Common Pregnancy Complications: Causes and Implications

Introduction

During pregnancy, women may experience a wide range of health problems and complications. These complications can have a negative impact on the health of the mother, the unborn baby, or both. This paper examines some of the more common complications of pregnancy, including bleeding disorders, hypertension, psychological disorders, placental abruption, and cervical insufficiency. As will be shown, pregnancy complications are rather prevalent. This topic was selected in response to the need to develop a better understanding of the various problems that can affect the health of the mother and/or the unborn child. With that understanding, relevant strategies can be adopted to secure and further promote the health of both.

Common Complications of Pregnancy

At the outset, it is worth noting that, as the Centers for Disease Control and Prevention (CDC, 2020) points out, "pregnancy complications" is an all-inclusive term for the various health concerns that can arise during pregnancy. As noted in the introduction, the CDC (2020) is categorical that these complications can affect not only the health and wellbeing of the mother, but also that of the child. Regarding the prevalence of pregnancy complications in the United States, available data indicate that "complications during pregnancy, childbirth, and the postpartum period ranked as the 6th greatest cause of death among women aged 20 to 34 in the United States" (Collier and Molina, 2019). This underscores the urgency of addressing this public health concern.

One of the more common pregnancy complications is hypertension. According to the CDC (2019), there are several categories of hypertensive disorders during pregnancy: gestational hypertension, preeclampsia, and eclampsia. Gestational hypertension is high blood pressure that develops during the course of the pregnancy. Preeclampsia is defined as "high blood pressure and signs of problems with the kidneys, liver, and other organs" (CDC, 2019). Eclampsia, on the other hand, is diagnosed when a pregnant woman presents with seizures alongside preeclampsia and has no other condition that would account for the seizures, such as epilepsy (CDC, 2019). It is also important to note that a woman may have been diagnosed with hypertension prior to becoming pregnant; in that case, the condition is referred to as chronic hypertension.

Hypertension during pregnancy can trigger a number of serious problems. For instance, it can negatively affect the development of the placenta, effectively depriving the baby of an adequate oxygen supply (Braunthal and Brateanu, 2019). This can result in placental abruption, low birth weight, and premature delivery. The types of hypertension described above affect the body differently and vary in severity. According to the CDC (2019), rates of hypertension during pregnancy have been on an upward trajectory over recent decades, indicating that more needs to be done to reverse this trend. Braunthal and Brateanu (2019) identify the following as higher-risk groups: women with conditions such as kidney disease or lupus, those who are overweight or obese, those diagnosed with diabetes, those with a family history of gestational hypertension, and those under 20 or over 40 years of age.

Another significant pregnancy complication involves bleeding disorders. In essence, these disorders affect the blood's ability to clot normally following injury, whether internal or external. Failure of the blood to clot as expected can result in severe bleeding. James, Steer, and Weiner (2017) note that bleeding disorders can negatively affect the health of both the mother and the baby during pregnancy, with complications including severe postpartum hemorrhage and bleeding during the pregnancy itself.

Bleeding disorders may be attributed to a number of factors, including certain obstetric complications, the effects of blood thinners (anticoagulants), platelet disorders, hemophilia, and diseases such as Von Willebrand disease (James, Steer, and Weiner, 2017). Given the serious complications that can result, the authors emphasize the importance of careful investigation of clinical signs and symptoms, with diagnosis accomplished through blood tests. Once a bleeding disorder is identified, close monitoring is essential. There may also be a need to involve a multidisciplinary team of specialized healthcare professionals — such as an OB/GYN with experience in managing high-risk pregnancies, an anesthesiologist, and a hematologist — to provide specialized care and manage the patient's heightened baseline risk of bleeding.

A third complication worth examining is placental abruption. In the words of James, Steer, and Weiner (2017), "placental abruption occurs when the placenta partly or completely separates from the inner wall of the uterus before delivery" (p. 217). The authors describe it as a serious yet relatively uncommon pregnancy complication. The placenta plays a crucial role during pregnancy: in addition to clearing waste products from the baby's blood, it supplies oxygen and essential nutrients to the developing baby. This organ is normally attached to the wall of the mother's uterus throughout the pregnancy.

Complete or partial separation of the placenta from the uterine wall prior to delivery deprives the baby of its nutrient and oxygen supply and can trigger serious bleeding in the mother. Additional complications for the mother include organ failure and shock resulting from blood loss, as well as blood clotting problems. For the baby, abruption can result in stillbirth or premature birth, as well as stunted growth due to insufficient nutrient delivery. Because this complication typically occurs suddenly, urgent intervention is critical. James, Steer, and Weiner (2017) note that the exact cause of placental abruption largely remains unknown; however, speculated causes include sudden loss of amniotic fluid and serious abdominal trauma, such as that resulting from a heavy blow to the abdomen or a traffic accident. Research into the causes of abruption is ongoing.

Cervical insufficiency, also referred to as incompetent cervix, results from weakness of the cervical tissue. Ordinarily, the cervix remains closed throughout pregnancy and then opens and thins just before childbirth. When the cervix thins and opens too early in the pregnancy, this constitutes cervical insufficiency. Complications associated with this condition include premature birth and miscarriage. Research has identified a wide range of contributing factors, including diethylstilbestrol exposure, uterine damage (for example, from a past complicated delivery), a short cervix (measuring below 25 mm), prior cervical surgery, and abnormal cervical or uterine formation (Li, Li, Zhao, Cheng, Burjoo, Yang, and Xu, 2020). Past studies have also indicated that race is a risk factor for incompetent cervix; James, Steer, and Weiner (2017) note that Black women face the highest risk of this particular complication.

Diagnosis of cervical insufficiency can be made through ultrasound and pelvic examination. One intervention that has been used is cerclage, a procedure that reinforces the strength of the cervix (Li, Li, Zhao, Cheng, Burjoo, Yang, and Xu, 2020).

A number of psychiatric disorders can occur during pregnancy, ranging from mood disorders and anxiety disorders to depression. These disorders should be considered an integral part of the overall health and wellbeing of both the mother and the unborn child, particularly because they are often related to the physiological and temperamental changes associated with pregnancy (McLeish and Redshaw, 2017). One of the more commonly underdiagnosed psychiatric conditions during pregnancy is postpartum depression (McLeish and Redshaw, 2017). Identified risk factors for postpartum depression include poor social support and anxiety. Treatment options include antidepressants and psychotherapy.

Conclusion

This paper has demonstrated that women may encounter a wide range of complications during pregnancy, and that these complications can have a significant impact on the wellbeing of both the mother and the unborn child. Several suggestions have been offered regarding how government can intervene to protect the health of pregnant women. The importance of social support for pregnant women has been highlighted, as has the need for healthcare practitioners to be responsive to the religious needs of their clients. Finally, the paper has underscored the importance of ethically conducted research in advancing knowledge that can safeguard the health of future mothers and their fetuses.

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