Pregnancy Complications

Dr Manavita MahajanMD, MRCOG (UK), FRCOG(UK)

Diploma Gyn Endoscopy, Louisville, USASr Consultant Obstetrician & Gynaecologist

FMRI Gurgaon

Bacterial infection Increased tendency for UTI in pregnancy Untreated , may lead to kidney infections ,

sepsis and premature delivery Treated with appropriate antibiotics

Urinary Tract Infection in pregnancy

Bacterial infections Can be treated Cause Miscarriage / preterm labour / stillbirth /

neonatal infections if left untreated Viral Infections Long term serious infections in mother and

child Anti viral therapy , other measures to reduce

mother to child transmission

STI’s In Pregnancy

85% of population has Rh antigen on their

blood cells(called Rh+ blood group) So 15% of pregnant women may be having Rh

negative blood group If married to a Rh positive man , the baby can

be Rh positive(inherits this from the father) The Rh factor does not affect a person’s

general health.

RH negative Blood group in the mother

Baby’s red cells may leak into mothers blood circulation

occasionally Problem arises when mother produces antibodies against

Rh postive baby cells These antibodies can target baby’s red blood cells

producing anemia , heart failure and even stillbirth An injection of RhIg to the mother in pregnancy and after

delivery can prevent antibody formation in the mother against baby’s Rh antigen thus protecting her babies

If the mother already has the antibody , then the Injection(RhIg) does not work

Rh Negative Pregnant Woman

Rh-negative women should also receive

treatment after any miscarriage, ectopic pregnancy, or induced abortion to prevent any chance of the woman developing antibodies that would attack a future Rh-positive baby.

Rh Negative Pregnant Woman

To Summarize All pregnant women must get their 1. Blood Group and Rhesus Factor checked in

pregnancy2. Periodic blood tests must be performed to

detect the development of antibodies against Rh factor

3. All Rh Neg Prgnant women should get RhIg injection at 28 weeks and after delivery

Rh Negative Pregnant Woman

Poor growth in the unborn baby Usually suspected by clinical Examination and

Confirmed by ultrasound assessment of Baby’s(fetal) growth

Risk Factors for IUGR include1. Birth defects or chromosomal abnormalities2. Pregnancy induced hypertension (PIH)3. Multiple pregnancy

Intra Uterine Growth Restriction (IUGR) In the fetus

4. Placental abnormalities5. Umbilical cord abnormalities6. Use of drugs, cigarettes, and/or alcohol7. Poor nutrition during pregnancy8. Severe Diabetes in mother9. Medical problems – kidney diseases , autoimmune disorders , Thyroid disorders , severe cardiac ailments or asthma in the mother

Causes of IUGR

The main principles of treatment are 1. Improve maternal Nutrition2. Improve maternal health / treat the

underlying medical conditions in the mother3. Monitor baby’s growth and well being by

periodic assessments4. Deliver if mature or if problems with baby’s

wellbeing

Treatment of IUGR

Early Delivery Increased risk for hypoxia (lack of oxygen when the

baby is born) Increased risk of fetal distress and caesarean section in

labour Increased risk for meconium aspiration and pneumonia

and respirator distress in the newborn Increased risk for motor and neurological disabilities problems like hypoglycemia (low blood sugar) and

Hypothermia( poor temperature control) Poor growth and development in infancy

Risks of IUGR

Any pregnancy that is located outside the uterus is called

an ectopic pregnancy Commonest location is the fallopian tube Life threatening for mother unless diagnosed and treated Symptoms – 1. Asymptomatic - no symptoms and the ectopic pregnancy

is detected on routine ultrasound assessment of early pregnancy

2. Sudden severe lower abdominal pain with fainting with missed periods

3. Recurrent episodes of abdominal pain in early pregnancy

Ectopic Pregnancy

Who is at risk Pregnant women Women with previous infections in the pelvis ,

tubal surgeries in the past women with history of infertility ,

endometriosis and those who have taken treatments for infertility

Women with previous ectopic pregnancy

Ectopic Pregnancy

Diagnosis – A challenging problem!Step 1. Correct diagnosis of pregnancy by blood pregnancy test called Beta HCGStep 2. Transvaginal Ultrasound of pelvis to check for pregnancy location if beta HCG levels more tha 1500 Step 1 & 2 may need to be repeated

Ectopic pregnancy

Surgical Laparoscopy is the surgical method of choice Allows diagnosis and treatment at the same

time Medical Treatment with

methotrexate(medicine) possible in certain women under supervision

Ectopic Pregnancy - Treatment

Contact us:Triveni Obstetrics & Gynaecology Clinic,

620 Galleria, DLF Phase-IV, Gurgaon.Pin Code 122002

Phone: +91-981-058-38 76, +91-124-257-28 92

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