some natural remedies apart from the conventional treatment which can help prevent and treat UTI. But before we discuss home remedy for urine infection during pregnancy, let’s acquaint you with its symptoms.
Symptoms of UTI While Pregnant
If you have a UTI, you may experience one or more of the following symptoms, and you must inform your doctor about the same (1).
Blood or mucus in the urine
Burning sensation while urinating
Abdominal pain
Fever and incontinence
Cloudy or foul-smelling urine
The urge to urinate frequently
Natural Remedies for a UTI During Pregnancy
Most urinary tract infections, especially lower urinary tract infections, often subside on their own. But when they don’t, antibiotics are prescribed as the first line of treatment. However, not all antibiotics are safe during pregnancy. Trying home remedies for UTI when pregnant can help speed the healing process. Here are some home remedies for UTI in pregnancy!
1. Increase Your Fluid Intake
Drinking plenty of water and fluids daily can help flush out bacteria from your urinary tract by making you pee more and also prevent infection. To keep your body hydrated, drink water throughout the day and whenever you feel thirsty. This way, the bacteria will be flushed out of your system, lessening the chances of an infection, and help you treat a UTI while pregnant (2).
2. Urinate Frequently
During pregnancy, you must urinate often so that bacteria do not grow inside the bladder. If a person holds back urine for a long time, bacteria can multiply in the urinary tract, leading to an infection. But if you urinate frequently, it will put pressure on the bacteria and help clear them out from your bladder. So pee often and prevent and treat UTIs.
3. Take Probiotics
Probiotics support the human body’s flora which is used as a defence for the body. They promote a healthy balance of bacteria in the gut (keeping it free from harmful bacteria). Fermented foods like kimchi, probiotic yoghurt, and raw cheese are some of the healthiest probiotic foods. Eating these foods can help restore your body’s bacteria content without causing any disease (3).
4. Drink Cranberry Juice
The Cleveland Clinic suggests drinking unsweetened cranberry juice is one of the best remedies for UTIs. Cranberries help prevent UTIs from entering the urinary tract and thus prevent infection. Cranberry juice can also help prevent the growth of bacteria that might cause infection (4).
5. Use Clove Oil
Clove oil is known for its antimicrobial, antiviral, and antifungal properties. The antibacterial properties of clove oil help kill E.coli and prevent the chances of UTI. Topical application of clove oil can help prevent urogenital infections. However, using clove oil can also result in some adverse reactions on the body. Hence, it is suggested that you use it only after consulting with a doctor and under the supervision of your health care provider.
6. Increase Your Vitamin C Intake
Increasing your Vitamin C intake can reduce the chances of E. coli and prevent urinary tract infections. Vitamin C is believed to increase the acidic level of urine, which kills the bacteria that cause infections. It also strengthens the immune system. You can eat fruits and vegetables that are rich in Vitamin C. Red peppers, oranges, and kiwi are good sources of Vitamin C. Include them in your diet after consulting with a doctor and a nutritionist.
7. Avoid Drinks That Irritate the Bladder
The American Pregnancy Association says that Drinks like coffee, soft drinks containing citrus juice or caffeine, and alcohol may upset your bladder and perpetuate excessive urination. It is best to avoid these drinks (5).
8. Refrain From Using Irritating Feminine Products
Using products like deodorant, douches, and powders can irritate the urethra and cause a UTI.
Now that you know about UTI home remedy for pregnant women, let’s take a look at how to prevent UTIs.
How to Prevent UTIs When Pregnant?
Mentioned below are some tips that can help you prevent a urinary tract infection during pregnancy. Even if you have a urinary tract infection, the Mayo Clinic suggests the following steps to prevent the infection from repeating and worsening (6).
1. Wear Loose Clothes
Wear light and loose-fitting clothes and innerwear to allow the air to pass and to keep the urethra dry. Also, wipe yourself dry from front to back after any bowel movement to ensure that bacteria don’t get into the urethra (7).
2. Eat Healthy Foods
Eat healthy food and lead a healthy lifestyle. Consult a dietician and ask what you can eat during pregnancy. Avoid eating unhealthy food at all costs.
