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Pregnancy-related health conditions: What you need to know

Phil Day: Superintendent Pharmacist | minute read

Pregnancy can cause the body to change in different ways. Many of these changes are perfectly natural and shouldn't cause you to worry. However, there are some health conditions that can occur during pregnancy that need careful monitoring by health professionals. In this article, we outline what conditions you should be aware of so that if you experience them, you can get the best care and support throughout. We look at what these conditions are, how common they are, what symptoms to look out for, and what to do if you're concerned.

Deep vein thrombosis (DVT)

DVT is a term used to describe a blood clot in the body. It forms in a deep vein and usually starts off in the leg. DVTs can be very dangerous if they start to move around the bloodstream as they can cause a blockage in the lungs.

DVT is not a common condition in pregnancy, but there are factors that can make you more at risk of developing them. These include:

·        A multiple pregnancy (such as twins or triplets)

·        Being a smoker

·        Having a close family history of blood clots

·        Being 35 or older

·        Having a BMI of 30 or more (obesity)

·        Getting pregnant through IVF treatment

·        Being dehydrated

·        Recovering from a serious infection or injury

DVT sometimes doesn't present any symptoms, but contact your doctor or midwife straight away if you experience any of the following:

·        A red patch of skin on your lower leg

·        A noticeable ache that's warm to touch

·        A swollen area on your leg that’s uncomfortable and may cause pain when you walk on it

If you find yourself struggling to breathe, experiencing pain in your chest, or noticing blood when you cough, phone 999 immediately.

If you are found to have a DVT, this can be treated using a medicine called heparin that will help the clot to dissolve and won't pose a risk to your baby. There are also steps you can take to lower the risk of developing DVT in pregnancy. Regular, gentle activity is encouraged, and you can read about exercising safely during pregnancy on the NHS website. Try to keep hydrated by drinking plenty of water and noncaffeinated fluids. Let your doctor or midwife know if you have a family history of clots or a recent injury.

Gestational diabetes

Gestational diabetes is a temporary condition that causes high blood sugar during pregnancy. It happens due to your body not producing enough of the blood sugar-regulating hormone insulin whilst there’s extra demand on your body. It's thought to affect around 1 in 20 pregnancies in the UK and usually goes away when your baby is born. This condition can affect anyone, but there are factors that can make you more likely to develop it. These include:

  • A BMI of 30 or higher (obesity)

  • Previous gestational diabetes in an earlier pregnancy

  • A close family history of diabetes (parents or siblings)

  • Being over 40 years old

  • A previous birth where your baby weighed 10lb or more

  • Previous weight-loss surgery such as a gastric band

  • African-Caribbean, Black, Middle Eastern, or South Asian ethnicity

You’ll usually be offered a test for gestational diabetes in the first trimester of your pregnancy if you have any of the risk factors listed above.

Symptoms of the condition itself are uncommon, but you may find you experience the following due to a spike in your blood sugar levels if you have gestational diabetes:

  • Tiredness and fatigue

  • Blurred vision

  • Itchy skin

  • Being more thirsty

  • Needing to pass urine more frequently

  • A dry mouth

If you do experience gestational diabetes during your pregnancy, it can be monitored and managed with the help of your doctor or midwife and shouldn't cause you or your baby any serious health issues. You'll be able to test your levels at home using a special testing kit. Blood sugar levels can be controlled through diet & exercise, and you'll be given support around how best to look after yourself as your pregnancy progresses. Ask your healthcare professional about low GI (glycaemic index) foods and what activity is safe in pregnancy.

Intrahepatic cholestasis of pregnancy (ICP)

ICP is a liver condition that can develop in pregnancy. It's usually temporary and is characterised by intensely itchy skin, particularly on the hands and feet. ICP is caused when the bile acids that usually help your gut to digest food don’t travel as usual through the body, instead building up in areas they shouldn't be. It is thought to affect 1 in 140 pregnancies in the UK (although this has been found to be 1 in 70-80 pregnancies in women of South Asian ethnicity).

As well as itchy skin, some pregnant women with ICP may also experience pale stools when they go to the toilet, pee that's dark in colour, and rarely, symptoms of jaundice such as yellowish eyes and skin. A liver function test (LFT) will be conducted by your doctor to confirm or rule out ICP as the cause of your itching. Although ICP shouldn't interfere with your baby's development, some studies have suggested a link between ICP and premature labour or stillbirth. If you are diagnosed with ICP, it will be closely monitored throughout your pregnancy to ensure you're given the best possible care. Your doctor or midwife will offer advice to manage the itching, including creams and ointment to ease your symptoms. You can also find information, support, and advice at the charity website, ICP Support.

Pre-eclampsia

Pre-eclampsia is a pregnancy-related condition characterised by high blood pressure (hypertension) and the presence of protein in the urine. These symptoms will be screened for during routine antenatal appointments with your doctor or midwife. Some pregnant women with pre-eclampsia also experience symptoms including:

  • Swelling of the face, feet, and hands

  • Being sick

  • Intense headaches

  • Blurred eyesight

  • Pain under the ribs

The NHS advises seeking immediate medical advice if you notice any of these symptoms. According to the British Heart Foundation, pre-eclampsia affects up to 1 in 25 pregnancies in the UK. Certain factors can increase the chance of developing pre-eclampsia, including:

  • An existing health condition like hypertension, diabetes, or kidney disease

  • A BMI of over 35

  • Multiple pregnancy

  • Close family history of pre-eclampsia (mother or sister)

  • First pregnancy

  • Over 10 years since the last pregnancy

If you are diagnosed with the condition, your healthcare professional will monitor it closely throughout your pregnancy and put measures in place to ensure the best possible outcome for you and your baby. Many cases of pre-eclampsia are mild, with symptoms clearing up shortly after birth. In rare cases, pre-eclampsia can develop into eclampsia, a condition that leads to dangerous fits. This is why the condition needs to be closely monitored and managed by your doctor. You may be given medicine to help control your blood pressure, and you may have a period of time in hospital before and/or after your baby is born, so doctors can make sure you're healthy enough to return home. For more information and support on living with pre-eclampsia in pregnancy, have a look at this UK pre-eclampsia charity website.

Severe morning sickness

This condition is known medically as hyperemesis gravidarum (HG). While many mums-to-be experience morning sickness as a natural part of their pregnancy (estimated to be 8 in 10), HG is a condition that causes severe and prolonged vomiting. The NHS reports that due to unreported cases, it's difficult to pinpoint how many pregnancies are affected. They estimate it's likely to be around 1-3 in 100. Women experiencing HG may find it difficult to keep food and fluids down and find themselves being sick numerous times throughout the day and night. Regular, repeated vomiting can lead to other symptoms such as dehydration and weight loss. In rare cases, complications can arise such as a torn oesophagus. This is why it's important to speak to your doctor or midwife early so they can advise on the best treatments to help you manage your symptoms.

HG is unlikely to cause harm to your baby, but effective treatment will help to minimise the impact on your physical and mental well-being. Treatments include anti-sickness medicines (your healthcare professional will advise you which ones are safe to take during pregnancy) and steroids. If your sickness doesn't ease off with these initial treatments, you might have to be monitored and treated in hospital as a precaution. These treatments could include intravenous fluids and anti-sickness medicines to help with dehydration and ease any nausea.

If you're experiencing HG as part of your pregnancy, you can find more information, guidance, and support from the charity Pregnancy Sickness Support. Chat with volunteers through a live chat service or WhatsApp, speak to other mums-to-be living with HG, and find tips and advice about coping techniques.