Complications of pregnancy. What are the complications during pregnancy?

Physiological (normal) pregnancy is considered to be a pregnancy with one fetus, located in the cephalic presentation (the final position of the fetus in the uterus is established at approximately 34–36 weeks), uncomplicated by signs of threatened miscarriage, lasting 37–41 weeks.

Pathological (or complicated) can be called multiple pregnancies and breech pregnancies (on these two points, obstetric ideas have changed significantly over time, and even now the opinions of obstetricians may often not coincide). Very common complications are miscarriage, as well as post-term pregnancy (with the duration of pregnancy being more than 41 full weeks). The most serious complication of pregnancy, of course, is gestosis. Preeclampsia, severe forms of which can be deadly for the mother and fetus. Disturbances in the mother-placenta-fetus system can lead to the development of placental insufficiency, fetal growth retardation, and hypoxia (oxygen deficiency), which is also a deviation from the normal physiological course of pregnancy. Also, factors that can significantly complicate the course of pregnancy include intrauterine infection and the development of immunological incompatibility of the blood of the mother and fetus, pathology from the location of the placenta (placenta previa) and an abnormal amount of amniotic fluid(polyhydramnios, oligohydramnios).

Multiple pregnancy

In this case, two or more children develop. Frequency multiple pregnancy V last years has increased significantly due to the widespread introduction of reproductive technologies such as IVF. Reliable diagnosis is carried out when ultrasound examination. The frequency of complications in multiple pregnancies is significantly higher than in singleton pregnancies, which does not allow it to be classified as physiological, as previously thought. The most common complications in multiple pregnancies are miscarriage, gestosis, anemia, placental abruption, and placental insufficiency. Methods of delivery for twins depend on the duration of pregnancy, the location and condition of the fetuses. Caesarean section has to be resorted to much more often than in singleton pregnancies. For triplets, cesarean section is considered optimal.

Pregnancy with a breech fetus

During breech birth, adverse outcomes occur approximately 5 times more often than during cephalic birth, which does not allow pregnancy in this case to be classified as physiological. Diagnosis is carried out on the basis of external and internal examination; the role of ultrasound in diagnosis is very important. The frequency of caesarean sections for breech presentation varies in different obstetric hospitals (from 30% to 70%). In order for spontaneous childbirth in the case of breech presentation to end safely, the size of the mother’s pelvis must be normal, the child’s weight must be average, the mother’s age must be optimal, and labor must be effective. If there is the slightest deviation from the normal course of labor, it is in the best interests of the child to opt for a caesarean section.

Preeclampsia

It develops only in the second half of pregnancy. The classic triad of symptoms is edema, the presence of protein in the urine, and increased blood pressure. The reasons for the development have not been fully established. Depending on the severity of the symptoms, they distinguish between edema (edema) of pregnancy, nephropathy, preeclampsia, and eclampsia. The last two forms are severe and require immediate delivery. If gestosis develops against the background of any diseases of the pregnant woman, then they speak of “combined gestosis”; it is more severe than simple forms. General principle: the earlier gestosis manifests itself, the more severe it is. Treatment of gestosis is carried out only in an obstetric hospital. And gestosis will end only with the end of pregnancy. Sometimes, with severe forms of gestosis, in order to avoid severe complications (placental abruption, convulsions, multiple organ failure), it is necessary to resort to early delivery. The method of delivery depends on the severity of gestosis and the immediate obstetric situation in each specific case.

Placenta previa.

Incorrect location of the placenta in the uterus (blocking the internal os). There is a high risk of bleeding at any stage of pregnancy. Treatment is only in a hospital. Childbirth is by caesarean section only.
Placental insufficiency, fetal growth restriction, fetal hypoxia.

As a result of insufficient placental function, the baby in utero does not receive the nutrients it needs for normal development. As a result, the fetus begins to lag behind in development, and in the worst case scenario, its death may occur. Until some time, placental insufficiency can be compensated due to the mother’s and fetus’s own mechanisms or through specific treatment in an obstetric hospital. The main task: maintaining placental blood flow, monitoring the child’s condition (cardiotocography, Doppler study). If signs of decompensation appear and the fetus is in a threatening condition, immediate delivery is required.

Immunological incompatibility of the blood of mother and fetus.

It can occur due to incompatibility by blood group or Rh factor. Diagnosis is carried out based on the determination of group and Rh antibodies. It is very important to determine management tactics to assess the condition of the fetus. The most effective method treatment of hemolytic disease of the fetus, if it is diagnosed in utero - intrauterine blood transfusion to the fetus. Delivery in immunocompromised pregnancies is carried out ahead of schedule, and comprehensive treatment of the child continues after birth.

Intrauterine infection.

It may be the result of penetration of a bacterial or viral pathogen into the fetus. If infected in the early stages, spontaneous miscarriages and non-developing pregnancies may occur. Infection with the rubella virus in the first trimester causes fetal malformations and is a 100% indication for termination of pregnancy!!!

If infected in the second half of pregnancy, signs of placental insufficiency may appear. There are specific echographic (ultrasound) signs of intrauterine infection. The general principle of treatment is antimicrobial therapy, treatment of fetoplacental insufficiency.

Thus, if your pregnancy proceeds with complications, then you need to think in advance about who you can trust with your health and the life of your unborn baby. Be responsible when choosing a maternity hospital and do it in advance!

Many women experience minor health problems during pregnancy, but some experience serious complications. In such cases, treatment is necessary, so it is important to report any unusual symptoms to your doctor immediately.

BLOOD DISEASES Anemia

Anemia, common during pregnancy, occurs when there are not enough blood cells in the mother's blood. Many pregnant women suffer from anemia to varying degrees, but with a mild form of the disease it does not create any problems. Because your body redirects its resources towards your baby, it is unlikely that your baby will become iron deficient. But if anemia occurs as a result of hereditary hemoglobin-related diseases, it can threaten the health of the mother and child.

During pregnancy, hydremia is the most common condition. The volume of blood circulating in the body to support the child increases by 40-50%. This sharp increase is achieved due to an increase in blood serum. If red blood cells do not increase to the same extent, their percentage drops, causing hydremia.

Another major cause of anemia during pregnancy is iron deficiency. Because the mother needs to produce enough red blood cells for herself and her baby, she needs more iron to maintain blood volume. Most women do not have sufficient reserves of it, and it is difficult for them to consume the right amount. As a result, many women suffer from anemia during pregnancy.

Iron deficiency anemia can also be caused by folic acid deficiency, blood loss, and chronic disease. If there is not enough iron intake during pregnancy, a woman will be iron deficient at the time of birth, which can cause postpartum hemorrhage. Anemia during pregnancy can be caused by a lack of folic acid in the diet, which is a lack of vitamin B for the production of red blood cells.

