Pregnancy is an exciting journey filled with all the emotions, anticipation and joy, to name a few. However, it’s essential for mamas-to-be to be aware of potential complications that can arise during pregnancy.
While a lot of pregnancies progress smoothly, some women may experience challenges. This article aims to shed light on common pregnancy complications in hopes of empowering mamas-to-be with knowledge and preparedness to keep them and their little one safe!
I sure hope your pregnancy is smooth sailing – but just in case – here are 6 of the most common (ish) complications you may experience.
Let’s start navigating the most common pregnancy complications now.
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1. Gestational Diabetes Mellitus (GDM)
What is gestational diabetes?
Gestational diabetes, or GDM, is one of the most common pregnancy complications. GDM is basically temporary diabetes that happens during pregnancy. It affects how your body uses sugar resulting in high blood sugars, which can affect yours and your baby’s health both during and after pregnancy.
Why does it happen?
Pregnancy hormones can prevent you from making enough insulin or make your body resistant to the effects of insulin.
How and when will I be tested for GDM?
Between weeks 24 and 28 you will complete a screening test. You will drink 50 grams of a glucose solution (glucola) all at once. Your blood sugar will be tested 1 hour after completion of the drink. If your blood sugar is elevated, it can vary somewhat depending on your practice but typically elevated is over 130-140 mg/dL, you will need to complete a 3 hour diagnostic glucola test.
Potential complications associated with gestational diabetes
Depending on your blood sugar results, your provider will recommend taking your blood sugars a certain number of times throughout the day. A lot of women control their gestational diabetes with diet alone but some do require medication.
Uncontrolled blood sugar levels during pregnancy can increase the risk of:
- Baby > 9 lbs
- C-section
- Preterm birth
- Baby experiencing low blood sugars after birth (hypoglycemia)
- Jaundice
- High blood pressure
- Increased risk of mom getting type 2 diabetes later in life
What if I’m diagnosed with GDM?
First off, don’t panic! It’s more common than you may think and you can still have a full-term pregnancy and a healthy baby if you have GDM. My biggest advice is to stay on top of your blood sugars and educate yourself.
Like I said above, a lot of women can control their diabetes in pregnancy with diet and exercise alone. Women who control their blood sugars well typically don’t experience complications during pregnancy, birth, or postpartum.
Education is key! Your provider should work with you to develop a tailored plan on how best to monitor your blood sugars. The severity of your condition will determine how “aggressive” you will need to be with monitoring.
Related Reading: What is Gestational Diabetes Mellitus: An L&D Nurse Explains
2. Gestational hypertension
What is gestational hypertension?
Another fairly common pregnancy complication is gestational hypertension. Gestational hypertension is defined as high blood pressure that occurs in pregnant women after 20 weeks gestation. Typically the blood pressure reading is above 140/90 without elevated protein in the urine.
Why is gestational hypertension a concern?
The biggest concern with gestational hypertension is that it will eventually develop into preeclampsia. However, elevated blood pressure, without the presence of preeclampsia, carries risks of its own.
Some potential risks associated with hypertension include:
- Can result in decreased blood flow to your placenta → fewer nutrients and oxygen getting to baby
- Decreased blood flow can stress your organ system function
- May be associated with low birth weight or poor fetal growth
- Can lead to preeclampsia
Gestational hypertension treatment
The best treatment is usually delivery of your baby. Usually, providers will try their best to get you at least to (early) term, 37 weeks, before they schedule an induction of labor. Each situation is unique however and will be treated on a case-by-case basis.
In the meantime, until delivery, there are some treatment options.
Blood pressure medication
Typically only used if blood pressure is really high or delivery is far away. Medication can be very effective but not without other potential risks for both mama and baby.
Bedrest
Even though this is a fairly common one, research shows that bedrest is only mildly effective at keeping blood pressure down.
Increased prenatal visits and fetal monitoring
This is a big one and one that holds true for most complications during pregnancy, blood pressure related or not. With gestational hypertension, you can expect your provider to increase the frequency of your visits to keep a close eye on your blood pressure, check for any presence of protein in your urine, monitor for any other symptoms, and to keep a closer eye on baby.
3. Preeclampsia
What is preeclampsia?
“Preeclampsia is a serious disorder that can affect all the organs in your body. It usually develops after 20 weeks of pregnancy, often in the third trimester.” (source) Preeclampsia, the more serious form of gestational hypertension, is characterized mainly by high blood pressure and excess protein in your urine.
Warning signs and symptoms
In addition to elevated blood pressure and protein in the urine, the main signs and symptoms of preeclampsia include:
- Severe headache that won’t go away
- Swelling of face and hands
- Blurry vision, spots/floaters in vision
- Unexplained, sudden weight gain
- Shoulder pain
- Decrease platelet count
- Difficulty breathing
Risk factors
Sometimes preeclampsia happens out of nowhere, with no rhyme or reason. There are some things, however, that might increase your risk of getting preeclampsia. Here are some of the bigger risk factors:
- History of preeclampsia in previous pregnancy
- Family history of preeclampsia
- High blood pressure prior to pregnancy
- Diabetes
- Pregnancy in women older than 35 years of age
- Carrying multiples
- Pregnancy in black women
- IVF conception
- Close interval pregnancy
Potential complications
Preeclampsia is serious! I say that not to scare you but rather to just bring awareness to the condition. It has the potential to cause harm to both you and your baby, especially if not closely monitored, so don’t take it lightly. Here are some potential complications associated with preeclampsia:
- Fetal growth restriction
- Necessity of preterm delivery
- HELLP syndrome
- Eclampsia
- Placental abruption
- Organ damage
Preeclampsia treatment
The treatment plan is pretty similar to that of gestational hypertension. The most effective treatment for preeclampsia is delivery. Some women, however, are diagnosed with preeclampsia early on in pregnancy and treatment might not be the safest option in that moment.