3. Avoid Using Feminine Hygiene Products
Do not use perfumed products, powders, or douches as these can irritate the already vulnerable area and worsen the condition (6).
4. Avoid Using Spermicides
Use lubricated condoms which do not have spermicides. The incidence of UTIs is high among women who are sexually active. So if you are having sex with your partner, be careful.
5. Use Lubricants
Use a lubricant while having sex with your partner, as excess friction while having sex can cause micro-trauma to the urethral mucosa and facilitate the ascent of bacteria.
6. Treat Vaginal Infections
Treat vaginal infections effectively as concomitant vaginal infection often precipitates a urinary tract infection. So if you have a vaginal infection, get it treated in time and lower your chances of a UTI.
FAQs
1. What is a urinary tract infection in pregnancy?
Despite the body’s natural defences, certain fungi, bacteria, and viruses enter the urinary tract and inhabit the bladder, urethra, and urinary tract. A woman may get a urinary tract infection when bacteria enter her urethra and cause an infection. A woman’s urinary tract can be a breeding ground for bacteria, more so during pregnancy.
2. How can pregnant women test for UTI?
To test for a UTI, collect a urine sample for lab analysis. Methods include urinating directly into a cup or letting it flow into a cup while sitting on the toilet. An alternative is to collect the sample in a clean cloth and bring it to the doctor or clinic. If a UTI is detected, antibiotics are typically prescribed for treatment (8). Follow your healthcare provider’s instructions for preventing UTIs during pregnancy.
3. Can a UTI be harmful to my baby?
Experiencing a UTI while pregnant heightens the likelihood of developing elevated blood pressure, potentially leading to preterm birth and a smaller-than-average baby.
4. When to see a doctor if home remedies for UTI don’t work during pregnancy?
Kidney infection is a serious issue, and more so during pregnancy. It is suggested that you visit your doctor if you experience any symptom typically linked with UTIs. You can continue home remedies with the prescribed treatment after discussing with your doctor.
UTI is generally caused by bacteria which enter through the urogenital tract and cause pain and discomfort. The recurring nature of the disease adds to the risk of bacteria developing drug resistance. They can precipitate undesirable side effects too, so you can try these home remedies to get rid of it. However, do consult your doctor before trying out these natural remedies for UTI in pregnancy.
Also Read:
Home Remedies for Cough during Pregnancy
Home Remedies for Gastric Problems in Pregnancy
Natural Remedies for Morning Sickness during Pregnancy
Read more
Eclampsia in Pregnancy: Causes, Symptoms & Treatment
Pregnancy is a delicate time and women are suggested to relax and follow a healthy lifestyle in order to avoid any complication but that’s not easy. Many pregnancies are complicated by a serious condition called eclampsia. Even after leading a healthy lifestyle and taking the necessary precautions, a woman might be affected by this condition. In this article, we have covered everything you need to know about eclampsia. Read on to the symptoms and causes of eclampsia. Also learn, how this condition can be treated!
What Is Eclampsia?
Eclampsia is a medical condition that affects pregnant women. This medical condition is not very common, however, if a pregnant woman is suffering from eclampsia, it calls for immediate medical intervention, as it can be dangerous for both the mother and child. A more serious complication or progression of another medical condition known as preeclampsia, eclampsia is often characterized by a sudden surge in high blood pressure, that results in seizures.
Let’s tell you the difference between preeclampsia and eclampsia.
Preeclampsia is a medical condition which affects a woman mostly during pregnancy, but in rare cases soon after delivery as well. Women who suffer from preeclampsia generally have high blood pressure, and a significant amount of protein in the urine is observed. Additionally, a drop in the number of platelets which is responsible for clotting, as well as trouble with the functioning of the liver and kidney is observed as well.
When in extreme cases, preeclampsia progresses and a patient suffers from seizures, it is known as eclampsia. A seizure is medically defined as a sudden change or disturbance in the activity of the brain. Sometimes, due to an uncontrolled electrical imbalance, a person can have a seizure, which results in a decrease or loss of alertness, violent shaking or convolutions, changes in behaviour, changes or loss of consciousness. It is worth noting that even if a woman has no history of seizures or epilepsy, she can end up being affected with eclampsia.
