Pregnancy Complications

Medically Reviewed On: July 11, 2006

Summary


A pregnancy complication is any condition or illness that threatens the mother and/or fetus during pregnancy. Common pregnancy complications include preeclampsia, premature labor, gestational diabetes and depression.

Pregnancy complications may result from a number of possible factors, including pre–existing disorders or diseases (e.G., diabetes, high blood pressure) or abnormalities of the sperm or egg. Complications may also result from sexually transmitted diseases, amniotic fluid abnormalities, placental abnormalities and viral, bacterial and parasitic infections.

Many complications may cause serious problems for the mother and/or fetus. In addition, a number of complications may result in death of the mother or loss of the fetus. Women experiencing heavy vaginal bleeding or spotting, abdominal pain or any other common sign or symptom of pregnancy complications should contact their obstetrician–gynecologist (ObGyn) immediately.


The Centers for Disease Control and Prevention (CDC) estimates that nearly 4 million American women give birth every year. Of these women, almost one–third will have some form of pregnancy complication. Although women with high-risk pregnancies are more likely to experience complications, all pregnant women have some risk.

Although many pregnancy complications cannot be prevented, there are a number of steps a woman can take to reduce her chances of developing certain complications. Women can reduce their risk of complications by not smoking, drinking alcohol or using illegal drugs. A healthy diet is another important prevention factor. Pregnant women should eat a balanced and nutritious diet and avoid certain foods (e.G., unpasteurized milk, raw eggs, processed meats). In addition, all prescribed and over–the–counter medications should be approved by a physician before they are taken by a pregnant woman.

It is also essential for women to keep all of their prenatal appointments. During these visits, certain physical signs are monitored and a variety of tests are performed that enable physicians to prevent pregnancy complications or to detect them early. Women who do not receive the proper prenatal care and fail to undergo the recommended tests and screenings risk the chance that potential complications may go undetected.

About pregnancy complications

Most women have healthy and uneventful pregnancies. However, there are a number of complications that can occur during the prenatal period.

According to the Centers for Disease Control and Prevention (CDC), nearly 4 million American women give birth every year. Of these women, almost one–third will have some form of pregnancy complication. The CDC also estimates that two to three women die of pregnancy–related causes each day in the United States. This statistic refers to deaths that occur during pregnancy or those caused by pregnancy within one year after the pregnancy. In addition, many complications may result in first or second trimester miscarriage.


Pregnancy complications may result from the mother’s pre–existing disorders or diseases, the condition of the sperm or the egg or a number of additional factors. Although some women are more likely to have complications during pregnancy, they can develop in any woman. As a result, all pregnant women should know the signs and symptoms of pregnancy complications. Common signs and symptoms include:

</font><ul type="square">[*]<font size="2" face="Verdana, Helvetica, sans-serif">Any type of vaginal bleeding</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Abdominal pain</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Any loss of fluid from the vagina or increased vaginal discharge</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">More than three contractions in an hour</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Swelling of the face or fingers</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Severe or constant headaches</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Shoulder pain</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Persistent vomiting (not related to morning sickness)</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Fever or chills</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Frequent and/or urgent urination or pain during urination (dysuria)</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Dizziness or faintness</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">A noticeable change in frequency or absence of movement by the fetus (once it has begun moving)</font>[/list]<font size="2" face="Verdana, Helvetica, sans-serif">Expectant mothers should contact their obstetrician–gynecologist (ObGyn) immediately when they experience any of these signs or symptoms.

There are a number of tests performed during pregnancy that enable physicians to prevent pregnancy complications or to detect them early. An ObGyn typically gives expectant mothers a schedule for prenatal visits, various blood tests and screenings, and additional procedures that may be required. Although not all complications can be prevented, women can reduce the risk of many of them by keeping all of their prenatal appointments. Women who do not receive the proper prenatal care and fail to undergo the recommended tests and screenings risk that potential complications may go undetected. This can often result is serious complications for the expectant mother and her fetus.

