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1.Cholestasis of pregnancy

If you are itching like crazy, you may have a condition called cholestasis of pregnancy, which could be dangerous for your baby. Although many women are told that itching is a normal pregnancy symptom, it could also be a symptom of a more serious condition.

Your liver produces a yellow-green liquid known as bile. Bile is important for digestion, so once it’s been produced it is stored in the gall bladder, ready to flow into your gut. If you have cholestasis, the flow of bile from your liver is reduced significantly, causing the salts found in bile to build up and “leak” into the bloodstream.

More about it:

•Cholestasis usually occurs in the third trimester.

•The cause is uncertain but the condition sometimes runs in families, so there may be a genetic component.

•It is also possible that the increase in pregnancy hormones may cause the flow of bile from the liver to slow down.

•If you’ve had cholestasis before, you have an increased chance of getting it again with your next pregnancy.

•Intense itching, often on the palms of your hands or the soles of your feet, although it can occur anywhere, is the main symptom. Itching may get worse as your due date approaches.

•Other possible symptoms that you should be aware of:

–A yellow tinge to your skin and the whites of your eyes.

–Nausea and a loss of appetite.

–Dark urine.

–Light-coloured faeces.

Is cholestasis serious?

Itching is a fairly common pregnancy symptom, so it is not necessary to see your doctor for every itch. However, if the itching becomes persistent or unbearable, it’s best to be on the safe side and make an appointment. This is especially true if you notice any of the other symptoms, or if someone in your immediate family also had cholestasis of pregnancy or another type of liver disease.

Other than driving you absolutely crazy, cholestasis is unlikely to be harmful to you. However, it can be quite dangerous for your baby, causing preterm delivery, fetal distress and in extreme cases even stillbirth. Because of this, you should monitor Baby’s movements carefully and inform your doctor if you notice a change in the usual pattern. Many doctors will recommend an early delivery, around 37–38 weeks, for Baby’s safety.

The itching will disappear a few days after you give birth and it’s unlikely you’ll experience any more liver problems.

2.Diabetes

Diabetes in pregnancy can lead to increased risk of infections, especially candida and urinary tract infections, a greater possibility of miscarriage, a higher likelihood of hypertension and pre-eclampsia, increased cases of excessive amniotic fluid and a higher incidence of newborn deaths. Diabetes can also cause the placenta to function poorly, which in turn can lead to growth retardation of your unborn baby. There is greater risk of abnormalities too.

Type-2 and gestational diabetes is on the increase across the world, due to increasingly unhealthy lifestyles. This is also true for pregnancy or gestational diabetes (GD). Apart from the increased risks of your baby being over 4.5kg at birth (macrosomia) and low blood sugar (hypoglycaemia) in your baby after birth, many health professionals seem not to be too concerned about GD in pregnancy as it mostly disappears after delivery without long-term effects.

And yet, research shows that women who develop GD are at an increased risk for also developing type-2 diabetes. There are also studies showing a link between raised glucose levels reaching Baby in pregnancy, and the development of diabetes and obesity later in life. One very big risk factor for the development of this disease is obesity. Research has also shown a link between gaining excessive weight between pregnancies and GD in a following pregnancy.

Many women remain overweight (or pick up more weight) after the births of their babies – possibly due to lifestyle changes. This highlights the importance of a healthy lifestyle in pregnancy and after birth – not always easy with a new baby in the house, but well worth it.

Self-help tips:

✓Cook all healthy meals in double or triple batches and freeze them for future use. This will ease your domestic burden and make it easier to eat healthily.

✓Mother Nature’s fast food – whole fruit – allows fructose to be released more slowly than processed, cooked or juiced fruits and can help provide a healthy diet for women with moderate symptoms of diabetes.

✓Take a brisk walk every afternoon to aid healthy weight management and positive self-esteem, which are vital to combating diabetes with its self-destructive lifestyle link.

3.Ectopic pregnancy

An ectopic pregnancy is when the fertilised egg implants in the fallopian tube, or very rarely in the ovary or abdominal cavity, instead of your womb (uterus). Only about 1% of pregnancies are ectopic.

The cause is often not clear, but repeated sexually transmitted infections, pelvic inflammatory disease, sterilisation by tying of your tubes and some types of assisted fertility treatments make ectopic pregnancy more likely. Smokers, women who have had a previous ectopic pregnancy and those over 35 are at greater risk.

What are the symptoms?

You might initially experience all the normal signs of early pregnancy. The pregnancy may stop spontaneously with slight bleeding like a light period. Pain on one side of your lower abdomen may start at any time between four and 10 weeks of pregnancy, and sometimes there is pain in your shoulders if blood has leaked into the abdomen.

What should I do if I suspect an ectopic pregnancy?

See your doctor or clinic, who will do a sonar to check. If there is an ectopic pregnancy, they will usually do minor surgery to remove the embryo or, in some instances, prescribe medication to end the pregnancy. They will also try to find the cause.

What happens if my fallopian tube bursts?