Symptoms

♦ Fatigue, loss of energy.

♦ Paleness.

♦ Decreased immunity to disease.

♦ Dizziness, fainting, rapid breathing.

Treatment

During pregnancy, iron deficiency anemia is treated with iron supplements. In addition, the main part of the diet should be foods rich in iron - molasses (black molasses), red meat, beans, spinach, fish, chicken and pork. Vitamin C is needed to improve iron absorption, so take iron supplements with orange, tomato or vegetable juice.

There are cases when a woman’s body does not absorb enough iron, so injections of iron supplements may be required. You can also take folic acid or vitamin B12. In severe cases, blood transfusions may be required, especially as labor and delivery approaches.

Deep vein thrombosis

This condition, commonly called DVT, occurs when a blood clot blocks a vein in one of the legs, usually in the calf, upper leg or groin.

Symptoms

♦ Pain, tenderness and swelling in the calf, upper leg or groin area.

♦ Heat in swollen places.

Treatment

If you suspect you have DVT, you should go to the hospital right away. This condition should not be ignored because if a blood clot is left untreated, it may

reach the lungs and cause a life-threatening pulmonary embolus. A special ultrasound examination called Doppler is used, which quickly detects the presence of DVT. Treatment usually involves injections or blood thinners.

It is very easy to confuse DVT with a normal and harmless condition. superficial thrombophlebitis. Sometimes small patches of skin with veins on the lower legs become inflamed and red, especially if the mother is overweight. In such cases, a soothing cream and support tights are sufficient.

Gestational diabetes

A type of diabetes that occurs during pregnancy when the body does not produce enough insulin to cope with high blood sugar levels. During pregnancy, the placenta produces a hormone, human placental lactogen, which counteracts insulin and sets the stage for diabetes. The main complication for women with gestational diabetes is that the baby can grow very large. It is often recommended that birth take place no later than the 40th week.

You are at risk of gestational diabetes if you have had it before, are over 35 years old, are overweight, are of Asian descent, have had a previous child weigh more than four kilograms, have a parent or sibling with diabetes or a previous the child was born with disabilities or was stillborn. Diagnosis is based on measuring fasting blood sugar levels after consumption a certain amount Sahara.

Symptoms

♦ Sugar in urine.

♦ Excessive thirst.

♦ Excessive urination.

♦ Fatigue.

Treatment

Many women with gestational diabetes can control their sugar levels by following a relatively sugar-free diet. For some women, this is not enough, but not because they do not follow the diet, but due to the pregnancy itself. These women need insulin injections (at least twice daily) or oral medications to control their blood sugar. The hospital's diabetes specialists will teach you how to check your sugar levels and how to administer the injections yourself.

High blood pressure (hypertension)

If a woman's blood pressure rises before pregnancy, it is called essential hypertension. If your blood pressure only rises during pregnancy, it is called pregnancy-related hypertension (PHH). GOB occurs in 8% of pregnant women and can begin any time after the 20th week, but usually resolves by the time of delivery. It finally disappears after the birth of the child.

Many doctors tend to identify GOB and preeclampsia. Although GOB less dangerous for mother and baby than preeclampsia, it often develops into preeclampsia, so the distinction between the two diseases is often irrelevant.

Symptoms

There are usually no signs of high blood pressure until organs, such as the kidneys and eyes, are affected by the reduced blood supply that accompanies hypertension. Since untreated hypertension eventually leads to serious complications, blood pressure checks should be done regularly during prenatal checkups.

Preeclampsia

Preeclampsia is a syndrome that occurs only during pregnancy and is characterized by high blood pressure, protein in the urine, and increased swelling of the legs and feet. Preeclampsia occurs in 8-10% of pregnant women and 85% of first-time pregnant women. Mothers in their forties, teenage mothers and those with diabetes, blood pressure problems, kidney problems or rheumatological disorders have an increased risk of preeclampsia.

Many women who have preeclampsia feel absolutely fine and are only aware of the disease through high blood pressure. If the following symptoms appear, the condition may become more serious.

Symptoms

♦ Sudden excessive swelling of the lower legs or weight gain.

♦ Constant headaches.

♦ Fog in the eyes, flashes and spots before the eyes.

♦ Pain on the right side of the body in the upper abdomen, just under the ribs.

Treatment

The cause of preeclampsia remains unknown, and therefore there are no ways to prevent or treat the disease. The only treatment is induced labor for women who are close to carrying a child to term or who are seriously ill. If preeclampsia occurs during early stages pregnancy or it manifests itself in a mild form,

Pills help lower blood pressure. Aspirin in small doses - 75 mg per day - can reduce the risk of developing preeclampsia. Check regularly and many problems will be detected early. Try not to worry as this increases your blood pressure. Eat well, eat healthy foods, reduce salt and fat intake, eat more fruits, vegetables and calcium, drink plenty of fluids. You may be asked to monitor your blood pressure so that any major changes can be recorded.

Eclampsia

Preeclampsia can develop into eclampsia, a rare but very serious disease.

Symptoms

♦ Seizures and fits.

♦ Comatose state.

Treatment

Eclampsia is a medical emergency in which the mother will be provided with oxygen and medications to prevent seizures and seizures. Urgent delivery of the baby is usually required to allow further treatment for the mother.

HELLP syndrome

HELLP syndrome, a life-threatening condition, is a unique variant of preeclampsia. It got its name from the following characteristics: H - hemolysis (disintegration of red blood cells); EL - growth of liver enzymes; LP - low platelet count. HELLP syndrome occurs in tandem with preeclampsia, but because some of its symptoms may occur before preeclampsia, they are misdiagnosed as a different diagnosis. As a result, the correct treatment may not be prescribed, leaving mother and child completely unprotected. In the UK, between 8 and 10% of all pregnant women have pre-eclampsia, of whom 2-12% have HELLP syndrome. Older white women who have more than one child are at greater risk for the disease.

Symptoms

♦ Headache.

♦ Nausea, vomiting.

♦ Pain in the abdomen and pain in the upper right part due to an enlarged liver.

These symptoms may or may not be present:

♦ Severe headache.

♦ Visual impairment.

♦ Bleeding.

♦ Swelling.

♦ High blood pressure.

♦ Protein in urine.

Treatment

The only one effective way The treatment for women with HELLP syndrome is childbirth. The sooner preeclampsia is detected and the sooner measures taken to counteract it, the better the outcome for mother and baby.

Birth cholestasis

Also called cholestasis of pregnancy. This is a liver condition in which the normal flow of bile from the liver to the intestines is reduced. This leads to the deposition of bile salts in the blood. Although the resulting itching does not cause any harm to the mother and disappears soon after birth, the condition is potentially dangerous for the unborn baby. Doctors who suspect cholestasis will test the mother through blood tests, including a bile acid test and a liver function test.