In addition, women can also reduce their risk of pregnancy complications by not smoking, drinking alcohol or using addictive drugs. All prescribed and over–the–counter medications should also be discussed with a physician before they are used during pregnancy. Maintaining a healthy diet is another important prevention method because fetuses require adequate nutrition to properly develop. ObGyns typically recommend that pregnant women add about 300 calories to their daily intake of food. There are also a number of foods an expectant mother should avoid including:

</font><ul type="square">[*]<font size="2" face="Verdana, Helvetica, sans-serif">Soft, unpasteurized cheeses (e.G., feta, goat, Brie, blue cheese)</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Unpasteurized milk, juice and cider</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Raw eggs and foods containing raw eggs, including cookie dough, some ice creams and some salad dressings</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Raw or undercooked meats, poultry, fish or shellfish</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Processed meats (e.g., hot dogs, deli meats)</font>[/list]<font size="2" face="Verdana, Helvetica, sans-serif">In addition, pregnant and breastfeeding women should not eat shark, swordfish, king mackerel or tilefish, according to the U.S. Food and Drug Administration (FDA). These types of fish may contain high levels of mercury, a metal that can damage a fetus’s developing brain. The agency also advises limiting other kinds of fish and shellfish to a maximum of three servings a week and not eating the same type more than once a week. Canned light tuna is safer than canned albacore and tuna steaks, according to the FDA.

Overexertion or lack of physical fitness can also cause problems during pregnancy.

Potential risk factors
In some pregnancies, known as high-risk pregnancies, the mother and/or fetus are at an increased risk of experiencing complications. A pregnancy may be classified as high risk for a number of reasons, including:

</font><ul type="square">[*]<font size="2" face="Verdana, Helvetica, sans-serif">Age. Women over age 35 have an increased risk of certain chromosome abnormalities and placental problems (e.g., placenta previa). Studies also suggest an increased risk of miscarriage and low birth weight in pregnant women in this age group. There is also an increased chance of developing gestational diabetes and high blood pressure (preeclampsia). In addition, teen mothers are more likely to give birth prematurely than woman over the age of 20.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Multiple pregnancy. Women carrying two or more babies are at an increased risk for a number of complications, including premature labor and low birth weight.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Certain chronic health conditions. Many medical conditions can increase a woman’s risk of pregnancy complications. These may include:</font>[/list]<font size="2" face="Verdana, Helvetica, sans-serif"></font><ul type="square">[*]<font size="2" face="Verdana, Helvetica, sans-serif">Diabetes mellitus</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">High blood pressure</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Asthma</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Kidney disease</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Thyroid disorders (e.g., hyperthyroidism, hypothyroidism)</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Parathyroid disorders (e.g., hyperparathyroidism, hypoparathyroidism)</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Pituitary disorders (e.g., pituitary tumors, pituitary insufficiency)</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Adrenal gland disorders (e.g., Cushing’s syndrome)</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Blood disorders (e.g., blood–clotting disorders, anemia, sickle–cell anemia)</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Autoimmune disorders (e.g., lupus, scleroderma, myasthenia gravis)</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Gastrointestinal disorders (e.g., Crohn’s disease)</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Neurological disorders (e.g., epilepsy)</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Phenylketonuria (PKU)</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Group B strep infection</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">History of gynecological problems. Women with a history of pelvic inflammatory disease (PID), endometriosis and certain other gynecological conditions are more likely to have complications, including ectopic pregnancy.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">History of cervical procedures. Women who have had certain cervical procedures (e.g., loop electrosurgical excision procedure [LEEP], cone biopsy) may have an increased risk for pregnancy complications. Women who have an incompetent or weak cervix or cervical stenosis may also result in labor problems.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">History of pregnancy loss. Women with a history of pregnancy loss (e.g., miscarriage, stillbirth, ectopic pregnancy) have an increased risk of developing complications with their pregnancies.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">History of premature birth. Women who have already delivered a premature baby are more likely to have pregnancy complications, including additional premature births.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Sexually transmitted diseases (STDs). A number of STDs can be transmitted to a baby before, during or after birth, resulting in medical complications.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Use of assisted reproductive technologies (ART). Women who become pregnant as the result of ART (e.g., in vitro fertilization) are at an increased risk of multiple pregnancy, a condition linked to numerous complications.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">History of abortion. Women with a history of two or more second–trimester abortions are more likely to have an incompetent cervix, a condition linked to numerous complications.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Diethylstilbestrol (DES) exposure. Women who were exposed to DES when their mothers took the drug during pregnancy are at an increased risk for a number of complications, including ectopic pregnancy and preterm delivery.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Use of an intrauterine device (IUD). Women who conceive while using an IUD as a form of contraception are more likely to experience a miscarriage. Women who become pregnant while using the progesterone–releasing type of IUD are also more likely to have an ectopic pregnancy.</font>[/list]<font size="2" face="Verdana, Helvetica, sans-serif">Common complications
Common pregnancy complications include:

</font><ul type="square">[*]<font size="2" face="Verdana, Helvetica, sans-serif">Anemia. A condition in which there is a lower–than–normal amount of red blood cells in the blood. Red blood cells carry oxygen throughout the body and to the fetus. During pregnancy, anemia is most often due to iron deficiency. Other forms that may become diagnosed during pregnancy require further tests and a variety of treatments. Iron is a substance that helps the body produce red blood cells. Although anemia does not typically harm the fetus, severe anemia has been linked to an increased risk of preterm birth and low birth weight. It can also cause fatigue in the expectant mother.