This will happen if the pregnancy continues to grow, and pelvic pain will get even worse and your body will go into shock. You will need to get to a hospital as quickly as possible for treatment and to have surgery to remove your tube. Future fertility may be compromised but it is possible to still fall pregnant.

4.Incompetent cervix

An incompetent cervix is a cervix that doesn’t stay tightly shut during pregnancy. It’s important for the cervix to close properly to prevent the bag of amniotic waters that surrounds Baby from bulging out into the vagina, in turn, tearing the membranes and causing a loss of amniotic fluid, infection and often miscarriage. You will only know you have this if you start bleeding, you leak amniotic fluid or you need an internal examination.

An incompetent cervix usually recurs in each pregnancy, so to fix it a “purse-string” stitch, also called a Shirodkar or McDonald stitch, is done at about 14 weeks. It’s inserted under general anaesthetic, but is a quick procedure and you don’t need to worry about Baby. The stitch is usually removed at about 36 to 38 weeks so you can deliver normally.

5.Pre-eclampsia

High blood pressure that develops in pregnancy for the first time, especially if accompanied by swelling, headaches, nausea and visual disturbances, could be a very serious condition known as pre-eclampsia (early symptoms) or eclampsia (full-blown condition). Pre-eclampsia usually occurs in the third trimester, and may occur again in subsequent pregnancies.

Symptoms of pre-eclampsia:

•Rapid weight gain

•Abdominal pain

•Severe headaches

•Reduced urine

•Dizziness

•Excessive vomiting and nausea

Who’s at risk?

Overweight women are more at risk of pre-eclampsia, so try to keep your pregnancy weight gain under control by eating a healthy diet. Deficiencies in iodine and essential fatty acids (EFAs) have more recently been shown to put expectant mothers at greater risk too, while eating a diet rich in seafood (fish and kelp) and supplementing essential fatty acid (EFA) intake offer an easy prevention solution.

A number of other factors make pre-eclampsia more likely too, including:

•Family history: If a close family member had pre-eclampsia, you’re more at risk.

•Personal history: If you had pre-eclampsia before, you may develop it in your next pregnancy too.

•Certain medical conditions or diseases: Such as diabetes or chronic kidney disease.

•Lifestyle choices: Smoking and alcohol use increase your chance of developing pre-eclampsia.

Treatment for pre-eclampsia

The treatment you receive will depend on the severity of the condition and will include lots of bed rest and special blood pressure medication. This medication may make you feel dizzy and light-headed, so if you need to take it, you should always sit or stand up slowly. You may need to stay in hospital for a few days so they can monitor you and Baby.

Calcium supplementation could help for high blood pressure and aspirin can help prevent blood clots, but always talk to your doctor before taking anything. Although anxiety doesn’t cause pre-eclampsia, it could make it worse, so try to relax as much as possible. Homeopathic remedies for anxiety are totally safe to take in pregnancy, but seek advice from an expert in herbal medicines before taking such preparations.

After birth, you will be carefully monitored and treated for about three to six weeks.

Left untreated, pre-eclampsia could have very serious consequences, so make sure that you go for regular checkups and see a doctor immediately if you notice any of the symptoms of pre-eclampsia.

What if I had high blood pressure before falling pregnant?

If you had high blood pressure before falling pregnant, your blood pressure and medication will be monitored carefully throughout pregnancy. You’ll also need to adjust your diet – for example, you’ll need to cut down on salt, animal proteins and fatty and processed foods, and eat more fresh fruit and vegetables.

It’s very normal for your hands and feet to swell during pregnancy; 80% of pregnant women experience this! However, if swelling is excessive in these areas or if you’re swollen over your pelvis, arms and face as well, then consult your doctor, as this may indicate pre-eclampsia.

6.Toxoplasmosis

This is an infection caused by a parasite called Toxoplasma gondii. This parasite is found in many birds and mammals, but is usually passed on to humans if they touch an infected cat’s faeces, especially if the litter box isn’t cleaned regularly. If cats have used pot plants or flower beds as a litter box, it can be contracted when gardening. Children’s sandpits are often contaminated too.

If you contract toxoplasmosis, you may have a few flu-like symptoms such as swollen glands, fatigue, fever and muscle aches. However, many people don’t have any symptoms at all. If an expectant mom becomes infected, it could pass through the placenta to her baby. Toxoplasmosis could cause the baby to have jaundice, convulsions, malformations and reduced mental development, but your doctor will prescribe medication you can take to prevent this from happening. Only about 10% of infected babies will have any symptoms.

Prevent toxoplasmosis

If you’re hygienic and your pets are healthy, it’s unlikely that you’ll contract toxoplasmosis from interacting with your pets. Take these steps too:

✓Ask someone else to change the cat’s litter box.

✓Wear thick gloves when gardening.

✓Ensure that sandpits are always closed when not in use, and change the sand if a cat has used it as a litter box.

✓Wash all fruit and vegetables thorough before using.

✓Don’t eat undercooked meat.

✓Wash your hands after touching pets and working with raw meat.