Problems affecting Mommy
Problems Affecting Woman in pregnancy and birth
Preeclampsia is a complication of pregnancy. It involves high blood pressure that develops late in pregnancy or shortly after delivery. Preeclampsia may lead to premature detachment of the placenta from the uterus (placental abruption) and problems in the newborn.
Amniotic Fluid Embolism:
Very rarely, a volume of amniotic fluid—the fluid that surrounds the fetus in the uterus—enters the woman's bloodstream, usually during a particularly difficult labor. The fluid travels to the woman's lungs and may cause the arteries in the lungs to constrict. This constriction may result in a rapid heart rate, irregular heart rhythm, collapse, shock, or even cardiac arrest and death. Widespread blood clotting (disseminated intravascular coagulation) is a common complication, requiring emergency care.
After the baby is delivered, excessive bleeding (postpartum hemorrhage) from the uterus is a major concern. Ordinarily, the woman loses about 1 pint of blood after delivery. Blood is lost because some blood vessels are opened when the placenta detaches from the uterus. The contractions of the uterus help close these vessels until the vessels can heal.
Loss of more than 1 pint of blood during or after the third stage of labor (when the placenta is delivered) is considered excessive. Severe blood loss usually occurs soon after delivery but may occur even as late as 1 month afterward.
Excessive bleeding may result when the contractions of the uterus after delivery are impaired. Then, the blood vessels that were opened when the placenta detached continue to bleed. Contractions may be impaired if the uterus has been stretched too much—for example, by too much amniotic fluid in the uterus, by several fetuses, or by a very large fetus. Contractions may also be impaired when a piece of placenta remains inside the uterus after delivery, when the labor was prolonged or abnormal, when a woman has been pregnant several times, or when a muscle-relaxing anesthetic was used during labor and delivery. Excessive bleeding can result if the vagina or cervix is torn or cut during delivery or the blood level of fibrinogen (which helps blood to clot) is low. Excessive bleeding after one delivery may increase the risk of excessive bleeding after subsequent deliveries.
Before a woman goes into labor, doctors take steps to prevent or to prepare for excessive bleeding after delivery. For example, they determine whether the woman has any conditions that increase the risk of bleeding, such as too much amniotic fluid. If the woman has an unusual blood type, doctors make sure that her type of blood is available. After delivery of the placenta, the woman is monitored for at least 1 hour to make sure that the uterus has contracted and to assess vaginal bleeding.
If severe bleeding occurs, the woman's lower abdomen is massaged to help the uterus contract, and she is given oxytocin continuously through an intravenous line to help the uterus contract. If bleeding continues, prostaglandins can be injected into the uterine muscle to help the uterus contract. The woman may need a blood transfusion.
Doctors look for the cause of excessive bleeding. The uterus may be examined for retained fragments of the placenta. Dilation and curettage may be performed to remove these fragments. In this procedure, a small, sharp instrument (curet) is passed through the cervix (which is usually still open from the delivery. The curet is used to remove the retained fragments. This procedure requires an anesthetic. The cervix and vagina are examined for any tears.
If the uterus cannot be stimulated to contract and bleeding continues, the arteries supplying blood to the uterus may have to be closed off. The procedures used usually have no lasting ill effects, such as infertility or abnormalities in menstruation. Removal of the uterus (hysterectomy) is rarely necessary to stop the bleeding.
Very rarely, the uterus is turned inside out, so that it protrudes through the cervix, into or through the vagina. An inverted uterus is a medical emergency that must be treated promptly. Doctors return the uterus to its normal position (reinvert it) by hand. Usually, the woman recovers fully after this procedure.