Symptoms

♦ Itching, especially on the palms and soles, which may be worse at night and become intolerable.

♦ Presence of liver enzymes in the blood.

Treatment

Since this disease carries a huge risk for the child, doctors insist on early birth, around 37-38 weeks, which significantly reduces the risk of a stillborn baby. Medications may be prescribed to relieve itching.

DISEASES OF THE UTERUS Fibroid

A benign tumor on the wall of the uterus, more common in older women, and it usually does not affect pregnancy. Pregnancy hormones speed up the growth of fibroids and can sometimes cause problems, such as preventing the baby from growing properly. The location of the fibroid may also make vaginal birth impossible.

Symptoms

♦ Painful sensations in the abdominal area.

♦ Mild fever.

Treatment

If fibroids cause discomfort, the only option during pregnancy is to take pain-relieving medications. After childbirth fi-. bromine usually decreases in size. If it continues to be a problem, it is removed surgically several months after delivery. It is considered unsafe to remove the fibroid during a caesarean section due to the risk of severe blood loss and possible hysterectomy to correct the bleeding.

INTESTINAL DISEASES Anal fissure

Sometimes pregnancy or difficult childbirth causes the anal lining (anal tissue) to rupture. Bowel movements can “pop” this rupture, leading to bleeding and severe pain; Permanent rupture prevents treatment and leads to the formation of scar tissue. Anal fissures are usually associated with intestinal diseases; constipation and frequent bowel movements can intensify and aggravate the disease. Anal fissures can appear due to syphilis, tuberculosis, granulomatous disease and tumors.

Fissures can be confused with hemorrhoids, painful swelling in the anus caused by enlarged veins and genital warts. This disease is mainly diagnosed by proctoscopy, which allows examination of the anal canal. Cracks can be prevented by regular and gentle bowel movements. Eat more fibrous foods and take a laxative.

Symptoms

♦ Pain during and after bowel movement.

♦ Bright red bleeding.

♦ Constipation.

Treatment

Anal fissures can be acute or chronic and it is important to treat them as soon as possible as complications can arise. Treatment depends on the severity of the condition. Acute or recent fissures are usually treated with colon-forming laxatives and topical numbing cream. In severe cases, surgery is necessary. After treatment, it is very important to eat regularly and eat foods high in fiber. And drink plenty of fluids.

DISEASES OF THE DIGESTIVE SYSTEM Hyperemesis gravidarum

Sometimes morning sickness can develop into a more extreme condition. About one in 200 women are admitted to hospital early in pregnancy due to uncontrollable vomiting and the need to prevent dehydration with intravenous drips. If left untreated, the disease can cause low potassium levels in the blood and interfere with normal liver function.

Symptoms

♦ Severe nausea and uncontrollable vomiting.

♦ Weight loss.

♦ Dehydration.

♦ Dark yellow urine.

♦ “Sooting” small amounts of urine.

Treatment

Fortunately, hospital treatment with no food or drink and IV fluids to provide rehydration fluid is usually very successful. Then gradually and little by little they begin to give food, and recovery takes several days.

INFECTIONS

It is worth remembering that most women do not get sick at all during pregnancy, that a significant part of the mother's infectious diseases do not affect the child in any way, and that serious infections are very rare.

Cytomegalovirus

Cytomegalovirus (CMV), a virus of the herpes family, is a common congenital infection and is spread through contact with saliva, urine, and stool. Approximately 1% of newborns are infected each year. The vast majority are unaffected by the virus, but around 8,000 children a year develop permanent disabilities such as learning disabilities, deafness and blindness.

A pregnant woman exposed to CMV for the first time has a 30-40% chance of passing it on to her child. Women who had CMV for less than 6 months before pregnancy are considered to be at low risk of complications. Laboratory tests will help determine whether a woman has previously had an infection, and a culture of microorganisms is grown from a urine sample to detect active infection. If CMV is diagnosed, the baby is tested for infection using amniocentesis. In newborns, the virus is identified by body fluids within three weeks after birth.

Symptoms

♦ Sore throat.

♦ Fever.

♦ Body aches.

♦ Fatigue.

Treatment

There is currently no preventative treatment for congenital CMV, but a new generation antiviral drug called ganciclovir may help infected children. Meanwhile, the risk of contact infection with CMV can be reduced by careful hygiene: washing hands after contact with saliva and urine of small children.

Toxoplasmosis

Although this infection is rare in the UK, it can seriously affect the fetus. It can be spread through contact with outdoor cats and by eating undercooked meat and unwashed vegetables. If a pregnant woman is infected, she is more likely to pass the infection to her baby, and possible consequences will depend largely on when she received the named virus. If this occurs during the first trimester, the chance of the baby becoming infected is less than 2%, although the impact on the baby's development may be greater. If the infection does not appear until late in pregnancy, the chances of the baby becoming infected are increased, but the consequences will be much less severe. General symptoms may occur, but the infection may go unnoticed.

Some doctors always check for toxoplasmosis in the early stages of pregnancy, others do not. This often depends on your risk factors, such as whether you have an outdoor cat.

Symptoms

♦ Poor general health.

♦ Mild fever.

♦ Swelling of the glands.

Treatment

If blood tests show that you have developed toxoplasmosis just before conception or during pregnancy, see a maternity specialist or doctor to discuss possible complications. You will likely need antibiotics to reduce the chance of passing the infection to the baby or an amnicentesis in the second trimester to determine if the baby is infected.

Recent research in France shows that even if an unborn baby is diagnosed with the virus, treatment with appropriate antibiotics gives the baby a high chance of being born healthy.

Listeriosis

Listeriosis, caused by bacteria found in raw, unwashed vegetables, unpasteurized milk and cheese, and raw and undercooked meats, can cause serious illness during pregnancy, leading to premature birth, miscarriage, stillbirth, or infection of the baby. Listeriosis is difficult to detect because symptoms can appear anywhere from 12 hours to 30 days after eating contaminated food and are ignored because they are similar to the flu and can be interpreted as side effects pregnancy.

Symptoms

♦ Headache.

♦ Fever.

♦ Muscle pain.

♦ Nausea and diarrhea.

Treatment

Infection can be avoided by avoiding any food that may be contaminated. If an infection is detected, antibiotics are required for treatment.

Rubella

Rubella, also called measles, is usually a relatively mild infection, but it can cause serious complications during pregnancy, causing birth defects ranging from deafness to encephalitis (inflammation of the brain) and heart disease. Fortunately, most women are immune to this disease, both due to vaccination and because they had it as children.