A pregnant woman requires 30 milligrams of iron a day, twice the normal amount needed by the body. Women can prevent anemia by getting the recommended amount of iron through foods containing iron (e.g., red meats, shellfish, oatmeal) and prenatal vitamins. Women are usually tested for the condition at their first prenatal visit, and again between 24 and 28 weeks. Women who are diagnosed with the condition may be prescribed an iron supplement.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Depression during pregnancy. According to the March of Dimes Birth Defects Foundation, approximately 10 to 20 percent of women experience major symptoms of depression during pregnancy. Depression is characterized by feelings of sadness combined with other symptoms (e.g., trouble sleeping, lack of interest, restlessness, changes in appetite, feelings of guilt, loss of energy, difficulty concentrating) lasting for two weeks or longer. It may be caused by changes in the brain caused by hormones or a stressful life event such as a death. Women with a family history of the condition are at increased risk. However, in some cases the cause of the depression cannot be identified.

Depression during pregnancy can lead to poor weight gain, as well as drug or alcohol abuse, and possibly suicide. These conditions can pose serious risks for the expectant mother and her fetus. Women can treat their depression with support groups, professional counseling or therapy. Certain brands of antidepressants may also be prescribed without causing harm to the patient or her fetus.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Gestational diabetes. A condition in which women develop type 2 diabetes during pregnancy. Type 2 diabetes is a disease in which glucose (blood sugar) builds up in the blood because of the body’s inability to use insulin effectively. During pregnancy, hormones from the placenta make it difficult for the mother’s body to use insulin. The condition can cause the fetus to grow too large (macrosomia). This abnormal growth can lead to problems with delivery. After birth, the baby may have breathing difficulties and low blood sugar. Diet, exercise and in some cases insulin injections may be used to keep the disease in control.

According to the American Diabetes Association (ADA), gestational diabetes affects about 4 percent of all pregnant women. Screening for the disease usually occurs between the 24th and 28th week of pregnancy. Screening generally involves a blood test taken one hour after a special sugar is given. In most women, the disease disappears after delivery. However, it often returns in future pregnancies, and many women with gestational diabetes develop type 2 diabetes later in life.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Hyperthyroidism and hypothyroidism. The thyroid is a gland located in the neck. According to the March of Dimes, about 2 percent of pregnant women have a thyroid disorder. Common disorders include hyperthyroidism (the thyroid produces too much thyroid hormone) and hypothyroidism (the thyroid does not produce enough thyroid hormone). These conditions can be present before pregnancy, or develop during pregnancy or shortly after delivery.

Symptoms of hypothyroidism include fatigue, weight gain, constipation, cold intolerance and muscle and joint pain. Hyperthyroidism may cause nervousness, weight loss, heat intolerance, increased heart rate, hypertension and goiter. Both conditions are usually treated with medication. Left untreated, hypothyroidism may cause long–term neurologic or developmental difficulties in the baby. Hyperthyroidism can lead to a pregnancy–related conditio, pre-eclampsia, which is characterized by hypertension, proteuria and other blood abnormalities in the mother. Women experiencing symptoms should advise her physician for necessary testing.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Preeclampsia. Preeclampsia is a pregnancy–induced condition characterized by high blood pressure (hypertension) and the presence of protein in the urine (proteinuria). The condition increases the mother’s risk of several complications, including stroke and pulmonary edema (fluid in the lungs). Potential complications for the fetus include premature birth and intrauterine growth retardation. Although delivery is the only cure for preeclampsia, the condition can be controlled with bed rest and medication. According to the Preeclampsia Foundation, preeclampsia affects at least 5 to 8 percent of all pregnancies.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Premature labor. Most pregnancies last 38 to 42 weeks. Labor that occurs before the end of the 36th week of pregnancy is known as premature labor. Babies who are born preterm are at a higher risk for long–term health problems and death. In some cases premature labor may be prevented with medications and rest. In other cases, delivery may be delayed only long enough for the mother to be transported to a hospital with a neonatal intensive care unit (NICU). The mother may also be given a drug during her pregnancy to speed up the fetus’s lung development. Women experiencing symptoms of preterm labor should contact their obstetrician–gynecologist (ObGyn) immediately or go to the hospital. Common symptoms include contractions, pelvic pressure, backache and cramps.</font>[/list]<font size="2" face="Verdana, Helvetica, sans-serif">Sexually transmitted diseases
Women with sexually transmitted diseases (STDs) can infect their babies before, during or after birth. STDs that can cause complications during pregnancy include:

</font><ul type="square">[*]<font size="2" face="Verdana, Helvetica, sans-serif">Bacterial vaginosis (BV). This form of vaginitis occurs when the normal balance of bacteria in the vagina is interrupted and there is an overgrowth of harmful bacteria. In some women, the condition causes discharge, odor, pain, itching and burning. Pregnant women with the condition are more likely to have premature babies or babies with a low birth weight (less than 5 pounds). In some cases, the bacteria also infect the uterus and fallopian tubes. Known as pelvic inflammatory disease (PID), this disorder can increase a woman’s risk of ectopic pregnancy, a condition in which a fertilized egg grows outside the uterus. According to the Centers for Disease Control and Prevention (CDC), about 800,000 pregnant women are infected with bacterial vaginosis each year in the United States. The disease can be treated and cured during pregnancy with antibiotics.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Chlamydia. This disease is caused by the bacterium Chlamydia trachomatis. According to the CDC, about three–quarters of infected women have no symptoms. Left untreated in a pregnant woman, the disease can lead to premature delivery. In addition, babies who become infected during delivery can develop chlamydial infections in their eyes and respiratory tracts. According to the CDC, chlamydia is a leading cause of infant pneumonia and conjunctivitis (pink eye) in newborns. The CDC estimates that about 200,000 pregnant women are infected with chlamydia each year in the United States. The disease can be treated and cured during pregnancy with antibiotics.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Genital herpes. This disease is caused by the herpes simplex viruses type 1 (HSV–1) and type 2 (HSV–2). According to the CDC, about 800,000 pregnant women are infected with herpes simplex each year in the United States. In most women, the disease causes mild signs and symptoms or no symptoms at all. When signs do occur, the disease may present as one or more blisters on or around the genitals or rectum. Women who contract the disease during pregnancy have a greater risk of transmitting the disease to their babies. During pregnancy, genital herpes can cause life–threatening infections in fetuses. Although transmission from an infected mother to her baby is rare, women with active genital herpes at the time of delivery often undergo Caesarean section (C–section). Although there is no cure for genital herpes, antiviral medications may be prescribed to reduce symptoms during pregnancy.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Human papillomavirus infection. Also known as genital warts, this condition is caused by the human papillomavirus, a group of viruses that can infect a woman’s vulva, cervix and the linings of the vagina. Most people with the infection do not develop any symptoms. When symptoms do occur, the disease usually presents as single or multiple growths in the genital area. Although it rarely occurs, an infected woman can transmit the virus to her baby during delivery. Babies exposed to the virus can develop warts in their throats and voice box.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Gonorrhea. This disease is caused by Neisseria gonorrhoeae, a bacterium that can grow and multiply easily in the cervix, uterus, fallopian tubes and urethra. Most women with the disease have no symptoms. During delivery, an infected woman can pass the disease to her baby. This can lead to blindness, joint infection or a life–threatening blood infection in the baby. According to the CDC, about 40,000 pregnant women are infected with gonorrhea each year in the United States. The disease can be treated and cured during pregnancy with antibiotics.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Hepatitis B. This disease is caused by the hepatitis B virus (HBV), which attacks the liver. The disease can be transmitted from a mother to her baby during delivery. Babies infected with the virus at birth may develop cirrhosis of the liver or liver cancer. According to the CDC, about 40,000 pregnant women are infected with hepatitis B each year in the United States. Women should be tested for the virus early in their pregnancies. Patients who test negative for hepatitis B may be given the hepatitis B vaccine during pregnancy. Babies of women who test positive for the virus should be vaccinated at birth, one to two months after delivery and again at 6 months of age.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">HIV/AIDS. Human immunodeficiency virus (HIV) is the virus that causes acquired immune deficiency syndrome (AIDS). The virus gradually destroys a person’s immune system. As a result, patients often develop serious infections, cancer and other life–threatening diseases. According to the CDC, about 8,000 pregnant women are infected with HIV each year in the United States. The virus can be transmitted from an infected mother to her baby during pregnancy, delivery or breastfeeding. However, there are drugs available that may greatly reduce a woman’s risk of transmitting the disease during delivery. C–section may also be an option.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Syphilis. This disease is caused by bacterium Treponema pallidum. A woman with syphilis can infect her baby during her pregnancy. Many people infected with the disease do not have symptoms for years after they become infected. Babies may also be born without signs or symptoms of the disease. Left untreated, an infected baby may develop a number of complications within a few weeks of delivery. Babies who are not treated may develop brain damage, blindness and seizures. The disease can increase the risk of stillbirth or delivering a baby who dies shortly after birth. According to the CDC, about 8,000 pregnant women are infected with syphilis each year in the United States. The disease can be treated and cured during pregnancy with antibiotics.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Trichomoniasis. According to the CDC, about 80,000 pregnant women are infected with trichomoniasis each year in the United States. This disease is caused by the parasite Trichomonas vaginalis. In women, the disease most often infects the vagina, sometimes causing frothy, yellow–green discharge with a strong odor. It may also cause itching and irritation in the genital area, and discomfort during urination (dysuria) or sexual intercourse (dyspareunia). Women with the disease may have a baby born early (premature birth) or a baby with a low birth weight (less than five pounds). The disease can be treated and cured during pregnancy with antibiotics.</font>[/list]<font size="2" face="Verdana, Helvetica, sans-serif">Many of these complications can be prevented when the mother’s disease is detected before delivery. The CDC recommends that all pregnant women be screened for STDs on their first prenatal visit to an obstetrician–gynecologist (ObGyn). Some conditions may also be successfully treated if the disease is found in the baby after birth.

