Vaginal bleeding may happen occasionally during pregnancy. Vaginal bleeding could range from some spotting to a hemorrhage that requires immediate medical attention. In any case, even if it is just some spotting, it should be checked because it could be a symptom of certain complications.  

Causes of slight bleeding

Slight bleeding is when there is some brownish, dark red or pink spotting. Some of the most frequent causes of this type of bleeding are:  

• Implantation. A few days after the egg is fertilized it embeds itself in the wall of the uterus. On doing so it could break some capillaries and cause spotting. This could happen during the time that your period was expected.  

• After a physical. During pregnancy there is a greater blood flow to the area of the cervix. An internal exam could cause some capillaries to bleed and some spotting to happen.

• After having sex. For the same reasons as before, now being at a higher risk in the area, it is possible for some spotting to happen.

In any event, it is important that you tell your doctor about this spotting so that he may rule out any other kind of problem.  

Causes of heavy vaginal bleeding

It is considered heavy vaginal bleeding if, even though the bleeding is not excessive, it doesn’t stop for one whole day, or if the bleeding requires more than one sanitary pad per day.  Heavy bleeding could be due to one of the following:

• Ectopic pregnancy. This is when the fertilized egg doesn’t embed in the uterus, but remains in the fallopian tubes or elsewhere. When the egg grows, it causes the tube to rupture and, as a consequence of that, internal bleeding that must be stopped immediately. You must go to the hospital as soon as possible or phone the ER if the bleeding happens along with acute intense pain in the abdomen or the shoulder.  

• Miscarriage. Most miscarriages happen in the first three months. If the bleeding comes with a grey or pinkish tissue, store it in a Ziploc back so that your doctor may determine whether it is a miscarriage.  

• Placental abruption. In the second half of the pregnancy, when the placenta is larger, it could partially break off from the uterus wall, and this causes profuse bleeding. You must go to the hospital and be seen by a doctor immediately.  

Although it may appear that after a while, the hemorrhage stops, you should contact your doctor as soon as possible or go to the hospital to find out the cause of the bleeding and what to do to stop it if it is abundant.  

Bleeding before and after delivery  

When delivery is imminent, the mucous plug that was sealing off the cervix sometimes comes out and you may see some blood (bloody show). This is normal. But if the bleeding is heavy, then you must go to the hospital to rule out placental abruption.

Once you deliver your baby, you will bleed for a few days. But if the bleeding gets heaver or especially if it has an unpleasant odor, you must contact your practitioner to rule out an infection due to remains of the placenta or other causes.

Sometimes, although conception has happened, the fertilized egg doesn’t lodge itself in the correct place, but in one of the fallopian tubes. When it starts to grow, this could cause internal bleeding that must be treated immediately.

The fertilized egg

When you ovulate, you liberate an ovule or egg that travels down the fallopian tubes (these are two tubes that run from the ovaries to your uterus). The encounter with your partner’s sperm takes place in the fallopian tubes. Once fertilized, the egg must travel until it reaches the uterus, where it will embed itself in one of the walls and will start to grow until it becomes a baby.

Due to different causes, this fertilized egg sometimes fails to travel down the tubes and remains in the place where it was fertilized and starts to grow there. That poses a very big danger for the mother because when it grows it can cause the fallopian tube to burst and cause severe internal bleeding.

Ectopic pregnancy can also happen in the ovary and in other places other than the uterus.  

How to recognize an ectopic pregnancy

Acute pain is usually one of the first symptoms of ectopic pregnancy. It is an acute and pulsating pain, either on the left or the right side, or in the low abdomen. It’s usually felt in the area where menstrual cramps are felt.  

A pain typical of ectopic pregnancy is shoulder pain that appears as a reflex of the inflammation happening in the fallopian tube. Spotting, a drop in blood pressure with an accelerated heart-beat, a sensation of pressure in the rectum, or general malaise in the area, as if there were an intestinal problem.  

Due to the severe consequences an ectopic pregnancy could have, it is important to go to the hospital or the doctor’s office immediately, if you suspect the symptoms could pertain to an ectopic pregnancy.  

Why ectopic pregnancies happen

Generally, the cause is due to the impossibility of the egg to follow its usual path due to some scar or tissue that prevents it from traveling to the uterus as it usually would.