Ideally, you should have a blood test to check for immunity, and if you are not immunized, you should get vaccinated before you become pregnant and then wait three months before conceiving. If you received the vaccine before you knew you were pregnant, your chances of harming your baby are very low. At the 18th week you can

a thorough ultrasound examination to check the baby's development.

Symptoms

♦ The rash appears first on the face, then spreads throughout the body.

♦ Fever.

♦ Swelling of the glands.

Treatment

If you get rubella during pregnancy, the risk to your baby depends on when the illness starts. If this happens in the first month, the baby's chance of getting sick is 1:2. By the third month, it drops to 1:10. Unfortunately, nothing can be done during pregnancy to protect the baby. The doctor will explain to you what tests you need to take and possible options treatment.

Chickenpox

Since most adults had chickenpox as children, there is a good chance that you are immune to it and will never get sick, even if you come into contact with someone who has it. The infection is caused by the varicella zoster virus, which can manifest as chickenpox or herpes zoster, with the former occurring when you first contract the virus and the latter when the virus relapses. If the mother becomes ill, the child becomes infected in very rare cases. However, sometimes a serious condition called congenital chickenpox syndrome occurs, which can lead to developmental defects, even fatal ones.

Symptoms

♦ Rash with itchy blisters.

♦ Fever.

♦ Malaise.

♦ Fatigue.

Treatment

If you are pregnant, not immune, and have been in contact with someone who has chickenpox, tell your doctor as soon as possible. You will be offered an injection of immune globulin to try to protect against chickenpox, as this disease spreads in adults

into pneumonia. If you do become ill, you will also be offered antiviral medications to treat the infection. Chickenpox just before birth sometimes means that the baby may experience serious complications. In this case, the newborn will receive the above immunoglobulin.

Yeast infections

An increase in vaginal discharge is common during pregnancy as the body produces more mucus. As long as this discharge is scanty and white (although it becomes yellow after drying), this is normal. However hormonal changes during pregnancy can stimulate the growth of pathogenic microorganisms in the vagina, leading to yeast infections from a fungus called candida albicans. The disease occurs quite often - in approximately 25% of women.

Symptoms

♦ Viscous, white, milk-like discharge.

♦ Burning, redness and itching of the vulva.

Treatment

Although candida does not affect pregnancy, if left untreated, the baby can get an oral yeast infection (thrush) by passing through the vagina at birth. Candida can be treated with vaginal creams, ointments, suppositories and oral medications. Many medicines are available over the counter,

but be sure to consult your doctor before purchasing. To relieve symptoms and prevent candida, avoid feminine hygiene sprays and bath products. Reduce your intake of carbohydrates and sugar as they stimulate the growth of yeast microorganisms. Wear cotton underwear and tights with a cotton gusset; avoid synthetic fabrics and tight tights. After using the toilet, be sure to wipe your genitals from front to back. Eat live yogurt every day, which contains lactic acid bacteria, which reduces the risk of this infection.

Urinary tract infections (UTIs)

UTIs include infections of the bladder, kidneys, ureters (the tubes that lead from the kidneys to the bladder), and the urethra (the tube that carries urine from the bladder to the outside). UTIs are common during pregnancy. They range from mild to severe, ranging from bacteria in the urine to kidney infections. Because UTIs can be present in the body without causing any symptoms, urine tests are taken regularly throughout pregnancy. If these bacteria are found, serious kidney disease can be prevented with antibiotics.

Symptoms

♦ Urgent need to urinate.

♦ Sharp pain or burning sensation when urinating.

♦ Very little urine output; urine may be blood-stained, cloudy, or bad smell.

♦ Frequent urge to urinate. Pain in the lower abdomen, back or side.

♦ Back pain, shaking, fever, nausea and vomiting if the infection has spread to the kidneys.

Treatment

An untreated UTI can stimulate contractions and cause premature labor. You should consult a doctor; treatment is usually with antibiotics. To prevent relapses, drink more fluids to flush bacteria from your body.

Release regularly bladder while leaning forward over the toilet to remove all urine, stagnant urine is a breeding ground for bacteria. Cranberry juice can also help, as it acidifies the urine, making it less hospitable for bacteria.

Group B streptococcus

This usually harmless bacterium is found in the vagina of one in ten healthy women. It can be passed on to the baby during birth and cause serious illness. For this reason, if a woman is found to be a carrier of streptococcus, she should be treated with antibiotics during labor.

DISEASES OF THE JOINTS Carpal Syndrome

The carpal tunnel is located at the front of the wrist, enclosing the tendons and nerves that lead to the fingers. If your hand and fingers swell during pregnancy, the carpal tunnel also swells, putting pressure on the nerves. This pressure leads to a tingling sensation in all fingers except the little finger. Symptoms of carpal tunnel syndrome tend to worsen at night as the joints work during the day to relieve pain. This condition should disappear a few days after birth.

Symptoms

♦ Pain in the wrist.

♦ Tingling from wrist to fingertips.

♦ Rigidity of the fingers and joints of the hand.

Treatment

Sleep with your arms raised by the pillow. This can help with fluid retention. When you wake up, hang your arms over the sides of the bed and shake them vigorously, which will help distribute the fluid and reduce hand numbness. A wrist splint may also help.

Dysfunction of the pubic symphysis

The pelvic girdle consists of three bones (one in the back and two in the front) connected by ligaments. The bones are designed to form three

“fixed” joints; one in front, called the pubic symphysis, and two on the sides at the base of the spine. During pregnancy, the hormone relaxin relaxes all the ligaments of the pelvis, allowing the baby to have an easier passage at birth. However, the ligaments can relax too much, causing the pelvis to move, especially when stress is applied to it. The weight of the child aggravates the situation, and sometimes the joint of the pubic symphysis actually diverges somewhat. The result is pain (from mild to severe) in the pubic area. This condition can occur at any time, starting from the first trimester.

Dysfunction of the pubic symphysis can occur with prolonged immobility or excessive activity. It is also sometimes recorded after such physical activity.

tee, like breaststroke, or irregular

lifting weights.

Symptoms

♦ Pain, usually in the pubic area and/or lower back, but may be felt in the groin, inner and outer thighs, and buttocks.

♦ The pain may worsen when placing weight on one leg.

♦ Feeling of separation of the pelvis.

♦ Difficulty walking.

Treatment

Unfortunately, dysfunction of the pubic symphysis cannot be treated during pregnancy, since it is the result of the action of hormones. However, you should feel better when your body returns to its pre-pregnancy state. Nevertheless, certain measures must be taken to prevent the disease from progressing too far. If possible, avoid lifting weights on one leg: sit down to get dressed, get into the car with your buttocks first on the seat, and then bring your legs inside. When swimming, avoid breaststroke, turning in bed and squeezing your knees. If the pain is severe, ask your doctor for painkillers and make an appointment with a physical therapist, who may recommend wearing a pelvic support belt.

