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Fertility Diaries: They Dreamed of Motherhood Together

Placenta Previa

It has been speculated that in a natural pregnancy, the egg usually implants itself fairly high up in the uterus; but in an IVF pregnancy, the egg tends to implant toward the bottom. This could cause placenta previa, in which the placenta partially or completely covers the cervix, blocking the baby's eventual exit. Fortunately, this condition is easily diagnosed, usually during an expecting mom's first ultrasound.

Warning signs: unexplained vaginal bleeding, usually without pain.

If you're diagnosed: If there is no bleeding or just a little spotting, patients are usually advised to avoid intercourse and to keep vigilant watch for early contractions. If bleeding is present and continues, you might have to be hospitalized briefly for observation, and a cesarean section will probably be necessary.

Placenta Abruption

Usually occurring during the last trimester, an abruption is a partial or complete separation of the placenta from the uterine wall. This tear can cause bleeding and possibly decrease oxygen flow to the fetus. Your risk is higher if you have high blood pressure or sickle-cell anemia, or if you smoke, are over 35, or have had previous children.

Warning signs: unexplained bleeding, which could be heavy, or stomach pain without bleeding.

If you're diagnosed: Most patients are hospitalized for observation, and if bleeding doesn't recur, sent home at modified activity.

Preeclampsia

Between 4 percent and 7 percent of pregnant women develop this form of high blood pressure, which can affect blood flow to the placenta and, if severe, can damage a woman's liver, heart, and other organs. You're at greater risk if you're African-American, pregnant for the first time, over 35, or carrying more than one baby. A history of hypertension, diabetes, or kidney disease also increases your odds. Experts aren't sure how to prevent preeclampsia, but if you're at risk, you and your doctor will need to closely monitor your blood pressure.

Warning signs: sudden swelling of the face, hands, legs, or feet; rapid or sudden weight gain toward the end of pregnancy; severe headache; and/or pain on your right side, under the rib cage.

If you're diagnosed: For mild preeclampsia, your ob/gyn will want to see you more often and may put you on bed rest until delivery. In more severe cases, however, your doctor may need to induce labor.

Gestational Diabetes

Hormones produced by the placenta can interfere with the way you process insulin (a hormone that controls blood sugar), which can cause gestational diabetes. Resulting high glucose levels may lead to problems such as preeclampsia, respiratory problems for your newborn, and even, very rarely, stillbirth. Hypertension, high cholesterol, polycystic ovarian syndrome, or a family history of diabetes or heart disease can increase your risk, so if any of these conditions affect you, ask for a diabetes test during your first prenatal visit.

Warning signs: unquenchable thirst, frequent urination, excess weight gain, and/or a large baby — or no symptoms at all.

If you're diagnosed: Your doctor may perform more frequent ultrasounds and electronic fetal monitoring to keep close tabs on the baby's progress. To control glucose levels, you may need to take insulin shots or medication or just modify your diet. Gestational diabetes usually goes away after delivery.
NancyKalish

 

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