Some of the things that could cause an ectopic pregnancy are infections due to venereal diseases, other kinds of infections that affect the tissue of the tubes, surgery, or a condition known as endometriosis. Women who have already suffered ectopic pregnancies are at a higher risk.

Treatment

Ectopic pregnancy is detected with an ultrasound and confirming the pregnancy with certain tests.  

The only way of preventing internal bleeding or stopping one if it has started, is to eliminate the fertilized egg. In emergency cases, conventional surgery is done, or the surgery may be done with a laparoscopy.  

This procedure only involves two incisions in the abdomen, where the instruments are introduced that will extract the fertilized egg. In some instances, depending on the size, it’s possible to save the tube and repair the damage, but this is not always possible and the whole tube must be removed.  

If the fertilized egg is small enough, it is possible to use certain medication to stop growth and for it to be reabsorbed.  

In any case, ectopic pregnancies are not frequent and the probabilities of having one have more to do with the risk factors explained before.  

Diabetes is an illness that for genetic reasons, affects Latinos at a higher rate than other ethnic groups. The problem of diabetes is that it is a “silent” illness. That is, the symptoms don’t show until the illness is already established. If you have diabetes, and you don’t know, you may be having trouble conceiving or to maintain your pregnancy.  

What is diabetes?

People who suffer from diabetes cannot correctly process the food they eat in order to help the cells obtain the energy from it, in the form of glucose or sugar. Through digestion, the food we eat breaks down into smaller and smaller elements down to glucose molecules, which are what the cells “eat” or use as fuel.  

In order for the glucose to be able to penetrate the cells, the action of a hormone called insulin is required. Insulin is like a key that opens a door in the cell to enable the sugar or glucose to enter. In people with diabetes, this mechanism does not work properly or there is not enough insulin to open the door, or the cell doesn’t “hear” that someone is knocking on the door.

Sugar that doesn’t penetrate the cells remains in the bloodstream. This makes the person very thirsty, because the body wants to get rid of this sugar and therefore urinates very frequently. Besides, there is permanent fatigue, because the cells are not receiving their fuel.  

Types of diabetes

There are three types of diabetes: type I, type II and gestational diabetes and although the results of each of them are the same - sugar cannot penetrate the cells - the causes of the illness are different.  

Type I diabetes is the most severe. When a person has type I diabetes, she cannot secrete insulin. The cells in charge of secreting insulin are destroyed by the immune system and it is necessary to inject insulin in order to survive. It is also diabetes that has its onset before the person turns 20. That’s why it’s also known as juvenile diabetes.

Type II diabetes is the most common, both amongst Latinos and the population at large. Although in this type of diabetes enough insulin is secreted, the cells cannot manage it properly. In order to compensate for that, the pancreas secretes more insulin and eventually loses the capacity to secrete it. People with type II diabetes usually have a family history of this illness and tend to be overweight.  In general this type of diabetes may be controlled with diet and exercise, but there are cases when it is necessary to take medication in order to compensate for the lack of insulin.  

Gestational diabetes only happens during pregnancy and it is due to the interaction of pregnancy hormones with insulin production. The problem is that excess sugar in the bloodstream may affect the baby. Although this illness disappears after giving birth, people with a family history of diabetes are at a higher risk of developing type II diabetes after having given birth.  

Diabetes: a silent illness.

Because the symptoms of diabetes do not manifest clearly until the illness is already present, it is very difficult to detect, unless specific tests are done. In the case of Latinos, there is also a genetic predisposition towards suffering diabetes, added to the fact that most of us don’t have regular medical coverage and therefore don’t undergo regular check-ups that could detect it early on.  

If you are trying to conceive and don’t know for sure if you could be suffering from this illness, it is important that you see your doctor for a physical. This is because excess sugar in the bloodstream early in pregnancy could affect the baby’s development. The baby’s organs and basic structures are formed in the first few weeks of pregnancy. A high glucose level in the bloodstream is related to malformations and miscarriages.

It is possible to treat diabetes and have a healthy pregnancy and baby. Besides the diet and exercise required to control type II diabetes, you may require medication that you can take during pregnancy. Your doctor will give you the appropriate treatment.  

