Maternal complications during pregnancy

Last updated: May 20, 2022

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Nausea and vomiting are common conditions of pregnancy and are typically treated with hydration and nonpharmacologic methods. If nausea is refractory to nonpharmacologic methods, antiemetics should be started and added in a step-wise fashion. Hyperemesis gravidarum is a severe form of nausea and vomiting of pregnancy characterized by ketonuria and weight loss, and typically requires inpatient admission, intravenous fluid hydration, and antiemetic therapy. Cervical insufficiency refers to painless cervical dilation that occurs in the absence of uterine contractions and/or labor, usually in the second trimester of pregnancy, and that may require cervical cerclage. Other maternal complications of pregnancy include peripheral edema, gestational thrombocytopenia, and gestational diabetes.

Overview of maternal complications during pregnancy
Risk factors Clinical features Diagnostics Management
Nausea and vomiting of pregnancy
  • Rehydration
  • Adapt diet and avoid triggers.
  • Ginger tea/capsules
  • Antiemetic therapy
  • Thiamine repletion (in severe recurrent vomiting)
Hyperemesis gravidarum
Cervical insufficiency
Trauma in pregnancy Maternal
  • Almost 1 in 4 pregnant women in the US experiences intimate partner violence [1]
  • Imbalance due to the gravid abdomen (↑ risk of falls)
  • Incorrect use of seatbelts during pregnancy (↑ risk of abdominal trauma)
  • Minor trauma: obstetric surveillance
  • Major trauma: initial stabilization and resuscitation (further assessment in trauma center)
Fetal

In pregnant women, a thorough history, examination, and, if necessary, diagnostics are essential to rule out potential causes of nausea and vomiting that are not pregnancy-related.

Because antiemetics are potentially teratogenic, their use should be considered only if nausea and vomiting are refractory to dietary changes and supportive therapy.

A shortened cervical length alone is not sufficient to diagnose cervical insufficiency.

Trauma in pregnancy
Maternal Fetal
Clinical features
Diagnostics
Management

Avoid examining the mother in the supine position in order to avoid possible supine hypotensive syndrome.

The mother should be evaluated and treated before the fetus. Early and optimal diagnostics and trauma management of the mother is the best treatment for the fetus.

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