Complications of Pregnancy

Complications of Pregnancy

DOI: 10.4018/978-1-7998-4357-3.ch005

Abstract

Although the majority of pregnancies are uneventful, sometimes complications do happen. Pregnancy complications are the conditions or pathological processes associated with pregnancy. They can occur during or after pregnancy and range from minor discomforts to serious diseases that require medical interventions. They can involve the mother's health, the baby's health, or both. Complication of pregnancy can cause maternal morbidity and mortality. The most common causes of maternal mortality are maternal bleeding, maternal sepsis, hypertensive disease, obstructed labour, and pregnancy with the consequence of abortion, which includes miscarriage, ectopic pregnancy, and medical abortion. The primary means of preventing maternal deaths is to provide rapid access to emergency obstetric care, including treatment of haemorrhage, infection, hypertension, and obstructed labour. Proper antenatal care can reduce the maternal mortality rate by reducing the number of pregnancies among women of reproductive age. Thus, adequate monitoring and appropriate intervention strategies should be provided for better maternal and fetal outcome.
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Key Facts

  • Half a million women die each year due to complications of pregnancy and childbirth; 99 percent of these deaths occur in developing countries (WHO, 2014).

  • Impaired foetal growth is more common in pregnancies occurring before the age of 18 years and low birth weight is an important risk factor for adult onset of diabetes (Norris, 2012).

  • Though mortality among 1 to 4-year old declined by more than 80 percent over the past five decades whereas adolescent mortality rates only improved by 41 to 48 percent (Viner et al, 2011).

  • In the United States, severe complications of pregnancy, childbirth and puerperium affect 1.6 percent mothers (CDC, 2015) and 1.5 percent of mothers in Canada (The Society of Obstetricians and Gynecologists of Canada (SOGC), 2009).

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Introduction

Majority of pregnancies normally take place without any complications. Some pregnant women, however, will experience complications that can affect their health, the health of their baby or both. Diseases or conditions that the mother had before becoming pregnant can sometimes lead to complications during pregnancy. There can be some complications during delivery. Even with complications, early detection and prenatal care may reduce any additional risks to both mother and child.

There is, however, no clear distinction between the symptoms and discomforts of pregnancy and the complications of pregnancy. Though the symptoms of normal pregnancy do not generally interfere with the routine activities of mother in her day to day life or do not pose any risk to her health or that of her baby yet in other cases, similar symptoms may manifest either as discomfort or as complications, which usually depend on the severity of those symptoms. For instance, mild nausea is only a discomfort as morning sickness but if severe and accompanied by vomiting, it may cause an imbalance of water and electrolytes and then it can be classified as a complication of pregnancy (hyperemesis gravidarum).

Complications of pregnancy are, therefore, the health related issues which are caused due to pregnancy. Complications which occur primarily during delivery are termed obstetric labour complications and complications that occur primarily after birth of the child are called puerperal disorders. Any difficulty or abnormality that arises during the process of labour or the delivery is called obstetric labour complication.

The Trust for America's Health (TAH) reported about one-third of American births had some complications as of 2011, many of which were directly related to the health of the mother, including rising rates of obesity, type 2 diabetes and physical inactivity. In an effort to reduce neonatal and maternal death rates, the U.S. Centers for Disease Control and Prevention (CDC) has led an initiative to improve women's health prior to conception (Levi et al, 2011).

In the United States, severe complications of pregnancy, childbirth and puerperium affect 1.6 percent mothers (CDC, 2015) and 1.5 percent of mothers in Canada (The Society of Obstetricians and Gynecologists of Canada (SOGC), 2009).

Globally, the complications related to pregnancy, childbirth and puerperium declined from 377,000 deaths in the year 1990 to 230,600 deaths in the year 2016. Maternal bleeding, maternal sepsis and other infections, pregnancy induced hypertension, obstructed labor and pregnancy ending in abortion which includes miscarriage, ectopic pregnancy and elective abortion were reported to be the most common causes of maternal mortality (GBD, 2016).

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