Amniotic fluid and placental complications
Amniotic fluid is clear liquid that cushions and protects the fetus during development. It also provides the fetus with fluids and promotes normal development of the lungs, gastrointestinal tract, muscles and bone. The amount of fluid is controlled by both the fetus and placenta.

During pregnancy, a woman will have her amniotic fluid measured. Obstetricians–gynecologists (ObGyns) use ultrasound to measure the depth of the fluid in four areas of the uterus. The measurements are added up to determine the amniotic fluid index. These measurements may reveal a number of complications, including:

</font><ul type="square">[*]<font size="2" face="Verdana, Helvetica, sans-serif">Oligohydramnios. This is a condition in which there is too little amniotic fluid. A woman may be diagnosed with this condition when her amniotic fluid depth is less than 5 centimeters (cm). This can occur when there are certain problems with the fetus (e.g., lack of kidneys, abnormal kidneys) or if there are abnormalities in the placenta. According to the March of Dimes Birth Defects Foundation, this condition affects about 8 percent of pregnancies. When it occurs in the first half of pregnancy, the condition is linked to birth defects of the lungs and limbs, as well as an increased risk of miscarriage, premature birth and stillbirth. When the condition occurs later in the pregnancy it can cause poor fetal growth and complications during labor and delivery. In some cases, the fluid may be replaced with an artificial substitute once the patient is in labor (amnio infusion).</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Polyhydramnios. This is a condition in which there is too much amniotic fluid. A woman may be diagnosed with this condition when her amniotic fluid depth measures greater than 25 cm. This can happen with fetal abnormalities (e.g., problems with swallowing) and with certain abnormalities in the placenta. The March of Dimes estimates that 2 percent of pregnant women develop polyhydramnios. It may increase the risk of premature birth, preterm rupture of the membranes, umbilical cord accidents, placental abruption, poor growth and stillbirth. Women with the condition are also more likely to have a Caesarean section (C–section) and to experience severe bleeding after delivery. Polyhydramnios may be treated by removal of excess fluid or drugs that limit fluid levels.</font>[/list]<font size="2" face="Verdana, Helvetica, sans-serif">The placenta is an organ that forms from the same cells as the fetus. It attaches to the wall of the uterus, and the umbilical cord develops on the side of the placenta nearest the fetus. During pregnancy, the placenta forms connections with the mother’s blood supply to provide oxygen and nutrients to the fetus. It also connects to the fetus’s blood supply in order to remove waste products. In addition, the placenta protects the fetus from infections and harmful substances.

