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Pregnancy complications

  • Pregnancy complications may need special medical care.
  • Common complications include diabetes and anemia.
  • Go to all your prenatal care checkups, even if you feel fine.
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Preeclampsia

Preeclampsia is a condition that happens only during pregnancy (after the 20th week) or right after pregnancy. It’s when a pregnant woman has both high blood pressure and protein in her urine.

Most women with preeclampsia have healthy babies, but it can cause severe problems for moms. Without treatment, preeclampsia can cause kidney, liver and brain damage. It also may affect how the blood clots and cause serious bleeding problems.

In rare cases, preeclampsia can become a life-threatening condition called eclampsia. Eclampsia is when a pregnant woman has seizures following preeclampsia. Eclampsia sometimes can lead to coma.

What are the signs and symptoms of preeclampsia?
Signs and symptoms of preeclampsia include:

  • High blood pressure
  • Protein in the urine
  • Severe headaches
  • Vision problems, like blurriness, flashing lights, or being sensitive to light
  • Pain in the upper right belly area
  • Nausea or vomiting
  • Dizziness
  • Sudden weight gain (2 to 5 pounds in a week)
  • Swelling in the legs, hands, and face

Many of these signs and symptoms are normal discomforts of pregnancy. But if you have severe headaches, blurred vision or severe upper belly pain, call your health care provider.

What pregnancy complications can preeclampsia cause?
If you have preeclampsia, your health care provider can help you manage most health complications through regular prenatal care. Pregnant women with preeclampsia are more likely than women who don’t have preeclampsia to have these complications:

  • Low birthweight. This is when a baby weighs less than 5 pounds, 8 ounces. High blood pressure can narrow blood vessels in the uterus (womb) and placenta. The placenta grows in the uterus and supplies your baby with food and oxygen through the umbilical cord. Your baby may not get enough oxygen and nutrients, causing him to grow slowly.
  • Premature birth. This is birth that happens too early, before 37 weeks of pregnancy. Even with treatment, a pregnant woman with preeclampsia may need to give birth early to avoid serious health problems for her and her baby.
  • Placental abruption. In this condition the placenta separates from the wall of the uterus before birth. It can separate partially or completely. If this happens, your baby may not get enough oxygen and nutrients. Vaginal bleeding is the most common symptom of placental abruption after 20 weeks of pregnancy. If you have vaginal bleeding during pregnancy, contact your health care provider immediately.

How is preeclampsia diagnosed?
Your provider measures your blood pressure and checks your urine for protein at every visit. Because you can have mild preeclampsia without symptoms, it’s important to go to all of your prenatal care visits.

How is preeclampsia treated?
The cure for preeclampsia is the birth of your baby. Treatment depends on how severe your preeclampsia is and how far along you are in your pregnancy. Even if you have mild preeclampsia, you need treatment to make sure it doesn’t get worse.

Mild preeclampsia before 37 weeks. Some women in this condition can stay at home, but others need to stay in the hospital. Your provider checks your blood pressure and urine regularly to make sure your preeclampsia doesn’t get worse.

If your preeclampsia does get worse, your provider may induce labor. This means your provider gives you medicine or breaks your water (amniotic sac) to make you start labor. Inducing labor can help prevent possible problems from preeclampsia that gets worse.

Your provider also checks your baby’s health using:

  • Ultrasound. This is a prenatal test that uses sound waves and a computer screen to make a picture of your baby in the womb. Ultrasound checks that your baby is growing at a normal rate. It also lets your provider look at the placenta and the amount of fluid around your baby to make sure your pregnancy is healthy.
  • Nonstress test. This test checks your baby’s heart rate.
  • Biophysical profile. This test combines the nonstress test with an ultrasound.

Mild preeclampsia at 37 weeks or beyond. Most women in this condition don’t have serious health problems.

Severe preeclampsia at 34 weeks or beyond. This condition requires you to be in the hospital, and your provider may induce labor.

Severe preeclampsia before 34 weeks. This condition requires you to stay in the hospital for close monitoring. Your provider may treat you with a medicine called corticosteroid. This medicine helps speed up the growth of your baby’s lungs. If your preeclampsia gets worse, you may need to give birth early. Most babies of moms with severe preeclampsia before 34 weeks of pregnancy do better in a NICU than if they stay in the uterus.

Severe preeclampsia and HELLP syndrome. HELLP syndrome is a rare but life-threatening liver disorder. It happens in about 1 to 2 of 1,000 pregnancies. About 2 in 10 women (20 percent) with severe preeclampsia develop HELLP syndrome.

