Prenatal Problems

Some pregnancies are more complicated than others.

Thyroid disease
Cause Too much (hyper) or too little (hypo) thyroid hormone, resulting in an over- or underactive metabolism. Thyroid disease occurs in about 3 percent of pregnancies, and hypothyroidism is five times more common than hyperthyroidism. "Most of the time, thyroid disease precedes the pregnancy," says Ashi Daftary, M.D., a maternal-fetal medicine specialist at Magee-Women's Hospital of the University of Pittsburgh Medical Center. Many women aren't aware they have it, however. The increased medical scrutiny received during pregnancy often reveals the condition, and many experts maintain that all expectant women should be tested for it.
Danger If not controlled, thyroid disease can increase the risk for miscarriage, fetal growth delays, preterm birth, preeclampsia, impaired neurological development and, in rare cases, death of the fetus.
Treatment For hyperthyroidism, a doctor may prescribe oral medications that suppress thyroid hormone production. For hypothyroidism, thyroid-replacement pills are generally taken.

Gum disease
Cause "Hormonal changes affect blood supply to the gums," says Sally J. Cram, D.D.S., a periodontist (gum specialist) in Washington, D.C., and consumer advisor for the American Dental Association. "Pregnant women may experience red, puffy or irritated and tender gums that bleed easily, particu-larly during the second and early third trimester." An estimated 60 to 75 percent of women get this "pregnancy gingivitis," an aggravated response to the bacterial film, or plaque, that builds up on teeth. If neglected, it can lead to periodontal disease, an infection of the gums and bone under the teeth.
Danger Women with untreated perio-dontal disease are seven times more likely to deliver a preterm or low-birth-weight baby. The disease also can cause large, noncancerous "pregnancy tumors" on the gums that may require surgical removal after delivery.
Treatment Brush twice and floss once daily. If you need help controlling plaque, your dentist may recommend an antibacterial mouth rinse and professional teeth cleaning every two to three months during pregnancy.