Besides the risks for the baby’s development, diabetes also puts your health at risk. The high levels of blood sugar imply a greater risk for developing kidney, eye, circulatory and other problems.  

Symptoms of diabetes

One of the most common symptoms of diabetes is the fatigue it causes, because the cells cannot use the glucose they need. Other common symptoms:  

• Constant thirst. Sugar is in the bloodstream and the body tries to eliminate it through urine.

• Frequent urination. Due to the large amounts of water the diabetic drinks and the kidney’s efforts to eliminate sugar, the need to urinate is very frequent during the day and at night.

• Greater appetite. As the cells are not receiving the proper nutrients, diabetics feel hungry even after having eaten.

• Wounds that don’t heal. It’s important to check the soles of your feet frequently because any wound in this area takes a long time to heal and they usually get infected. The immune system is also affected by the excess sugar in the bloodstream.

Latinas have the same rate of hypertension as the rest of the population. However and due to the fact that this is a silent illness and also that we do not always have regular medical coverage, it is common for us to discover during pregnancy that our blood pressure is high. This can go from being something without repercussions for the pregnancy to being the symptom of a serious illness known as preeclampsia.

What is hypertension?

The blood that circulates in our veins exerts pressure on them. Hypertension is an excess of pressure, or stress, on these veins.

The heart contracts to propel the movement of the blood through our veins and arteries and then it relaxes. Then it contracts and relaxes again. These movements comprise heart beats.

Normal blood pressure is around 120/80 mm Hg. Although now there are digital systems to read blood pressure, what originally measured these figures were the millimeters that mercury would rise in the blood-pressure machine. The first figure measures the pressure when the heart contracts and there is a maximum drive of the blood, that is to say, when the veins sustain the highest pressure. The second figure measures the pressure on the veins when the heart relaxes. These readings give a clear idea as to whether the pressure is normal, high or low.

The first figure is the high or maximum reading, and the second the low or minimum reading. When the higher reading is over 140 mm, and the lower reading is over 90 mm it is considered hypertension.

Types of hypertension.

During pregnancy a series of changes occur in the circulation of the blood which can alter blood pressure. What usually happens is that the mother’s veins relax in order to adapt to the increase in blood volume. That’s why people who suffer from high blood pressure can have normal readings during the first months of the pregnancy. However there are certain cases where this does not occur and veins do not adapt to the increase in blood flow.

The consequence of the blood not flowing normally now that the volume is larger is that the baby may not get sufficient oxygen or nourishment, because he receives everything through the mother’s blood.

• Chronic hypertension. This is the most common type of hypertension which is usually present before pregnancy. As a general rule, if this is under control, there is no reason for this type of hypertension to create problems during pregnancy. But it is important to constantly monitor blood pressure because chronic hypertension can contribute to the onset of an illness known as preeclampsia which can have serious consequences for the pregnancy.

• Hypertension caused by the pregnancy. It’s a similar hypertension to the previous one but it is created by the pregnancy itself. It is also known as gestational hypertension. This type of high blood pressure is different from the one caused by preeclampsia. Its symptoms are not so severe and it is usually possible to control.  Preeclampsia. It is also known as toxemia and is an illness that can present severe risks both to the mother and the baby.

If you have been diagnosed with some type of hypertension, your doctor will watch your pregnancy closely to make sure you do not develop the more serious types of the illness. Besides monitoring your blood pressure regularly, checking for the presence of protein in your urine and doing other tests, your doctor will make sure that the baby is growing normally (which means that he is getting adequate oxygen and nourishment) by means of ultrasounds or sonograms and other tests.

Symptoms of Hypertension

If you suffer from headaches, especially during the second half of your pregnancy, you must report it to your doctor as soon as possible. Changes in vision can also be an indication of high pressure.

If you experience a sudden swelling in your face and hands, or a fast rise in your pressure you must contact your doctor immediately or go to the hospital.

After delivery, if your high blood pressure was due to your pregnancy everything will probably go back to normal. If your hypertension was chronic you should continue to monitor it.

Preeclampsia, also known as toxemia, is an illness that only happens during pregnancy and that can become very serious. It is important to know the symptoms so that preeclampsia doesn’t become eclampsia, a condition that can have severe consequences both for the mother and the fetus.  

