Prenatal Problems

Some pregnancies are more complicated than others.


Most pregnancies are perfectly healthy, and moms-to-be glide through them with nothing more severe than a few bouts of nausea and the occasional backache. However, some women do develop more serious health problems that can threaten their own and their baby's well-being, sometimes even their lives. Don't worry—life-threatening complications are extremely rare. But it's important to know what signs and symptoms to look out for.

Here are some common pregnancy problems, along with information on their causes and treatments.

Morning Sickness

Cause: Hormones—and during pregnancy, levels skyrocket. As many as 85 percent of women suffer some nausea and/or vomiting, mostly in the first trimester.

Danger: "Though morning sickness is uncomfortable and can be emotionally trying, there is no physical harm to mother or baby as long as the mother doesn't become dehydrated," says Joel M. Evans, M.D., director of The Center for Women's Health in Darien, Conn., and author of The Whole Pregnancy Handbook (Gotham, 2005).

However, severe morning sickness, or hyperemesis gravidarum, can rob you and your baby of essential hydration and nutrients.

Treatment: Stay hydrated with water, sports drinks or whatever fluids you can keep down. Eat frequent, small meals and snacks high in complex carbohydrates, such as whole grains or vegetables. Sour and salty foods sometimes help, as may ginger. Ask your doctor about taking vitamin B6, alone or with an antihistamine. If you vomit more than a few times a day, lose weight or can't keep down water, call your doctor. You may need intravenous nutrition.

Gestational Diabetes

Cause: Blood-sugar (glucose) levels soar because the body develops an insensitivity to insulin, a hormone that ushers blood sugar into cells. Some 3 to 5 percent of pregnant women develop gestational diabetes, usually in the late second or the third trimester.

Danger: Elevated blood sugar can disrupt fetal metabolic function, so you grow a large baby, but not necessarily a healthy one, says Elizabeth Stein, R.N., M.P.H., a certified nurse-midwife in New York. A big baby is more likely to have birth complications and need to be delivered by forceps, vacuum or Cesarean section. Very large newborns may have low blood sugar, develop jaundice or breathing problems and need to be observed in the high-risk nursery.

Treatment: Reduce blood sugar by exercising regularly and eating a diet low in sweets and other simple carbs. If blood-sugar levels remain high, you may need to consult a nutritionist and take prescription medications or insulin injections. Gestational diabetes disappears after delivery, though it predicts a 50 percent greater chance of developing type II diabetes later in life.

Preeclampsia ("Toxemia")

Cause: Unknown, although a recent study found a higher risk when either the mom or dad has a family history of preeclampsia, suggesting a genetic link. Preeclampsia affects about 5 to 8 percent of pregnant women—often in the third trimester, though sometimes earlier—and is more common in first pregnancies and in women who have gestational diabetes, are over 40 or under 18, overweight, sedentary or carrying multiples.

Danger: The mother may develop any of the following: high blood pressure; protein in the urine; swelling of the hands and feet; sudden weight gain of as much as a pound or more a day; blurred vision; severe headaches; dizziness and intense stomach pain. Preeclampsia can slow fetal growth and boost the risk of the placenta separating from the uterine wall. In very rare cases, it develops into eclampsia, which can cause stroke, liver damage, coma and death of mother and baby.

Treatment: "The only true treatment is to deliver the baby," Evans says. Bed rest and, in some cases, blood pressure medi-cation can prevent mild preeclampsia from getting worse. Mind-body exercises, such as relaxation breathing, meditation and imagery, have been shown to lower blood pressure, which can be helpful in the management of preeclampsia.

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.