Multiple pregnancies and Genetic testing

Health Conditions and Pregnancy

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What is it?
Malaria is an infectious disease found worldwide in warmer weather (mainly tropical and subtropical areas). Most people get infected after a mosquito infected with malaria parasites bites them. Others can get it from blood transfusions, organ transplants, or the shared use of needles or syringes contaminated with infected blood.

Pregnancy-Associated Malaria (PAM), also known as placental malaria, is distinctively deadly to both mother and fetus. PAM is usually caused by infection with Plasmodium falciparum, the most dangerous malaria-causing parasites that infect humans. A pregnant woman is more susceptible to contracting malaria and related complications. Some sources mention that pregnant women are more likely to get infected or develop complications repeatedly because immunity is lowered naturally during pregnancy.

Malaria in pregnancy gets in the way of transferring essential substances that typically cause stillbirth, spontaneous abortion, premature delivery, or dangerously low birth weight. Problems can also include placental deficiency, hypoglycemia (deficiency of glucose in the bloodstream.), and anemia (lack of red blood cells). Apart from high mortality risk, infants with low birth weight are at increased risk of poor cognitive and social development. It can also lead to increased chances of getting sick as adults, such as type 2 diabetes and cardiovascular diseases.


It can range from mild to severe and can develop between 7-30 days after infection. Most people get a high fever, chills, headache, sweating, muscle soreness, and fatigue. At the same time, others can also have nausea, vomiting, diarrhea, anemia (low red blood cell count), or jaundice (yellowing of the skin and eyes). It can also lead to kidney failure, seizures, confusion, coma, or death, but rare cases.

  • Treatment:
    Malaria is not passed through breast milk, so breastfeeding will not give your baby malaria. The prevention of low birth weight related to malaria during pregnancy remains a priority in research. However, if you get infected and are pregnant, you should visit your doctor to avoid serious complications.

    For severe malaria caused by the Plasmodium falciparum parasite, an intravenous drip (used to put fluid or medicines directly into a vein) medication is usually recommended. For some types of malaria, medication taken weekly until you give birth is recommended. However, not all malaria medications are safe for pregnant women, and some have associated risks. Therefore, it is essential to discuss the best option with your doctor. You cannot completely be immune to malaria, so protecting yourself is very important.

  • Prevention:
    Mosquitoes that spread the infections are more active at night. To prevent infection, close all your windows and do not leave the door open when you go in and out of your room/house. You should wear light-colored clothing (mosquitos do not like dark colors), wear long-sleeved clothes, and stay in a cool room (if possible because mosquitoes do not like the cold). Remember to use mosquito nets and chemical mosquito repellents (ones that are safe to use while pregnant). You should also keep your area clean by destroying the mosquitoes’ breeding areas (still water) and emptying all containers with old water.


What is it?

HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system. If HIV is not treated, it can lead to AIDS (acquired immunodeficiency syndrome), which is the late stage of HIV infection due to weakening the immune system. There is currently no effective cure for HIV. Once people get HIV, they have it for life, but it can be controlled and live long, healthy lives while also protecting their partners with proper medical care. People get infected only through blood, semen, vaginal fluids, and breast milk transmission. The virus is not spread by casual contact (hugging or touching), touching items touched by an infected person, saliva, sweat, or tears that are not mixed with an infected person’s blood).

There is a 15 – 45% chance of passing HIV from mother to child anytime during pregnancy, childbirth, and breastfeeding (called perinatal transmission) if the proper precautions are not taken. Suppose the mother gets infected while she is already pregnant. In that case, the baby is protected due to the protective barrier formed by the placenta. In early pregnancy, contraction by blood is possible since the placenta isn’t yet fully developed. If the baby gets infected, it can affect all its bodily functions and be fatal. The baby can get infected during labor because the placenta will be separated. However, advances in research have made it possible for several women to give birth without transmitting. 

Some women get complications in their pregnancy such as preterm labor, low birth weight, perinatal mortality (death of a fetus), high blood pressure, diabetes, and growth restriction of the baby. It’s usually recommended that women living with HIV give birth naturally (vaginal birth) unless there is another reason why this would be difficult. If vaginal birth is difficult, it may be safer to have a cesarean section, which removes the baby from the womb. If a mother has a high viral load, they may also be advised to have a cesarean section.


Once HIV gets into your blood, it will multiply and infect white blood cells (specifically the T lymphocytes). Symptoms will appear in 3-6 weeks and last for less than 10 days. Symptoms can include fever, night sweats, fatigue rash, headache, swelling in your neck, armpits, & groin, sore throat, body ache, joint pains, nausea, vomiting, and diarrhea. After these symptoms are gone, the virus will continue to multiply and attack the immune system until it breaks it down, which may take 10 years.


Suppose you have never taken HIV drugs before pregnancy, in your first trimester, or taken medication and found out you are pregnant in the 1st trimester. In that case, your doctor will discuss your treatment plan. Your doctor will prescribe treatment that will not affect your baby. Treatment should be started immediately. Most HIV medicines are safe during pregnancy and will not increase the risk of birth defects. Usually, pregnant women can use the same HIV treatment process as non-pregnant women. Unless, of course, if the known side effects outweigh the benefits.

