Major Dangers During Pregnancy

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In a very small proportion of births, serious complications that affect the mother may develop. Until recent years these often progressed rapidly, and many mothers died during pregnancy. The tremendous improvements in prenatal care and deliveries about 3.4 in 10,000 live births. The poisonous condition known as toxemia of pregnancy is responsible for one-forth of these deaths. Its cause is not known, but rapid recognition and treatment of the early signs usually prevent high blood pressure and other very serious symptoms from developing later.

Spontaneous abortion occurs in a small percentage of women during the first 16 weeks of pregnancy, either because of some abnormality in the fetus or some condition in the mother that prevents her from carrying her baby for the full nine months. (The loss of the baby after the sixteenth week of pregnancy is called miscarriage.) In ectopic pregnancy, the fertilized ovum burrows into the fallopian tube instead of the uterus. Since the tube is too small to support the baby’s growth, the fetus is apt to burst through after if has reached a certain size, rupturing the fallopian tube at the same time.

Puerperal or childbed fever, which develops after the delivery of the child, has declined tremendously since the mid-19th century. At one time puerperal fever would sweep through a hospital ward, killing almost all the new mothers present. Dr. Ignaz Semmelweiss discovered that this disease was due to an infection the doctor himself carried from the dissection room or from a woman who already had the disease. Oliver Wendell Holmes, the American author physician, came to a similar conclusion at about the same time Semmelweiss make his great though much opposed, discovery.

Today we know that puerperal fever is a streptococcal infection of the lining of the uterus and that is spreads throughout the body. Because babies are delivered under strictly aseptic (bacteria-free) conditions today, puerperal fever has been practically eliminated. If it does develop it is promptly treated with sulfonamide (sulfa) drugs or antibiotics and usually responds very quickly.

A high proportion of these maternal deaths, especially from hemorrhage and toxemia, can be prevented by adequate prenatal care, better obstetric treatment, and the prevention and control of infections. Deaths from ectopic pregnancy, which account for 8 percent of maternal mortality, usually can be prevented by early diagnosis and prompt surgery. A major part of the responsibility, however, rests with the pregnant woman herself. She must learn the importance of seeking prenatal care early, of observing good health and nutritional habits during pregnancy, and of cooperating completely with her physician.

Community responsibility in this area involves the provision of adequate prenatal clinics and hospital and nursing facilities, especially in low-in-come areas.

Danger signals during pregnancy

Every expectant mother should be familiar with certain danger signals the might arise during the course of pregnancy. William Birch and Dona Meilach in their book, A Doctor Discusses Pregnancy, suggest that the following signs should be reported to the physician:

Any sign of bloody discharge from the vagina.

Persistent severe headaches.

Severe nausea and vomiting. “Severe” means several times within an hour.

Swelling of the ankles, feet, hands and face, particularly if any of these puff-up suddenly and the finger rings feel tight. (Slight swelling during the last months in hot weather is common.)

Chills and fever of over 100⁰, not accompanied by a common cold.

Continual abdominal pains that are not relieved by a bowel movement.

A sudden gush of water from the vagina.

Very frequent, burning urination.

An increased, unusual thirst, with reduced amounts of urine. If one does not urinate for an entire day despite normal intake of fluids, the condition should be reported.

Other dangerous conditions which can occur during pregnancy or delivery of the child are hemorrhage, infection (sepsis), accidental abortion, and ectopic pregnancy.

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