A pre-existing condition may worsen in pregnancy, and it is a disease that is not directly caused by pregnancy but is related to various pregnancy complications. A major component of this risk may result from the need to use drugs during pregnancy to treat the disease.
Having a long-term or chronic illness does not mean that you cannot have a reasonably trouble-free pregnancy and a healthy baby. But you may need extra care to minimize any risk to you and your child.
Ideally, you should discuss your illness and how it will impact your pregnancy with a health care provider before you try taking a baby. But if your pregnancy is unplanned, you may need to see your GP or a doctor as soon as you find out that you are pregnant. This will allow your health care providers to decide how to manage your pregnancy best.
So, which pre-existing conditions may worsen in pregnancy? Here are some of them:
1. Chronic Hypertension and Pregnancy
What is chronic hypertension?
Blood pressure is the force of blood flowing against the walls of the artery. Each time the heartbeats, it pumps blood into these arteries. The highest blood pressure occurs when the heart contracts. High blood pressure (hypertension) directly raises the risk of heart attacks and stroke.
Chronic hypertension happens when a pregnant woman has or experiences pre-existing hypertension before the 20th week of pregnancy which conditions can worsen during pregnancy.
Preeclampsia is another type of hypertension during pregnancy. It is a very serious condition. It causes hypertension and complications with one or more organs such as the kidneys.
How is pregnancy affecting chronic hypertension?
Conditions can worsen during pregnancy in most women with mild chronic hypertension if there are no other complications. But risks are much higher for mother and baby if hypertension is severe. This is also true if there are other disorders, such as diabetes, or preeclampsia that develop along with chronic hypertension.
Risks of severe chronic hypertension during pregnancy may include:
- Blood pressure increasing
- Heart failure
- Bleeding in the brain
- Kidney failure
- Early removal of the placenta from the uterus (placental abruption)
The risks to the child before and after birth depend on the severity of the disease.
Risks may include the following:
- Restriction of fetal growth (less growth in the womb due to poor placental blood flow)
- Preterm pregnancy (before 37 weeks of pregnancy)
- Stillbirth
2. Diabetes in pregnancy
What’s diabetes?
Diabetes is a disease in which the body is unable to make enough insulin or to use insulin normally. Insulin is a hormone in the body. It helps sugar (glucose) in the blood to reach the body’s cells. When glucose cannot enter the cells, it builds up in the blood. This leads to high blood sugar levels (hyperglycemia).
High blood sugar can cause problems in the body. It can inflict damage to the blood vessels and nerves. It can affect your eyes, your kidneys, and your heart. In early pregnancy, high blood sugar can lead to birth defects in a growing child.
The risks
High blood sugar levels before and during pregnancy can:
- Worsen any long-term diabetes problems such as eye problems, heart, and kidney failure.
- Raise the risk that you will have a miscarriage or that your baby will be born too early.
- Raise the risk of your child will have birth defects.
- Cause difficulties for your child, such as gaining too much weight and having trouble breathing.
- Create a need for insulin injections more often.
- Cause low blood glucose levels, which can be life-threatening if uncontrolled
- Cause high blood glucose ketoacidosis, which can also be life-threatening if untreated
Later on in life, women with gestational diabetes are more likely to develop type 2 diabetes. These conditions can worsen during pregnancy. They are also more likely to develop gestational diabetes after pregnancy. If you have gestational diabetes, you should be checked for a few months after your baby is born 3 years after that.
3. Asthma: Pre-existing condition and Pregnancy
To have asthma does not necessarily mean to have a complicated pregnancy. With proper treatment of asthma and proper care during pregnancy, most women with asthma will have a healthy pregnancy.
Asthma is one of the most common health problems that can make it more difficult. In some cases, an asthma diagnosis is not made until a woman becomes pregnant. Asthma affects a woman in several forms during pregnancy.
Possible complications for the mother
Asthma, when not controlled, will put extra stress on the mother as well as the fetus. The lack of oxygen would affect not only the mother but also the fetus. Other complications for the mother related to uncontrolled asthma are:
- Preeclampsia (toxemia in pregnancy): This is a pregnancy health issue marked by high blood pressure, water retention, and protein in the urine.
- Bleeding in pregnancy or hemorrhage after birth anemia
- Depression
- Higher rate of C-section
- Giving birth too early (preterm birth)
- Pulmonary embolism: This is where the blood clot is created and travels to the lung. It’s life-threatening.
- Possible complications with the fetus
The loss of oxygen from the mother to the fetus will lead to many health issues in the fetus:
- Perinatal mortality
- Intrauterine growth retardation. It’s a poor fetal development in the womb. It causes the fetus to be smaller than normal because of its gestational age.
- Preterm birth
- Low birthweight
- Neonatal hypoxia. This is when the fetus does not get enough oxygen.
4. Epilepsy: Pre-existing Condition in Pregnancy
What is epilepsy during pregnancy?
Epilepsy is a nervous system disease. It’s sometimes called seizure disease. Normally, the nerves of the body send information by electrical and chemical signals. People with epilepsy have irregular electrical signals in their brains. This could cause a seizure. Seizures can cause extreme muscle shaking. Or they can be very mild with hardly any symptoms at all.
Women who have epilepsy appear to have more seizures when pregnant. This is especially true of women who already have a lot of seizures.
Epilepsy and the drugs used to treat it may have numerous effects on the mother, the pregnancy, and the developing child. Many women are in a place to have a healthy pregnancy and child. However, epilepsy does increase the risk of some complications of pregnancy. These shall include:
What are the complications of epilepsy in pregnancy?
- High blood pressure of pregnancy
- Stillbirth
- Slightly smaller baby
- Congenital disabilities in the spine and brain (neural tube defects).
- Lower vitamin D levels. Epilepsy medicine can influence how well your body absorbs vitamin D. This problem is generally taken care of by consuming prenatal vitamins.
- Severe bleeding in the newborn. Some epilepsy medicines can influence vitamin K levels, which are essential for blood clotting.
- Withdrawal symptoms in the newborn.
- Sleeping or feeding problems.
5. Pregnancy and Pre-existing Heart Condition
What is pre-existing heart disease in pregnancy?
Pre-existing heart disease is a heart condition you had when you were pregnant. Usually, this means a heart disease that you were born with (congenital). These may have heart problems that may have been fixed. It can also have problems with the heart valve.
Common heart problems that can be affected by pregnancy include:
- Mitral stenosis
- Atrial septal defect
- Ventricular septal defect
- Aortic stenosis
- Mitral valve prolapse
What are the complications of pregnancy in pre-existing heart conditions?
Normal pregnancy changes can cause problems if you have a heart condition. Your health care professional will watch you closely to make sure you and your baby are healthy.
If you have a congenital heart defect, there’s a risk that your baby will also have a heart condition. It might not be the same heart condition that you have. You’re likely to need high-risk prenatal monitoring.
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