Anti-viral treatments or Antiretroviral therapy (ART) focus on reducing perinatal transmission and help manage the virus to help protect both you and your baby. Medications that bring down viral load (measure the virus in your blood) help prevent it from passing on to your baby. You have to take extra precautions to avoid infections since HIV reduces your immunity. Practicing good hygiene, healthy eating, and exercise are critical to a healthy pregnancy with HIV.


The best way is not to get infected, but if you do, you need to take precautions to prevent transmitting it to your baby. As soon as you are positive, you have to start medications immediately. After giving birth, your baby needs to take HIV medicine for 4-6 weeks. 

Your doctor may recommend a cesarean (C-section) delivery to lower the risk of transmission. A vaginal delivery can be an option if your HIV is managed well and your viral load is not detectable. When breastfeeding, there is a risk of transferring. Therefore, your doctor might recommend not nursing and only using formulas. You should also not pre-chew your baby’s food.

Heart conditions

What is it?

Heart conditions include a range of diseases, disorders, and conditions affecting the heart and blood vessels. Heart conditions have different types, including angina (chest pain with short and sharp attacks), heart attack, atherosclerosis (buildup of fats, cholesterol, and other substances in and on your artery walls called plaque), heart failure, cardiovascular disease, and cardiac arrhythmias (abnormal heart rhythms). Other heart conditions include congenital heart defects (present at birth), cardiomyopathy (weakened or abnormal heart muscle and function), infections of the heart, and heart valve disorders.

When pregnant, the heart works harder to pump more blood to help the baby develop and grow. Labor and delivery also add to the heart’s workload. If you have heart disease, it can lead to symptoms similar to a heart attack. Some underlying heart conditions cause minimal to no problems during pregnancy. In contrast, others may be much riskier and increase the chance of complications. Simple congenital heart defects can be repaired, and mild heart valve deformities & heart murmurs are generally considered low-risk. Congenital heart disease will increase your risk of a miscarriage, premature birth, or a low birth weight of your baby.


Symptoms include fainting (blood pressure & volume changes), trouble breathing when laying down (might also be caused by the growing uterus), palpitations (rapid, strong, or irregular heartbeat), heart murmurs, chest pain, fatigue, and dizziness.


Women with pre-existing heart conditions, like chronic high blood pressure, heart disease, and high cholesterol, should carefully monitor it before getting pregnant and after giving birth. Your doctor may advise you to get regular exercise, prescribe medications or other treatments. Regular ultrasounds are needed to monitor your baby’s growth and development.  


Almost 50% of pregnant women develop heart arrhythmias (abnormal heartbeat). There are usually no symptoms and are only discovered when taking the woman’s pulse. However, symptoms like dizziness, lightheadedness, or palpitations occur occasionally. To assess the heart’s rhythm, an electrocardiogram (ECG, test that detects and records your heart’s electrical activity) or 24 hour Holter monitor (a small, wearable device that keeps track of your heart rhythm) may be recommended. If symptoms continue or worsen, arrhythmia treatment may be considered.


If your blood pressure rises suddenly, it could be a sign of preeclampsia (high blood pressure and damage to another organ system, usually liver and kidneys). Your doctor will prescribe you medication if your blood pressure gets dangerously high. 


Depending on the severity, a C-section may be required or an assisted vaginal delivery with forceps or vacuum to avoid pushing towards the end of labor. After delivery, some mothers require intensive monitoring to ensure they are recovering from the delivery.


Suppose you have a pre-existing heart condition and plan on getting pregnant. In that case, you should have a pre-pregnancy consultation with a cardiologist (doctor specializing in treating heart problems). 

Suppose you do not have pre-existing conditions and are planning or are pregnant. You should consult your doctor to start a healthy diet and lifestyle changes like exercising, limiting caffeine, and stopping smoking from risking developing heart problems.


What is it?

Asthma is a chronic lung condition where your airways narrow and swell. It may produce more mucus, making it difficult to breathe. Some people have minor asthma, while for others, it is major and intervenes with daily activities and can lead to a life-threatening asthma attack.

Asthma can impact your pregnancy and affect your and your baby’s health. You should treat it effectively to try and prevent complications; however, if you don’t monitor it, the risk of getting complications increases. These complications can include high blood pressure,  damage to other organ systems (usually kidneys), limited fetal growth, premature birth, C-section, and putting your baby’s life in danger. Pregnancy can worsen your asthma if you have severe asthma, especially if you stop taking your medications. 


Women experience different ranges of asthma symptoms when they get pregnant. It could be the same as before they were pregnant, or it could get worse. Symptoms can include heartburn, persistent coughing (especially at night), wheezing (whistling sound) when breathing, and shortness of breath.


Your doctor will provide you with the right medication that is the safest for your pregnancy.  The lower your asthma severity before pregnancy, the better you can control it while you are pregnant. You should regularly take your medications to reduce your asthma attack risk.


You need to take good care of yourself by keeping your prenatal appointments, regularly taking your medications, not smoking, avoiding smokers or dust, and recognizing your warning signs such as coughing, tightening of the chest, and shortness of breath.


What is it?

Diabetes is a chronic disease occurring when the pancreas does not produce enough insulin (hormone regulating blood sugar) called type 1 or when the insulin produced can’t be effectively used called type 2. Lack of insulin or cells that stop responding to insulin will leave too much blood sugar in your bloodstream. Gradually, this can cause serious health problems like heart disease, vision loss, and kidney disease. 