Who Is Most at the Risk of Getting Eclampsia?
As mentioned before, eclampsia is a rare condition, however, those who identify with the following are at a higher risk of getting eclampsia:
If a woman is already suffering from preeclampsia, then she will be at the risk of getting eclampsia as well, given that eclampsia is a progressive state of preeclampsia.
Women who have a history of suffering from chronic or gestational hypertension or high blood pressure.
Women who are undergoing a pregnancy after the age of 35 or below the age of 20.
Those who are having their first pregnancy.
Women who are carrying twins or triplets.
Pregnant women who have a history of kidney ailments or disorders.
Pregnant women who are suffering from or have a history of diabetes and other conditions that affect the blood vessels.
What causes Eclampsia in Pregnancy
Following conditions can cause eclampsia during pregnancy.
1. Hypertension or High Blood Pressure
One of the most commonly noticed causes for preeclampsia is a spike in the woman’s blood pressure during pregnancy. Hypertension or high blood pressure takes place when there is an increase in the force of blood that is pushing against the arteries. In serious circumstances, the arteries and other blood vessels get damaged due to the extreme force when the blood is pushed against the walls of the blood vessels and arteries. This is a serious condition, as damaged arteries can lead to restricted flow of blood. This, in turn, can cause swelling in some of the blood vessels that are located in your brain. For a pregnant mother, this can put her baby at risk as well. The abnormal flow of blood can interfere with the normal functioning of the brain, which leads to eclampsia or seizures.
2. Proteinuria
Proteinuria is a condition in which there is an excessive amount of protein in the urine. In most common cases, preeclampsia tends to affect the normal functioning of your kidneys, and the reason behind this is an excessive protein in your urine. The function of the kidney is to filter out toxins and wastes from your blood. In some cases, such as those in which you are suffering from preeclampsia, the kidneys, instead of flushing out, tends to retain certain nutrients that are found in your blood. In most cases, the most prominent nutrient that is retained is protein. This protein is further redistributed across your body. In some cases, the glomeruli in the kidney are damaged, which in turn leads to the retention of proteins. Glomeruli are responsible for the filtering function of the kidneys. When a doctor suspects preeclampsia, in most cases, the urine of the patient is tested to check for abnormal levels of protein.
3. History of Preeclampsia
Eclampsia is a progressive state of preeclampsia, and women who suffer from an existing state of preeclampsia are more at the risk for eclampsia as well.
What Are the Symptoms of Eclampsia?
It is worth noting that the symptoms of eclampsia and preeclampsia, more often than not, tend to overlap. This is because eclampsia is a progressive condition of preeclampsia. To understand eclampsia and its symptoms during pregnancy, you need to know what the symptoms of preeclampsia are as well. Some of the most common symptoms associated with preeclampsia include:
A rise in blood pressure; chronic or gestational hypertension
Sudden or excessive weight gain
Vomiting and nausea
Frequent headaches
Problems associated with the vision, particularly blurry vision, and in some cases, a loss of vision.
Difficulty or pain while passing urine
Pain in the abdomen, prominently towards the right side of the abdomen
Abnormal swelling over the face and in the hands
While these above are the symptoms associated with preeclampsia, once there is a progression of the condition, a woman suffering from eclampsia can experience the following symptoms as well:
Sudden seizures
Unexplained change of behaviour, particularly agitation and irritability
Loss of consciousness
If you notice the above symptoms, it is best to access medical intervention at the earliest, to avoid any complications.
How Can Eclampsia Affect the Baby?
