Complications in Pregnancy

Ectopic Pregnancy
An ectopic pregnancy, or eccysis , is a complication of pregnancy in which the pregnancy implants outside the uterine cavity. With rare exceptions, ectopic pregnancies are not viable. Furthermore, they are dangerous for the mother, internal bleeding being a common complication. Most ectopic pregnancies occur in the Fallopian tube (so-called tubal pregnancies), but implantation can also occur in thecervix, ovaries, and abdomen. An ectopic pregnancy is a potential medical emergency, and, if not treated properly, can lead to death.

H Mole
Molar pregnancy is an abnormal form of pregnancy, wherein a non-viable, fertilized egg implants in the uterus, and thereby converts normal pregnancy processes into pathological ones. It is characterized by the presence of a hydatidiform mole (or hydatid mole, mola hydatidosa). Molar pregnancies are categorized into partial and complete moles.

Eclampsia
Eclampsia (Greek, "shining forth"), an acute and life-threatening complication of pregnancy, is characterized by the appearance of tonic-clonic seizures, usually in a patient who had developed pre-eclampsia. (Preeclampsia and eclampsia are collectively called Hypertensive disorder of pregnancy and toxemia of pregnancy.) Eclampsia includes seizures and coma that happen during pregnancy but are not due to preexisting or organic brain disorders.

Umbilical cord prolapse

Umbilical cord prolapse happens when the umbilical cord precedes the fetus' exit from the uterus. It is an obstetric emergency duringpregnancy or labor that imminently endangers the life of the fetus. Cord prolapse is rare. Statistics on cord prolapse vary, but the range is between 0.14% and 0.62% of all births in most studies. Cord prolapse is often concurrent with the rupture of the amniotic sac. After this happens the fetus moves downward into the pelvis and puts pressure on the cord. As a

result, oxygen and blood supplies to the fetus are diminished or cut-off and the baby must be delivered quickly.

Placenta Previa
Placenta Previa (placenta previa AE) is an obstetric complication in which the placenta is attached to the uterine wall close to or covering the cervix. It can sometimes occur in the later part of the first trimester, but usually during the second or third. It is a leading cause of antepartum haemorrhage (vaginal bleeding). It affects approximately 0.5% of all labours. It is hypothesized. to be related to abnormal vascularisation of the endometrium caused by scarring or atrophy from previous trauma, surgery, or infection.

Abruptio Placenta
Placental abruption (also known as abruptio placentae) is a complication of pregnancy, wherein the placental lining has separated from the uterus of the mother. It is the most common pathological cause of late pregnancy bleeding. In humans, it refers to the abnormal separation after 20 weeks of gestation and prior to birth. It occurs in 1% of pregnancies world wide with a fetal mortality rate of 2040% depending on the degree of separation. Placental abruption is also a significant contributor to maternal mortality. The heart rate of the fetus can be associated with the severity.

Abortion -

is medically defined as the termination of a pregnancy by the removal or expulsion from the uterus of a fetus or embryo usually before it is viable. An abortion can occur spontaneously due to complications during pregnancy, or can be induced, in humans and in other species. In the context of human pregnancies, an induced abortion may be referred to as either therapeutic or elective. The term abortion most commonly refers to the induced abortion of a human pregnancy; spontaneous abortions are usually termed miscarriages.

Types :
Threatened abortion is a condition of pregnancy, occurring before the

20thweek of gestation, the patient usually experiences vaginal bleeding with

or without some cramps, and the cervix is closed. Bed rest is usually the only treatment needed. In a few cases the symptoms disappear and the rest of the pregnancy is normal.
Inevitable abortion is when the bleeding continues and becomes heavy,

it usually means that the cervix is dilating and the contents of the uterus are being expelled. Pregnant women will experience lower abdominal cramping and bleeding.
Complete abortion is when all the contents are expelled. There is no

treatment other than rest is usually needed. All of the tissues that came out should be saved for examination by a doctor to make sure that the abortion is complete. The laboratory examination of the saved tissue may determine the cause of abortion.
Incomplete abortion is a name given to abortion where the uterus

retains part or all of the placenta. Bleeding may occur because part of the placenta may adhere to the uterine wall and the uterus does not contract to seal the large blood vessels that feed the placenta. The usual treatment is a drug that induces labor by stimulating uterine contractions, a surgical procedure called curettage can also be done to remove the remaining material from the uterus, the goal of this treatment is to prevent prolonged bleeding or infection.
Missed abortion - is a case in which an intrauterine pregnancy is present

but is no longer developing normally. Before widespread use of ultrasonography, the term missed abortion was applied to pregnancies with no uterine growth over a prolonged period of time, typically 6 weeks after its (fetus) death. A missed abortion is usually indicated by the disappearance of the signs of pregnancy except for the continued absence of menstrual periods. Missed abortions are usually treated by induction of labor by dilation (or dilatation) and curettage (D & C).