What is preeclampsia

This illness usually has its onset at mid pregnancy and it is an abnormal response to the need the mother’s veins have to accommodate the larger blood volume that now flows in her veins.  

During pregnancy, the mother’s blood volume increases by 20-40%. This is because some organs now require more blood flow. The uterus, for example, will increase 500 times its size and will require oxygenation and nutrients. The same thing will happen with other organs that are now making an extra effort.

The normal response to these changes is that the mother’s arteries and veins relax to enable the blood volume to increase. However, in preeclampsia, the opposite occurs: the mother’s veins contract and besides, the blood tends to coagulate. The result is that the mother’s vital organs are not receiving the oxygen they need. The baby doesn’t receive enough oxygen either, nor the nutrients required in order to grow.

Symptoms of preeclampsia

Throughout your prenatal appointments, several urine samples will be taken in order to make sure, amongst other things, that there is no protein in it. Protein in urine indicates there could be a malfunction in the kidneys. This is one of the red flags that signal there a possibility of preeclampsia. This control is carried out so frequently because it is very important to detect this illness as soon as possible, as it could turn into a very severe condition in a very short time.

Besides protein, another red flag is the rapid increase in blood pressure, due to the incapability of the veins and arteries to accommodate the greater blood volume.  

Face and hands could be bloated, along with a fast weight gain.  This is because the circulatory system is not working properly and there is a lot of water retention.

Headaches, blurred vision and momentary loss of vision and other symptoms are also an indication that something isn’t right.

Treatment of preeclampsia

Some women, despite having the first symptoms of preeclampsia, don’t feel bad and they can be surprised by the measures their doctor will take if he discovers any of these symptoms. If your doctor thinks you may have advanced preeclampsia, he will have you hospitalized immediately. This is because preeclampsia could very rapidly turn into eclampsia.   

Eclampsia could cause strokes, rupturing of internal organs, the placenta breaking away from the wall of the uterus and even death. Convulsions are another sign that this illness is serious. If you experience convulsions at any time of your pregnancy, call 911 immediately. Don’t wait for someone to take you to the hospital.  

In the event that the symptoms of preeclampsia are not severe, it may be possible to control them with rest, by drinking water and avoiding salt. You should rest on your left side in order to enable blood circulation and eliminate pressure on the expectant mother’s arteries.

When it is more advanced, once in the hospital, medication will be administered to aid in eliminating liquids.  

In the event that preeclampsia is considered severe, the only remedy to control it is to induce preterm labor. Once the placenta has been eliminated from the body, all the symptoms disappear.

Risks for developing preeclampsia

It is fortunately not a very common illness. However, women who have hypertension, diabetes and obesity are at a higher risk. Latinas are at a higher risk of having diabetes and we also have the highest levels of obesity. For this reason, it is important to pay attention to the symptoms describe earlier.  

Being over 35, carrying multiples or having had preeclampsia before, or a family history of it, also increase the risk of suffering from it.

Latinas, because of a series of genetic factors have three times the incidence of gestational diabetes than other women in the United States. This illness can affect pregnancy if left untreated.

What is gestational diabetes?

Gestational diabetes is a type of diabetes that only occurs during pregnancy. Just as with other types of diabetes, the body does not secrete enough insulin, or the insulin does not act normally. The difference is that the causes of this type of diabetes are pregnancy hormones and that the sugar that is in the blood then reaches the baby.

When there is diabetes present, the food we eat cannot reach the cells that need them. In the digestion process, what we eat turns into glucose or sugar, amongst other things. That is the fuel that cells use to function. In order to be able to “fuel up” with sugar or glucose, they need a key to open the tank, and that key would be insulin. When diabetes is present, there is not enough insulin or it doesn’t act as it should. The result is that the sugar that did not reach the cells circulates around the blood.  

The effect of gestational diabetes on the baby

All the sugar that is in the blood crosses the placenta and reaches the baby. When the baby receives such a large amount of food, the baby starts to gain weight. A baby that is too big can have problems during delivery, along with other complications such as:

• Low sugar levels: this is known as hypoglycemia. What happens is that during pregnancy, the baby has had to produce a lot of insulin in order to be able to use all the sugar that she was receiving from the mother. The levels of insulin production are very high. When the baby is born, all that insulin is still acting, but as the baby is “disconnected” from the mom, she is not receiving such a large amount of sugar. Insulin then acts on what is left, and it could cause your blood sugar level to go down rapidly. The baby will slowly adjust the amount of insulin she secretes, in accordance with the food intake. However, at first the blood sugar drop could be very abrupt and the baby could faint and need glucose in order to adjust slowly.  

