Pregnancy - Complications

Complications

Each year, according to the WHO, ill-health as a result of pregnancy is experienced (sometimes permanently) by more than 20 million women around the world. Furthermore, the "lives of eight million women are threatened, and more than 500,000 women are estimated to have died in 1995 as a result of causes related to pregnancy and childbirth."

Pregnancy poses varying levels of health risk for women, depending on their medical profile before pregnancy.

The following are some of the complaints that may occur during and/or after pregnancy due to the many changes which pregnancy causes in a woman's body:

• Pregnancy induced hypertension
• Anemia
• Back pain. A particularly common complaint in the third trimester when the patient's center of gravity has shifted.
• Carpal tunnel syndrome in between an estimated 21% to 62% of cases, possibly due to edema.
• Constipation. A complaint that is caused by decreased bowel mobility secondary to elevated progesterone (normal in pregnancy), which can lead to greater absorption of water.
• Braxton Hicks contractions. Occasional, irregular, and often painless contractions that occur several times per day.
• Edema (swelling). Common complaint in advancing pregnancy. Caused by compression of the inferior vena cava (IVC) and pelvic veins by the uterus leads to increased hydrostatic pressure in lower extremities.
• Regurgitation, heartburn, and nausea. Common complaints that may be caused by Gastroesophageal Reflux Disease (GERD); this is determined by relaxation of the lower esophageal sphincter (LES) and increased transit time in the stomach (normal in pregnancy), as well as by increased intraabdominal pressure, caused by the enlarging uterus.
• Haemorrhoids. Complaint that is often noted in advancing pregnancy. Caused by increased venous stasis and IVC compression leading to congestion in venous system, along with increased abdominal pressure secondary to the pregnant space-occupying uterus and constipation.
• Pelvic girdle pain. PGP disorder is complex and multi-factorial and likely to be represented by a series of sub-groups with different underlying pain drivers from peripheral or central nervous system, altered laxity/stiffness of muscles, laxity to injury of tendinous/ligamentous structures to ‘mal-adaptive’ body mechanics. Musculo-Skeletal Mechanics involved in gait and weightbearing activities can be mild to grossly impaired. PGP can begin peri or postpartum. There is pain, instability or dysfunction in the symphysis pubis and/or sacroiliac joints.
• Postpartum depression
• Postpartum psychosis
• Round Ligament Pain. Pain experienced when the ligaments positioned under the uterus stretch and expand to support the woman's growing uterus
• Thromboembolic disorders. The leading cause of death in pregnant women in the USA.
• Increased urinary frequency. A common complaint referred by the gravida, caused by increased intravascular volume, elevated GFR (glomerular filtration rate), and compression of the bladder by the expanding uterus.
• Urinary tract infection
• Varicose veins. Common complaint caused by relaxation of the venous smooth muscle and increased intravascular pressure.
• PUPPP skin disease that develop around the 32nd week. (Pruritic Urticarial Papules and Plaques of Pregnancy), red plaques, papules, itchiness around the belly button that spread all over the body except for the inside of hands and face.