Take special precautions during labor and delivery. Feet should be kept as close to each other as possible. Good birth positions include all fours, kneeling on the edge of the bed, or lying on your side with your upper legs supported.

PROBLEMS WITH THE CHILD Growth problems

Sometimes it seems that a child is growing too slow or too fast. Both are not normal. How well a child grows is determined by many factors. So, if you smoke, your baby will be smaller than average overall, and if the mother has diabetes, she will likely have a larger than average baby. If abnormal growth of the baby is suspected, the usual way to determine this is to measure the size of the fetus (from the pelvic bone to the top of the uterus).

However, this method is now considered relatively inaccurate. To more accurately determine the size of the baby, an ultrasound examination is used, and the result obtained is compared with the average for your term.

The child is too small

In addition to determining the actual size, ultrasound examination is used to determine other important parameters. The amount of fluid around the baby will decrease if the placenta is not functioning well. Very Small child will move less, breathe less frequently, and generally be less active. Together with heart rate, these factors make up biophysical profile. A normal profile assumes that the child is currently healthy.

Another useful test to determine poor growth or health small child is the umbilical cord assessment. Ultrasound examination is also used for it, and the speed of blood movement in the umbilical cord is determined. If the rate decreases, it is assumed that the placenta is not functioning well enough.

When the decision to give birth is made, many factors are taken into account. These include: how mature the child is, how healthy he is supposed to be, and the health status of the mother. Some very sick babies are born via caesarean section. If the baby is sick and needs to be taken out prematurely, you may be given steroid injections to help develop baby's lungs.

The baby is too big

Tall or heavy mothers tend to give birth to larger babies than small and underweight mothers. However, there are some serious conditions that cause the baby to become too big. The most common is diabetes.

Many mothers worry whether they will be able to give birth to a large baby. Ultrasound is not always accurate when determining the size of a large child; taking into account its weight, the error is approximately 10%. If the baby is large and the end of the pregnancy is near, you may be offered birth support so that it is born before it becomes even larger. If the baby is large for its term, but there is time before delivery, it is best to discuss the birth plan with your doctor, taking into account your views and the doctor's advice.

Polyhydramnios (hydramnios)

About 2% of pregnant women have too much amniotic fluid, a condition known as polyhydramnios. Most cases are uncomplicated and occur with gradual fluid accumulation during the second half of pregnancy. In about half of the cases, polyhydramnios disappears, and women give birth to healthy children. Sometimes polyhydramnios is a warning sign that the baby has a birth defect or that there is a medical problem, such as gestational diabetes.

Polyhydramnios can occur during fetal anemia or with certain viral infections. In severe cases, uterine contractions occur and premature birth is possible.

Symptoms

♦ The size of the uterus is larger than usual.

♦ Heaviness in the abdomen.

♦ Poor digestion of food.

♦ Swelling of the legs.

♦ Shortness of breath.

♦ Hemorrhoids.

Treatment

Polyhydramnios is usually diagnosed by ultrasound. If the condition is advanced, amniocentesis may be used to remove excess fluid. If the membranes rupture, there is a risk of umbilical cord prolapse when the umbilical cord comes out before the child, so please contact your local maternity ward immediately.

Low water

A condition in which there is too little amniotic fluid in the uterus. Most women with this diagnosis have normal pregnancy, but sometimes this signals health problems or leads to problems. In the early stages of pregnancy, there is a small risk that the baby will develop a deformed foot because there is not enough room for normal growth. For more later this may indicate a pathological condition of the fetus. Sometimes birth defects occur, such as diseases of the digestive and urinary systems. If oligohydramnios continues for several weeks of pregnancy, it can lead to pulmonary hypoplasia (underdevelopment of the fetal lungs).

Symptoms

♦ The size of the uterus is smaller than average.

♦ Fetal movements are less frequent than usual.

♦ Slow growth.

Treatment

Oral and intravenous hydration and bed rest may improve the condition. American doctors have tried to replace the fluid with a process in which the amount of amniotic fluid is increased by saline solution, fed directly to

amniotic sac through a catheter inserted into the uterus. The treatment was experimental and did not help in all cases. If the disease was considered safe, childbirth was carried out; if there was a risk to the child, contractions were stimulated. Women with this condition are advised to take extra care, get plenty of rest, eat properly and drink plenty of water.

Knotted umbilical cord

Sometimes the umbilical cord in the uterus becomes knotted or tangled and even wrapped around the baby's neck. This can reduce blood flow to the baby, so it is vital to deal with such problems as quickly as possible.

Symptoms

♦ Decreased child activity.

If the blood supply to the baby has decreased for any reason, an urgent birth is required, usually a cesarean section.

Umbilical cord prolapse

Sometimes the baby's umbilical cord enters the birth canal before the head or other parts of his body. A prolapsed umbilical cord can be very dangerous for the baby. When the umbilical cord is pinched, the flow of blood and oxygen is cut off, leading to very serious consequences.

Prolapse most often occurs if polyhydramnios is present; during the birth of the second child of twins; the child is in a pelvic or transverse presentation; when membranes rupture, both natural and during vaginal examination until the moment when the child descends into the pelvis.

Symptoms

♦ Decrease in fetal heart rate

Treatment

If the umbilical cord still pulsates or is visible or felt in the vagina, your doctor will deliver the baby to relieve pressure from the umbilical cord. To help him, you may be asked to kneel and lean forward. The doctor will keep his hand in the vagina until

the baby will not be born the fastest possible way, usually through emergency Caesarean section, forceps, or a vacuum extractor if the baby is in the correct position.

Pathological condition of the fetus

This term is used to describe any situation in which a child is believed to be in danger - usually when oxygen supply is reduced. This condition can be caused by various reasons: maternal illness (anemia, hypertension, heart disease, low blood pressure); the placenta is no longer functioning properly or has separated from the uterus prematurely; compression or entanglement of the umbilical cord; fetal infection, malformation; prolonged or excessive contractions during contractions.

Symptoms

♦ Change in the degree of activity of fetal movements.

♦ Lack of fetal movements.

♦ Change in fetal heart rate.

Treatment

Immediate delivery is usually recommended. If vaginal delivery is not imminent, then a caesarean section is performed. Mothers may first be given medications to slow down uterine contractions, which will increase oxygen supply to the baby and dilate the baby's blood vessels to improve blood supply.