If you have HELLP syndrome early in your pregnancy, you almost always need to give birth early to prevent serious health problems. You may need medicine to control your blood pressure and prevent seizures. Some women also need blood transfusions. A blood transfusion means you have new blood put into your body.

If you have preeclampsia, can you have a vaginal birth?
Yes. A vaginal birth may be better than a cesarean birth (c-section) for a woman with preeclampsia. A c-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus. Having a vaginal birth lets you avoid the stress of surgery. It’s safe for most women with preeclampsia to have an epidural to cope with pain during labor and birth as long as her blood can clot normally.

What causes preeclampsia?
We don’t know what causes preeclampsia. But you may be more likely than other women to have preeclampsia if:

If you’ve had preeclampsia before, what are your chances of having it again?
If you’ve had preeclampsia before, you’re more likely than other women to have it again in another pregnancy. The earlier in pregnancy you had preeclampsia, the higher your risk is to have it again in another pregnancy. Women who are overweight may be more likely to develop preeclampsia in another pregnancy than women at a healthy weight.

How can you reduce your risk for preeclampsia?
There’s no way to prevent preeclampsia. But if you’re overweight or obese, getting to a healthy weight before pregnancy may help lower your chances of having preeclampsia.

Last reviewed October 2012

See also: High blood pressure during pregnancy, HELLP syndrome

When to call your provider

  • If you have heavy bleeding or bleeding for more than 24 hours
  • If you have fever, chills or severe headaches
  • If you have vision problems, like blurriness
  • If you have quick weight gain or your legs and face swell

Most common questions

What is mononucleosis?

Mononucleosis (also called mono) is an infection usually caused by the Epstein-Barr virus (EBV). It’s sometimes caused by another virus called cytomegalovirus (CMV). EBV and CMV are part of the herpes virus family. Mono is most common in teenagers and young adults, but anyone can get it. Mono is called the “kissing disease” because it’s usually passed from one person to another through saliva. In addition to kissing, it can also be passed through sneezing, coughing or sharing pillows, drinks, straws, and toothbrushes.

You can have mono without having any symptoms. But even if you don’t get sick, you can still pass it to others. Symptoms can include:

  • Achy muscles
  • Belly pain
  • Fatigue (feeling tired all the time)
  • Fever
  • Sore throat
  • Swollen glands in your neck

If your symptoms don’t go away or get worse, tell your health care provider. He’ll most likely do a physical exam and test your blood to find out for sure if you have mono.

There’s no vaccine to prevent mono. There’s also no specific treatment. The best care is to take it easy and get as much rest as you can. It may take a few weeks before you fully recover.

Can Rh factor affect my baby?

The Rh factor may be a problem if mom is Rh-negative but dad is Rh-positive. If dad is Rh-negative, there is no risk.

If your baby gets her Rh-positive factor from dad, your body may believe that your baby's red blood cells are foreign elements attacking you. Your body may make antibodies to fight them. This is called sensitization.

If you're Rh-negative, you can get shots of Rh immune globulin (RhIg) to stop your body from attacking your baby. It's best to get these shots at 28 weeks of pregnancy and again within 72 hours of giving birth if a blood test shows that your baby is Rh-positive. You won't need anymore shots after giving birth if your baby is Rh-negative. You should also get a shot after certain pregnancy exams like an amniocentesis, a chorionic villus sampling or an external cephalic version (when your provider tries to turn a breech-position baby head down before labor). You'll also want to get the shot if you have a miscarriage, an ectopic pregnancy or suffer abdominal trauma.

I had a miscarriage. How long should I wait to try again?

Before getting pregnant again, it's important that you are ready both physically and emotionally. If you don't need tests or treatments to discover the cause of the miscarriage, it's usually OK for you to become pregnant after one normal menstrual cycle. However, it may take longer for you to feel emotionally ready to be pregnant again. Everyone responds differently to a miscarriage. Only you will know when you are ready to try to get pregnant again.

Are gallstones common during pregnancy?

Not common, but they do happen. Elevated hormones during pregnancy can cause the gallbladder to function more slowly, less efficiently. The gallbladder stores and releases bile, a substance produced in the liver. Bile helps digest fat. When bile sits in the gallbladder for too long, hard, solid nuggets called gallstones can form. The stones can block the flow of bile, causing indigestion and sometimes serious pain. Staying at a healthy weight during pregnancy can help lower your risk of gallstones. Exercise and eating foods that are low in fat and high in fiber, like veggies, fruits and whole grains, can help, too. Symptoms of gallstones include nausea, vomiting and intense, continuous abdominal pain. Treatment during pregnancy may include surgery to remove the gallbladder. Gallstones in the third trimester can be managed with a strict meal plan and pain medication, followed by surgery several weeks after delivery.

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