Pregnancy Complications

This page is designed to inform you on a range of possible problems during pregnancy. Most pregnancies will not involve these problems. Hopefully it will help in preventing them and you never need to use them.

  • Group B Strep
  • Diabetes

    GROUP STREP B

    Group B Stretococcus (GBS) has been identified as the number one cause of life threatening infections in newborn babies. This bacteria is normally found in the vagina and/or lower intestine of 15% to 40% of all healthy, adult women. Out of every 1,000 women, 150-350 test positive for GBS. Those women who test positive for GBS are said to be colonized. Because GBS usually does not cause problems for the adult female most women carry it and do not know it. Yet, GBS can cause serious illness in babies born to women carrying the bacteria.
    Group B Strep should not be confused with Group A Strep which causes strep throat.
    The vast majority of GBS infections are acquired during childbirth when the baby comes into direct contact with the bacteria carried by the mother.
    An estimated 12,000 infants in the U.S. will become infected with GBS each year. This bacteria will result in the death of an estimated 2,000 infants yearly, while leaving many others mentally and/or physically handicapped.
    GBS usually causes infant illness within the first seven days of life, but late onset infections may occur up to three months of age. Performance of a cesarean section will not eliminate the risk of infection.
    GBS infections are more common than other illnesses for which pregnant women are screened, such as rubella, Down's Syndrome and spina bifida. Yet, GBS remains generally unknown to the public. Fortunately, there is testing and a preventative treatment available that can help prevent many of these infections.

    High Risk Situations are:

    1. When labor is premature.
    2. When there is prolonged rupture of membranes (more than 12 hours) before the baby is born.
    3. When the mother has a fever higher than 100.4 F before or during labor.
    4. When women have a history of GBS in previous births.

    Preventing Infection:

    There is a fast and effective treatment for many situations. Medical research indicates that giving antibiotics through the vein to the mother during labor can greatly reduce the frequency of GBS infection in the baby immediately after birth or during the first week of life.
    Treating the mother with oral antibiotics during the prgnancy may decrease the amount of GBS for a short time, but it will not eliminate the bacteria completely and will leave the baby unprotected at birth. Also, waiting to treat the baby with antibiotics after birth is often too late to prevent illness.



    DIABETES

    Women with diabetes, especially poorly controlled preexisting diabetes, are at increased risk of certain pregnancy complications. These include pregnancy-induced hypertension (preeclampsia), a condition characterized by high blood pressure and protein in the urine, that can slow fetal growth and result in premature delivery and polyhydramnios, an excess of amniotic fluid, that also can result in premature birth. The doctor will carefully monitor women with diabetes for signs of these and other complications. He or she may recommend tests such as ultrasound to assure that the fetus is growing at a normal rate. Late in pregnancy, the doctor also may recommend a "nonstress test" (which may be repeated weekly), a simple painless procedure in which the fetal heart rate is electronically monitored before and during fetal movement. In most cases, these tests will show that the pregnancy is progressing normally. Though women with diabetes are at increased risk of cesarean delivery, most can have a normal vaginal delivery.


    Treating Gestational Diabetes

    Because this condition can hurt you and your baby, you need to start treatment quickly. Treatment aims to keep blood glucose levels equal to those of pregnant women who do not have gestational diabetes. Treatment always includes special meal plans and scheduled physical activity. It may also include daily blood glucose testing and insulin injections. You will need help from your doctor, nurse educator, and other members of your health care team so that your treatment can be changed as needed. For the mother-to-be, treatment for gestational diabetes helps lower the risk of a cesarian section birth that very large babies may require. Sticking with your treatment will give you a healthy pregnancy and birth and help your baby avoid future poor health.