Hematology ( Normal Values )

ESR (Erythrocyte Sedimentation Rate) - It is a nonspecific screening
test that indirectly measures how much inflammation is in the body. This test can be used to monitor inflammatory or cancerous diseases. It cannot be used to diagnose a specific disorder although it is used in detecting and monitoring tuberculosis, tissue death, certain forms of arthritis, autoimmune disorders and some inflammatory diseases.

An increased SED rate (ESR) may be due to anemia, kidney disease, osteomyelitis, pregnancy, rheumatic fever, rheumatoid arthritis, syphilis, systemic lupus erythematosus, thyroid disease, tuberculosis or other inflammatory conditions. A very high SED rate (ESR) may occur with giant cell arteritis, hyperfibrinogenemia (increased fibrinogen levels in the blood), multiple myeloma, macroglobulinemia primary, necrotizing vasculitis or polymyalgia rheumatica. Lower than normals levels may be due to congestive heart failure (CHF), hyperviscosity, hypofibrinogenemia (decreased fibrinogen levels), low plasma protein (due to liver or kidney disease), polycythemia or sickle cell anemia. ESR (male): 0 - 15 mm/hr ESR (female): 0 - 20 mm/hr

HEMATOCRIT (HCT)- The hematocrit refers to the 'percentage' of one's red

blood cells. Normal Adult Female Range: 36 - 46 percent Normal Adult Male Range 41 - 53 percent Normal Newborn Range: 49 - 61 percent

HEMOGLOBIN (HGB) - Hemoglobin is a protein that is carried by red cells. It

picks up oxygen in the lungs and delivers it to the peripheral tissues to maintain the viability of cells. Hemoglobin is made from two similar proteins that "stick together". Both proteins must be present for the hemoglobin to pick up and release oxygen normally. One of the component proteins is called alpha, the other is beta. Before birth, the beta protein is not expressed. A hemoglobin protein found only during fetal development, called gamma, substitutes up until birth. Normal Adult Female Range: 12.0 - 16.0 g/dL Normal Adult Male Range: 13.5 - 17.5 g/dL Normal Newborn Range: 14 - 20 g/Dl

RBC - (Red Blood Cell Count aka Erythrocyte count)

RBC count (female) 3.5 - 5.5 mill/mm3 RBC count (male) 4.3 - 5.9 mill/mm3 RBC volume (female) 19 - 31 mL/kg RBC volume (male) 20 - 36 mL/kg Lower ranges are found in Children, newborns and infants

WBC - (White Blood Cell Count aka Leukocyte count)

Includes Basophils, Neutrophils, Eosinophils, B Cells, T Cells, Band Cells, Monocytes Normal Adult Range: 4,000 - 12,000/mm3 Higher ranges are found in children, newborns and infants.

PLATELET COUNT - aka Thrombocyte Count

Normal Adult Range: 150,000 - 400,000/mm3 Higher ranges are found in children, newborns and infants

NEUTROPHILS and NEUTROPHIL COUNT

- (This is the main defender

of the body against infection and antigens. High levels may indicate an active infection.) Normal Adult Range: 54 - 62 percent

LYMPHOCYTES and LYMPHOCYTE COUNT

- (Elevated levels may indicate an active viral infections such as measles, rubella, chickenpox, or infectious mononucleosis.)

Normal Adult Range: 25 - 33 percent

MONOCYTES and MONOCYTE COUNT

- (Elevated levels are seen in tissue breakdown or chronic infections, carcinomas, leukemia 'monocytic' or lymphomas.) Normal Adult Range: 3 - 7 percent

EOSINOPHILS and EOSINOPHIL COUNT

indicate an allergic reactions or parasites.) Normal Adult Range: 1 - 3 percent

- (Elevated levels may

BASOPHILS and BASOPHIL COUNT -

(Basophilic activity is not fully understood but it is known to carry histamine, heparin and serotonin. High levels are found in allergic reactions.) Normal Adult Range: 0 - 0.75 percent