38 Greenslopes Maternity Your Journey Most women have a normal, healthy pregnancy. But sometimes health problems or events can affect the outcome for both the mother and baby. This chapter briefly looks at some of the complications and unexpected outcomes of pregnancy and birth. During pregnancy Bleeding during pregnancy If you have any bleeding during your pregnancy, contact your doctor immediately, so that appropriate investigation and treatment can be started. Reasons for bleeding can include miscarriage, placental abruption and placenta praevia. These are explained further on. Breech baby A breech baby is one with its bottom down and its head up towards the top of the uterus. Your baby may be breech when you are six or seven months pregnant, but in most cases will turn in the last couple of months. If your baby does not turn, your doctor may offer external cephalic version (ECV) where the baby is turned by encouraging it to do a somersault. If this is not successful or the baby turns back to a breech position, it is common practice for the baby to be born by caesarean birth. Gestational diabetes About five percent of women develop raised glucose (sugar) levels during pregnancy which can potentially affect the baby. Many women can control their blood sugar levels with a diabetic diet and exercise, but others will need insulin to stop excessive sugar and fats crossing the placenta and causing problems for the baby’s growth and other problems. If the screening test (Glucose Challenge test) is positive, then a glucose tolerance test is recommended. If this is positive, you are taught to measure your blood sugar levels and advised about the right diet for you. Your doctor may refer you to a specialist if required. High blood pressure High blood pressure (hypertension) in pregnancy may develop because of the pregnancy or you may already have high blood pressure. It can occur after 20 weeks gestation, be a one-off event, or part of a more complex condition such as preeclampsia. Treatment includes rest, monitoring of your blood pressure, monitoring of your baby and your wellbeing and may require medication. If your blood pressure doesn’t settle then you may need to have your baby earlier. Placental abruption This is the most common cause of bleeding during the second half of pregnancy and is often associated with abdominal pain and/or tenderness. Placental abruption occurs when part, or all, of the placenta separates from the wall of the uterus before the birth of your baby. The amount of bleeding varies and the cause is not always known. Sometimes, there is no bleeding, but severe sudden abdominal pain. Treatment may involve monitoring you and your baby, bed rest and/or, the birth of your baby. Placenta praevia This is when some or the entire placenta implants in the lower part of the uterus, instead of being attached to the top part of the uterus. Bleeding can occur from the placenta (this is the mother’s, not baby’s, blood) when the cervix starts to open or if the uterus contracts. This may involve being admitted to hospital for careful monitoring of you and your baby, and in most cases requires a caesarean birth. If you have any bleeding during your pregnancy, contact your doctor immediately, so that appropriate investigation and treatment can be started. Info to note Most women have a normal, healthy pregnancy. But sometimes health problems or events can affect the outcome for both the mother and baby.
GPH Materntiy Your Journey Book PI499 0216
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