Pathological Pregnancy: Causes and Management

What is a pathological pregnancy?

It is about pathological pregnancy when a pathology appears during pregnancy and can have consequences for the expectant mother or her baby. The mother and child then require increased monitoring by the health team and special care. Every year in France 10 to 15% of pregnant women stand in front of it. Pregnancy can also be pathological when it comes to pregnant womena chronic illness or who have one special risk before pregnancy (hypertension, obesityEtc.).

What are the main pathologies of pregnancy?

pre-eclampsia

Preeclampsia is a pathology that occurs in the second half of pregnancy and which a high blood pressure to the presence of protein in the urine (proteinuria). It manifests through symptoms such as edemafrom headachefrom visual disturbancesfrom abdominal pain or a decrease in urine production. Pregnant women who suffered from preeclampsia during a first pregnancy and a nephropathy (kidney disease), sufferchronic high blood pressure or a autoimmune disease (lupus, antiphospholipid syndrome, etc.) are more likely to develop this pathology. “In most cases, follow-up care helps prevent serious complications,” says Pre Benachi. But if a severe form occurs, the only way to stop the progression of the pathology is to remove the fetus.”

gestational diabetes

the gestational diabetes or gestational diabetes usually occurs during the second trimester and goes away after delivery. This disruption of glucose regulation which leads to a chronic hyperglycemia (an excess of sugar in the blood) would affect one in ten women.

“In addition to the increased risk of high blood pressure and premature birth in the mother, gestational diabetes also exposes the baby to macrosomia, i.e. excessive birth weight, and neonatal hypoglycemia,” confirms Pre Benachi.

Of dietary measures generally help to balance diabetes. Otherwise A insulin treatment. Several factors such as late pregnancy, a high body mass index (BMI) or type 2 diabetes in the family favor gestational diabetes.

cholestasis gravidique

liver disease most commonly occurring at the end of pregnancy (third trimester). cholestasis gravidique manifests through severe itching – at the level of the palms of the hands, the soles of the feet and the entire body – associated with an elevation of the bile acid in blood. In France, it affects 1% of pregnancies. “This rare pathology represents a significant risk for the fetus, specifies Prof. Benachi. Treatment is based on taking a bile salt binder. If necessary, the medical team may also be asked to discharge the baby earlier. »

The risk of premature labor

leading cause of hospitalizations during pregnancy, Risk of premature labor (MAP) affects 10% of pregnant women. This is characterized by changes in the cervix and regular and painful uterine contractions Occurs between the 22nd and 36th week of amenorrhea. A strenuous job, dependent children, age (before 18 or after 40), a twin pregnancy or a uterine malformation can be risk factors. outraged RestDepending on the severity of the PAD, the OB/GYN may prescribe a drug to stop uterine contractions. “In the case of an upcoming birth, we also administer corticosteroids to speed it up fetal lung maturation », warns Pr. Benachi.

high-risk pregnancies

It is highly recommended for women who have a pregnancy project and have one chronic pathologyautoimmune disease, type 1 diabetes, epilepsyetc – or who is present risk factors (Hypertension, Body mass index too low or too high, kidney failure, etc.) to be discussed with your attending doctor beforehand. “Some pathologies can affect pregnancy, it is important to do an inventory with a specialist during an inventory pre-consultation ‘ recommends Pre Benachi.

For example the pregnant diabetics (type 1 diabetes) should be subject to special surveillance. I’chronic hyperglycemia can actually cause maternal complications – kidney problems, retinopathy – and fetal malformations. Therefore, diabetes needs to be well balanced before conceiving a baby.

Pathological pregnancy and management

The care of high-risk pregnancies differs depending on the pathology and severity. Some only require a easy monitoring when others force a hospitalization the pregnant woman. Expectant mothers who a obstetric, fetal or maternal riskduring her pregnancy will be guided by a Type 2 or 3 maternity for specific support. It should be remembered that type 1 maternity wards – almost half of the establishments – admit pregnant women who do not pose a priori risk; Type 2 are equipped with a Neonatal Department and can receive premature from 33 to 34 weeks amenorrhea. Finally, type 3 maternity wards (12% of establishments) have a intensive care unit and can also cope with high-risk pregnancies very premature (less than 32 weeks amenorrhea). “The nature of motherhood defines the care of the child and not that of the mother,” adds Pre Benachi. If the mother’s pathology requires treatment in a specific hospital that is not type 3, and the child risks being born before the 32nd week of amenorrhea, priority is given to the mother and the child is transferred secondarily.

However, be aware of this every maternity ward in France is able to perform an emergency birth : If necessary, mother and child are transferred to a higher-level facility.

What is sick leave?

Fatigue, labor pains, risk of preterm birth: if medical complications warrant it, your GP or OB/GYN can prescribe one for you pathological vacation. This 14-day break from work allows the expectant mother to slow down and rest until her delivery. Sick leave is calculated like maternity leave and can be reimbursed by health insurance and can be ordered at any time during pregnancy.

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