It goes without saying that any medical complications that a pregnant woman faces, in some way or the other, can affect the health, growth, and development of the baby as well. It has been observed that both preeclampsia and eclampsia can affect the placenta. The placenta is an organ that is responsible for the delivery of nutrients and oxygen from the blood of the mother, to the fetus. When the mother is suffering from eclampsia or preeclampsia, the high blood pressure often causes a reduction in the flow of blood through the arteries and blood vessels. This compromises the flow of blood and nutrients to the foetus, through the placenta. If the function of the placenta is compromised, then the baby gets affected. In some cases, babies have seen to be born with a lower than normal birth weight as well as other weight complications. Women who suffer from eclampsia, in most cases, have issues with the functioning of the placenta, which in turn often leads to preterm delivery, so that safe delivery is ensured. In the worst case scenario, which is rare, eclampsia can cause stillbirth.
How Is Eclampsia Diagnosed?
If you happen to have seizures during pregnancy, your doctor is most likely to issue tests to determine what are the causal factors contributing to the seizures. On the other hand, if you have had a history of preeclampsia or have been diagnosed with eclampsia in your previous pregnancies, then the doctor will recommend tests that can determine if you are affected with preeclampsia again, or if it progressed to eclampsia. Some of the tests that the doctor is most likely to recommend are as follows:
1. Urine Tests
One of the first tests that your doctor might issue will be a urine test. This is to determine the level of protein in your blood and to see if you are suffering from proteinuria. In most cases of preeclampsia or eclampsia, there is a significant amount of protein in the urine, caused due to the retention of protein and similar nutrients by the kidney. A urine test can help with such a conclusion.
2. Blood Tests
Another test that your doctor is likely to suggest is a blood test. With the help of a blood test, a doctor can help assess your medical condition. A blood test primarily includes a complete blood count test, a platelet count test, as well as insights about the liver and kidney function. A complete blood count test can tell you if you have the optimal amount of blood cells in your blood, while a platelet count helps determine if the clotting function of your body is normal. With the help of these tests, your doctor can help diagnose your condition.
3. Creatinine Tests
The waste that is created or secreted by the muscles is known as creatinine. Essentially, a healthy kidney is supposed to filter out most of the creatinine from your muscles or blood. The glomeruli, which is found in the kidney, is responsible for filtering out toxins and waste. However, if the glomeruli is damaged, then chances are that there is an increase in the amount of creatinine in the body, as it is not being flushed out. This can help indicate if you are suffering from preeclampsia or eclampsia.
What Are the Treatments for Eclampsia?
Eclampsia is a rare medical condition, however, if diagnosed with it, immediate medical intervention is necessary. The following treatments are usually recommended for eclampsia.
If you have been diagnosed with preeclampsia or if you have had a history of preeclampsia before, then the doctor will take the necessary steps to prevent the condition from escalating to eclampsia. Certain medications will help with this. Additionally, regularly monitoring your heart rate, blood pressure, creatinine levels and urine will help manage or keep preeclampsia from progressing to eclampsia.
In some cases, preterm delivery of the child may be required. Based on how far along the mother is, as well as the health and development of the child, the doctor might suggest an early delivery.
In some cases, anti-convulsing drugs or steroids will be administered to help prevent or treat a seizure. Additionally, medications to lower blood pressure levels will be administered.
The mother and child will have to be under regular observation even after delivery, as in extremely rare cases, postpartum eclampsia or preeclampsia might take place.
Prognosis
While preeclampsia can instil a sense of fear, it is important to note that in most cases, a full recovery is possible. Several mothers recover as soon as a day or two after the delivery of their child. Soon after birth, the mother’s hypertension or blood pressure levels return to what it was prior to their pregnancy. This can be observed within a range of one-two to six weeks. Eclampsia, after giving birth, is often taken care of with the right medication, a good diet, and a healthy lifestyle. Having said that, the risk of complications should not be completely ruled out. Your doctor should be able to assess your medical condition and guide you one the same.
Like many medical conditions, eclampsia can be tackled with the right medical attention and guidance. Follow healthy habits and instructions by doctors to have a healthy baby.