Placental problems are among the most frequently occurring complications in the second half of pregnancy. Common placental problems include:

</font><ul type="square">[*]<font size="2" face="Verdana, Helvetica, sans-serif">Placental abruption. Also known as abruptio placentae, placental abruption is a serious complication in which the placenta partially or completely separates from the wall of the uterus before delivery. As a result of this detachment, the fetus can be deprived of oxygen and nutrients and the mother can suffer life–threatening bleeding. According to the March of Dimes, placental abruption occurs in approximately 1 in every 100 pregnancies. However, the risk is increased for women who smoke cigarettes, use cocaine or have high blood pressure during pregnancy. Although it occurs most often in the third trimester, the condition can develop any time after the 20th week of pregnancy. The main sign of placental abruption is bleeding. Ultrasound can be used to diagnose the condition.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Placenta accreta, placenta increta, placenta percreta. In some pregnancies, the placenta may attach itself too deeply and too firmly into the uterine wall (placenta accreta), attach itself even more deeply into the uterine wall (placenta increta) or attach itself through the uterus, sometimes extending to nearby organs (placenta percreta). According to the March of Dimes, these disorders occur in approximately one in every 2,500 pregnancies. They generally do not cause symptoms until the third trimester and may result in vaginal bleeding and preterm delivery. Because these conditions prevent the placenta from easily detaching from the uterine wall after delivery, they often require surgical removal of the placenta, and in some cases, a hysterectomy. These conditions also occur more frequently in women who have had a previous C–section.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Placenta previa. A condition in which the placenta lies low in the uterus, partially or completely covering the internal opening of the cervix. The March of Dimes estimates that the condition occurs in approximately one in every 200 pregnancies. It is more common in women who smoke, use cocaine, or are over the age of 35. Placenta previa may cause painless vaginal bleeding during the second half of the pregnancy. The condition may be detected during a routine ultrasound examination. When the condition is diagnosed during the second trimester, it usually corrects itself by the end of the pregnancy. If the placenta previa has not resolved by the latter part of the pregnancy, the expectant mother may require hospitalization and monitoring until delivery. Because there is a risk of severe bleeding, women with placenta previa may undergo a C–section.</font>[/list]<font size="2" face="Verdana, Helvetica, sans-serif">Viral, bacterial and parasitic infections
There are a number of viral, bacterial and parasitic infections that can cause complications during pregnancy, including:

</font><ul type="square">[*]<font size="2" face="Verdana, Helvetica, sans-serif">Chickenpox (varicella). Characterized by an itchy rash and fever, this condition is caused by the varicella–zoster virus. The March of Dimes Birth Defects Foundation estimates that one in 2,000 women will develop chickenpox during pregnancy. When a woman is infected during the first 20 weeks of pregnancy, there is a small risk that the baby will be born with congenital varicella syndrome (a group of birth defects). When infection occurs near the time of delivery, the baby may be born with the infection. Left untreated, the disease can be deadly for an infant. However, most babies are treated rapidly and the disease causes only mild illness. Women who develop the infection have a chance of developing a severe form of pneumonia while pregnant (varicella pneumonia). Women who are not immune (as determined by blood test) and not yet pregnant can receive a vaccination before conceiving. Pregnant women who are not immune and have been in contact with an infected person can receive an injection of VZIG, which can prevent the disease or reduce its severity.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Cytomegalovirus. This common viral infection is characterized by high fever, sore throat and swollen lymph glands. A woman infected with the virus during pregnancy can transmit the infection to her baby. According to the March of Dimes, approximately 40,000 babies are born infected with the virus each year. Of these babies, about 8,000 will develop lifelong disabilities. The virus can also cause serious illness and death.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Fifth disease. Also known as erythema infectiosum, the disease is caused by parvovirus B19. An infected woman may have joint pain and swelling, and mild flu–like symptoms. Most babies are not affected when their mothers are infected with the disease during pregnancy. However, when a baby is infected, the virus can affect the baby’s ability to produce red blood cells. This can lead to anemia, heart failure and possibly death.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Influenza. Also known as the flu, influenza is a contagious infection of the nose, throat and lungs caused by viruses. Pregnancy can alter the immune system. As a result, pregnancy increases a woman’s risk of complications from the flu, such as pneumonia.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Group B streptococcus (GBS). Also known as group B strep, this infection is caused by bacteria. According to the March of Dimes, between 10 and 30 percent of pregnant women carry the infection, and there is a one percent chance of the infection being passed to the baby. Once infected with GBS, a baby can develop pneumonia, sepsis (blood infection), or meningitis (inflammation of the membranes covering the brain and spinal cord). Babies with GBS can be treated with antibiotics. In most babies, the infection causes no long–term damage, but it can lead to permanent neurologic damage or death. Women can be screened for the infection during the last few weeks of pregnancy. Those who test positive or at high risk may be treated with antibiotics during labor and delivery.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Listeriosis. Caused by the bacterium Listeria monocytogenes, listeriosis is a form of food poisoning commonly found in unpasteurized milk and dairy products, poultry, fish and ready–to–eat meats (e.g., cold cuts). Diagnosed by a blood test, the condition is characterized by flu–like symptoms with fever, muscle ache, chills, nausea and diarrhea. In some patients, the condition may progress to meningitis and blood infection. When it occurs in a pregnant woman, the condition can result in life–threatening illness in the baby, miscarriage or stillbirth. Antibiotics are often given to prevent infection in the baby.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Rubella. Also known as German measles, rubella is a contagious viral infection spread through the air or through close contact. According to the March of Dimes, about 25 percent of babies whose mothers are infected with rubella in the first trimester are born with one or more birth defects (congenital rubella syndrome). These birth defects may include eye defects, hearing loss, mental retardation, heart defects and movement disorders. Major outbreaks of rubella are rare in the United States because of widespread use of the rubella vaccine but some women are still susceptible to infection. As a result, pregnant women are usually tested for rubella immunity during an early prenatal visit.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Salmonellosis. Caused by the bacteria Salmonella, salmonellosis is a form of food–borne infection commonly found in raw or undercooked meats, unpasteurized dairy products, raw or undercooked eggs and alfalfa sprouts. Common symptoms of the condition include diarrhea, fever and abdominal cramps. In some cases, a pregnant mother can pass the infection to her baby. This can cause diarrhea, fever, and in rare cases, meningitis.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Toxoplasmosis. This condition is caused by infection with the parasite Toxoplasma gondii. Pregnant women can contract the infection from ingestion of raw or undercooked meat, improper handling of cat litter, ingesting contaminated soil or, rarely, blood transfusion or organ transplant. According to the March of Dimes, about 400 to 1,000 babies are born with the infection each year in the United States. Once infected, a baby may develop eye infections that cause blindness, hearing loss, learning disabilities, and long–term physical and mental disabilities. Infection of a woman during pregnancy can also result in miscarriage and stillbirth. When a blood test reveals that a pregnant woman is infected, amniocentesis may be ordered to determine if the baby is also infected. When the fetus is not yet infected, antibiotics may be prescribed. Medications are also prescribed to the mother when the fetus is thought to be infected, and to the baby after birth.</font>[/list]<font size="2" face="Verdana, Helvetica, sans-serif">Pregnancy loss
Common forms of pregnancy loss include:

