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Concept
Pre-existing disease in pregnancy
Summary
A pre-existing disease in pregnancy is a disease that is not directly caused by the pregnancy, in contrast to various complications of pregnancy, but which may become worse or be a potential risk to the pregnancy (such as causing pregnancy complications). A major component of this risk can result from necessary use of drugs in pregnancy to manage the disease.
In such circumstances, women who wish to continue with a pregnancy require extra medical care, often from an interdisciplinary team. Such a team might include (besides an obstetrician) a specialist in the disorder and other practitioners (for example, maternal-fetal specialists or obstetric physicians, dieticians, etc.).
Chronic hypertension in pregnancy can lead to increased complications for both the mother and fetus. Maternal complications include superimposed pre-eclampsia and caesarean delivery. Fetal complications include preterm delivery, low birth weight, and death. Increasing rates of obesity and metabolic syndrome play a key role in the increased prevalence of chronic hypertension and associated complications. While high blood pressure treatment has been shown to decrease the incidence of severe hypertension during pregnancy, there was no significant difference in pregnancy complications (for example, superimposed pre-eclampsia, stillbrith/neonatal death, small for gestational age).
Diabetes mellitus and pregnancy
Diabetes mellitus and pregnancy deals with the interactions of diabetes mellitus (not restricted to gestational diabetes) and pregnancy. Risks for the child include miscarriage, growth restriction, growth acceleration, fetal obesity (macrosomia), polyhydramnios and birth defects.
Thyroid disease in pregnancy
Thyroid disease in pregnancy can, if uncorrected, cause adverse effects on fetal and maternal well-being. The deleterious effects of thyroid dysfunction can also extend beyond pregnancy and delivery to affect neurointellectual development in the early life of the child. Demand for thyroid hormones is increased during pregnancy which may cause a previously unnoticed thyroid disorder to worsen.
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Related concepts (13)
Hypercoagulability in pregnancy
Hypercoagulability in pregnancy is the propensity of pregnant women to develop thrombosis (blood clots). Pregnancy itself is a factor of hypercoagulability (pregnancy-induced hypercoagulability), as a physiologically adaptive mechanism to prevent post partum bleeding. However, when combined with an additional underlying hypercoagulable states, the risk of thrombosis or embolism may become substantial. Pregnancy-induced hypercoagulability is probably a physiologically adaptive mechanism to prevent post partum hemorrhage.
Complications of pregnancy
Complications of pregnancy are health problems that are related to, or arise during pregnancy. Complications that occur primarily during childbirth are termed obstetric labor complications, and problems that occur primarily after childbirth are termed puerperal disorders. While some complications improve or are fully resolved after pregnancy, some may lead to lasting effects, morbidity, or in the most severe cases, maternal or fetal mortality. Common complications of pregnancy include anemia, gestational diabetes, infections, gestational hypertension and pre-eclampsia.
Maternal physiological changes in pregnancy
Maternal physiological changes in pregnancy are the adaptations that take place during pregnancy that enable the accommodation of the developing embryo and fetus. These are normal physiological adaptations that cause changes in behavior, the functioning of the heart, blood vessels, and blood, metabolism including increases in blood sugar levels, kidney function, posture, and breathing. During pregnancy numerous hormones and proteins are secreted that also have a broad range of effects.