Discuss two maternal health conditions and the effects that not managing or detecting these conditions can have on the health of the mother, as well as the developing infant.

Question

What will be an ideal response?

Answer 1

Answer will vary among students based on the health conditions chosen.
Medical disorders in the mother can threaten the life and health of both the mother and the fetus. If diagnosed early, many diseases can be managed to ensure a healthy outcome. Disorders and/or symptoms that should be managed and/or monitored for include preexisting diabetes, gestational diabetes, chronic hypertension, gestational hypertension, and preeclampsia.
• Preexisting diabetes: The risk of diabetes depends on how well it is managed by the mother before and during pregnancy. Without proper management, pregnant women with existing diabetes may experience episodes of severe hypoglycemia, or hyperglycemia, preterm labor, and pregnancy-related hypertension. Infants may be large, suffer physical and mental abnormalities, and experience other complications such as severe hypoglycemia or respiratory distress, which can be fatal.
• Gestational diabetes: The most common consequences of gestational diabetes are complications during labor and delivery and a high infant birthweight. Birth defects associated with gestational diabetes include heart damage, limb deformities, and neural tube defects. To ensure that the problems of gestational diabetes are dealt with promptly, physicians screen for risk factors and test high-risk women for glucose intolerance immediately and average-risk women between 24 and 28 weeks gestation. Gestational diabetes usually develops during the second half of pregnancy, with subsequent return to normal after childbirth. Some women with gestational diabetes, however, develop diabetes (usually type 2) after pregnancy, especially if they are overweight. For this reason, health-care professionals strongly advise against excessive weight gain during—and after—pregnancy. Weight gains after pregnancy increase the risk of gestational diabetes in the next pregnancy.
• Chronic hypertension: In addition to the threats hypertension always carries (such as heart attack and stroke), high blood pressure increases the risk of fetal growth restriction, preterm birth, and separation of the placenta from the wall of the uterus before birth, resulting in stillbirth.
• Gestational hypertension: Gestational hypertension is high blood pressure during the second half of pregnancy, and blood pressure usually returns to normal during the first few weeks following child birth. Gestational hypertension increases the risk for subsequent hypertension and heart disorders, and it is also a sign of the most serious complication of pregnancy, preeclampsia.
• Preeclampsia: Preeclampsia is a condition characterized not only by gestational hypertension but also by protein in the urine. The cause of preeclampsia remains unclear, but it usually occurs with first pregnancies and most often after 20 weeks of gestation. Obesity may increase the risk. Symptoms typically regress within 2 days of delivery. Both men and women who were born of pregnancies complicated by preeclampsia are more likely to have a child born of a pregnancy complicated by preeclampsia, suggesting a genetic predisposition. They also tend to have a higher BMI and increased blood pressure during childhood and adolescence, indicating a greater risk for heart disease. Black women have a much greater risk of preeclampsia than white women. Preeclampsia affects almost all of the mother’s organs—the circulatory system, liver, kidneys, and brain. Blood flow through the vessels that supply oxygen and nutrients to the placenta diminishes. For this reason, preeclampsia often restricts fetal growth. It also seems to increase the risk of epilepsy for the infant. In some cases, the placenta separates from the uterus, resulting in preterm birth or stillbirth.