Miscarriage

Miscarriage is the loss of a pregnancy within the first 20 weeks. About 10-20% of known pregnancies end in miscarriage, with more than 80% of miscarriages occuring before 12 weeks.

Most first-trimester miscarriages are caused by chromosomal abnormalities in the fertilised egg that keep the embryo from developing. Vaginal bleeding is usually the first sign and you are advised to contact your doctor or midwife as soon as possible if you notice bleeding. Although it’s not uncommon to bleed in early pregnancy even if you are not miscarrying.

If your Consultant suspects a miscarriage, they will order an ultrasound and may perform a blood test.

High Blood Pressure

Blood pressure is checked at every antenatal appointment using a sphygmomanometer. Blood pressure will change a little throughout pregnancy and is perfectly normal. Progesterone (pregnancy hormone) relaxes the walls of your blood vessels, which may make blood pressure fall during the first and second trimesters. Lower blood pressure may make you feel faint if you stand for too long or get up quickly.

It is lowest between 18 and 20 weeks of pregnancy. If you have high blood pressure before 20 weeks, it is called essential hypertension. This means you probably had high blood pressure before you became pregnant. After 20 weeks, high blood pressure is called gestational hypertension, which is the name for high blood pressure that develops during pregnancy.

If your blood pressure goes too high you may be advised to take medication to control it, with earlier gestational hypertension, increasing the need to control it with medicine. If you developed high blood pressure after 20 weeks it’s likely to return to normal after your baby is born, but it may take a few weeks.

Gestational Diabetes

Gestational diabetes is a type of diabetes that arises during pregnancy. In some women this occurs because the body cannot produce enough insulin to meet the extra needs of pregnancy. If gestational diabetse is found during the first trimester of pregnancy, the condition most likely existed before the pregnancy.

An Oral Glucose Tolerance Test OGTT) is used to diagnose, which involves a blood test before breakfast, then again two hours after a glucose drink. Risk factors include obesity, a family history of Type 2 diabetes (parent, brother or sister), an unexplained stillbirth or neonatal death in a previous pregnancy, and/or a very large infant in a previous pregnancy (4.5kg or over), you have had gestational diabetes before, or your family origin is South Asian, Black Caribbean or Middle Eastern.

Pre-eclampsia

Pre-eclampsia is thought to happen when the placenta isn’t working properly, which without treamtent can make you and your baby quite ill. Pre-eclampsia occurs in the second half of your pregnancy. You’re most likely to develop it in the third trimester, after 27 weeks.

Your Consultant will carry out tests for igns of pre-eclampsia each time you have your antenatal appointment, such as high blood pressure and protein in your urine. Symptoms include sudden, severe swelling of your face, hands or feet, severe headaches, problems with your vision, such as blurring or flashing before your eyes, severe pain just below your ribs, or a general feeling of being unwell.

Pre-eclampsia can range from mild to severe. Mild pre-eclampsia is quite common, affecting about one mum-to-be in 10 in her first pregnancy. If it’s mild you may not know that you have it until your midwife picks up signs of it during one of your antenatal checks. Early monitoring and treatment will help to keep you and your baby well.

Ectopic Pregnancy

An ectopic pregnancy is when a fertilized egg implants outside the uterus. This happens in approx 2% of pregnancies, with the majority occuring in a fallopian tube. It’s important to catch this type of pregnancy early because the growing embryo could rupture your fallopian tube and cause internal bleeding, which can in turn be fatal. Since there’s no way to transplant an ectopic pregnancy into the uterus, ending the pregnancy is the only option.

Placenta Previa

If you have placenta previa, your placenta is lying unusually low in your uterus, next to or covering your cervix. Placenta previa isn’t usually a problem early in pregnancy. But if the placenta remains dangerously low as your pregnancy progresses, it can cause bleeding, which can lead to other complications and may require you to deliver early. The location of your placenta will be checked during your midpregnancy ultrasound exam, but only a small percentage of women who have placenta previa in midpregnancy still have it when they deliver their baby. Placenta previa is present in 0.5% of deliveries.