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Uncommon complications in pregnancy

Gestational diabete

Gestational diabetes is high blood sugar that develops during pregnancy and usually disappears after the birth. It occurs when the body cannot produce enough insulin (a hormone responsible for controlling bloodsugar levels) to meet the increased demands of pregnancy. Symptom saren’t common, but many women are screened for this condition duringpregnancy, particularly if they have certain ‘risk factors’. Ask your midwife if you are at risk of developing gestational diabetes and if you need tobe tested.

Pre-eclampsia

Pre-eclampsia is a rare but serious condition of pregnancy, usually occurring after 20 weeks. It is defined as raised blood pressure and protein in the urine. Pre-eclampsia is usually detected through regularantenatal checks, but can sometimes develop quickly Symptoms include:

  • severe headaches
  • sudden increase in swelling - particularly in the face, hands,feet or ankles
  • problems with your vision
  • pain just below your ribs
  • feeling very unwell or tired.

If you have any symptoms of pre-eclampsiaor intrahepatic cholestasis of pregnancy call your maternity triage/assessment unit straight away.

Intrahepatic cholestasis of pregnancy

Intrahepatic cholestasis of pregnancy is a liver disorder that can develop in pregnancy (usually after 30 weeks gestation), affecting up to one in every 140 pregnant women. Symptoms include:

  • severe itching, normally on the hands and feet (commonly)
  • dark urine, pale stools (rarely)
  • yellowing of the skin and whites of the eyes (rarely)

If you have any symptoms of pre-eclampsiaor intrahepatic cholestasis of pregnancy call your maternity triage/assessment unit straight away.

Placenta praevia

Placenta praevia can be picked up on an ultrasound scan as a ‘low lyingplacenta’ in mid pregnancy. This is when the placenta is covering all or part of the entrance to the womb. If you are found to have a low lying placenta you will be re-scanned between 32-36 weeks. The majority of low lying placentas will move to the upper part of the womb by 36 weeks, however 10% of low lying placentas remain low. This can cause bleeding in pregnancy that is sudden and severe.

A caesarean birth may be recommended in cases of severe placenta praevia, and the likelihood of needing for a blood transfusion can be higher. The placenta can also sometimes implant abnormally into the wall of the womb. This is a rare condition known as placenta accreta.

The risk of having placenta accreta is higher if there is a previous scar on the womb, such as from a previous caesarean section, as the placenta can invade into the previous scar. This is a very serious condition that can be challenging to manage and a hysterectomy (operation to remove the womb) is sometimes needed at the time of delivery.