Gestational diabetes is diagnosed first during pregnancy (gestation) when the woman did not have diabetes before she got pregnant. Some long-term diabetes problems (eye problems and kidney disease) can worsen with pregnancy, especially if you have high blood glucose levels. There is also a higher chance of developing preeclampsia (sometimes called toxemia) and too much protein in your urine during the second half of pregnancy. High blood glucose levels can increase the possibility of birth defects like heart, brain, or spine defects. Complications include early birth (preterm), miscarriage or stillbirth ( baby dies in the womb), the baby can weigh too much, breathing problems, and low blood glucose (hypoglycemia).


Diabetes symptoms are the same whether you are pregnant or not. Most women don’t experience symptoms, but some may have increased thirst, dry mouth, frequent urination, and fatigue. You should talk to your doctor if you experience these symptoms. 


It is essential to stay healthy (exercising and eating healthy) and keep your blood glucose as close to normal as possible. If you take oral diabetes medicine, your doctor might switch you to insulin. You should get regular checkups before and during pregnancy to monitor your blood sugar level. Most women with gestational diabetes don’t have it anymore after giving birth. Some continue to have it, referred to as type 2 diabetes.


There are no guarantees to prevent gestational diabetes. The best way is to have a healthy lifestyle before you get pregnant. You need to follow your meal plan, be physically active, take diabetes medicines (if necessary), stop smoking, and take vitamins (if your doctor recommends it).


What is it?

Epilepsy (also known as a seizure disorder) is a chronic neurological (central nervous system) disorder where brain activity becomes abnormal, causing recurrent and unprovoked seizures or periods of unusual behavior, sensations, and sometimes loss of awareness. This might be genetic or because of a brain injury. People with epilepsy have abnormal electrical signals in the brain that cause a seizure. They cause severe muscle or very mild with barely any symptoms.

Most women with epilepsy can deliver healthy babies but require special care during their pregnancy due to random seizures. Pregnancy does not cause epilepsy, but women with epilepsy are more likely to have more seizures during pregnancy. This could be due to medicines that treat epilepsy working differently during pregnancy, such as not being absorbed or not working. Seizures during pregnancy can cause low fetal heart rate, decreased oxygen to the fetus, fetal injury, premature separation of the placenta from the uterus (placental abruption), miscarriage due to trauma (falling during a seizure), preterm labor, premature birth, birth defects (spine and brain), stillbirth, smaller size, and severe bleeding in newborn. Babies who have mothers with epilepsy are likely to develop seizures when they get older.


Epilepsy symptoms are the same for women who are pregnant and not. A woman may have frequent seizures with no known cause. In addition to seizures, the most common symptoms are headaches, mood swings or energy shifts, dizziness, fainting, confusion, and memory loss. Some women may also feel that they are about to have a seizure right before it happens.


The most important thing is to continuously monitor and manage your epilepsy with prenatal and postnatal care. You have to visit your doctor regularly, who might prescribe you medications to be taken in small doses to prevent or control your seizures. Your doctor will choose the type of medication with the least side effects for your pregnancy.

It is uncommon to have seizures during delivery, but it is possible. If you have a seizure, it might be stopped with intravenous (fluids injected into a vein) medication. If the seizure does not stop, your doctor might perform a C-section. You are more likely to have a seizure during labor if you had frequent seizures in your third trimester. Your doctor will review the best delivery method with you to avoid the increased risk of seizures during your delivery. Women with epilepsy might use the same pain relief methods during labor and delivery as other pregnant women.


There are no guarantees to prevent gestational diabetes. The best way is to have a healthy lifestyle before you get pregnant. You need to follow your meal plan, be physically active, take diabetes medicines (if necessary), stop smoking, and take vitamins (if your doctor recommends it).


What is it?

It is a condition when a person has excessive fat that increases the risk of getting more health problems like heart disease, diabetes, high blood pressure, and certain cancers. It is caused by inherited, physiological, and environmental factors, poor diet, and exercise choices.

Pregnant women normally gain weight, but obesity can cause several health risks for you and your baby. Complications like stillbirth and recurrent miscarriage, gestational diabetes, high blood pressure and damage to other organ systems (usually liver and kidneys), cardiac dysfunction, sleep apnea (sleep disorder where breathing is interrupted repeatedly during sleep), and C-section and the risk of C-section complications. The baby will also be susceptible to health risks such as birth defects, significantly larger than average, impaired growth, childhood asthma, and obesity.


Epilepsy symptoms are the same for women who are pregnant and not. A woman may have frequent seizures with no known cause. In addition to seizures, the most common symptoms are headaches, mood swings or energy shifts, dizziness, fainting, confusion, and memory loss. Some women may also feel that they are about to have a seizure right before it happens.


The best treatment is to lose weight. Pregnant women who are obese need to start a diet and exercise routine to improve their own and their baby’s health. Talk to your doctor before you begin to determine the best type of exercise routine while you are pregnant. You should start slowly and build slowly. Since your joints aren’t strong, you should start small with walking and swimming. Do not overdo your workouts because it can be dangerous to your baby. You should also eat nutritious foods and avoid empty calories like fast food, fried food, soft drinks, pastries, sweets, and microwave dinners.


The only way to prevent obesity is to have a regular exercise routine while eating a healthy and balanced diet. 

Thyroid Disease 

What is it?

