Pregnancy complications

Our approach

Every family looks forward to a healthy pregnancy and to the birth of a healthy newborn. And, for the vast majority of women, pregnancy follows a fairly routine course. But for some, there may be unexpected difficulties and challenges along the way with a high-risk pregnancy.

Fortunately, advances in medicine have helped improve the care of both mothers and unborn babies. The fellowship-trained Maternal Fetal Medicine (MFM) team at Northwell Health works closely with obstetricians and pediatric doctors specializing in genetics, cardiology, and neurology, as well as infectious disease, hematological, lung and kidney problems. We also have the highest tier Neonatal Intensive Care Unit (NICU) available, making us a referral center for the most high-risk situations.

This means that no matter what obstacle gets in your way, large or small, we will have a specialist ready to find the best path around it to provide the healthiest outcome for everyone. 

Overview

There are many different types of pregnancy complications that can affect the mother, baby or both. These complications range from common to rare, and can have a wide variety of causes and effects.

The best way to avoid complications is to start a conversation with your doctor before you try to get pregnant. We have a highly trained team that specializes in anticipating complications and paving a clear path to a healthy delivery.

Even if a complication does arise, our team will come up with a safe approach to make sure you and your baby get through the pregnancy with the best outcome possible.

Causes and risks

Our team of specialists works hard to identify risk factors before they have a chance to affect your pregnancy, which is why it’s important to speak with your doctor before you try to get pregnant or at the beginning of your pregnancy:

Risk factors vary for each individual pregnancy, but some common ones include:

  • Use of certain medications; consult your doctor on which medications are safe in pregnancy
  • Medical conditions, such as diabetes, hypertension, thyroid disease, lupus or cancer
  • Pregnancy complications in the past, such as preterm delivery, pregnancy loss or preeclampsia
  • A previous child who required surgery at birth  
  • Obesity or a history of bariatric surgery
  • Hereditary diseases that run in your or your partner’s family

Types

Pregnancy complications can take many forms and each comes with its own unique symptoms. Below are some of the more common pregnancy complications:

  • Amniotic fluid complications — The levels of amniotic fluid surrounding the fetus can be a sign of an issue with the pregnancy. High amounts of fluid can put too much pressure on the uterus, leading to preterm labor. Low levels of amniotic fluid can be a sign that your water broke, or that the placenta is not working properly. Our team will monitor the baby more closely and work with you to determine the best time for delivery.
  • Bleeding — A small amount of bleeding early in the pregnancy is fairly common and may be normal. Heavy, sudden bleeding late in your pregnancy is more concerning. You should call your doctor immediately to discuss any bleeding in pregnancy. Our team will determine the severity of the bleeding and take action, if necessary, to keep you and your baby as safe as possible.
  • Ectopic pregnancy — Ectopic pregnancies occur when the baby develops outside of the uterus. In most cases, the fertilized egg gets stuck in the fallopian tube due to damage or blockage and begins to develop in the tube. Rarely, the baby develops in the ovary, cervix or belly. Symptoms can include abdominal pain or bleeding. Pregnancies outside of the uterus can be dangerous and cannot result in a healthy baby. Our team will develop a treatment plan that best suits you and your needs.
  • Miscarriage — A miscarriage is an unexpected loss of the baby within the first 20 weeks of a pregnancy. Some miscarriages occur before women know they are pregnant. Though miscarriages cannot be stopped or reversed, our team of specialists will ensure you’re given the right care to manage a miscarriage as safely and thoughtfully as possible, and to minimize the chance of it happening again in the future.
  • Placental complications — In a normal pregnancy, the placenta attaches to the uterine wall and provides oxygen and nutrients to your baby. In some cases, the placenta detaches or attaches improperly causing complications. For example, placenta previa occurs when the placenta covers the cervix. This can cause bleeding before or during delivery, and requires a C-section to safely deliver your baby. Placental abruption occurs when the placenta detaches from the uterus early, which can affect your baby’s nutrient and oxygen supply. Placental abruption tends to occur in the final trimester of pregnancy and may cause vaginal bleeding  A placenta that attaches improperly may also cause the baby to gain weight more slowly than usual, a condition known as “growth restriction.” In severe cases, the baby may need to be delivered early to overcome one of these placental issues.
  • Preeclampsia — Preeclampsia is a condition in which women who previously had normal blood pressure develop high blood pressure 20 weeks or more into their pregnancy. Preeclampsia can lead to serious and sometimes fatal complications if left unattended. It can only be cured by delivering the baby. To make sure there are no serious or fatal complications, our team is equipped to closely monitor you and your baby, sometimes giving you medication to control your blood pressure and minimize risks, until a safe delivery can be achieved. 
  • Gestational diabetes — Pregnancy hormones can affect how you digest food. A small percentage of women will develop diabetes in pregnancy, which can be managed with the help of our specialists through healthy food choices, moderate exercise, and occasionally medication in order to keep you and your baby safe.

The warning signs of pregnancy complications can be difficult to spot because your body is already going through such drastic changes. Even in the healthiest pregnancies, it's common for women to feel nauseated, tired and bloated. It is important to call your doctor if anything feels off, even if you think it may be normal. 

Diagnosis and testing

Every diagnosis starts with a conversation. Our doctors carefully listen to how you’re feeling and your medical history to get a sense of what might be going on and if any action is needed. If they think there might be something wrong, there are a variety of tests to carefully choose from.

Some of the most common tests include:

  • Amniocentesis
  • Blood work
  • Hospital observation
  • Physical exam
  • Urine test
  • Ultrasound

No matter what the situation is, our doctors try to use the least invasive testing option whenever possible. Our team of specialists is well equipped to help you find answers while keeping you comfortable and at ease.

Treatment options

If you are facing pregnancy complications, your treatment plan will vary greatly from other women’s plans. That’s because our team of obstetricians works closely with MFM specialists who have completed additional research and training in order to be prepared to tackle any complication, no matter how complex. Your obstetricians and MFM physicians will work with you to create a highly individualized approach tailored to your exact situation, because every pregnancy is different.

 

Some common treatments for different pregnancy complications include:

  • Nutrition counseling
  • Exercise or lifestyle changes
  • Medication
  • Certain surgical procedures
  • Careful and frequent surveillance with ultrasound or fetal heart rate monitoring
  • Fetal transfusion
  • Delivery of the baby