Let's take a look together at the most common types of complications, the reasons for their occurrence, the level of impact on the child's development, treatment methods and prevention methods. We will pay special attention to gestosis, oligohydramnios, and Rh sensitization.

Timely diagnosis will help avoid unpleasant consequences for the mother and her baby. The severity of complications during pregnancy can cause spontaneous abortion, lead to uterine bleeding, developmental disorders and even the death of the child.

One of the complications that appears in the first 10 weeks of pregnancy is called toxicosis. His constant companions:

nausea and vomiting;
loss of taste;
profuse salivation.

As a consequence of serious changes in the vascular system, vital functions are disrupted.

Preeclampsia becomes no less dangerous to the health of a pregnant woman. Preeclampsia is especially dangerous for a child: it can cause frequent illnesses and even sudden death during intrauterine development. Preeclampsia manifests itself when, after a sudden deterioration in health, blood pressure begins to increase, accompanied by mucous swelling and protein urine.

A doctor who discovers gestosis in a pregnant woman must prescribe treatment for her, and if there is no positive result, send the pregnant woman to a hospital.

If the fetus is not positioned correctly, the normal course of pregnancy is disrupted, which can lead to prenatal leakage of amniotic fluid, expulsion of small fetal fragments, and rupture of the uterine cavity. The main causes of these complications may be:

multiple pregnancy;
excess amniotic fluid (polyhydramnios);
abnormalities and tumors of the uterus;
weak tone of the abdominals and uterus.

Fetal presentation may be hereditary. The incorrectness of its position is found during the end of pregnancy through an external examination and confirmation by ultrasound examination. If the incorrect position of the fetus (head down) was detected in time, it will be returned to its normal state using special gymnastics. If it is impossible to perform this operation, the pregnant woman is placed in a maternity hospital to determine further methods of delivery. With early loss of amniotic fluid, medical workers will be nearby and provide her with possible assistance.

Polyhydramnios is an excessive amount of amniotic fluid (about 2 liters). During such disorders, the size of the uterus increases, pressure occurs on the diaphragm and nearby organs, complicating the functioning of the kidneys, breathing, and blood circulation. The woman feels unwell, heaviness and pain in the abdomen, shortness of breath. She experiences swelling in her legs. With polyhydramnios, the child often moves and ends up in the wrong position.

Oligohydramnios is characterized by a small amount of amniotic fluid (less than 0.5 liters). In such a situation, the walls of the uterus envelop the fetus, depriving it of mobility, which harms its normal location. The child's condition worsens: the skin dries out and becomes wrinkled, body growth slows down, club feet and curvature of the spine are observed.

Oligohydramnios causes premature placental stratification, which leads to pathology labor activity. Most often, the correct diagnosis (oligohydramnios or polyhydramnios) is established during an ultrasound examination. Diagnosis of these disorders is carried out with the aim of identifying and treating them.

Anemia in pregnancy is a disease characterized by a decrease in hemoglobin in red blood cells. Anemia threatens every woman, since the cause of this disease is a lack of iron, which a pregnant woman so needs. Anemia is accompanied by hypoxia, fetal anemia, and malnutrition. Women complain of shortness of breath, general weakness, headache, blurred vision, and frequent fainting. Quite often, anemia is accompanied by toxicosis, which can provoke premature birth.

Emergence Rhesus conflict can only be observed in Rh-negative women carrying an Rh-positive fetus: the mother’s body perceives the child as someone else’s flesh, which is very dangerous for the baby. The formed antibodies, penetrating the child’s circulatory system, cause anemia (destruction of red blood cells), poisoning, possible subsequent termination of pregnancy, and early birth.

To prevent severe consequences, women at risk are often tested for the presence of antibodies. In advanced situations, the pregnant woman is placed in a hospital setting.

Prevention of pregnancy complications is a certain set of mandatory rules that the expectant mother must follow to maintain her health and the health of her baby.

Strict adherence to the daily routine is necessary: choose a time for physical activity and frequent, proper rest. Don't overwork, avoid sedentary work, go for walks.

Don't forget to add variety to your menu. Take vitamins and only natural products nutrition. Keep an eye on your body weight for any deviations.

Clothing should be loose and exclusively cotton. Do not wear high-heeled shoes. Don't forget to pry up the bandage.

Hygiene procedures should include frequent washing, warm showers, and rubbing. Completely avoid hot showers, douching, baths, alcohol, smoking, and drugs.

Sexual activity is possible until the ninth month, but requires increased caution. Avoid sudden movements and pressure on the abdomen.

Complications of multiple pregnancy can be widespread and highly specific. The most common complications are:

premature birth;
insufficient fetal weight;
developmental delay;
Cerebral palsy, cerebral palsy;
congenital developmental disorders.

In addition, there are less common pregnancy complications:

Complications after a frozen pregnancy often occur in the first trimester. This complication has other names: failed miscarriage or non-developing pregnancy, and in the final stages - antenatal death of the fetus. Frozen pregnancy is characterized by rejection of the fetus and its removal from the mother's body. Sometimes the fetus does not come out on its own and surgery is required.

Complications in early pregnancy include the following:

ectopic pregnancy;
spontaneous miscarriage;
infectious abortion;
bleeding from the tissues of the corpus luteum;
uterine strangulation.

Ectopic pregnancy occurs in the ovaries, cervix, and fallopian tubes. Accompanied by amenorrhea, pain and heavy bleeding.

Spontaneous miscarriage occurs during the first trimester of pregnancy. It is accompanied by heavy uterine bleeding, anemia, and hypotension.

Infectious abortion (endometritis) leaves behind fertilized egg tissue that must be cleaned out of the uterine body. Accompanied by bleeding, nausea, fever, and general weakness.

Bleeding from the corpus luteum occurs as a result of rupture of the cyst. Characterized by significant uterine bleeding.

Uterine incarceration is a rare complication in which the uterus protrudes from the pelvic cavity and becomes lodged in the pelvic bones. May delay urination and promote spontaneous miscarriage. Treatment requires rapid intervention.

Complications after an ectopic pregnancy do not occur immediately; they can be characterized by nagging pain in the lower abdomen, from the side of the attached egg. It happens that the embryo, along with the blood, is carried into the abdominal cavity. With the termination of pregnancy, tissue ruptures, fainting and pain, accompanied by heavy bleeding, often occur.

During the operation, it is possible to remove or strip fallopian tube. The next pregnancy cannot be planned earlier than in six months.

Medication and magnetic therapy have a positive effect on the course of the postoperative process. It is recommended to undergo a course of rehabilitation treatment.

