The document discusses various pregnancy complications, including bacterial and viral infections, the implications of Rh-negative blood groups, intrauterine growth restriction (IUGR), and ectopic pregnancies. It emphasizes the importance of monitoring maternal health, conducting periodic blood tests, and providing appropriate treatments to mitigate risks for both mothers and babies. Key recommendations include blood type screening, administering Rh immunoglobulin injections, and ensuring proper nutritional and medical support during pregnancy.

1. 
Pregnancy
Complications
Dr Manavita Mahajan
MD, MRCOG (UK), FRCOG(UK)
Diploma Gyn Endoscopy, Louisville, USA
Sr Consultant Obstetrician & Gynaecologist
FMRI Gurgaon

2. 
 Bacterial infection
 Increased tendency for UTI in pregnancy
 Untreated , may lead to kidney infections , sepsis
and premature delivery
 Treated with appropriate antibiotics
Urinary Tract Infection in
pregnancy

3. 
 Bacterial infections
 Can be treated
 Cause Miscarriage / preterm labour / stillbirth /
neonatal infections if left untreated
 Viral Infections
 Long term serious infections in mother and child
 Anti viral therapy , other measures to reduce mother
to child transmission
STI’s In Pregnancy

4. 
 85% of population has Rh antigen on their blood
cells(called Rh+ blood group)
 So 15% of pregnant women may be having Rh
negative blood group
 If married to a Rh positive man , the baby can be Rh
positive(inherits this from the father)
 The Rh factor does not affect a person’s general
health.
RH negative Blood group
in the mother

5. 
 Baby’s red cells may leak into mothers blood circulation
occasionally
 Problem arises when mother produces antibodies against
Rh postive baby cells
 These antibodies can target baby’s red blood cells
producing anemia , heart failure and even stillbirth
 An injection of RhIg to the mother in pregnancy and after
delivery can prevent antibody formation in the mother
against baby’s Rh antigen thus protecting her babies
 If the mother already has the antibody , then the
Injection(RhIg) does not work
Rh Negative Pregnant
Woman

6. 
 Rh-negative women should also receive treatment
after any miscarriage, ectopic pregnancy, or induced
abortion to prevent any chance of the woman
developing antibodies that would attack a future Rh-
positive baby.
Rh Negative Pregnant
Woman

7. 
 To Summarize
 All pregnant women must get their
1. Blood Group and Rhesus Factor checked in
pregnancy
2. Periodic blood tests must be performed to detect the
development of antibodies against Rh factor
3. All Rh Neg Prgnant women should get RhIg
injection at 28 weeks and after delivery
Rh Negative Pregnant
Woman

8. 
 Poor growth in the unborn baby
 Usually suspected by clinical Examination and
Confirmed by ultrasound assessment of Baby’s(fetal)
growth
 Risk Factors for IUGR include
1. Birth defects or chromosomal abnormalities
2. Pregnancy induced hypertension (PIH)
3. Multiple pregnancy
Intra Uterine Growth
Restriction (IUGR) In the
fetus

9. 
4. Placental abnormalities
5. Umbilical cord abnormalities
6. Use of drugs, cigarettes, and/or alcohol
7. Poor nutrition during pregnancy
8. Severe Diabetes in mother
9. Medical problems – kidney diseases , autoimmune
disorders , Thyroid disorders , severe cardiac ailments
or asthma in the mother
Causes of IUGR

10. 
 The main principles of treatment are
1. Improve maternal Nutrition
2. Improve maternal health / treat the underlying
medical conditions in the mother
3. Monitor baby’s growth and well being by periodic
assessments
4. Deliver if mature or if problems with baby’s
wellbeing
Treatment of IUGR

11. 
 Early Delivery
 Increased risk for hypoxia (lack of oxygen when the baby
is born)
 Increased risk of fetal distress and caesarean section in
labour
 Increased risk for meconium aspiration and pneumonia
and respirator distress in the newborn
 Increased risk for motor and neurological disabilities
 problems like hypoglycemia (low blood sugar) and
Hypothermia( poor temperature control)
 Poor growth and development in infancy
Risks of IUGR

12. 
 Any pregnancy that is located outside the uterus is called
an ectopic pregnancy
 Commonest location is the fallopian tube
 Life threatening for mother unless diagnosed and treated
 Symptoms –
1. Asymptomatic - no symptoms and the ectopic
pregnancy is detected on routine ultrasound assessment
of early pregnancy
2. Sudden severe lower abdominal pain with fainting with
missed periods
3. Recurrent episodes of abdominal pain in early
pregnancy
Ectopic Pregnancy

13. 
 Who is at risk
 Pregnant women
 Women with previous infections in the pelvis , tubal
surgeries in the past
 women with history of infertility , endometriosis and
those who have taken treatments for infertility
 Women with previous ectopic pregnancy
Ectopic Pregnancy

14. 
 Diagnosis – A challenging problem!
Step 1. Correct diagnosis of pregnancy by blood
pregnancy test called Beta HCG
Step 2. Transvaginal Ultrasound of pelvis to check for
pregnancy location if beta HCG levels more tha 1500
 Step 1 & 2 may need to be repeated
Ectopic pregnancy

15. 
 Surgical
 Laparoscopy is the surgical method of choice
 Allows diagnosis and treatment at the same time
 Medical Treatment with methotrexate(medicine)
possible in certain women under supervision
Ectopic Pregnancy -
Treatment

16. Contact us:
Triveni Obstetrics & Gynaecology Clinic,
620 Galleria, DLF Phase-IV, Gurgaon.
Pin Code 122002
Phone: +91-981-058-38 76, +91-124-257-28 92
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