Special Concerns in Pregnancy

While the majority of women experience healthy pregnancies, certain conditions can occur, such as placenta previa, preeclampsia, gestational diabetes, or thyroid problems. Henry Ford obstetricians and certified nurse midwives give individualized care during pregnancy, with Maternal-Fetal Medicine specialists providing expertise for women with high-risk pregnancies.

• Placenta Previa: In the mid-term of pregnancy, placenta previa is a fairly common ultrasound diagnosis. Placenta previa means that the placenta (the afterbirth) is positioned over the mouth of the womb (cervix). In most women, the placenta will naturally move away from the cervix so that by the end of the pregnancy the placenta previa state has resolved. Many placenta previa patients can carry until full term. Early delivery is sometimes recommended when bleeding is excessive and continuous. Any pregnant woman experiencing bleeding, spotting, or brown discharge should report these symptoms to the health care provider.
• Preeclampsia: Some pregnant women develop a condition of high blood pressure and protein in the urine, called preeclampsia, in mid to later stages of pregnancy. Symptoms may also include swelling, most often in hands and feet, and headaches. Most women require bed rest whereas more severe cases of preeclampsia require hospitalization for treatment. Bed rest and treatment with blood pressure medications usually help control the condition. Early delivery may be recommended in continuing severe cases of preeclampsia. The preeclampsia condition usually resolves rapidly after delivery.
• Gestational Diabetes: Pregnancy-related diabetes is called gestational diabetes. This type of diabetes may sometimes be controlled through diet or require insulin or medications. Diabetes in pregnancy can cause the unborn baby to grow large, which may cause difficulty in delivery, or may affect the newborn after birth, requiring a short stay in the special baby nursery to manage blood glucose levels. In many women the gestational diabetes disappears after delivery whereas in others the diabetes may continue or recur again in future pregnancies. All women who have had gestational diabetes need follow-up care over the long term as their risk of developing diabetes later in life is increased.
• Thyroid Problems: The thyroid gland can become over-active (called hyperthyroidism) or under-active (called hypothyroidism) during pregnancy. Hyperthyroidism may cause weight loss, rapid heart rate and/or heartbeat irregularity, fever, and blood pressure elevation. Treatment with medication allows a woman to complete her pregnancy safely. Hypothyroidism produces different symptoms, such as weight gain and fatigue, and requires treatment with replacement thyroid hormone medication. The hormones do not have an effect on the unborn child because the mother's thyroid hormones do not cross the placenta, and the baby makes his or her own thyroid hormones.