The goal will be to get you to 37 weeks before delivering but it will depend on how both you and baby are doing. You can expect to have more frequent prenatal visits with increased monitoring of your blood pressure, your baby, and protein in your urine, among other things.
In addition, you might be on some kind of blood pressure medication, possible bedrest, and might even require a stay in the hospital, depending on how things are going.
Again, it’s hard to determine one specific treatment plan because it will vary some based on your specific symptoms and how the condition is impacting you and your little one.
4. Placenta previa
What is placenta previa?
“When the placenta lies low in the uterus, it may partly or completely cover the cervix.” (source) You might hear your provider say complete or partial previa depending on how much of your cervix is being covered by your placenta.
Why is a placenta previa a concern?
It can be dangerous for your uterus to contract when your placenta is too close to or covering your cervix. In this case, a C-section birth would be the safest mode of delivery.
The potential good news?
Previas can (and often do) move without you having to do anything at all! “Some types of placenta previa resolve on their own by 32 to 35 weeks of pregnancy as the lower part of the uterus stretches and thins out. Labor and delivery then can happen normally.” (source) This especially holds true if the previa is found at your 20 (ish) week anatomy scan. The earlier in pregnancy it’s discovered, the more time it has to move.
5. Abnormal amniotic fluid levels
The thing with amniotic fluid levels? They might be too high, too low, or just right. Although it might not seem like a big deal if amniotic fluid level is too high or too low, it might indicate an underlying problem. Abnormal amniotic fluid levels is another pretty common pregnancy complication you might experience or hear about.
The Amniotic Fluid Index (AFI)
The AFI is a standard way to measure the amount of amniotic fluid in a pregnant person. It is done via ultrasound and can be used to determine if there are any potential complications with the pregnancy.
It is typically not standard or necessary to complete an AFI on a healthy, uncomplicated pregnancy. An AFI is usually only completed on women experiencing certain types of complications during pregnancy.
The normal amniotic fluid level range is between 8 and 18 cm. Levels of amniotic fluid outside of this normal range might indicate a problem or complication.
Polyhydramnios
Polyhydramnios occurs in about 1-2% of pregnancies and occurs when amniotic fluid levels are too high. It’s not typically diagnosed until levels reach about 24-25 cm and often is noted at your 20 week anatomy scan.
It’s not always clear why polyhydramnios happens but could result from certain infections, gestational diabetes, a birth defect, complications resulting from having twins, or infant anemia. I should say though, often we see polyhydramnios without the presence of any of the above complications.
Oligohydramnios
Oligohydramnios occurs when you have too little amniotic fluid. Usually defined as a fluid level less than 5 cm, oligohydramnios, common than polyhydramnios, occurs in about 4% of pregnancies.
Preexisting conditions, high blood pressure for example, can have an impact on oligohydramnios. When it comes to signs and symptoms, some things to watch out for are a smaller measurement than what is normal for baby’s gestational age and less weight gain. Otherwise, this is something that would likely be noted at your 20 week anatomy scan.
To learn more about amniotic fluid levels, including how AFI is measured and what you can do to monitor your amniotic fluid levels, read my article below.
Related Reading: Your Complete Guide to Amniotic Fluid Levels During Pregnancy
6. Preterm labor
I hope this is something you never have to worry about. In fact, I hope you never have to worry about any of the complications we have discussed today.
Like any complication during pregnancy, preterm labor can be really scary. According to ACOG, preterm labor is labor that starts before 37 weeks of pregnancy. Preterm labor does not automatically equate to preterm birth but preterm labor does normally require prompt medical attention.
Risk factors for preterm labor
Sometimes preterm labor happens and we just don’t know why. There are some things that might put a woman at an increased risk for preterm labor. Some of the more common risk factors include:
- Preterm labor or birth in a previous pregnancy
- Having a short cervix
- Short interval between pregnancies
- Carrying multiples
- History of certain types of surgery on the uterus or cervix
- Certain lifestyle factors (smoking or substance abuse during pregnancy)
Signs of preterm labor
Be sure to be on the lookout for any signs of preterm labor. Prompt medical attention is a must if you think you are experiencing preterm labor. Here are some of the more common signs:
- Pelvic or lower abdominal pressure
- Constant low, dull backache
- Mild abdominal cramps
- Regular contractions or abdominal tightening
- Increase or change in vaginal discharge
- Water breaking
- Mama intuition (because sometimes you just know)
Managing preterm labor
Management of preterm labor will be done on a case-by-case basis. The management and treatment plan will be unique to that particular mama and that particular pregnancy.
If baby would benefit from a delay in delivery (even though sometimes a delay is not possible no matter what we do), certain medications might be administered by the medical team.
These medications would be used to help baby’s organs (primarily the lungs) mature faster, reduce the risk of certain complications associated with preterm birth, and attempt to delay delivery.
Wrapping up
While complications are a possibility, they shouldn’t overshadow the beauty of pregnancy. By being prepared and proactive, expectant mamas can embrace this special time with confidence and joy, knowing they have the knowledge and resources to handle any challenges that come their way.
If you like what you read in this article and are looking for more pregnancy and birth content, I’ve got you covered! With hundreds of blog articles and nearly 250 podcast episodes, Mommy Labor Nurse is your go-to resource for all things pregnancy and birth! I’ll highlight just a few of my favorite resources below but be sure to check out my website for so much more!
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