Pregnancy Complications

It's Complicated

Every pregnancy is different. While everyone wishes for a smooth sailing journey, some may experience otherwise. Our experts share more on the symptoms of pregnancy complications, essential screening tests and how to cope with the disappointment after a miscarriage.

Pregnancy Red Flags

Pain
While minor cramping is common during early pregnancy, see the doctor if you experience severe abdominal pain. This may be a symptom of an ectopic pregnancy, a possible risk of miscarriage, or an ovarian cyst complication. If it occurs during late pregnancy, it may be a symptom of placental separation, uterine rupture, or even labour pains! You should note the nature of the pain, its intensity and frequency, and if there are other symptoms to rule out non-pregnancy conditions such as appendicitis or urinary tract infection.

Bleeding
It is not uncommon to have vaginal bleeding in the early stages of pregnancy. Nonetheless, you should note the amount of bleeding, the nature of the blood, and whether it is there is any pain. A quick trip to the doctor can ascertain how the pregnancy is doing. If the bleeding is heavy, or there is severe pain, it is advisable to visit the doctor immediately. In particular, bleeding during late pregnancy may be due to a low lying placenta, premature placenta separation, or a possible risk of premature labour.

Breathlessness/Chest Pains
It is common for pregnant women to have episodes of breathlessness. This may happen even while resting. It is usually harmless and resolves itself when you get distracted by other activities. However, if you feel chest pain and your breathing is laboured, or rapid and shallow, see a doctor immediately to exclude underlying heart or lung problems.

Severe Headaches
Mild headaches are common during pregnancy. If you feel other symptoms as well, such as nausea, blurring of vision, abdominal pain, or have high blood pressure during the pregnancy (pre-eclampsia), see a doctor immediately. This may be a sign of an impending seizure (eclamptic fit). If it pre-eclampsia, your baby may have to be delivered early.

Vomiting
Some degree of nausea and vomiting is common. Dehydration may occur if you cannot retain any food or even water. If normal anti-vomiting medication does not work, and you feel very weak and lethargic, see a doctor and consider admitting to the hospital for an IV drip. Severe vomiting may indicate an underlying bladder infection or thyroid disease.

Leg swelling with pain and redness
Most pregnant women experience leg swelling due to water retention. If you see redness and pain, it could be a sign of deep vein thrombosis. Book an appointment with your doctor to exclude this. Pregnant women also have a higher risk of developing blood clots, which can be life threatening if it dislodges and travels to the lungs.

Essential Screening Tests during Pregnancy

Your doctor may recommend some tests to give you a peace of mind and ensure a smooth delivery during your pregnancy. If there are complications, these tests help you and your doctor decide the next steps, which may include further testing. Dr Jazlan Joosoph, Specialist in Obstetrics and Gynaecology & Consultant, Raffles Women’s Centre, shares some of them.

Nuchal Translucency Test
NT Screen

Also called the NT screen, this is done during your first trimester, when you are 11 to 14 weeks pregnant. It is an ultrasound that evaluates your baby’s risk of Down Syndrome, chromosomal abnormalities and heart problems.

CTG Scan

The CTG scan is usually done during the third trimester. This scan monitors the foetus’ heart rate to ensure that your baby gets adequate oxygen from the placenta and monitor for signs of delivery.

Ultrasound Test

Done over the course of your pregnancy, the ultrasound test monitors the foetal growth and abnormalities.

Routine Blood Tests

Blood Test

Blood tests are mostly done at the end of the first trimester. These tests sets the groundwork for the rest of your pregnancy by detecting any underlying health issues the pregnant mother may have. It screens your body for the full blood count, blood group, antibody screening, as well as checking for evidence of infection or gestational diabetes.

Non-invasive Prenatal Testing (NIPT)

NIPT

The NIPT test is a fairly new screening test, also used to detect the likelihood of Down Syndrome and other chromosomal abnormalities. It is the most accurate test for Down Syndrome, which can be done earlier in your pregnancy, after 10 weeks.

Overcoming the Disappointment of a Miscarriage

Almost 10 to 20 per cent of all pregnancies end in a miscarriage. However, according to Dr Tony Tan, Specialist in Obstetrics and Gynaecology & Consultant, Raffles Women’s Centre, most miscarriages occurring in the first three months are not preventable, as these are foetuses that usually have chromosomal abnormalities or severe structural abnormalities. Dr Tan advises on how to respond if you or your loved one is affected.

Mums
While physical pain can easily be treated, the same cannot be said for emotional pain. Some women take two weeks to recover, while others take months, or even years. Because many mums review the sequence of events leading to the miscarriage in their minds and blame themselves for it; knowing and understanding the causes of miscarriages can reduce the pain.

Dads
Dads tend to be ignored during miscarriages. While some dads feel detached, there are others experiencing sadness as well. They need to understand the reasons for the miscarriage, which may not be due to activities caused by them. While both parents should grieve together; some dads may want to rationalise miscarriages, which mums may not appreciate. Just grieving and coming out of it together is the best way.

Relatives & Friends
Rather than rationalising why miscarriages happen, a simple “I am sorry about your loss” would do. Avoid giving advice or reasons for it, as they may not be scientific. It can even cause the parents to blame themselves or each other for the miscarriage, when the reason was due to chance. For example, patients have often confided that they felt very guilty as friends or relatives have suggested that they have miscarried because they were too stressed at work, or because they had taken certain foods, or done some unusual exercises.