It is a medical condition that keeps the thyroid gland (found in front of the neck and produces hormones to help regular other organs) from making the right amount of hormones. Thyroid disease occurs when the thyroid gland makes too much (hyperthyroidism) or too little (hypothyroidism) hormones. Thyroid hormones control metabolism in your body, and without monitoring, they can affect your entire body. When there are too many hormones, your body uses energy too quickly, making you tired, faster heartbeat, losing weight without trying, and making you feel nervous. When there are too few hormones, you will feel tired, gain weight, and not tolerate cold temperatures. 

Both conditions make it difficult to get pregnant. Thyroid hormones are crucial for the normal development of your baby’s brain and nervous system. Your baby depends on your supply of thyroid hormone for the first trimester. However, after 12 weeks, your baby’s thyroid works independently can not risk transmission but can’t make enough thyroid hormones until 18-20 weeks. Thyroid disease can cause complications during pregnancy like miscarriage, premature birth, low birth weight, preeclampsia (dangerous rise in blood pressure in late pregnancy), thyroid storm (sudden, severe worsening of symptoms), congestive heart failure (a condition where the heart muscle is wear and cannot pump as it used to), stillbirth, and anemia. Thyroid disease can affect the baby in ways like a fast heart rate, early closing of the soft spot in the baby’s skull, poor weight gain, and irritability.

Postpartum thyroiditis is a thyroid inflammation that causes stored thyroid hormone to leak out of your thyroid gland. It affects about 1 in 20 women during the first year of giving birth and is more common in women with type 1 diabetes.


Some signs of hyperthyroidism in pregnancy include fast and irregular heartbeat, fatigue, difficulty dealing with heat, shaky hands, unexplained weight loss. Some signs of hypothyroidism include extreme fatigue, difficulty dealing with cold, muscle cramps, severe constipation, trouble with concentration, and memory loss. Postpartum thyroiditis usually has no symptoms, but it can be irritability, trouble dealing with heat, tiredness, sleeping, and a fast heartbeat.


You may not need treatment if you have mild hyperthyroidism during pregnancy. However, if it is severe, you might be prescribed antithyroid medicines that prevent too much thyroid hormone from entering your baby’s bloodstream. Hypothyroidism treatment consists of medications that replace your hormone that the thyroid can no longer make. You should visit your doctor regularly to monitor the progress of your pregnancy. Postpartum thyroiditis doesn’t usually need treatment. Although, if the symptoms are irritating you, your doctor might prescribe a beta-blocker (medicine that slows your heart rate).


To reduce the risk of thyroid disease, you should perform a thyroid neck check, minimize soy intake, have a thyroid X-ray (but be careful of other X-rays since the thyroid is vulnerable to radiation), consider supplements, avoid environmental toxins, do not go on a starvation diet, eat well, and stop smoking.

Rh Factor / Rhesus factor 

What is it?

It is a type of protein inherited and located on the red blood cells surface. You are Rh-positive if your blood has the protein and negative if your blood lacks the protein. Most people have Rh-positive. The Rh factor is needed when it comes to blood donations and transfusions. Rh-positive people will not make anti-Rh antibodies, but Rh-negative people will produce the antibodies that attack the Rh-positive blood. Hence, an Rh-positive can receive both positive and negative transfusions, but Rh-negative can only receive Rh-negative blood.

It doesn’t mean that you’re unhealthy if you’re Rh-negative. It is only a concern if you are pregnant and negative, but your baby is positive. This is called Rh incompatibility, where your immune system produces Rh antibodies that attack your baby’s blood cells because it is seen as a foreign object. This happens when your and your baby’s blood come into contact through miscarriage, abortion, ectopic pregnancy, molar pregnancy, bleeding & abdominal trauma during pregnancy, tests that require cells or fluids to be withdrawn, and delivery of a baby (either vaginal or cesarean).

These antibodies don’t cause harm to your first pregnancy. However, suppose your next baby is also positive. In that case, these antibodies might damage your baby’s red blood cells leading to life-threatening anemia (the baby’s body can’t replace the destroyed red blood cells quickly). 


You will not have any symptoms if you have Rh compatibility. However, your baby will develop symptoms after birth like pale skin & mucous membranes (lining the cheeks and gums), limp & sleepy, jaundice (yellowing of skin and whitening of eyes), trouble breathing, and swelling of face, arms, & legs.


You don’t need treatment if you and your baby are both Rh-negative. Suppose you are negative and your baby is positive. In that case, your doctor will inject you with Rh Immune Globulin (Rhlg) (a medication that prevents antibody production) after each blood contact.

Your baby will require treatment if there is an Rh incompatibility. Treatments can be phototherapy to decrease jaundice, blood transfusions through the umbilical cord and after birth to treat severe anemia, Immunoglobulin to decrease the red blood cells destruction. Your baby might get brain damage even if s/he has been treated. The incompatibility can be fatal to your baby.


You cannot pick the Rh factor your baby gets. However, if you are negative and your baby is positive, your doctor may inject you with Rhlg before the antibodies are produced. These injections are usually administered in the 28th week of your pregnancy and up to 72 hours after birth.

Rh Factor / Rhesus factor 

What is it?

