What are the most common complications of pregnancy?

Although most pregnancies are uncomplicated, sometimes unforeseen issues arise. Here are some of the most common complications of pregnancy.

Complications related to amniotic fluid.

Amniotic fluid is the liquid contained in the sac that surrounds the fetus. Too much or too little amniotic fluid can be a sign of a problem during pregnancy. Excess fluid can lead to premature rupture of membranes and/or preterm labor, as well as issues such as worsening maternal breathing difficulties.

Common causes of excess fluid include diabetes, twins or triplets (multiple pregnancies), infections, incompatible blood types, and birth defects. Very little fluid can also be a sign of congenital defects, problems with the placenta, slow fetal growth, premature rupture of membranes, or fetal death.

Bleeding

Bleeding, while common during pregnancy, can also be a sign of placental complications, vaginal or cervical infection, or preterm labor. Bleeding at the end of pregnancy may increase the risk of serious complications and warrant intervention or even preterm delivery. If bleeding occurs at any time during pregnancy, it should be reported to your doctor immediately.

Ectopic pregnancy

An ectopic pregnancy occurs when an embryo implants somewhere other than the inside of the uterus (most often in one of the fallopian tubes that connect the ovaries to the uterus). Pregnancies in these locations can be life-threatening and cannot continue safely or be transferred to the uterus.

Approximately 1% of all pregnancies are ectopic, and about half of ectopic pregnancies occur without known risk factors or explanations. 

Here are some reasons why the risk of ectopic pregnancy may increase:

• Fertility treatments to become pregnant
• Previous tubal surgery
• Pelvic inflammatory disease or other uterine infections
• A previous ectopic pregnancy.

The early signs suggesting that a woman may have an ectopic pregnancy are abdominal pain and/or bleeding early in pregnancy (usually between three and six weeks after the missed period). In this case, the doctor may perform an ultrasound and monitor hormone levels to determine the location and status of the pregnancy.

If an ectopic pregnancy is confirmed, treatment may include medication, but surgery may be necessary. If left untreated, pregnancy loss can lead to an emergency situation.

Having an ectopic pregnancy does not mean it is impossible to get pregnant again and give birth to a healthy, full-term baby. However, it is important to note that having had an ectopic pregnancy increases the risk of having another. After an ectopic pregnancy, the risk of having a second pregnancy is 10%, and after a second, the risk of having a third is 25%.

Miscarriage or fetal loss

A miscarriage is a loss of pregnancy that occurs up to 20 weeks of gestation (most miscarriages occur before 12 weeks). Miscarriages, which occur in 10 to 30 percent of all pregnancies (and perhaps more frequently), are usually due to genetic or chromosomal abnormalities when they occur in the early stages of pregnancy.

Miscarriages are often preceded by heavy bleeding and cramping. To confirm a miscarriage, the doctor may order an ultrasound and blood tests. The fetus and contents of the uterus are typically expelled naturally, but if this does not happen, medications may be used to induce expulsion or a dilation and curettage procedure may be performed, which uses special instruments to remove the abnormal pregnancy.

Fetal loss during the second trimester can occur for reasons such as problems with the placenta, infection, or, in some cases, if the cervix opens too soon (this is called cervical insufficiency, previously known as incompetent cervix). Depending on the cause and clinical situation, cervical insufficiency can be treated with surgery to place a cerclage, a stitch that helps keep the cervix closed.

Placental complications

Under normal circumstances, the placenta attaches to the uterine wall. Complications that can occur include:

• Placental abruption

Sometimes, the placenta separates from the uterine wall too early, causing bleeding and a reduction in the supply of oxygen and nutrients to the fetus. The separation can be total or partial. Placental abruption, whose cause is often unknown, occurs in approximately 1 in 100 live births.

Placental abruption is more common in people who smoke, have high blood pressure, or have multiple pregnancies. It is also more common in women who have already had children or have a history of placental abruption. Symptoms and treatment depend on the degree of separation. Symptoms may include bleeding, cramping, and abdominal tenderness. Hospitalization is often necessary, and preterm delivery may be required.

• Anterior placenta

Normally, the placenta is located away from the cervix (the opening of the uterus). In the case of placenta previa, it attaches near the cervix or covers it. This type of placental complication occurs in approximately 1 in 200 births and is more common in people with scarring in the uterus, which is normal after multiple pregnancies. Placenta previa may also occur in people with fibroids or other uterine problems or who have previously undergone uterine surgery.

Symptoms may include bright red vaginal bleeding and may be associated with tenderness or abdominal pain. The baby is usually delivered by cesarean section because the placenta interferes with vaginal delivery, making it unsafe.

• Preeclampsia or eclampsia

Preeclampsia is characterized by high blood pressure induced by pregnancy. It may also be accompanied by an abnormal amount of protein in the urine. Eclampsia, the most severe form, is defined by seizures due to this condition. Eclampsia can lead to coma, permanent disability, or even death.

The cause of preeclampsia is unknown, affecting approximately 3-8% of pregnant women, but preeclampsia is more common in the first pregnancy. Other risk factors include:

• Preeclampsia in a previous pregnancy
• High blood pressure, diabetes, kidney disease, and certain autoimmune diseases before pregnancy.
• Multiple pregnancy (twins, triplets, etc.)
• Age under 18 or over 35 at the time of delivery
• Obesity with a body mass index (BMI) over 30
• African American race
• Unfavorable socioeconomic situation

Symptoms may include:

• High blood pressure
• Headaches
• New or worsening blurred vision or spots
• New or worsening shortness of breath
• Decreased urine production.
• Abdominal pain, especially in the upper right part of the liver.

Treatment, which varies according to the severity of the condition and the stage of pregnancy, may include hospitalization, bed rest, medications to lower blood pressure, close monitoring of the fetus and mother, and sometimes preterm delivery.

If you have pregnancy complications or recurrent miscarriages, it is essential to explore all available options. Medically assisted reproduction (MAR), an area where NatuVitro excels, could potentially offer you the solutions you seek. Our team of experts is committed to supporting you throughout this journey, providing you with personalized care to increase your chances of a successful and healthy pregnancy. Contact NatuVitro today and let us be part of your path to the family you dream of. 

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