Understanding Labor and Delivery Complications - the Basics

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What Are the Common Labor and Delivery Complications? continued...

Umbilical Cord Compression

Because the fetus moves and kicks inside the uterus, the umbilical cord can wrap and unwrap itself around the baby many times throughout pregnancy. While there are "cord accidents" in which the cord gets twisted around and harms the baby, this is extremely rare and usually can't be prevented.

Sometimes the umbilical cord gets stretched and compressed during labor, leading to a brief decrease in blood flow to the fetus. This can cause sudden, short drops in fetal heart rate, called variable decelerations, which are usually picked up by monitors during labor. Cord compression happens in about 1 in 10 deliveries. In most cases, these heart rate changes are of no major concern, and the birth proceeds normally. But a cesarean delivery may be necessary if the baby's heart rate worsens or the fetus shows other signs of distress, such as a decrease of fetal blood pH or passing of the baby's first stool (meconium).

Amniotic Fluid Embolism

This is one of the most serious complications of labor and delivery. Very rarely, a small amount of amniotic fluid -- the fluid that surrounds the fetus in the uterus -- enters the mother'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. For the mother, this constriction can result in a rapid heart rate, irregular heart rhythm, collapse, shock, or even cardiac arrest and death. Widespread blood clotting is a common complication, requiring emergency care.

Preeclampsia

Preeclampsia is a complication of pregnancy involving high blood pressure that develops late in pregnancy or shortly after delivery. Preeclampsia may lead to premature detachment of the placenta from the uterus.

Uterine Bleeding (Postpartum Hemorrhage)

After a baby is delivered, excessive bleeding from the uterus, called postpartum hemorrhage, can be a major concern. Excessive bleeding may result when the contractions of the uterus after delivery are impaired, and the blood vessels that opened when the placenta detached from the wall of the uterus continue to bleed.

Post-Term Pregnancy and Post-Maturity

In most pregnancies that go a little beyond 41 to 42 weeks, called post-maturity or a post-term pregnancy, no problems develop. However, problems may develop if the placenta can no longer provide enough nourishment to maintain a healthy environment for the fetus.

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