Is a dangerous infectious disease that affects the lungs, mainly spread through tiny droplets into the air due to the coughing, sneezing, or release of fluids of an infected person. If it is left untreated, it can spread to other organs. There are two types called active and inactive or latent TB. Active is when you get sick and contiguous. Latent is when you have the infection but aren’t contagious (the bacteria are inactive). Other than the lungs, TB can infect the kidneys, uterus, brain, bone, and bone marrow.

TB can cause serious risk to a pregnant woman and her baby if it isn’t diagnosed and treated before it worsens. Early diagnosis and appropriate treatment (within 2 weeks) can benefit the baby. Late diagnosis and treatment can lead to fetal mortality, prematurity, growth delay, and low birth weight. A woman with untreated active TB can infect her baby. Breastfeeding is safe for mothers treated with first-line anti-TB drugs since it only has a small presence in breast milk and is not toxic.


Symptoms aren’t unique and can seem like regular pregnancy changes like increased respiratory rate, loss of appetite, and fatigue. The symptoms depend on where the bacteria is growing in your body. Symptoms for TB in the lungs can include severe cough (lasts 3 or more weeks), chest pain, coughing up blood (referred to as hemoptysis) or coughing up sputum (mucus in the lungs), fatigue, weight loss, indigestion, loss of appetite, chills, fever, and night sweats.


The same anti-TB drugs used for non–pregnant women can be used by pregnant women. Your doctor could treat you with a combination of 4 drugs for 6 months which includes the first 2 months (initial phase) of 4 antibiotics and pyridoxine (prevent vitamin B6 deficiency) the last 4 months (continuation phase) of treatment of 2 main antibiotics and pyridoxine. The drugs can reach the baby but have no effects. However, some TB medications should be avoided because it can damage the fetus. Discuss with your doctor to determine the safest one to use. 


You have to avoid people infected with TB, practice good hygiene,  and get vaccinated. If you get infected, you have to be treated early to prevent TB from reaching your baby. The baby is unlikely to be infected while in the womb.


What is it?

It occurs when the baby’s feet are pointed towards the birth canal instead of its head. This happens for about 3-4% of all pregnancies. A baby isn’t considered breech before the 35/36 week mark. Breech happens in situations like the pregnant woman having a history of multiple pregnancies, multiple babies at once, history of delivering prematurely, has placenta previa (placenta partially or fully blocks the neck of the uterus which interferes with regular delivery of a baby), uterus containing either too little or too much amniotic fluid and abnormally shaped uterus or other problems such as fibroids (tumors made of smooth muscle cells and fibrous connective tissue that develop in the uterus). 

The complications that come with a breech pregnancy can include high chances that your baby will get stuck in the birth canal and for the umbilical cord cutting off the baby’s oxygen supply.


There are 3 types of breech positions. Complete breech is when the baby’s butt points down, and the legs are folded at the knees with the feel tucked in. Frank breech is when the baby’s butt points down, and their legs are straight up in front of their body, with their feet near the face or head. Footling breech is when one or both of the baby’s feet point down hence being the first part of the body to come out. 


Doctors usually suggest a C-section for all babies with breech positions, particularly premature because they are smaller and more fragile. Since premature babies have a larger head than their bodies than full-term babies, they can’t stretch the cervical opening as much, making it more difficult for the head to emerge.


Your doctor may be able to turn the baby when you’re between 32-37 weeks pregnant. There are different ways of turning the baby.

  •  External version (EV): this is a procedure where the doctor manually turns the baby’s position using her/his hands through your stomach. This is usually possible between 36 and 38 weeks of pregnancy. It requires two people to perform along with constant monitoring of the baby. However, some reports state that the procedure is only effective 50% of the time. 
  • Inversion is a popular method where pregnant women invert their bodies to prompt the baby to flip. Some methods are the pregnant woman standing on her hands underwater, elevating their hips with pillows, or taking the stairs to help the pelvis elevate.


STI & Pregnancy

What is it?

It is an infection spread predominantly by sexual contact, including kissing, vaginal, anal, and oral sex. Some STIs can also be transmitted from mother to child during pregnancy, childbirth, and breastfeeding. An infection is when a bacteria, virus, or parasite enters and grows in or on your body.

Getting infected with an STI while pregnant can cause severe problems for you and your baby. STIs during pregnancy can cause many complications such as: 

  • HIV: pregnant women can pass HIV to their babies during pregnancy, labor, and vaginal delivery, or breastfeeding if it isn’t diagnosed before or early in pregnancy to reduce the risk of transmission.
  • Hepatitis B: when pregnant women get infected close to delivery, the risk of transmission is the greatest. Transmission can be prevented if infants are treated immediately after birth.
  • Chlamydia: can cause preterm labor, premature rupture of the membranes, and low birth weight. It can be transmitted to the babies during vaginal delivery. It can be treated with an antibiotic if it’s diagnosed during pregnancy.
  • Syphilis: can cause premature birth, stillbirth, and death after birth. Untreated infants have a high risk of complications involving multiple organs.
  • Gonorrhea: untreated gonorrhea can cause premature birth, premature rupture of the membranes, and low birth weight. It can be transmitted to the babies during vaginal delivery.
  • Hepatitis C: can increase the risk of premature birth, small size for gestational age, and low birth weight. This type of liver infection can be passed to the baby during pregnancy.

Other side effects include eye infection, pneumonia, blood infection, brain damage, blindness, deafness, and chronic liver disease.