• Paralysis of the arm. As these babies are larger than normal, their passing through the birth canal could be difficult.  Some babies literally get “stuck”. This is dangerous for two reasons. On the one hand, they can press against the umbilical cord and limit the amount of oxygen they receive and on the other; they could suffer damages on the nerves that give movement to the arm, since it gets stuck against the mother’s pubic bone.   

• Risk of being overweight. Studies show that children of diabetic mothers that didn’t control their diabetes during pregnancy have a greater tendency towards obesity and some developmental problems.  

• For the mother, gestational diabetes also has risks. On the one hand, there is a higher risk of having a C-section if it isn’t properly controlled and on the other, there is a much higher risk of developing type II diabetes after giving birth.  

How to detect and treat gestational diabetes

Because of the consequences that gestational diabetes can have both on the baby and the mother, at around week 28, all pregnant women undergo a routine test to rule out this illness.

In general, gestational diabetes is controlled with proper diet and exercise, but it is sometimes necessary to prescribe medication. Nowadays insulin in tablets may be used, although insulin in shots is also used.

The objective of the diet plan to treat gestational diabetes is to keep a constant blood sugar level and avoid its peaking or plummeting. The best way to do this is to eat three meals a day with three snacks in between, and to avoid foods that could cause a fast increase in sugar, such as candy or refined flour.  

Along with proper diet, it is recommended to exercise moderately by walking or swimming, always making sure you follow your doctor’s orders, in order to avoid hypoglycemia or a drop in blood sugar.  

In order to control how you are responding to the treatment, glucose control sticks are used. These are small devices in which you deposit a drop of blood and they immediately register the sugar content of the drop. The figures that indicate that diabetes is under control are:  

• Less than 90 mg/dL before breakfast

• Less than 140 mg/dL one hour after eating.

• Less than 120 mg/dL two hours after eating.

Every year there are usually influenza epidemics. Due to its being a rather common illness, you could catch it during your pregnancy. Just as with any other infectious diseases during pregnancy, the onset of influenza should be closely monitored to avoid complications that could affect your pregnancy.  

What is influenza?

Influenza, or “flu", is a respiratory disease that is easily contagious by means of sneezing or coughing. When another person inhales the virus in the air, she can become infected. Two typical complications are bacterial pneumonia and dehydration.

The most common symptoms of influenza are, amongst others: fever, muscular pain, sore throat, chills or congestion. Sometimes, stomach or intestinal disorders could also happen. Because pregnancy causes changes in the immune system, it is important to closely monitor a pregnant woman if she has become ill with influenza. There is a three day window from the moment when a person is infected until the onset of the first symptoms.

Treatment of influenza

Because influenza is caused by a virus, there are is no possible treatment with antibiotics (such as when the illness is caused by bacteria).  The symptoms are alleviated with medication. For example, the doctor can prescribe medication for fever or congestion.

If you think you may have become infected by influenza, it is important that you speak to your doctor as soon as possible and that you don’t take any medications that have not been prescribed by your practitioner.  Don’t take something just because your partner or a family member did well on it while suffering from the flu. Not all meds are safe during pregnancy.

Speak with your doctor especially if you are in your first weeks of pregnancy and you have a fever. High fever is not good to have during pregnancy because it can interfere in the baby’s development, although the risk is very small. Your doctor can prescribe medication to keep your fever in check.

Some of the things you can do to feel better are:  

• Drink a lot of fluids: water, soup, juice or gelatin. 

• Eat small meals, but don’t stop eating completely even if you aren’t hungry.

• Use saline sprays or vapor baths to relieve your nose if you are quite congested, but avoid using decongestant drops because they can be harmful.  

• Rest as much as you can, propped up on pillows if you feel quite congested.

If you are coughing a lot or feel a lot of congestion, monitor the color of your secretions so you can inform your doctor.  