Also Read:
Overdue Pregnancy
Ectopic Pregnancy
Placenta Previa
Read more
Unicornuate Uterus: Causes, Symptoms & Treatment
A unicornuate uterus is a rare congenital uterine malformation that around 0.6% of the infertile population and 0.3% of the whole population are diagnosed with. Although there have been successful pregnancies in spite of having a unicornuate uterus, there are certain risks attached to it. If you have been diagnosed with the condition and need information on it, you have reached the right place. In this article, we shall touch upon some primary points about the condition and provide insights into the causes, diagnoses and treatments to manage a unicornuate uterus to enable you to get pregnant. Read on to know more.
What Is Unicornuate Uterus?
A unicornuate uterus is a congenital uterine abnormality, in which the uterus is smaller than a typically-sized uterus and has only one functioning fallopian tube. If the other side of the uterus is present, it may be a rudimentary horn. At times, it may be connected with the rest of the uterus or may contain a functional endometrium. In certain cases, the uterus may develop a smaller offshoot called a Hemi-uterus.
What Causes Unicornuate Uterus?
A unicornuate uterus is caused due to an abnormal müllerian duct or paired duct of the embryo. It is a congenital condition, i.e. women are born with it.
Symptoms of Unicornuate Uterus
There could be no symptoms when there is a hemi-uterus with a small cavity and a functional endometrium. It is asymptomatic because the cavity forms a connection with the uterus and the vagina, and drains out the menstrual fluid. So, there is no abdominal/pelvic pain or discomfort. This occurs in 65% of women, and the condition may remain undetected until the woman faces difficulty in conceiving. In such cases, unicornuate uterus treatment becomes delayed.
But, in many cases the horn does not connect to the uterine cavity, resulting in the following symptoms:
Chronic Pelvic or Period-Related Abdominal Pain: This can occur in cases where the functioning horn is solid and isolated from the rest of the uterus. The pain occurs because of a build-up of menstrual fluid that cannot drain out through the vagina.
Hematometra: This is the accumulation or retention of blood in the uterus because of its inability to drain out fluids. The symptoms are cramping pain during periods in the lower abdomen and pelvic midline, frequent urination, and urinary retention. Women in pre-menopause may also report abnormal bleeding or no menstruation at normal cycles. The build-up of blood may also cause low blood pressure or a vasovagal issue. However, women in menopause may be asymptomatic.
A history of infertility.
Premature birth, miscarriage, and breech baby.
Diagnosis of Unicornuate Uterus
This condition remains undiagnosed until a woman suffers from pregnancy complications like a history of infertility, repeated miscarriages, or premature delivery.
There are some tests that can help detect the condition and facilitate timely treatment:
Infertility and/or Regular Pelvic Tests: Unicornuate uterus may be suspected with the help of these tests. Detection is usually rare in these tests.
Imaging: A normal ultrasound often fails to diagnose a unicornuate uterus. An MRI, which is three-dimensional sonography, has better results.
Laparoscopy: Laparoscopy can help confirm the condition by allowing a thorough check-up of the uterus.
Hysteroscopy: This is a process in which a miniature telescope is inserted via the cervix to view the uterus for diagnosis or treatment of certain conditions. This can also detect a unicornuate uterus.
Now, let’s take a look at how unicornuate uterus can affect pregnancy.
Unicornuate Uterus and Pregnancy
Reproductive complications are common in women with a unicornuate uterus. Pregnancy in unicornuate uterus women is difficult because usually only one fallopian tube functions in this situation. Even if they become pregnant unicornuate uterus involves the following risks:
Miscarriage: There maybe foetal demise and stillbirth because of the abnormal shape of the uterus and inadequate blood flow to the uterus and the placenta.
Premature Birth: Women with unicornuate uterus may go into early labour because the baby outgrows the uterine space that is smaller than usual. This happens in the first stages of pregnancy. It increases the chances of a breech birth as well, where the baby is born ‘bottom first’ instead of the normal ‘head first’. This can lead to a cesarean (C-section) instead of a normal delivery.
Ectopic Pregnancy: Women with unicornuate uterus may witness an ectopic pregnancy. This occurs when a fertilized egg implants outside the uterus, typically in the fallopian tube. Unfortunately, ectopic pregnancies must be terminated as the pregnancy cannot survive outside the uterus.
