Many mothers envision having an uneventful pregnancy with little to no symptoms and the delivery of a healthy, full-term baby. Thankfully, most pregnancies and deliveries go on without a hitch.

However, for some expectant mothers, health problems do occur. The good news is that only 8% of pregnancies involve complications. These complications can involve the mother, baby or both. Even women who were healthy prior to getting pregnant can have complications.

Though not all complications can be prevented, getting early and regular prenatal care may help lower the risk of health problems before they become serious.

Common complications during pregnancy and delivery

Some common causes of and risk factors that can lead to health complications during pregnancy include:

Heart disease: In the U.S., cardiovascular disease (CVD) is now the leading cause of death in pregnancy and the postpartum period. It makes up 26.5% of pregnancy-related deaths, with higher rates of death among women of color and women with lower incomes, according to the American College of Obstetricians and Gynecologists.

Pregnancy makes the heart work harder.  In fact, the amount of blood in your body can increase by up to 50% when you’re pregnant. This causes your heart to pump more blood out to the body and causes your heart rate to increase, around 10-15 beats more per minute. Most of these changes are generally normal; however, in pregnant women with preexisting heart conditions they can increase the risk of complications. Some common heart conditions during pregnancy that can increase a woman’s risk of complications can include heart failure, high blood pressure, heart attack and arrhythmia. If you have a heart condition, you should be seen by a cardiologist (heart specialist) and a high-risk obstetrician before and during pregnancy.

  • Warning signs and symptoms (during pregnancy):
    • Fatigue
    • Fainting
    • Chest pain
    • Shortness of breath
    • Difficulty breathing while sleeping
    • Palpitations

Gestational diabetes: Gestational diabetes is a type of diabetes that can develop during pregnancy in women who don’t already have diabetes. Every year, 2% to 10% of pregnancies in the U.S. are affected by gestational diabetes. This condition typically develops during the middle of pregnancy and leads to high levels of blood sugar. It occurs when a woman’s body can’t make enough insulin during pregnancy. It’s important to manage this condition with the support of a healthcare provider. Otherwise, it can increase your risk of early delivery; cause your baby to grow very large, which can lead to difficult labor; and raise your chances of developing type 2 diabetes.

  • Warning signs and symptoms: Gestational diabetes doesn’t typically have any symptoms, but your doctor can test for it during pregnancy. Be sure to talk with your healthcare provider about your medical history and whether you have any risk factors that may suggest that you could develop the condition.

Preeclampsia: Preeclampsia is characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys. This condition typically starts after the 20th week of pregnancy. Women with preeclampsia are at increased risk for organ damage, preterm birth, pregnancy loss, and stroke.

  • Warning signs and symptoms:
    • High blood pressure
    • Too much protein in urine (your healthcare provider can test for this)
    • Swelling in face and hands
    • Headache that does not go away
    • Vision problems, including blurred vision or seeing spots
    • Pain in upper right abdomen
    • Trouble breathing

Bleeding: Bleeding can occur early or later in pregnancy. And while bleeding may not always be a cause for alarm, it is a cause for concern and a doctor should be consulted. However, bleeding later in pregnancy can be more serious. Heavy bleeding could be caused by various issues, including miscarriage, ectopic pregnancy, pre-term labor or a problem with the placenta, such as placental abruption (when the placenta detaches from the uterine wall before or during childbirth). If you have bleeding at any time in your pregnancy, contact your doctor; if you have bleeding late in pregnancy, contact your doctor right away or go to the hospital immediately.

  • Warning signs and symptoms:
    • Vaginal bleeding
    • Abdominal, pelvic or back pain

Infection: Fortunately, infections such as a mother’s common cold or an unpleasant stomach bug are generally not a threat to her unborn baby. However, some infections before and during pregnancy may be harmful to women and their developing babies. They can lead to serious illness, birth defects, and lifelong disabilities for the baby, such as hearing loss or learning problems. Some postpartum infections can be more serious and even life-threatening. In fact, infection is one of the leading causes of a mother’s death within the first six days after giving birth.

  • Warning signs and symptoms: Symptoms of infection are not always obvious before and during pregnancy because a woman may not always feel sick. However, some symptoms of infection both during pregnancy and postpartum may include:
    • Fever higher than 100.4
    • Severe pain in lower belly
    • Chills or feeling very cold

If you think you might have an infection or think you are at risk, see your healthcare provider.

  • Be sure to follow these tips to help prevent infections before and during pregnancy:
    • Wash your hands with soap and water after using the bathroom, preparing food or eating, caring for and playing with children, gardening, handling pets and coming in contact with sick people, to name a few.
    • Avoid unpasteurized (raw) milk and foods made from it.
    • Get tested for sexually transmitted diseases (STDs), such as HIV and hepatitis B, and protect yourself from them.
    • Talk to your healthcare provider about being up to date with vaccinations.
    • Do not touch or change dirty cat litter.
    • Stay away from those who are sick or have been exposed to someone who is sick.

See your healthcare provider for routine visits before, during and after your pregnancy—even when you feel fine—and be sure to speak up and voice any concerns.

References

  • 1. American College of Cardiology. “Pregnancy Complications May Signal Future Heart Troubles.” February 2018. Accessed March 24, 2020
  • 2. American College of Obstetricians and Gynecologists. Bleeding During Pregnancy. September 2019. Accessed February 18, 2020
  • 3. American College of Obstetricians and Gynecologists. Heart Disease in Pregnancy. May 3, 2019. Accessed February 17, 2020
  • 4. American Heart Association. “What is Cardiovascular Disease?” Accessed March 2, 2020
  • 5. Centers for Disease Control and Prevention. 10 Tips for Preventing Infections Before and During Pregnancy. February 26, 2020. Accessed March 9, 2020
  • 6. Centers for Disease Control and Prevention. Gestational Diabetes and Pregnancy. February 27, 2020. Accessed on March 2, 2020
  • 7. Centers for Disease Control and Prevention. Gestational Diabetes. May 30, 2019. Accessed on February 17, 2020
  • 8. Centers for Disease Control and Prevention. Vital Signs: Pregnancy-related Deaths, United States. May 9, 2019. Accessed on March 3, 2020
  • 9. Johns Hopkins Medicine. 4 Common Pregnancy Complications. Accessed February 17, 2020
  • 10. March of Dimes. Warning Signs of Health Problems After Birth. July 2018. Accessed on March 3, 2020
  • 11. National Institutes of Health. Medline Plus. High Blood Pressure in Pregnancy. December 31, 2019. Accessed on March 2, 2020
  • 12. Northwestern Medicine. Cardiac Signs and Symptoms During Pregnancy. Accessed March 3, 2020
  • 13. Office on Women’s Health. Pregnancy Complications. April 19, 2019. Accessed February 17, 2020