Preventing influenza

Every year, vaccines are made for the type of influenza epidemic that is expected. In general, vaccines for influenza are considered safe during pregnancy and they can prevent you from having to suffer from the illness. The viruses that are injected in these vaccines are inactive. That means that they are not infectious. The vaccines are usually available between October and May, which is the flu season.  

Other more common and also effective measures are staying away from people with the flu, washing your hands frequently, whether you have been in contact with ill people or not, and avoid touching your nose or mouth with unwashed hands, because the nose  and mouth are the points of entry for the influenza virus.

Becoming ill is not pleasant, and depending on the type of illness, it could cause discomfort and uncertainty in the patient, she does not exactly know what the consequences may be.  But if the illness happens during pregnancy, the concern about its effects on the baby’s development can create a lot of anxiety in the moms-to-be. 

Illnesses during pregnancy

There are some illnesses that are known for being “silent”, since they don’t cause symptoms and they could be present even before the pregnancy. If these illnesses are not properly treated, they could affect the baby’s development or the evolution of the pregnancy.  

The ideal scenario would be to have a check-up before conception, in order to better prepare for the pregnancy. However, this is not always possible. But in the analyses and the tests that are carried out during prenatal visits, some of these illnesses could be detected and treatment be initiated. That is why it is important to request a prenatal appointment as soon as you know that you are pregnant.  

Two of the most common illnesses in Latinas, which are not detected before pregnancy, are diabetes and hypertension. Fortunately, you could have a normal pregnancy with the proper treatment.  

Infectious diseases during pregnancy

Infectious diseases are caused by viruses and bacteria that enter our bodies and are usually of utmost concern for the moms-to-be, because of the possible effects on the baby. Not all infectious illnesses are dangerous for the pregnancy. A cold with no other complications is of no further importance. However, the flu or influenza with high fevers, is something the doctor must monitor. Following is a list of the infectious illnesses you must keep an eye on during your pregnancy.  

• Rubella. This infection is caused by a virus. It is not a serious disease, but it may cause birth defects. It shows as a pinkish rash with low-grade fever. The danger for the baby’s development is greater if the infection takes place during the first trimester. If it happens during the third trimester, it is very rare that the baby would have any side-effects.   

• Varicella. It is one of the most common illnesses in children and very easily contagious. In general, most pregnant women have had varicella or chicken pox in their childhood, because it is so common. If the mom-to-be becomes infected during pregnancy, it is rare for the baby to catch it. Varicella shows as a rash with little liquid-filled bumps.

• Fifth disease. There is a risk of miscarriage if you contract this illness during pregnancy. It is not severe but it is quite common amongst children. If you work with children, avoid contact with those who have been infected.  

• Tuberculosis. Although it is a common illness, tuberculosis does not cause malformations in the fetus and contagion is rare. This illness is passed on through the respiratory system, but to become infected, you have to be living in close quarters with the ill person, for a very long time.  

• Cytomegalovirus. It is rare for pregnant women to become infected with this. It is very common in young day-care aged children, but it is usually inconsequential.  

• Hepatitis. There are several types of hepatitis, generally due to a virus that attacks the liver. Although it may be transmitted to the baby during pregnancy and after birth, it may be successfully treated.  

• STDs. Some of them, such as HIV, Chlamydia, or gonorrhea may be passed on to the baby during the delivery. That is why tests are done before the delivery, to rule them out and to treat them if present. Vaginal herpes is an illness that can also cause severe problems in your baby if it is passed on when it goes through the birth canal. For that reason, if the herpes is active during delivery, a C-section is usually performed.  

Pregnancy-related illnesses

Some illnesses arise as a consequence of the pregnancy itself. For example, gestational diabetes appears as a consequence of the action of pregnancy hormones on insulin. Preeclampsia is another illness that only appears during pregnancy and immediate intervention is required.  

Prenatal visits are essential in order to prevent and successfully treat these conditions that may arise during pregnancy.

Illnesses and Disorders During Pregnancy

Becoming ill is not pleasant, and depending on the type of illness, it could cause discomfort and uncertainty in the patient, she does not exactly know what the consequences may be.  But if the illness happens during pregnancy, the concern about its effects on the baby’s development can create a lot of anxiety in the moms-to-be.