</font><ul type="square">[*]<font size="2" face="Verdana, Helvetica, sans-serif">Ectopic pregnancy. During a normal pregnancy, the fertilized egg (zygote) implants itself in the uterus. An ectopic pregnancy is a pregnancy in which the fertilized egg implants itself outside the uterus, usually in a fallopian tube. Blood tests, ultrasound and laparoscopy may be used to diagnose the condition. Most ectopic pregnancies require surgical removal. In some early cases medication is prescribed to dissolve the zygote or embryo. In most cases, an embryo left in place and allowed to grow will cause the organ it is implanted in to rupture. This can result in severe bleeding. Although most women who experience an ectopic pregnancy have healthy pregnancies in the future, there is a small chance of recurrence.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Miscarriage. The loss of a baby in the womb before the 20th week of pregnancy. Miscarriages most often occur in the first 12 weeks of pregnancy. According to the March of Dimes Birth Defects Foundation, as many as 50 percent of all pregnancies end in miscarriage. Many times the loss occurs before the woman knows she is pregnant. Infections, hormonal problems and other health problems can cause a miscarriage. However, most first–trimester miscarriages occur as the result of chromosomal abnormalities in the baby. After a miscarriage, most women are able to have healthy pregnancies in the future. There are no known ways to prevent a miscarriage.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Molar pregnancy. A pregnancy in which the early placenta grows abnormally into a mass of cysts (hydatidiform mole) and the embryo does not form, or is malformed and cannot survive. According to the March of Dimes, molar pregnancy occurs in approximately 1 in every 1,000 pregnancies. The condition results from an abnormal fertilized egg with two sets of chromosomes from the father and either one or no sets of chromosomes from the mother. Normally, the embryo would receive one set of chromosomes from each parent. The condition is diagnosed with ultrasound. Many times there will also be an abnormally high level of placental hormones (HCG). Treatment requires removal of the molar tissue from the uterus. The woman is then monitored to ensure that there is no remaining tissue. Remaining tissue can develop into choriocarcinoma, a rare form of cancer. Most women who experience a molar pregnancy are able to have healthy pregnancies in the future.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Stillbirth. The loss of a baby in the womb after the 20th week of pregnancy. Most stillbirths occur before labor begins; however, it may occur during labor and delivery. The first indication may be a lack of movement or kicking by the fetus. The condition is usually diagnosed before delivery with an ultrasound. When stillbirth is discovered, labor is typically induced.</font>[/list]<font size="2" face="Verdana, Helvetica, sans-serif">Other complications
Additional pregnancy complications include:

