Medical Conditions and Pregnancy Planning

Planning your pregnancy.

If you have either an acute or a chronic disease -- anything from asthma to cancer -- careful pre-pregnancy planning is especially important. Any medical condition that can affect you when you're not pregnant may have a significant effect on your pregnancy. Unfortunately, as women delay childbearing the passage of time makes them more likely to develop a chronic disease. Remember that the course of the disease may be affected adversely as your body undergoes the dramatic changes of pregnancy, and, conversely, some medical conditions put you into a higher risk category for pregnancy.

Some diseases or their treatment, such as diabetes and epilepsy, may increase the risk of miscarriage or birth defects. Heart disease and urinary tract infections may cause premature labor or result in poor growth of the fetus. Hypertension may cause fetal distress or abruptio placenta, in which the placenta separates from the uterus and threatens the fetus's oxygen supply. Both you and your medical practitioner must constantly be aware of the fact that there are two patients: the mother and the fetus.

Bodily Changes

When you become pregnant, your body changes drastically. Your shape changes, your size increases, your ankles swell. There are also unseen changes, however, that may cause noticeable symptoms. For example, when the hormone progesterone increases during pregnancy, it relaxes the body's smooth muscles. These muscles perform many functions, including the contracting of blood vessels. When you become pregnant, your rising progesterone levels cause your blood vessels to dilate, which can contribute to hemorrhoids and varicose veins, as well as cause a chronic stuffy nose or bleeding gums. You may also suffer from heartburn, since the muscle that controls the valve, or sphincter, between the stomach and esophagus relaxes, allowing acid to escape into the esophagus.

For every noticeable change, many more are not noticeable at all in a healthy pregnancy. Most major bodily organs, including the heart, lungs, and kidneys, have to work harder or differently in order to adapt to pregnancy. The bodies of most healthy women are able to adjust and adapt to these changes without difficulty. In some women with medical conditions, however, their disease may affect their body's ability to adapt to the demands of pregnancy.

Interestingly, some diseases may actually improve during pregnancy. Included in this category are certain immunological conditions, such as inflammatory bowel disease, asthma, and rheumatoid arthritis. The steroids your body produces when you're pregnant are similar to the treatment you'd ordinarily receive for these conditions. Bronwyn is a 23-year-old patient of mine who had asthma attacks that required visits to the emergency room nearly every month. During her pregnancy, however, because of the hormonal changes that occurred, her need for medication was reduced, and she had fewer attacks and emergency-room visits.