Complications in late pregnancy
There are numerous checks, examinations and ultrasound scans that are performed during the nine months of pregnancy. And they are aimed not only at assessing the correct development of the fetus, but also the state of health of the mother. Here are the possible ones complications at the end of pregnancy and which may occur after the second trimester. These are issues that must be closely monitored to avoid risks to the health of mother and baby and those of a premature birth.
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Ultrasound in pregnancy | PHOTO
Ultrasound in pregnancy | Examples of ultrasound scans during the 40 weeks of pregnancy
High-risk pregnancy
What is meant by the generic term of high-risk pregnancy? From a legal point of view it refers to a series of conditions that can compromise the correct and healthy development of the child, put at risk the health of the mother or the progress of the pregnancy itself. In this sense, therefore, the pregnant woman who works can ask for early maternity leave where the working conditions could compromise the pregnancy and the success of her. But early maternity can be requested even if the first ultrasound checks show some anomaly in the implantation of the embryo, in the fetal development, in the pregnancy itself.
If during the first ultrasound scans, for example, a small detachment of the placenta emerges, the woman will be put to rest for a few days, a therapy will be prescribed, very often based on progesterone, and we will talk about a high-risk pregnancy until the next ultrasound check. The same term is used to indicate all those complications which may arise in the nine months of gestation and which require absolute rest.
Complications in the second trimester
In the second trimester, the usual tests and routine checks are carried out, such as ultrasound scans and blood and urine tests, which are used not only to assess the development and growth of the fetus but also the state of health of the mother. Among the problems that can arise in these weeks we find:
- Gestational Diabetes: This is usually a pre-disposed condition that can develop during pregnancy. Gestational diabetes is called diabetes mellitus and increases the risk of developing type 2 diabetes after childbirth. Diabetes in pregnancy is called mellitus, GDM, and is first discovered during gestation. To diagnose gestational diabetes, a test called glycemic mini-curves can be performed immediately - around the 12th-14th week of pregnancy or even later around the 24th week. What's it about? The future mother will have a blood sample, then she will have to drink 50 grams of fasting glucose and after one hour a new blood sample will be made: the blood sugar values must not exceed 140 mg / dl. Gestational diabetes must be kept under control and treated with a radical change in the diet: no sugars, a limit to carbohydrates, lipids and carbohydrates and many fibers and proteins.
- Cytomegalovirus (CMV): it is a rather common virus that does not cause any problems except in pregnancy, this is because it can be transmitted from the mother to the fetus. For this, specific tests are carried out to check the presence of antibodies in the mother's body, which will mean that she has already caught the infection and is immune.
Preeclampsia
Call also gesturesi, is a syndrome that can generally present after the twentieth week of gestation and can have effects that may or may not be severe depending on the severity of the syndrome. THE symptoms they are the increase of pressure, the increase of proteins in the urine and the appearance of edema (bruises) on various parts of the body (legs, trunk, hands and face) and swelling of the lower limbs. The main consequence of gestosis is a poor blood supply of the placenta which can cause a delay in the growth of the fetus. For the mother, the risks are mainly connected tohypertension: kidney and liver problems, up to the most serious such as cerebral haemorrhage and stroke. The gynecologist usually prescribes anti-hypertensive drugs and continuous blood and urine tests and closely monitors the health of the mother and baby. In most cases, if the conditions worsen, it is decided to intervene by giving birth to the child by caesarean section or induced delivery.
HELLP syndrome
This term defines a set of pathological manifestations of pregnancy that generally appear towards the end of gestation or even after childbirth. The three characteristics of this syndrome are: haemolysis, increased liver enzymes, reduction of the number of platelets or thrombocytopenia. In many cases the HELLP syndrome is associated with hypertension or preeclampsia, among the main symptoms we remember in most cases a gastric pain, associated with nausea and vomiting and general malaise. The only treatment option for HELLP syndrome is to induce delivery as soon as possible.
Complications in the third trimester
In the third trimester, as the pregnancy draws to a close, it is important to monitor how the baby is growing and how the mother's organism and body is adapting to these big changes. Third trimester examinations and checks are essential to assess the presence of any disorders or complications that may create complications during childbirth or increase the risk of premature birth, or, again, that may justify a caesarean or early delivery.
- cuticles: it is a'inflammation of the renal pelvis and if it extends to the whole kidney it is called pyelonephritis. It is caused by a bacterial infection that reaches the kidneys from the intestine, bladder or other organ. During pregnancy you are more at risk because the ureters (the excretory channels that connect the bladder to the renal pelvis) are subjected to strong pressure that causes partial obstruction, blocking the exit of urine from the kidneys. L'infection it is favored precisely by the stagnation of urine. Symptoms of pyelitis are mainly frequent urge to urinate, burning when urinating and around the kidneys, sometimes fever, nausea and vomiting. Pyelitis must be diagnosed and treated in time because otherwise you risk permanent damage to the mother's kidneys and can increase the risk of premature birth.
- High pressure: typically you suffer from hypertension or are predisposed before pregnancy but in some cases hypertension can occur in the third trimester. Blood pressure usually drops during gestation, so a pressure value of 140/90 is considered an alarm bell. In this case, the doctor will prescribe tests to investigate the matter, such as urinalysis with protein dosages, flowmetry, cardiotocography and targeted blood tests.
Previous placenta
Otherwise said low placenta, is a condition in which the placenta adheres to the wall of the uterus in the lower part, therefore in an abnormal way. If diagnosed late in the pregnancy, placenta previa can cause a cesarean delivery, especially if it is a central placenta previa and thus obstructs the cervix, which would prevent the baby from channeling into the birth canal.
Extrauterine pregnancy
Separate chapter for the GEU, the ectopic pregnancy, which is not a complication of pregnancy but a very serious condition that cannot in any case lead to the birth of the child but which represents a health problem that can put a woman's life at risk. In practice, in this case the embryo is not implanted in the uterus at the beginning of pregnancy but in a different location such as in the fallopian tubes or in the abdomen. How is the diagnosis of a GEU? The first symptoms are those typical of early pregnancy, with pain in the lower abdomen, breast tension, nausea, and the pregnancy test will be positive, the beta-hcg values increase at the beginning but then grow very slowly. During the ultrasound, no speck or signal is observed: the uterus is empty, at which point a GEU must be suspected and then investigated with more in-depth ultrasounds or other diagnostic tools. It is important to locate the location of the GEU as soon as possible to remove the embryo and reduce the risks for the woman's life.