General symptoms include sores or bumps (genitals, mouth, or rectal area), pain when urinating’ unusual discharge from penis or vagina, unusual vaginal bleeding,pain during sex, sore & swollen lymph nodes (tissue that contains white blood cells, which fight infection), especially in the groin, lower abdominal pain, and rash on the body, hands, or feet.


STIs like chlamydia, gonorrhea, and syphilis can be treated and cured with antibiotics during pregnancy. STIs caused by viruses like hepatitis B, hepatitis C, and HIV cannot be cured. For some, antiviral medications are given to reduce the risk of transmitting it to your baby. 


To prevent you from getting STDs, risk of transmission, make sure to get regular checkups for you & your partner, use condoms consistently & correctly, and get vaccinated against HPV and hepatitis.

Multiple Pregnancies & Genetic Testing

Multiple Pregnancies 

Multiple pregnancies

Multiple pregnancies occur when more than one egg is released and fertilized casual fraternal twins/more. With multiple pregnancies, you will usually go through the same symptoms as a single pregnancy but more intensely, more painful, and harder to manage. There are two types called identical (monozygotic), non-identical (dizygotic), or fraternal. 

  • Identical: occurs when a single fertilized egg splits into two or more embryos creating same-sex babies (2+ boys or 2+ girls) with the same genes. 
  • Non-identical: occurs when 2+ separate eggs are fertilized with 2+ sperms. They can have the same or different sex. These siblings only share 50% of the chromosomes like any other siblings born at different times. They are more common than identical. 

Causes; There aren’t any concrete explanations for multiple pregnancies. Everyone has a chance, and therefore it doesn’t have to run in the family. However, some studies show non-identical pregnancies are more common in certain ethnic groups (such as more twins for Africans and the lowest chances for Asians) if the mother is 35 years old or above and if it runs on the mother’s side of the family. 

Risk factors: Most multiple pregnancies are healthy with healthy babies, but more risks are associated with them. You have a higher chance of anemia (limited healthy red blood cells to carry enough oxygen to your body’s tissues), pre-eclampsia (high blood pressure (hypertension) and high levels of protein in the urine (proteinuria)), gestational diabetes (elevated levels of glucose in the blood during pregnancy), and having a premature birth where more than half of all twins and almost all triplets & more are born prematurely. 

Pregnancy care: Because these pregnancies have a higher likelihood of growth problems, you will need to visit the doctor more frequently and have more ultrasound exams than a single pregnancy would need. In some cases, one fetus is bigger than the other, called discordant caused by an infection or a problem with the umbilical cord or placenta. However, this doesn’t mean a problem with the babies. With twin pregnancies, there can be vaginal pregnancies that depend on the position, weight, & health of each baby, your health & how the labor is going, and the experience of your doctor. If these conditions aren’t met, then you are more likely to have a cesarean pregnancy for twins or more. 

  • Pregnancy genetic testing (before and after birth)

It aids in identifying if the fetus has a genetic abnormality that can cause health conditions or birth defects. It is available before you give birth (prenatal genetic testing) and after (postnatal genetic testing). All women need to get genetic testing, especially if you or your partner have a family history of a genetic disorder, are above 35 years old, have a child with a genetic abnormality, previous stillborn, more than two miscarriages, or genital infections. There are two types of testing called screening tests performed to identify the women’s chance of having a baby with chromosome abnormalities and diagnostic tests to determine if the fetus has birth defects. 

Prenatal genetic testing: can determine certain genetic conditions. You will give a blood or saliva test (to identify your Rh factor, if you have iron deficiency, diseases such as STD, gestational diabetes, thyroid, etc.), urine test (to measure your glucose, protein, ketones (formed when there is not enough sugar or glucose), and bacteria), and other tests by swabbing your vagina or rectum (to check for signs of infection).

There are different types, but the common ones include carrier screening done on parents to identify certain inherited disorders, prenatal genetic screening done on pregnant women to detect the baby’s defects in the abdomen, heart, & facial features, cell-free DNA/ Non-invasive prenatal screening done on women with an increased risk of health conditions. Carrier screening can be done before or during pregnancy, prenatal genetic screening can be done in the first or second trimester, and cell-free DNA can either be done before or after the first-trimester screening. 

Postnatal genetic testing: is performed on newborns and can determine inherited anomalies, diseases, and developmental delays in children. Newborns undergo genetic screening called a newborn screening to check for specific genetic abnormalities using blood samples. 

Screening is recommended for the different types of a genetic disorders (at least 30). These screening tests differ from country to country. Some tests can be those for hypothyroidism (under activity of the thyroid gland), galactosemia (how your body metabolizes galactose), and sickle cell disease (a severe hereditary form of anemia).

    Pregnancy and risks

    Pregnancy & risks

    Pregnancy is used to describe when a fetus develops inside a woman’s womb or uterus that lasts around 9 months (40 weeks). Your body will change, and it might require you to change your daily routine (sleeping earlier or eating frequent, small meals).

    What is it?

