Let’s talk about pathologies during pregnancy: talking about ailments and illnesses during pregnancy is very complex as it is too vast a chapter to lend itself to simplifications

Among the most frequent problems, the most important are the following.

Pregnancy pathologies: high blood pressure (pre-eclampsia)

It may be pre-existing during pregnancy or appear for the first time during pregnancy (most often in the third trimester) even without any symptoms.

Sometimes it also appears after delivery.

Blood pressure values of 140/90 are considered already elevated, as pressure normally drops during pregnancy.

Tests to be carried out

• urine test with protein assays;
• specific blood tests;
• ultrasound with flowmetry;
• cardiotocography (electronic monitoring).

Solutions:

• rest;
• anti-hypertensive drugs;
• preterm delivery (with induction of labour or by caesarean section).

N.B. It is very important to measure blood pressure frequently during pregnancy and to contact your doctor or the hospital if values are 140/90 or higher.

Poorly growing babies (fetal hypodevelopment)

This is often the consequence of misdiagnosed high blood pressure, but may depend on various factors that impair the proper functioning of the placenta.

Tests to be performed:

• ultrasound with flowmetry;
• cardiotocography (electronic monitoring).

Solutions:

• therapy appropriate to the underlying condition (to correct high blood pressure, etc.);
• premature birth (with induction of labour or caesarean section).

Pregnancy and pathologies: gestational diabetes

It can appear during pregnancy and in most cases resolves after delivery.

Tests to be carried out

• urine test;
• ultrasound examination;
• basal glycaemia;
• oral glucose load curve or glycaemic mini-curve;
• glycaemic profile.

Solutions:

• hypocaloric diet (more frequently);
• insulin (more rarely).

Pathologies during pregnancy: vaginal bleeding

At the beginning of pregnancy, bleeding from the vagina may signify:

• threatened miscarriage;
• extrauterine pregnancy.

But very often the bleeding resolves spontaneously and the pregnancy proceeds quite normally.

Ultrasound assists us in making a diagnosis.

After the fifth month, vaginal bleeding can be an indication of:

• placenta previa (i.e. implanted too low, too close to the cervix)
• placental abruption;
• erosion of the cervix (normal condition) or the presence of a small polyp.

At the end of pregnancy, it can also simply signify a change in the cervix, marking the beginning of labour.

But blood loss should always be reported to the doctor and its cause investigated.

Threat of preterm delivery

Frequent or painful uterine contractions that usually occur after the fifth month of pregnancy and up to the end of the 37th week (but the greatest risk occurs if delivery occurs before the 34th week).

There can be many causes:

• high blood pressure;
• diabetes;
• infectious diseases;
• heart disease;
• hyperthyroidism;
• uterine fibroids;
• uterine malformations;
• cervico-vaginal infections;
• urinary infections;
• violent blunt trauma;
• twins;
• transverse fetal situation;
• fetal malformations;
• endouterine foetal death;
• polyhydramnios;
• rupture of membranes;
• placenta previa;
• placental abruption.

Therapy:

• Absolute bed rest;
• Mouth medication plus bed rest;
• Hospitalisation with the same drugs but intravenous drip plus bed rest.

A very serious condition: intrauterine death

A very rare occurrence, sometimes related to the pathologies listed above, but often without an apparent cause.

This is a very trying experience and sometimes appropriate psychological support is also necessary.

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Source:

Pagine Mediche