The main causes of ectopic pregnancy:

previous pelvic inflammation;
anatomical features;
arising as a result of the use of stimulants of reproductive technologies.
complications after termination of pregnancy (after abortion):
uterine diseases;
endometritis;
diseases in the pelvic area;
peritonitis;
pelvioperitonitis;
sepsis;
post-abortion syndrome;
risk of miscarriage;
premature birth;
improper attachment of the placenta (baby place);
placenta accreta;
malposition;
placental insufficiency.

Complications after medication interruption pregnancy can have physical and mental consequences. Medical (non-surgical) abortion takes place under the influence of the tablets Mifegin, Mifepristone, Pencrofton, RU 486, Postinor.

In medical centers engaged in the practice of medical abortion, the true information about this type of abortion is concealed, contraindications are hushed up, even leading to the death of the pregnant woman. Doctors say that this is an alternative to clinical abortion, but this is not entirely true: with the help of a medical abortion, the real death of the future person occurs. Women feel guilty after undergoing such an abortion. And many women cannot cope with this feeling.

Such good things are not thrown away

Ideal age for birth healthy child The period is considered to be from 20 to 30 years. The reproductive system is in its prime, although health is often already poor. By the age of 25, the walls of blood vessels in a woman’s body become thinner, the effects of stress accumulate, bad habits. As a result, the number of miscarriages is increasing not only among those who give birth after 30, but also among young people. Nadezhda Barsukova, obstetrician-gynecologist, candidate of medical sciences, consultant at the Angel women's center for prevention, diagnosis and treatment, talks about this.

– Most pregnant women postpone the moment of registration with the antenatal clinic. But in vain! It is in the early stages of pregnancy, up to 12 weeks, that during the examination attention is focused on identifying the risk of miscarriage. The state of health of both parents, the baggage of their chronic diseases, infections, hormonal disorders in expectant mother, abnormal structure of the uterus, cervical insufficiency, immune incompatibility. And the earlier the diagnosis is made, the more successful the pregnancy will be.

Infectious agents
Expectant parents often have no idea what a time bomb they are. Most pregnancy complications are caused by urogenital infections.

What does she provoke?	Symptoms	Consequences	Diagnostics
Preeclampsia	Edema, hypertension, disorders of the kidneys, so-called nephropathy.	It is necessary to go to the pregnancy pathology department, otherwise gestosis will develop into a state fraught with much more serious consequences, eclampsia - a complication with seizures and loss of consciousness.	Urinalysis according to Nechiporenko, general analysis urine, Zemnitsky test, ultrasound - to determine structural changes in the kidneys.
Polyhydramnios	Excessive accumulation of amniotic fluid, due to which the enlarged uterus puts pressure on neighboring organs, the diaphragm, complicating blood circulation and breathing, disrupting the functions of other organs.	In acute polyhydramnios, the amount of amniotic fluid increases rapidly. As a result, pregnancy, as a rule, is terminated prematurely, the fetus dies or is born with developmental defects. Possible uterine rupture.
Pyelonephritis	Pain in the lumbar region, increased body temperature, cloudy urine.	Long-term course of pyelonephritis leads to significant destruction of renal tissue, development renal failure and arterial hypertension.

Chlamydial infection is also common among pregnant women suffering from inflammatory processes. Moreover, the majority of chlamydia occurs without symptoms. The same applies to hepatitis B, a liver infection that can be transmitted to a child during pregnancy, causing liver problems in the newborn, but most often, premature birth.
The increase in sexually transmitted diseases is not decreasing either. Pathogens of this group often cause miscarriage. They are dangerous primarily because they are transmitted from mother to fetus through the placenta and genital tract, infecting the membranes, which leads to their damage, premature rupture of amniotic fluid and miscarriages. The placenta, in turn, protests against this malfunction in the body, accelerating or slowing down its development.

Protest rallies
Normally, most bacteria and viruses are retained by the placenta, preserving the health of the fetus. It is born, grows and matures simultaneously with the child. It is shaped like a flat disc and is attached to the uterus by many villi, which carry oxygen and nutrients to the baby. But the idyll can be disrupted by decreased immunity, infections, anemia (anemia), diabetes and the lifestyle of the expectant mother. The placenta reacts to them either with delayed or accelerated maturation.
With accelerated maturation, blood circulation in it is disrupted separate areas. Treatment is similar to the prevention and correction of late toxicosis, which is prescribed by a doctor.

Memo
On January 1, 1993, Russia adopted new birth criteria recommended by the World Health Organization. Nowadays, newborns weighing over 500 grams, born from the 22nd week of pregnancy, are provided with intensive and resuscitation care. Due to the immaturity of thermoregulatory mechanisms, premature babies are easily cooled, so they are constantly in an incubator, where they are connected to special equipment that regulates heat and maintains normal blood pressure.
One of the main problems of these children is related to the immaturity of their regulatory systems. The nervous system has not yet matured. Such babies are characterized by apnea syndrome (stopping breathing): they forget how to breathe. But with current methods of resuscitation, viable functions are restored in most cases, and by the age of one and a half to three years, premature babies are no different from their peers.

Delayed placental maturation is observed less frequently. The most common causes: strong medications, stress, physical strain, smoking and alcoholism. It has been proven that drinking alcohol during conception dramatically increases the likelihood of miscarriage. Alcohol causes chromosomal abnormalities in sperm cells, and many miscarriages tend to have chromosomal abnormalities. Even such a seemingly harmless habit as drinking coffee during pregnancy increases the risk of miscarriage, especially in the first 12 weeks: coffee constricts the blood vessels of the uterus, reducing the supply of nutrients and oxygen to the fetus. This provokes hypoxia (oxygen starvation) of the fetus. Coffee also increases the tone of the uterus. All terms can lead to miscarriage.
The condition of the placenta is checked by ultrasound. Analysis for hemostasiogram and coagulogram shows blood clotting. Blood flow and provision of nutrients and oxygen to the fetus depend on this. But all efforts to preserve the fetus will be in vain if the weakness of the cervix is revealed.

Ring the uterus!
Some women lose babies due to premature cervical dilatation. The diagnosis of “cervical insufficiency” (ICI - isthmic-cervical insufficiency) is made from 12 to 14 weeks by manual examination: the cervix is loose, shortened, slightly open, and finally by ultrasound (the condition of the internal cervical os is usually checked with a vaginal sensor). Why is cervical insufficiency dangerous? The fact that it is asymptomatic: it doesn’t hurt anywhere, it doesn’t drag, there are no signals about an impending threat. The opening of the cervix also occurs painlessly - without uterine contractions and bleeding.
The causes of functional insufficiency of the cervix are numerous: dilatation can occur due to excessive pressure during multiple pregnancy, there may be a congenital short cervix, but most often ICI develops against the background of hyperandrogenism (excessive production of androgens - male sex hormones).
With hyperandrogenism, the cervix softens and, with excessive load (uterine tone), opens slightly. An open cervix is not able to hold the growing fertilized egg, and already at 16 - 18 weeks the pregnancy is in jeopardy.
Surgical and conservative methods are used to maintain pregnancy. Surgical: under anesthesia, sutures are placed on the cervix within 10 to 15 minutes to help it cope with the load.
Conservative: use special obstetric rings and pessaries that relieve the load on the cervix. A pessary is a special design, a kind of bandage that closes the entrance to the cervix. The applied sutures are removed at 37 weeks.