</font><ul type="square">[*]<font size="2" face="Verdana, Helvetica, sans-serif">Rh incompatibility. Rh factor is a substance found in the red blood cells of some people. A person’s Rh factor can be determined by a blood test. People who do not have Rh factor are known as Rh negative. When a fetus is Rh positive and the mother is Rh negative, complications can develop. When the fetus’s blood cells enter the mother’s bloodstream, her immune system may react by producing antibodies, substances that fight perceived threats.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Although it is not usually a problem during a woman’s first pregnancy, in later pregnancies in which a baby is Rh positive, these antibodies can enter the fetus’s bloodstream and destroy its red blood cells. This condition, known as hemolytic disease or Rh disease, can cause death of the fetus. In a newborn, the disease may cause severe anemia, jaundice, brain damage and heart failure. To prevent these complications, shots may be given during a woman’s first pregnancy around the 28th week of pregnancy and within the 72 hours after delivery. This will prevent the development of Rh antibodies in future pregnancies. In extreme cases, blood transfusions may be necessary while the fetus is still in the uterus or after delivery.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Blighted ovum. Also known as an anembryonic pregnancy, a blighted ovum is a condition in which a fertilized egg develops a placenta and membrane but not an embryo. It can be caused by abnormal cell division or poor–quality sperm or egg. It typically occurs during the first few weeks of pregnancy, often before a woman is aware that she is pregnant. Diagnosis may occur when an ultrasound shows an empty uterus or an empty placenta. The condition usually results in miscarriage, though some women may choose dilation and curettage (D&C) to remove the placental tissue. The condition cannot be prevented, but women rarely experience a blighted ovum more than once.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Incompetent cervix. As a fetus grows during pregnancy, its weight begins to press on the cervix. In a woman with an incompetent or weakened cervix, the cervix may open under the weight, leading to premature delivery or a miscarriage. The condition may be caused by previous damage to the cervix during surgery, a difficult birth or D&C. An incompetent cervix may also result from a birth defect or from diethylstilbestrol (DES) exposure. Incompetent cervix may be diagnosed through a pelvic exam or an ultrasound. To prevent complications, the cervix may be sewn closed during the pregnancy (cervical cerclage).</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Cholestasis. Characterized by severe itching, cholestasis is a condition in which bile excretion from the liver is blocked. The condition can be diagnosed with blood tests. When it occurs during pregnancy, it can increase the risk of fetal distress, premature birth or stillbirth. Labor may be induced once the fetus’s lungs have matured.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Intrauterine growth retardation (IUGR). This term is used to describe a fetus who is smaller than normal (weight below the 10th percentile for gestational age). Because the baby does not grow at the normal rate, the condition typically results in a low birth weight. Diagnosed by ultrasound, IUGR may result from a mother’s poor nutrition, heart disease, high blood pressure, preeclampsia, eclampsia, smoking, drug use or alcohol use. Insufficiency of the placenta, multiple pregnancy, high altitude, birth defects and genetic disorders can also lead to the condition. IUGR fetuses are at an increased risk for intrauterine death. As a result, the fetus may be monitored and delivery may be recommended.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Urinary tract infection. An infection occurring along the urinary tract, which includes the kidneys, bladder, ureters and urethra. The condition is diagnosed with a urine test and can be successfully treated with antibiotics. Left untreated, the infection can spread to the kidneys, resulting in premature labor.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">Hyperemesis gravidarum. This is a condition characterized by frequent and severe vomiting. It is a concern during pregnancy because it may lead to dehydration (a depletion of body fluids). It may also interfere with the weight gain needed to supply adequate nutrition to the mother and fetus. Medication may be prescribed to reduce nausea and vomiting. In severe cases, the mother may require hospitalization and intravenous (I.V.) fluids to balance the level of electrolytes in the blood. Treatment may also require fasting, followed by a slow introduction of food back into the diet.</font>[*]<font size="2" face="Verdana, Helvetica, sans-serif">HELLP syndrome. Left untreated, preeclampsia can lead to HELLP syndrome, a condition characterized by hemolysis (the destruction of red blood cells), elevated liver enzymes and a low platelet count.</font>[/list]<font size="2" face="Verdana, Helvetica, sans-serif">Pregnancy Complications Article