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1.
Bleeding in early pregnancy
Occasionally,
a small amount of bleeding may occur at the time of the second or even third
periods, and there are instances in which women have continued to have
virtually normal periods for six or more months of what was an otherwise normal
pregnancy. This usually goes under the heading of a partially suppressed
period. The true significance of bleedings at the time of a suppressed period
in early pregnancy is that they do not seem to affect the pregnancy; they do
indicate that the pregnancy is unstable, and it is certainly true that
miscarriage is more likely in a woman who has had partially suppressed periods
than in one who has not. Doctors consider it wise for a woman who has bled at
the time of her first period to rest quietly till her next period is expected.
2. Abortion
(miscarriage)
Bleeding
from the vagina is abnormal at any stage of pregnancy and may be due to several
causes. Some are of little or no significance, while others are potentially
more dangerous. She must therefore report bleeding, excessive vaginal
discharge, or any acute abdominal pain to her doctor immediately.
An
abortion, by definition, is the discharge by the uterus of the products of
conception before the 24th week of pregnancy. There is no difference between an
abortion and a miscarriage, despite the frequently held view that an abortion
is something that is induced and a miscarriage is something that occurs
spontaneously. The two terms are synonymous and are so used here.
3.
Blighted Ovum
A
pregnancy where the fetus does not develop properly is termed a blighted ovum.
It is generally known to have occurred in most cases because the husband’s
seminal count is usually deficient and contains more abnormal sperm than usual.
A big
ovum can be diagnosed as early as the 6th week by ultrasonic scan because the
early-developing fetus will not be visible.
4.
Ectopic Pregnancy
An
ectopic pregnancy is a pregnancy that is situated outside the cavity of the
uterus and most frequently occurs in the fallopian tubes. The first symptom is
pain, which becomes severe and is followed by bleeding, whereas in abortion,
bleeding invariably precedes any pain or discomfort.
5.
Antepartum Haemorrhage
Before
the 24th week of pregnancy, any bleeding is, by definition, a threat
to miscarry or abort and is known as a threatened abortion. After the 24th
week, however, when the child is viable, such bleeding, known as antepartum
hemorrhage (bright red blood coming from the vagina after the 24th
week of pregnancy), should be reported to the doctor immediately.
6. Incompetent Cervix
An
incompetent cervix will cause miscarriage at about the 20th week of
pregnancy. The muscle surrounding the internal os may have been damaged so that
it is incapable of keeping the cervix closed during pregnancy. The internal
cervical os will then start to open soon after the 14th week, and by
about the 20th week of pregnancy, the cervix will be about 2–3 cm
dilaed. At this stage, the membranes, or bag of waters, will bulge through the
cervix into the vagina and will eventually break. There will be a sudden loss
of a large quantity of water from the uterus and the vagina, followed by
miscarriage, which usually occurs fairly quickly with comparatively little
discomfort.
7.
Incompetent Cervix
This is a
strange abnormality of pregnancy in which the placental tissue alone develops
in much the same way as it does in a blighted ovum. All the signs and symptoms
of early pregnancy are present and may frequently be rather excessive. It may
be first suspected at about the 14th or 16th week of
pregnancy, when the uterus is much larger than it should be. This rapid
enlargement may also cause intermittent vaginal bleeding. The diagnosis may be
very difficult, especially in the early stages of pregnancy, although the
continuous, intermittent loss of a small amount of bright or dark blood may
arouse suspicion. No fetal movement will be felt, and a fetal heart will not be
heard. An ultrasonic scan should be done at once in such cases.
8.
Polyhydramnios
The
normal amount of amniotic fluid at term is approximately 1 litter. If the
amount is thought to exceed 2 litters, then a condition of polyhydramnios is
present. This is a potentially dangerous condition and occurs in about 2–3
percent of all pregnancies.
9. Red
degeneration
Red
degeneration is a strange and peculiar condition in which a fibroid becomes
acutely inflamed. This usually happens in the middle of pregnancy, and the
fibroid suddenly becomes extremely tender and painful. The amount of pain can
be very considerable, and it can be very difficult to arrive at an exact
diagnosis. The treatment is complete bed rest. The pain usually passes off
spontaneously in about 48 hours, after which the fibroid becomes smaller and
often causes no more trouble.
10.
Fibroids in pregnancy
The
majority of fibroids are of no significance and have no effect upon a woman’s
fertility, her pregnancy, or her delivery. Some, however, impinge upon or
distort the actual cavity of the uterus and may cause complications in
pregnancy, as may a very large fibroid, which, by virtue of its size, distorts
the uterus and the other pelvic organs. Large fibroids may be responsible for
the onset of premature labor.
11.
Severe sickness
Severe
sickness in pregnancy, known as hyperemesis gravidarum, is less common than it
used to be. Nausea is a very common symptom in early pregnancy, frequently associated
with a certain amount of vomiting. If vomiting becomes excessive, the pregnant
woman will show signs of starvation.
This
condition is usually corrected within a few days.
12. Pre-Eclampsia
Pre-eclampsia
is a condition that is specific to pregnancy in which two of the three
symptoms, viz., raised blood pressure, swelling of hands, face feet or ankles,
or protein in the urine, are present. The cause of pre-eclampsia is still
unknown, despite a great deal of research. One aspect of the care of the
pregnant woman in the antenatal stages is always directed towards the
prevention of pre-eclampsia. This condition can almost be avoided if the
pregnant woman understands the importance of antenatal check-ups and carries
out her doctor’s instructions, especially those regarding her diet.
13. Pre-Eclampsia
Eclampsia
is a more severe form of pre-eclampsia. Any woman who is suffering from
pre-eclampsia. Any woman who is suffering from pre-eclampsia runs a risk of
developing eclampsia, which is characterized by the occurrence of convulsions
or fits. The fits last approximately 1 minute and are followed by a period of
unconsciousness. Eclampsia occurs in later pregnancy, or it may begin during
labor or even after delivery. When a convulsion happens, usually all the signs
and symptoms of pre-eclampsia are present.
14.
Ovarian cysts in pregnancy
The
ovaries always develop small cysts (up to 4cm in diameter) during pregnancy,
and these are of no consequence. Occasionally, however, a large ovarian cyst
measuring more than 6 cm in diameter is found in early pregnancy. When a cyst
of this size is discovered, it is generally removed at the first reasonable.
Opportunity.
15.
Placental insufficiency
A
satisfactory and normal placenta is, of course, vital if a normal, healthy baby
is to be produced. A complete failure of the placenta to develop will result in
abortion at an early stage. A second type of placental insufficiency may occur
after the placenta has properly developed. When this second type of placental
insufficiency occurs, it results in a slowdown and, later, a cessation of the
actual growth of the baby.
The
recognition of primary and secondary placental insufficiency is one of the main
duties of the doctors at antenatal check-ups, and modern scientific advances
have made this much easier.
16. Death
of the fetus in the uterus
On very
rare occasions, the baby dies in the uterus. If this occurs before the 24th
week of pregnancy, it will inevitably lead to miscarriages. If it occurs after
the 24th week, it will inevitably result in delivery occurring
fairly soon. Most women at some stages of their pregnancy feel certain that
their baby has died, especially if they do not feel it moving for some time. It
must, however, be remembered that even babies have periods of inactivity, and
so long as a woman feels her baby move on average 10 times in a day at least,
there is no cause for concern.
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