Following a healthy eating diet plan, exercising regularly and listening to your body are all important factors to consider whether pregnant or not. Understanding some of the common medical complications of pregnancy can help to ensure you are aware of any changes you may notice when pregnant.
If you are concerned you have any of these conditions then it’s best to speak to your GP or your obstetrician.
Asthma
This is a form of respiratory disease and is quite common in many people both young and old. Some women find their asthma worsens during pregnancy and others it remains unchanged or even improves.
During pregnancy as the baby grows, the uterus also grows and starts pushing on the diaphragm. If you have serious asthma it is good to speak to your GP in the early stages of your pregnancy so have an ‘Asthma Management Plan’ in place.
It is a myth that medications for treating asthma affect the growing and development of your growing baby.
Some women who are asthmatics may have a slightly higher risk of premature birth or babies born with a lower birth weight.
It is safe to continue to exercise during pregnancy with asthma just change your exercise if it exacerbates your asthma.
Anaemia
Anaemia is defined as a reduction of haemoglobin (Hb) concentration (a reduction of red blood cells RBC).
Normal values for Hb differ for every woman. Race, age, exercise level and health all impact Hb levels. The World Health Organisation (WHO) defines anaemia as a Hb less than 11g/dl. Not everyone will be symptomatic at this level so it may just be something your doctor will monitor rather than treat.
In pregnancy the most common form of Anaemia is Iron Deficient Anaemia. Iron is essential in pregnancy and some women do not eat enough in their diets or their bodies cannot cope making extra iron for the requirements.
Treatment options:
- Eating foods rich in iron such as; Lean meats, Livers (cooked), dark green leafy vegies such as Kale, spinach, silver beet, fortified cereals and breads, fish (minimise deep sea fish), egg yolks and raisins.
- Your doctor may also prescribe you an iron supplement. (Don’t be alarmed if your poo’s are black in colour)
Iron is better absorbed when teamed up with Vitamin C
Women who have previously had a post partum haemorrhage (PPH) are at greater risk at being iron deficient in further pregnancies.
Haemorrhoids
We’ve all heard the saying sitting on a cold floor will give you piles!!! This is a myth however pregnancy can give you piles.
So what are haemorrhoids or piles? These are a cluster of veins in your anus. They can be internal or external. Everybody needs these blood filled sacs as they help the sphincter muscle absorb the variations in abdominal pressure. Meaning when we cough, sneeze etc we don’t (always) pass gas every time.
During normal actions of using your bowels the sacs are compressed as the bowel empties. When this all becomes abnormal is when there is damage to these sacs cause a small prolapse and thrombosis of the blood vessels. These are the haemorrhoidal blood vessels hence being called haemorrhoids.
During pregnancy your pelvic floor muscles are altered as the weight of the growing uterus pushes down on them. This allows the vessels to become more exposed and allowing more risk for damage.
Symptoms for haemorrhoids can include a burning sensation, intermittent itching, bleeding, leakage of mucous, increased flatus, discomfort and pain.
The severity of the symptoms will determine how they are managed. Starting by having a diet rich in fibre and increasing fluid intake is the start. Taking a fibre supplement or a stool softener is the next option. Medication treatments can include topical creams such as Proctosedal, suppositories, anti-inflammatories and steroids can help. In sever cases surgery needs to be considered.
More often that not haemorrhoids resolve after pregnancy but can be worsened by childbirth in the short-term.
Pregnancy Induced Hypertension
(not pre-eclampsia)
Although this is a symptom of pre-eclampsia a discussion about pre-eclampsi warrants it’s own topic as it is a serious pregnancy complication.
Hypertension in pregnancy is one of the highest complications of pregnancy. The demands of the pregnancy on the body increases the workload on the cardiac system. It is defined as having a Blood Pressure (BP) higher than 140mmHg Systolic and 90mmHg diastolic.
It is unknown what actually causes the hypertension in pregnancy but it sis known that women who have mothers with hypertension in their pregnancy generally carry it through to their daughters. It is treated with medications and regularly Blood Pressure (BP) monitoring is conducted at pregnancy visits. Well managed hypertension will usually have good pregnancy outcomes. More serious complications to Hypertension involves it escalating to Pre-Eclampsia.
Gestational Diabetes
Diabetes of all forms is on the increase. Type 2 diabetes due to our obese society and Gestational because obese women are falling pregnant.
You do not need to be obese to develop Gestational Diabetes. It is very important to diagnose Gestational Diabetes as the biggest complication is not only the health of the mother but the baby as it can develop a condition called Macrosomia. This is when the baby produces higher than normal insulin, increasing growth hormone due to the woman’s increased blood glucose levels.
This condition is usually diagnosed by routine pathology test that all women have between 24-28 weeks of pregnancy. Up to 8% of women will develop this condition. Risk factors can include;
- Obesity
- Maternal age greater than 30 years
- Family history of Type 2 Diabetes
- Previous Gestational Diabetes
- Certain ethnic groups have a higher incidence such as Australian Aboriginal, Torres Straight Islander, Indian and Chinese
Management of Gestational diabetes in the first instance is dietary change. Sticking to the lose baby weight diet plans is a good start as they are rich in low Glycaemic Index foods as well as a good mix of meats, legumes, dairy, fruits and vegetables. Women with Gestational Diabetes are encouraged to have 3 main meals a day and 3 snacks a day.
If you are diagnosed with Gestational Diabetes you should be referred to a diabeties educator who will discuss daily monitoring of Blood Glucose levels. Exercise is also important with diabeties management such as walking 30-40 minutes per day.
In 15% of Gestational Diabetes diet and exercise regimens don’t work and women require Insulin. This is usually just for the pregnancy but a small group of women will develop type 2 diabeties later in life.
It is important for the health of the mother and baby that routine Antenatal Visits are attended when scheduled. If you are concerned about anything in your pregnancy then speak to your GP, midwife or obstetrician.
Ali Pickles
Registered Midwife (Diploma in Midwifery)
Registered Nurse (Bachelor of Nursing)
Child, Maternal Health Nurse Student (Master in Nursing Child, Community, Family)
Reference:
Henderson, C., & Macdonald, S. (Eds.). (2012). Mayes’
Midwifery: A Textbook for Midwives (14th ed.). Edinburgh:
Bailliere Tindall Publishers.
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