    • Pregnancy is used to describe when a fetus develops inside a woman’s womb or uterus that lasts around 9 months (40 weeks). Your body will change, and it might require you to change your daily routine (sleeping earlier or eating frequent, small meals). As your pregnancy progresses, a lot of the uncomfortable changes will stop. But some women might not feel any discomfort at all. Being pregnant before could make it easier/different when you get pregnant again. Every pregnancy is different. Pregnancy is split into three stages called trimesters. The significant events in each trimester are:

    First trimester (Week 1- 12)

    This stage starts when the sperm penetrates an egg and fertilizes it. The fertilized egg (a zygote) then goes through the fallopian tube to the uterus, where it implants itself in the uterine wall. The zygote comprises a cluster of cells that later form the fetus and the placenta. The placenta connects the mother to the fetus and provides nutrients and oxygen.

    Your body goes through several changes, and hormonal changes affect most of your organ systems. The clear sign of pregnancy is when your period stops. Additional changes can include:

    • Extreme exhaustion
    • Tender, swollen breasts (nipples might stick out)
    • Morning sickness (Upset stomach with or without vomiting)
    • Cravings or disgust for some foods
    • Mood swings
    • Constipation (difficult bowel movements)
    • Frequent urination (more than usual)
    • Headache
    • Heartburn
    • Weight gain or loss
    Second trimester (Week 13 - 28)
    • This is the stage where your doctor will look for birth defects and can determine the sex of your baby. Movement can be felt at week 20 of the pregnancy. Footprints and fingerprints are formed, and the fetus wakes up and sleeps at 24 weeks. Babies born at 28 weeks will experience serious health complications such as respiratory and neurologic problems and have a 92% survival rate, according to research made by the NICHD Neonatal Research Network.

      Several women experience less discomfort during this stage compared to the first trimester. There are noticeable changes like the abdomen expanding and feeling your baby move before the trimester ends. Your body will make the necessary changes to accommodate your growing baby. You might experience: 

      • Aching body (back, abdomen, thigh, or groin (area between the abdomen and the upper thighs)
      • Stretch marks (stomach, breasts, thighs, or buttocks)
      • Skin around the nipples darken
      • Noticeable line on the skin from the belly button to the pubic hairline
      • Mask of pregnancy (patches of darker skin on cheeks, forehead, nose, or upper lip that matches on both sides of the face)
      • Carpal tunnel syndrome (hands numb or tingle)
      • Itching (stomach, palms, and soles of the feet). Call your doctor if you see signs of a serious liver problem (Nausea, loss of appetite, vomiting, jaundice (yellowing of skin or whitening of eyes), or fatigue combined with itching)
      • Swelling (ankles, fingers, and face). Call your doctor if you see signs of preeclampsia (sudden or major swelling or gaining weight too quickly)
    Third trimester (Week 29 - 40)
    • This is the stage where your doctor will look for birth defects and can determine the sex of your baby. Movement can be felt at week 20 of the pregnancy. Footprints and fingerprints are formed, and the fetus wakes up and sleeps at 24 weeks. Babies born at 28 weeks will experience serious health complications such as respiratory and neurologic problems and have a 92% survival rate, according to research made by the NICHD Neonatal Research Network.

      Several women experience less discomfort during this stage compared to the first trimester. There are noticeable changes like the abdomen expanding and feeling your baby move before the trimester ends. Your body will make the necessary changes to accommodate your growing baby. You might experience: 

      • Aching body (back, abdomen, thigh, or groin (area between the abdomen and the upper thighs)
      • Stretch marks (stomach, breasts, thighs, or buttocks)
      • Skin around the nipples darken
      • Noticeable line on the skin from the belly button to the pubic hairline
      • Mask of pregnancy (patches of darker skin on cheeks, forehead, nose, or upper lip that matches on both sides of the face)
      • Carpal tunnel syndrome (hands numb or tingle)
      • Itching (stomach, palms, and soles of the feet). Call your doctor if you see signs of a serious liver problem (Nausea, loss of appetite, vomiting, jaundice (yellowing of skin or whitening of eyes), or fatigue combined with itching)
      • Swelling (ankles, fingers, and face). Call your doctor if you see signs of preeclampsia (sudden or major swelling or gaining weight too quickly)

    Antenatal Care

    It is a care you receive when you are pregnant to check on your baby. Your doctor or midwife will check both you and your baby’s health, give you helpful information for a healthy pregnancy (healthy eating and exercise), discuss choices for your care during pregnancy, labor, and birth.

    You will go through several tests like urine tests, blood pressure checks, pregnancy scans every time you go to the hospital, and screening for sickle cell and thalassemia at 10 weeks of pregnancy. It is normal to have 10 antenatal appointments during your first pregnancy. If you’ve previously given birth, you’ll have about 7 appointments that can be more if you develop a medical condition. 

    Your doctor or midwife will give you a schedule (after discussing with you) for your appointments. These appointments should be in an environment where you can easily talk about difficult issues such as mental health issues, drugs, domestic or sexual abuse. You will be asked about your family’s health or any support you might need to get the best of your pregnancy care. You must go to every appointment since it may influence your choice later in pregnancy.

    Postnatal care

    The riskiest time for the death of an infant or mother is the first few hours or days after giving birth. This is why postnatal care is necessary to help ensure the survival of mother and baby. Both infant and mother are kept in the hospital for the first 24 hours during postnatal care. Your baby needs constant care and attention. Your nurse or doctor will prioritize giving you information on exclusive breastfeeding, cleaning your baby’s skin, umbilical cord care, and keeping your baby warm. You will be getting counseling and education before leaving the hospital on signs of any danger to your baby and the steps you can take immediately.

