• Clinical science
  • Clinician

Maternal complications during pregnancy

Summary

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.

Nausea and vomiting of pregnancy (uncomplicated)

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.

Ondansetron, methylprednisolone, and scopolamine are contraindicated in the first trimester of pregnancy.

Hyperemesis gravidarum

Cervical insufficiency

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

References:[6][7][8][9][10][11][12][13][14]

Other complications

References:[6][7][8][9][10][11][12][13][14]

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  • 9. Ehsanipoor RM, Satin AJ, Lockwood CJ, Barss VA. Normal and Abnormal Labor Progression. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/normal-and-abnormal-labor-progression. Last updated June 7, 2017. Accessed June 16, 2017.
  • 10. Refuerzo JS, Smith JA, Ramin SM, Lockwood CL, Barss VA. Clinical Features and Evaluation of Nausea and Vomiting of Pregnancy. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/clinical-features-and-evaluation-of-nausea-and-vomiting-of-pregnancy. Last updated January 3, 2017. Accessed July 7, 2017.
  • 11. American College of Obstetricians and Gynecologists. Practice Bulletin No. 142: Cerclage for the Management of Cervical Insufficiency. Obstet Gynecol. 2014; 123(2): pp. 372–379. doi: 10.1097/01.AOG.0000443276.68274.cc.
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  • 15. Ciobanu et al. Thrombocytopenia in Pregnancy. Maedica. 2016; 11(1): pp. 55–60. pmid: 28465752.
last updated 08/27/2020
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