Complications in pregnancy

There are certain warning signs in pregnancy which needs immediate medical attention.

1. Bleeding

First trimester bleeding (0-3 months)

Bleeding during the first three months could be an indication of an ectopic pregnancy. Ectopic means the foetus is developing somewhere outside the uterus, for example in the Fallopian tube. It is a medical emergency.

First – second trimester bleeding (0-6 months)

Heavy bleeding with cramping can be a sign of a miscarriage during this time.

Last trimester bleeding (6-9 months)

• Bleeding during the 3rd trimester may indicate Abruptio placenta – which means the placenta tore lose from the uterine wall.
• It is also a medical emergency.
• Bleeding during pregnancy is thus always a serious matter .
• Visit you hospital if it occurs as soon as possible.

2. Severe nausea and vomiting

Nausea and vomiting is common in the first trimester of pregnancy. If you experience severe nausea and vomiting that leaves you dehydrated and malnourished, you should see your  doctor for a prescription medicine to stop the nausea. It can harm the baby if you are malnourished.

3. Active baby becomes quiet

An active baby is a healthy baby. If your baby suddenly quiets down and moves very seldom or not at all, it is a reason for concern. A baby should move or kick about ten times every two hours. If you are concerned about your baby not moving enough, please see your doctor. They have equipment to monitor the baby’s well-being.

4. Contractions early in third trimester

There are two types of contractions. The first are called Braxton-Hicks contractions. They are just painless contractions of the uterus, that are practise contractions. They do not increase in intensity. It can be called false labour.

• The real labour contractions are painfull, they increase in intensity and are rythmic.
• When they are ten minutes apart you are in labour.
• This need medical attention if you are not yet full time in your pregnancy.
• A baby’s lungs are not yet fully developed by 36 weeks, and premature birth could be a problem.

5. Water breaks

The baby grows in the uterus in a protective thin bag full of water. The bag (thin membranes) is called the amniotic sac and is filled with amniotic fluid.

Membrane rupture can happen subtly with amniotic fluid trickling out of your vagina, or with a sudden burst and gush of water down your legs.

If this happens you might go into spontaneous labour and you should get to a hospital as soon as you can.

Trickling amniotic fluid don’t necessarily start off labour, but it means there is less and less fluid for the baby to move around in. There is also a good chance of an infection because the sac that protects the baby is punctured.

6. Pre-eclampsia

A persistent severe headache, abdominal pain, visual disturbances and swelling can be an indication that you have developed pre-eclampsia.

It is a syndrome that develops after the 20th week of pregnancy.

It means your body has a ‘not happy’ reaction to the pregnancy. It is a very serious condition that needs to be monitored by medical practitioners.

Early signs of this syndrome is rising blood pressure and the presence of excess protein in your urine.

HIV & Pregnancy

Can two HIV-positive parents have an HIV-negative child?

Yes, they can. Although HIV can pass from an HIV-infected mother to her child during pregnancy, at the time of birth, or when breast-feeding the infant, medical treatment of both the mother and her infant can minimize the chances of that happening. HIV infection in both the mother and the father does not appear to affect the likelihood of having an HIV-infected baby.

HIV-infected women ideally should start antiretroviral therapy (ART) before pregnancy, both for her own health and to reduce the risk of HIV transmission during pregnancy to treat their own disease should start or continue to receive it during pregnancy. Women who are not being treated with ART before pregnancy should receive it during pregnancy. The goal is to lower the mother’s HIV viral load (the concentration of HIV in her blood) as much as possible to prevent infection of the fetus. The lower the mother’s viral load during pregnancy and birth, the lower the risk of infecting her baby. A baby’s chances of being born with HIV are less than 2 in 100 when the mother has a viral load so low that it’s undetectable.

After delivery, the infant should receive ART for 6 weeks. In addition, the mother should preferably breast-feed her baby for at least the first 6 months while she keeps on taking ARV’s daily.

For their own peace of mind, HIV-infected couples wanting to have children should receive counseling, if possible, before making a decision about conception. During counseling sessions, they should ask about the likelihood that they will survive long enough to parent effectively. They should learn how to deal with the possibility that their infant may become HIV infected.  And they should learn how to cope if members of their family or community judge and stigmatize their child

It is important to be tested for HIV before you plan to fall pregnant.

For more information on the prevention of HIV from mother -to-child: http://www.avert.org/fact-sheet-hiv-pregnancy.htm