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Pregnancy and Labour Complications

Any mother with complications in her pregnancy, or who has had significant problems in her past or in a previous pregnancy, will generally be advised to have delivery, usually by induction of labour, at 38 - 40 weeks. 

This is the time when the pregnancy has successfully reached full term, and there are no biological advantages for the baby to continue inside the womb.

However, there are still small risks to the baby of something going wrong in the remaining weeks of the pregnancy. Examples include: women who have had bleeding during the last half of pregnancy; women with kidney or liver problems such as obstetric cholestasis; women carrying twins; and women who have previously had a stillbirth.

Diabetes

Among women who are diabetic or become diabetic during pregnancy, there is a real, albeit small, chance of complications for the mother and baby. This is likely to mean extra visits, possibly extra fetal monitoring and induction close to the expected date of delivery. Women who are diabetic tend to have large babies.

If you have diabetes and your baby proves too big for a vaginal birth, then assisted delivery by vacuum or forceps, or a caesarean section may need to be considered. Additionally, if a preterm delivery is necessary because of your diabetes, and your cervix has not softened enough to induce labour, then a caesarean delivery may again be recommended.

Occasionally, babies of diabetic mothers may require admission to a special-care nursery even if delivered close to their due date.

Eclampsia and pre-eclampsia

Pre-eclampsia, a condition with hypertension (high blood pressure) and protein in the urine, occurs in around 5-7% of pregnancies. It is best treated by delivery, and usually goes away within 24-48 hours of the placenta being delivered. Thus, women who have pre-eclampsia will often be delivered at around 38 weeks, or sooner if their condition poses a risk to their health or that of their baby. In most cases, this will be by induction but, if severe or if there are other complications, it may need to be by caesarean section.

Eclampsia is a rare condition characterised mainly by fits/convulsions and is a consequence of untreated, severe pre-eclampsia. It is a dangerous situation for both mother and baby, since it can affect the mother’s brain and also the oxygen supply to the baby. It is treated by urgent delivery, often by immediate caesarean section. Furthermore, if you suffer from eclampsia during labour, you will be given anticonvulsants to stop further fits, and prompt delivery will be necessary, either by induction or caesarean section, since the condition usually improves once the baby is born.

Eclampsia can occur with relatively small rises in blood pressure. This is particularly true in teenage mothers.

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