Heavy Bleeding: This could pose a life threat because of a premature rupture of membranes during the first or second trimester.
Intrauterine Growth Retardation: Here, the newborn may be smaller in weight and size.
Placenta Previa: When a woman conceives, the placenta usually attaches to the upper part of the uterus, leaving the cervix free. In placenta previa, it attaches to the lower part of the uterus, spreading to the entire or part of the cervix.
Placental Abruption: Here, the placenta gets detached from the uterus, usually after the 20th week of pregnancy. If it goes undetected, it may result in a stillborn or premature baby.
Intrauterine Foetal Demise: The condition can lead to the demise of the foetus or stillbirth.
Abdominal Pain and Collapse: Detection of the condition may be delayed in spite of the advanced technology, which could result in collapse.
With the risks mentioned above, it is clear that a unicornuate uterus affects fertility in women. Let’s find out how.
Does Unicornuate Uterus Have Any Impact on Fertility?
A unicornuate uterus causes significant gynaecological and obstetrical complications. This has a major impact on fertility. Women are rarely able to conceive when there is a rudimentary horn. Even if they manage to conceive, there are various risks involved. For example, uterine rupture during the first or the second trimester could trigger heavy bleeding and pose a threat to the mother as well as the foetus.
Here’s the rate at which the condition can affect the fertility in women:
Live birth – 29.2%
Prematurity – 44%
Ectopic pregnancy – 4%
First-trimester abortion – 24.3%
Second-trimester abortion – 9.7%
Intrauterine fetal demise – 10.5%
Although there are ways to treat fertility, treating infertility due to a unicornuate uterus may be difficult, mostly because it is a congenital condition. However, there are treatments that can allow you to manage the condition. Let’s find out how.
Unicornuate Uterus – Possible Treatments
The treatment of a unicornuate uterus is never fully effective because the uterus cannot be enlarged surgically. The surgical and non-surgical procedures given below are the most accepted methods to manage the condition:
Cervical Stitch or Cerclage: This treatment is often suggested for those cases that report a history of miscarriages, premature delivery and incompetent cervix due to a unicornuate uterus. In this procedure, the cervix is stitched and closed during pregnancy.
Laparoscopic Surgery: This treatment is conducted to remove an isolated hemi-uterus because it causes abdominal pain due to the accumulation of menstrual blood that cannot flow out.
Emergency Delivery Under Special Care: Pregnancy is possible in a non-communicating uterus, as explained earlier in the article. However, this poses greater risks to pregnant women and could involve an emergency situation because a smaller uterus may rupture by the end of the second trimester due to space constriction. Utmost care and caution should be taken to avoid risks to the mother and the baby. To avoid this, doctors recommend a laparoscopy to remove the isolated hemi-uterus.
Usually, no surgical intervention is recommended unless the endometrial tissue in the rudimentary horn causes pain or a pelvic mass. A solid non-functioning hemi-uterus also need not be removed surgically.
Finally, the type of treatment depends a lot on the variations in the unicornuate uterus.
Some of the variations are given below:
A rudimentary horn may or may not be present.
The horn may or may not connect to the rest of the uterus.
The size of the uterus can also vary.
As most conditions are not treatable, one may want to consider assisted reproduction if they have experienced one or more of the symptoms mentioned in the article above.
Unicornuate Uterus and Assisted Reproduction
One of the most accepted treatments for a unicornuate uterus is IVF with embryo transfer. eSET (elective single embryo transfer) can reduce the high risk associated with multiple pregnancies and a singleton pregnancy in women with a unicornuate uterus. If a miscarriage occurs repeatedly, surrogate motherhood can be considered.
This condition may be very complex, but the good news is that many women have given birth to full-term healthy babies. Complications can be managed and averted with careful and advanced medical care. Speak to a medical practitioner who can provide you with solutions or effective ways to manage the condition and have a baby.
References and Resources: Healthline, Verywellfamily
Also Read: List of 10 Different Types Of Pregnancy
Read more
Sort By
Latest
Most Popular
Trending
Please select atleast one Filter