Horns get in the way
Anomalies in the development of the uterus can also be risk factors for miscarriage. The irregularly shaped uteruses that some women are born with can limit space for the fetus to grow or interfere with blood supply to the organ.
Unicornuate uterus usually leads to the highest risk of miscarriage, as well as obstetric complications: fetal malposition, intrauterine growth retardation.

Risk factors for miscarriage
Abortion before the first real birth
Acute infections during pregnancy
Toxicosis
Tumors of the uterus and ovaries
Uterine malformations
Nephropathy
Neurological disorders
Hypertonic disease
Thyroid diseases
Adrenal diseases
Father's age – 40 years or more
Smoking

Bicornuate uterus divided into two parts at different levels, which always merge in the lower sections. As a result of surgical treatment, the risk of miscarriage drops from 90 - 95 percent to 25 - 30 percent.
Saddle uterus often combined with a narrowing of the pelvis. Its pathology leads to abnormal position of the fetus, which makes natural birth impossible; caesarean section is practiced.
Duplication of the uterus– both are smaller than normal. This anomaly is usually combined with the presence of a septum in the vagina. In this case, sometimes there is obstruction of one of the ducts. Moreover, pregnancy develops in one of the uteruses, the other increases slightly, but its mucous membrane undergoes changes characteristic of pregnancy. The fetus is usually in the wrong position.
Intrauterine septum– a developmental anomaly that divides the uterine cavity, disrupting the normal development of pregnancy. It is removed through the vagina during hysteroscopy.
Uterine fibroids can also be a risk factor for the threat of miscarriage. Spontaneous miscarriage occurs either due to the size or location of the fibroid node. Ultrasound of the pelvic organs can exclude abnormalities in the development of the uterus: fibroids, polyps, endometriosis.

Ours - someone else's
Pregnancy is unique due to the simultaneous coexistence of two completely genetically different organisms - mother and fetus. After all, the child inherits half of the mother’s cells, the rest are proteins and genes from the father, foreign. Although nature during this period includes the so-called immunological compatibility, in the mother-placenta-fetus system a conflict with the threat of spontaneous miscarriage cannot be ruled out. Such problems are usually a consequence of a defect in the mother's immune system. Thus, antibodies that are formed in the mother’s blood and normally protect the body from any foreign invaders (bacteria, viruses) begin to attack the fetus. Antibodies act on blood vessels, including those of the placenta, damaging them. As a result, blood clots form in the vessels, disrupting blood circulation in vital organs and the placenta. The child's life support is seriously affected. An immunological conflict can also arise as a result of incompatibility between mother and fetus, for example, in blood type or Rh factor.
To prevent such shocks, once a month, starting from 8 weeks of pregnancy, an analysis is performed for group antibodies, as well as for antibodies to the Rh factor. Control and timely treatment lead to the birth of a healthy baby in 75 percent of cases.

Larisa Sinenko

Causes of miscarriages
Up to 6 weeks – malformations of the embryo. As a rule, these are chromosomal abnormalities. Perhaps, at conception, the parents were drunk, sick, or taking medications.
From 6 to 12 weeks – violation of the norm of sex hormones, hormone imbalance
thyroid gland, increased uterine tone or malformations, formation
antibodies hostile to the fetus, causing its expulsion.
From 12 to 22 weeks - anatomical, immune, infectious, endocrine causes, and
also a weak cervix (isthmic-cervical insufficiency).

The optimal age for the first pregnancy is from 18-19 years (the time of full puberty) to 25 years. Young pregnant women under 18 often have problems with uterine circulation and blood pressure. In addition, the risk premature birth they are much higher than other mothers. Women over 35 years of age are at risk for developing pregnancy complications. As the mother ages, the likelihood of miscarriage and the development of a number of genetic disorders in the fetus increases. However, if a pregnant woman takes care of herself and has good health, then her pregnancy can be as successful as at 20 years old.

Complications during pregnancy when taking stimulants

Nicotine, alcohol, and drugs can cause irreparable damage not only to the mother and her health, but also increase the risk of fetal disease and complications during pregnancy and during childbirth.

Complications during pregnancy: chronic diseases

Diseases of the kidneys, cardiovascular system, and diabetes increase the risk of complications during pregnancy and childbirth. If the mother, for example, has a heart defect, thyroid disease or high blood pressure, she needs to discuss her illnesses with her gynecologist and therapist before her planned pregnancy. Specialists will prescribe an individual treatment plan for the period before and during pregnancy. Chronic infections also require the development of an individual approach to minimize risks for mother and child as much as possible.

Pregnancy complications when carrying twins

Complications during multiple pregnancies occur 5 to 10 times more often than during normal pregnancies. In order for a woman pregnant with twins to have more opportunities to give birth to healthy children, she is often given special stitches or a silicone ring is placed on the cervix, which prevents premature dilatation of the cervix.

Complications during pregnancy: other factors

If a woman has already had miscarriages or stillbirths, then planning a new pregnancy should be done with great caution. The same applies to women whose previous pregnancy ended with a caesarean section. Doctors believe that childbirth, as well as artificial termination of pregnancy, are undesirable for women after abdominal surgery for the next 2-3 years. In the first case, the scar on the enlarging uterus will not be able to fully form, and complications will arise again; and during an abortion, there is a danger of perforation of the uterus where the former incision is located. Pregnancy complications also include Rh factor incompatibility. Therefore, at the first visit to the doctor during pregnancy, a woman is examined to determine her Rh factor and blood type. Read more in the article “Rhesus conflict: causes and consequences.”

Complications during pregnancy: consequences

Did the non-invasive examination reveal any abnormalities indicating possible complications? In this case, the doctor will usually advise the woman to clear her doubts by conducting reliable and reliable invasive tests. They involve obtaining samples of cells and tissues of the embryo, fetus and provisional organs (placenta, membranes) with subsequent study of the obtained materials. Currently, the following invasive methods are used in world practice: chorion and placentobiopsy, obtaining amniotic fluid (amniocentesis), biopsy of fetal tissue, taking fetal blood (cordocentesis). Since they are associated with a certain risk (albeit small) for the child’s health, doctors advise resorting to them in case of truly reasonable suspicions.