Pregnancy Complications
Title slide
Introduction
Pregnancies are times of many psychological and physiological adjustments that can negatively or positively affect the woman, her family, or the fetus. Pregnancy complications comprise health challenges taking place during pregnancy. They entail the mother’s wellbeing, the baby’s health, or both. Often, some difficulties arise during the pregnancy period, while others before pregnancies take place. Several groups of women are vulnerable to pregnancy complications. Some of these groups are as discussed below.
Vulnerable Groups
- Women under the age of 20
According to Zande (2017), women under the age of 20 years are more prone to pregnancy complications than those above 20 years. Underage mothers are most likely to deliver babies with low birth weight, deliver prematurely, develop preeclampsia, or experience pregnancy-induced hypertension. Associated risk factors for the group comprise high blood pressure, nutritional deficiencies, and underdeveloped pelvis. Concerning the case of the underdeveloped pelvis, young women’s bodies are still changing and growing. Most often, the pelvis has not undergone full enlargement and development to support a pregnancy.
Nursing intervention:
The use of contraception is most advised for underage children. If pregnancy happens, Horgan and Kenny (2011) suggest general countermeasures such as smoking cessation and attendance of antenatal clinics to diagnose and prevent potential pregnancy issues. For the case of the immature pelvis, extra care during labour pains and delivery is advised.
In the postnatal phase, obstetricians, general practitioners, midwives, social workers, and health visitors participate in counselling the underage and often the isolated and inexperienced mother.
- Women Over the age of 35
Beyond facing decreased chances of conceiving, women above the age of 35 years also face the risk of pregnancy complications. Bebbington, Sturt, Tennant, and Hurry (2015), in their study, associate most of these women with underlying conditions, such as diabetes, high blood pressure, and cardiovascular diseases that worsen the pregnancy. Besides these, women are at risk of giving birth to children with chromosomal challenges. Down syndrome is here the most common issue and results in decreased intellectual and physical abilities. Furthermore, these women face increased problems with miscarriages. Studies show that paternal age affects miscarriages. If the father is over 40 years and the woman above 35 years, the risk of miscarriages becomes more significant than if only the woman is above the mentioned age. The other challenges entail high blood pressure, low birth weights, and the need for cesarean delivery.
Intervention
Practitioners encourage preconception checkups, regular exercises, a healthy diet, and the right mental health. Determining the likelihood of some issues, such as chromosomal challenge, is possible with prenatal screening. Horgan and Kenny (2011) also advise affected mothers to take prenatal vitamins regularly, cease smoking, drinking, or use of risky substances, and consume a minimum of 400 micrograms of folic acid per day. Finally, there is a need to treat preexisting health conditions.
- Overweight or Underweight Women
Moreover, overweight or underweight women face increased threats of pregnancy complications. Obesity is a condition associated with overweight or body mass index (BMI) of more than 30. Women with the disease face higher threats of congenital disabilities that normal women. They risk delivering babies with conditions such as health challenges, cleft palate and lip, hydrocephaly, and spina bifida (Zande, 2017). In contrast, the underage women entail those weighing less than 100 pounds. They are most prone to delivering underweight babies.
Nursing Management
Vulnerable women are advised to lose weight before pregnancy. If pregnancy occurs, affected mothers are advised to manage their weight, place attention on exercise and diet, and regularly attend prenatal care to monitor weight and potential complications. For example, in the second and third trimesters, the mother needs an average of 300 extra calories a day. At the labour pain and delivery phase, special care is also essential to contain potential difficulties.
Underweight mothers are advised to put on weight. Women with eating disorders might need additional nutrients in the pregnancy period. Overall, the affected women need to eat frequent meals every few hours, work with a registered dietician, snack on a high nutrient high-calorie foods, cook with extra fats, and drink high-calorie beverage, with full-fat milk being one of them. Practitioners can also avail prenatal vitamins containing certain nutrients, such as calcium, iron, and foliate. DHA (docosahexaenoic acid) and Vitamin D can also help build sufficient nutrients.
- Women with Diabetes
Also, women with type 1 and type 2 diabetes face the risk of pregnancy difficulties. Inability or poor control of diabetes can risk childbirth defects. Even those women without prior diabetes conditions can be diagnosed with its symptoms or what is also known as gestational diabetes (Zande, 2017).
Intervention: Often, doctors recommend dietary changes if diagnosed with diabetes, or one might have to take some insulin to regulate the blood sugar levels.
- Women with Preexisting Medical Conditions or Prior Pregnancy Complications
Women with other range of preexisting medical conditions are also vulnerable. Those with chronic high blood pressure face heightened risk of preterm delivery, low birth weight, kidney damage, and preeclampsia. Also, women with Polycystic Ovary Syndrome (PCOS) face enhanced threats of miscarriage, gestational diabetes, miscarriages, and preeclampsia. Then, there are those with thyroid disease, such as hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid). The situation risks poor weight gain or heart failure in the fetus besides threatening congenital disabilities. Those women with previous pregnancy issues risk similar recurrence. For example, those who had prior preterm deliveries, chromosomal problems, or stillbirths risk facing similar situations in their subsequent pregnancies.
Nursing Intervention: Prenatal screening is paramount in identifying these conditions. Once noted, some situations such as high blood pressure can be managed to limit the impact on pregnancies.
- Women Suffering STIs
Furthermore, pregnancy complications are prone to women with STIs. There is a great danger of transmitting the disease to unborn babies, creating higher risks of a broad range of other related disorders. They entail low birth weight, pneumonia, blindness, acute hepatitis, meningitis, cirrhosis, chronic liver disease, deafness, conjunctivitis, and neurologic damage. Medical experts advise for the screening of varied STIs, including HIV, hepatitis C, hepatitis B, syphilis, chlamydia, and gonorrhea. Even without the danger of transmission to the child, some of these STIs cause risks of pregnancy complication by, for instance, heightening the threat of low birth weight, miscarriages, and premature births. HIV also can be transmitted to the child at childbirth, during pregnancy, or even during breastfeeding.
Nursing management:
Prenatal screening is essential. Noted conditions should be addressed accordingly. For example, Erythromycin, azithromycin, and amoxicillin can help treat chlamydia. Also, ceftriaxone and azithromycin are recommended for treating gonorrhea (Cavazos-Rehg et al., 2015).). In the case of an HIV positive mother, both the mother and the child will require medications to either prevent transmission or suppress the symptoms. Pre-exposure prophylaxis (PrEP) is essential if the mother is HIV negative and the partner HIV positive. The drug decreases the prospects of the mother contracting HIV from the partner.
- Women with Multiple Prior Pregnancies
Finally, pregnancy complications are common for those women who have had five or more prior pregnancies. They are prone to abnormally rapid labour accompanied by excess blood losses in their subsequent labour pains.
Intervention:
Conclusion
References
Bebbington, P. E., Sturt, E., Tennant, C., & Hurry J. (2015). Misfortune and resilience: a
community study of women. Psychological Medicine, 14 (2), 347-363
Cavazos-Rehg et al. (2015), Maternal age and risk of labour and delivery complications,
Maternal Child Health Journal, 19 (6), pp. 1202-1211
Horgan, R. P., & Kenny, L. C. (2011), Management of teenage pregnancy, Obstetrics &
Gynaecology, retrieved on 14th August 2020 from https://obgyn.onlinelibrary.wiley.com/doi/full/10.1576/toag.9.3.153.27334
Zande, I. (2017). The vulnerability of pregnant women in clinical research, Journal of Medical
Research, 43 (10), pp. 657-663