Pregnancy Complications

Miscarriage
Fifteen percent of pregnancies end in miscarriage, leaving many couples heartbroken. OB/GYN Dr. Lisa Masterson explains that a miscarriage, or loss of a fetus, can occur in the first 20 weeks of pregnancy. Loss of a fetus after 20 weeks of pregnancy is defined as a stillbirth.

If a woman has what’s called an incompetent cervix, her cervix will dilate, or open, painlessly and without contractions, in the second trimester of pregnancy. The cervix is meant to remain closed until the baby is ready to be born, so this dilation can cause a miscarriage. To prevent this from happening, doctors can sew the cervix closed in a procedure called cervical cerclage, which is performed at approximately 13 to 14 weeks.

One of the symptoms of miscarriage is bleeding, but 50 percent of pregnancies can have bleeding, so remaining in constant contact with your doctor is vital if this happens. If you want to get pregnant, make sure to schedule pre-conceptual care, where your obstetrician-gynecologist will look for potential complications such as:

Infectious problems:
Autoimmune problems like lupus Diabetes Thyroid problems Thrombophilias (blood clotting disorders) Genetic disorders

Miscarriages are common, but many women don't talk about it. One in seven women will have a miscarriage, and 15 to 20 percent of pregnancies will end in one. It's important for women to have a support system and talk about their difficulties, and not to suffer in silence.

 

Wendy Williams shares her heartbreaking history of trying to have a baby. 

 

Dr. Lisa explains what a cerclage is and how it's used to help prevent a miscarriage















Find support and resources for miscarriages in The Doctors Motherhood Survival Club!  

Test for Premature Birth
Premature labor, or premature birth, is the leading cause of infant mortality in the United States.

Premature birth is defined as an infant born at 37 weeks of gestation or earlier (a full gestation lasts 40 weeks), and afflicts approximately one in eight babies. A new product called FullTerm Fetal Fibronectin test , is FDA approved and can predict whether a mother is at risk for premature labor. 


Gestational Diabetes

One of the most important tests a pregnant woman should have is for gestational diabetes, a condition in which women either aren’t producing enough insulin or develop a resistance to insulin. Gestational diabetes develops in up to 10 percent of expecting women, and the test is performed at 24 to 28 weeks of pregnancy.

When a woman is pregnant, the placenta develops to supply essential nutrients to the baby. The placenta also produces several hormones that are needed to sustain pregnancy, some of which will interfere with the mother’s ability to metabolize glucose, or sugar. Glucose is metabolized with insulin, and during pregnancy, a woman will need up to three times as much insulin to control her glucose levels.

“Pregnancy causes an insulin resistance, because [the body] wants to maximize the sugar that’s in the blood so that more can go to the baby,” OB/GYN Dr. Lisa Masterson explains.

A woman has an increased chance of developing gestational diabetes if she:
a) Had gestational diabetes during a previous pregnancy
b) Previously gave birth to a baby who weighed more than 9 pounds
c) Is overweight
d) Is 25 years of age or younger

“It all comes down to decreasing your risk with diet and lifestyle, which is how we deal with diabetes,” Dr. Lisa says.

Cholestasis of Pregnancy
Cholestasis of pregnancy, is a more serious rash that usually appears in the third trimester and can have adverse effects on the baby. Cholestasis occurs when bile gets trapped in the mother's liver. The bile acids enter the bloodstream, can affect the fetus and result in a stillbirth. Cholestasis causes itching, often on the palms of the hands and soles of the feet, and can also cause jaundice, a yellow staining of the skin. The itching can spread to the trunk of the body, as well.

More on skin issues during pregnancy.

Molar PregnancyOB/GYN Dr. Lisa Masterson explains a molar pregnancy and how the condition is treated.