Understanding the Complications in Early Pregnancy

14 August 2024

Dr Ewa Goncikowska

Understanding the Complications in Early Pregnancy

Experiencing any kind of complication during a pregnancy is scary and stressful, and if you’ve already been through a fertility journey to get pregnant, the stakes are even higher.

While many women have smooth pregnancies, others may encounter complications that can be worrying and overwhelming.

Complications can occur at various stages of pregnancy, but the first trimester (before 13 weeks gestation) poses more significant risks, and it’s crucial to recognise and manage them early.

We asked Dr Ewa Goncikowska, fertility consultant and gynaecologist at The Evewell West London, to help explain complications in early pregnancy.

What is considered an ‘early pregnancy complication’?

Early pregnancy complications are conditions that may affect you or your baby’s health during the early stages of pregnancy.

You have various scans and appointments at key stages of your pregnancy so your midwife, doctor or consultant can monitor the baby(s) and watch for complications during pregnancy – therefore it’s vital you attend all your prenatal appointments, as early detection and prompt treatment can help reduce the chance of serious complications.

What are the most common complications of pregnancy?

Complications during pregnancy can happen for many reasons. Previous, current, and new (caused by being pregnant) medical conditions can cause pregnancy complications.

Some common early pregnancy complications are:

Miscarriage

Miscarriage is the loss of a pregnancy before 24 weeks gestation. Sadly, about 10-20% of pregnancies end in miscarriage, most of which are due to foetal chromosomal abnormalities. More than 80% of miscarriages happen in the first trimester.

Symptoms of miscarriage include abnormal vaginal bleeding, spotting and pelvic cramps, although some women may have no symptoms.

If you do experience any symptoms, you should contact your doctor immediately and will require a scan to assess the pregnancy. Depending on the scan findings, your doctor may advise rest, medications or surgery. Unfortunately, if a miscarriage is happening, there is no way to stop it.

Ectopic pregnancy

This is a condition where the embryo implants outside your womb, most commonly in your fallopian tube. The embryo cannot develop outside your womb, and you may need surgery or medication to remove/ treat the ectopic pregnancy.

Symptoms of ectopic pregnancy include lower abdominal pain, vaginal bleeding, shoulder pain, and feeling faint/ dizzy. If you experience any of these symptoms, you should seek urgent medical advice as it may become a life-threatening situation.

Hyperemesis gravidarum (HG)

Hyperemesis is severe and excessive nausea and vomiting during pregnancy. If you’re unable to keep food or fluids down, it can lead to dehydration and weight loss, as well as dramatically affecting your day-to-day life.

Molar pregnancy

A molar pregnancy is an abnormal growth of all or part of the placenta. You may experience abnormal vaginal bleeding in pregnancy, and hyperemesis as the placenta produces higher amounts of pregnancy hormones than normal.

Molar pregnancies require surgical treatment and further monitoring.

Who is at risk for early pregnancy complications?

Complications can develop during any pregnancy, but your risk is higher if you have a pre-existing medical condition or illness, particularly if poorly controlled.

Some examples include:

• Diabetes
• Cancer
• High blood pressure. Some people have high blood pressure (hypertension) before pregnancy, while other people develop it during pregnancy. High blood pressure during pregnancy may affect the blood flow to the womb.
• Kidney problems
• Epilepsy
• Anaemia
• Sexually transmitted infections (STIs)
• Previous pelvic surgery
• Endometriosis

Many medications used to treat chronic health conditions can safely be used in pregnancy. Some medications may need more frequent monitoring during pregnancy or changes in the dose. Please check with your doctor before you stop or change any of your current medications.

Other factors that may increase your risk of pregnancy complications include:

• Being older than 35
• Being younger than 20
• Smoking cigarettes and drinking alcohol-containing beverages
• Being pregnant with twins, triplets or more
• Having a history of miscarriage
• Having obesity
• Having anorexia

How can I reduce my risk of complications during early pregnancy?

Although complications in early pregnancy can be frightening, it is important to remember that most women have healthy pregnancies and deliveries.

How do I prevent pregnancy complications?

While some pregnancy complications are beyond your control, there are some things you can do to lower your risk of developing pregnancy complications.

These include:

• Being healthy before pregnancy. This includes maintaining a healthier weight, stopping smoking and cutting down on alcohol.
• Ensuring good control of pre-existing medical conditions.
• Maintaining a healthy lifestyle throughout pregnancy by eating nutritious foods, getting regular exercise, and not drinking alcohol or smoking cigarettes.
• Attending all your prenatal appointments, ultrasounds and tests.
• Reporting any troubling or unusual symptoms to your pregnancy care provider.
• Trying to reduce your stress levels and getting plenty of rest during pregnancy.

If you have any concerns or questions about your pregnancy, don’t hesitate to talk to your doctor. With proper care and management, you can minimise the risk of complications and have a healthy pregnancy and delivery.