The Pregnancy

The vast majority of pregnancies are uncomplicated and end with the birth of a normal, healthy baby. Even when complications do occur, early diagnosis and treatment will often prevent serious problems. Early and regular prenatal care is the best insurance against problems in pregnancy. Regular care enables the doctor to watch for abnormal changes in blood pressure, blood, urine, or weight. Such changes may be warnings of potential problems.

Regular care also helps you learn to recognize the difference between the normal changes your body is going through and those which may represent early warning signs.

It is important that you recognize these early warning signs so that you can notify your doctor or someone at the clinic immediately.

• Bleeding, no matter how slight, from the vagina, rectum, nipple, or lungs (coughing blood)

• Swelling or puffiness of the face or hands

• A sudden large weight gain

• Persistent severe swelling of the legs

• Severe or repeated headaches

• Dimness, blurred vision, flashes of light, or spots before your eyes

• Sharp or prolonged pain in your abdomen

• Severe or continued vomiting

• Chills and/or fever

• Sudden escape of fluid from the vagina

If you notice any of these signs, do not wait for your next checkup. Contact your doctor immediately, so the cause of the problem can be identified and treatment begun.

Following are some of the problems that can occur during pregnancy.

Miscarriage

A miscarriage occurs when the fetus is born before it has developed enough to live outside the mother's body. Early signs of miscarriage are bleeding and cramps and if you notice bleeding from your vagina, you should call your physician immediately. Save the pads you wear to catch the blood, clots, and tissue, because the doctor will want to inspect them as soon as possible.

In some cases, miscarriage is nature's way of preventing the birth of fetuses that for various reasons could not have survived. Miscarriage can be caused by certain health problems, but usually there is no apparent reason. Usually, such miscarriages cannot be prevented.

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Severe Vomiting

Nausea and vomiting affect some women in early pregnancy. However, if vomiting continues or is so severe you cannot keep anything down, it should be reported. You need nourishment and so does your baby. If you keep vomiting, neither of you is getting the foods and liquids you need.

Anemia

The most common form of anemia occurs when your body does not have enough iron to build the extra red blood cells you need while you are pregnant. This form of anemia can usually be prevented by eating foods that are high in iron. Foods high in iron include liver, red meats, dried beans, leafy green vegetables, and iron-fortified cereals.

Many doctors prescribe iron supplements during pregnancy because the need for iron is greater than is usually contained in the average diet. When you are taking an iron supplement your bowel movements will be darker and harder so you should increase the amounts of fluids and roughage in your diet. Be sure to keep iron supplement tablets, like all medicine, in a safe place so children cannot accidentally eat them.

There are other, more serious forms of anemia, and if any of them are found during the early laboratory tests, your pregnancy will be followed more closely. Be sure to tell your doctor if you or any relatives are anemic or have blood diseases.

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Bladder and Kidney Infections

The risk of bladder or kidney infection increases during pregnancy due to changes and increased pressure in the urinary tract. Warning signs include abdominal pain, chills, fever, frequent urination in mid-pregnancy, burning on urination, and blood in the urine. If you have any of these problems, seek treatment immediately. If you do get a urinary infection it is especially important that you increase the amount of fluid you drink every day.

Toxemia

Toxemia is a serious complication of pregnancy. Although the cause is unknown, it can be successfully treated if diagnosed early. Signs of toxemia include a sudden weight gain, swelling of the feet and hands, severe headaches, dizziness, blurred vision, or spots before the eyes. These may be accompanied by changes in the urine and an increase in blood pressure. Toxemia usually occurs only in the last half of pregnancy.

Notify your doctor at once if you have any of these signs. Untreated toxemia is dangerous to both a pregnant woman and her unborn baby because it sometimes progresses to convulsions. Toxemia can usually be controlled at home if it is found early and the doctor's instructions are followed. However, some women are hospitalized to prevent complications or convulsions.

Rubella

Rubella, or German measles, is usually a mild disease in children and adults. But, if a woman is infected just before or during pregnancy, particularly early pregnancy, rubella can cause heart disease, blindness, hearing loss, and other serious health problems for the baby.

Avoid contact with anyone who has German measles or other infections. If you or someone in your family has been exposed to rubella, tell your doctor at once. The progress of your developing baby will be carefully monitored.

Although a vaccine for rubella is available, it should not be given to a woman who is pregnant or a woman planning to become pregnant within 3 months. Remember, most women are immune and therefore the baby is not at risk.

Rh Factor

As part of your physical examination your blood is checked for a substance called the Rh factor. If your blood contains this factor, you are Rh positive. If your blood does not contain it you are Rh negative. About 85 percent of white women are Rh positive. The Rh factor is much less common in black and Asian women.

If the mother has the Rh factor, or both parents have the Rh factor, or if neither parent has the Rh factor, there is no problem. However, if you are Rh negative and the father is Rh positive, there is a possibility that the baby's blood may also be Rh positive, i.e., the opposite of yours. In this case your body manufactures substances called Rh antibodies that will affect your unborn baby's Rh positive blood cells. Antibodies are normally useful because they protect you from many common diseases, but in this case, the antibodies can make your baby anemic and sensitize you for future pregnancies. Fortunately, Rh sensitization does not usually affect the baby in your first pregnancy.

If you are Rh negative and you have not become sensitized to the Rh factor, you should have an injection of Rh immunoglobulin within 72 hours of every delivery, miscarriage, or abortion. This usually protects each baby in future pregnancies. If you know you are Rh negative, be sure to remind your doctor or someone at the clinic.

Sexually Transmitted Diseases

Sexually transmitted diseases (STDs) are infections spread by sexual contact. Many people call them venereal diseases or VD. The most serious in pregnancy are gonorrhea, syphilis, and genital herpes. Prompt medical care can protect both you and your baby.

Usually, gonorrhea produces no symptoms at all in women. However, it may cause vaginal discharge or burning on urination. If untreated gonorrhea spreads through the blood to other parts of the body, it poses a real danger for mothers and babies in pregnancy. This form of gonorrhea may cause fever, joint pains, or skin rash.

Gonorrhea may also spread to your baby's eyes during birth. All women should be tested for gonorrhea early in their pregnancy. The prompt detection and treatment of gonorrhea will prevent complications for infected mothers and their babies.

Syphilis is a very serious infection that can infect the baby before birth. All mothers receive a blood test for this infection early in their prenatal care. In adults, the infection usually starts as a firm, reddish sore on the genital area or in the vagina. It does not hurt. Even without treatment, the sore heals and other symptoms such as a skin rash may follow. After several weeks, these signs also disappear with or without treatment. You should tell your doctor about any unusual lumps, sores, or rashes on your body. Unless you are treated with antibiotics, the syphilis germs are still in the body, even though the sores and rashes go away. Infection in the baby is usually prevented when the mother is fully treated in pregnancy.

Herpes, a virus infection that causes painful blisters on the genitals, is becoming more common. Symptoms can be relieved with medicine, but there is no cure. The infection may reappear on its own. If you or your sexual partner have any signs of herpes infection, you should tell your doctor about them, because this disease may influence the way your pregnancy is managed.

Some kinds of vaginitis are acquired sexually but this disease frequently occurs in pregnancy for no apparent reason. These infections usually are not serious, but can be bothersome because they cause pain, itching, and discharge. A pelvic exam is necessary for your doctor to determine the cause of the infection and to select a safe and effective medicine to cure it.

Any time you are exposed to an STD, or think you might have one, it is very important that both you and your partner receive prompt medical attention.