    This care is even more important for infants who are born too early, too small, suffer from different kinds of infections, or suffocate during delivery to keep you and your infant healthy. Counseling is given to the mother, partner, and available family. Postnatal exams allow doctors to look for anything odd with the mother or baby.

    Danger signs of pregnancy and what to do when she gets these signs

    Almost all women feel pain or discomfort throughout their pregnancy, but some are worse than others and may require them to get immediate medical care. Signs to look out for that are dangerous to your pregnancy are;

    • Unusual discharge or bleeding from your vagina
    • Your water breaking before labor starts or the liquid is greenish or brown color (doesn’t look healthy or clean)
    • Your baby moves less than usual or not at all
    • Cramps or pain in your stomach during the first few weeks of pregnancy
    • Sudden swelling of your hands, feet, or face
    • Pain or burning while urinating combined with a sore back and fever is terrible
    • Painful area behind your calf or knee which is reddened and too warm to the touch
    • Intense headaches that last more than a few hours
    • Blurry or double vision or seeing white flashes or spots
    • Fever above 38° C that lasts more than a day
    • Injury to your stomach
    • 5 or more uterine contractions in one hour before 36 weeks
    • Unable to pee but get very thirsty
    • During late pregnancy, frequent throwing up and getting sick even more so if you have pain and fever
    • Diarrhea nausea, or vomiting for more than a day

    If you get any of these signs, you have to immediately call or visit your doctor to make sure everything is alright and to take the necessary steps for treatment if needed.

    Abnormal pregnancies

    There are several causes for abnormal pregnancies, terrible like issues with the placenta that can be deadly for the fetus. The different types of abnormal pregnancies include pregnancy failure (miscarriage), ectopic pregnancy, and molar pregnancy.

    Pregnancy failure (miscarriage)
    • also known as early pregnancy loss or spontaneous abortion and occurs in the 1st trimester (20th weeks) of pregnancy. Several factors contribute to this, but fetal abnormalities are the most common. Other causes can be a woman who has already experienced miscarriage and older women. The most common symptoms are bleeding from the vagina and uterine cramping. 


    There are different causes for miscarriages, such as genetic issues and a mother’s health conditions. Genetic problems include intrauterine fetus death (embryo formation stops), blighted ovum (embryo doesn’t form at all), problems with the placenta (the organ that joins the mother’s blood supply to the baby’s), molar pregnancy (no development of the fetus but there’s an abnormal growth of placenta), & partial molar pregnancy (abnormal placenta and abnormal fetus growth). The mother’s long-term health conditions include uncontrolled diabetes, infections, uterus and cervix problems, thyroid disease, health disease, immune system disorders, kidney disease, antiphospholipid syndrome (the immune system wrongly produces antibodies that attack the embryo/fetus), Polycystic ovary syndrome (PCOS) (ovaries are larger than usual that can lower egg production and is the leading cause for infertility), and more. 

    Risk factors:

    Multiple risk factors raise the chances of miscarriage, such as a woman who is 35 or above, being overweight, smoking, alcohol, drugs, excess caffeine, food poisoning, physical trauma, and certain medications. 


    Since many causes of miscarriage are unknown, you wouldn’t be able to prevent it, but you can lower your chances by:

    • Quitting smoking, alcohol, drugs

    • Limit caffeine intake (less than 200 mg per day) and herbal teas (maximum 4 cups)

    • Eating a balanced healthy diet and being a healthy weight before getting pregnant

    • Clean fruits and vegetables thoroughly

    • Avoid infections

    • Avoid certain foods like unpasteurized milk/cheese, raw or undercooked meat or eggs, liver,

    Ectopic pregnancy

    occurs when the embryo attaches outside the womb and is fatal to the fetus. This abnormality in pregnancy mainly occurs in the fallopian tube but can also happen in the abdomen, cervix, or ovary. It may cause bleeding and pain in your pelvis. Some women may not have any symptoms unless the site the egg attaches itself to breaks. A ruptured ectopic pregnancy has symptoms such as hemorrhaging (excessive release of blood from blood vessels) and extreme pain, which can cause maternal death; however, if treatment is provided before the rupture, maternal death can be avoided. 


    • Medical treatment: is used to treat an early ectopic pregnancy without heavy bleeding. It is injected into your body, prevents growth cells, and breaks down existing cells. After being injected, your doctor will examine you to check if the treatment has been effective. 
    • Laparoscopic surgery: a small cut is made in the stomach (around or in the belly button) for a thin camera tube to view the area and remove the ectopic pregnancy. There are two types of laparoscopic surgery, and the amount of bleeding and damage will determine the type of procedure. 

    Emergency surgery: this is necessary if you have heavy bleeding where you will get an abdominal cut to remove the torn tube, but in some cases, the fallopian tube is saved.

      Molar pregnancy

      occurs when an undeveloped egg gets fertilized, causing the tissue that was supposed to become a fetus turns into a large mole that can grow and fill the uterus. Another way is when two sperms fertilize one egg causing the placenta (organ providing nourishment to the fetus) to turn into a mole. Fetal tissue that is available will have serious defects. Symptoms can be the same as a normal pregnancy but can also have unusual ones like discomfort in the pelvis and vaginal discharge that look like grapes. To treat this pregnancy, the abnormal tissue needs to be removed.

      Surgical treatment is effective for most women called dilatation and auction evacuation (D&E), where a thin tube is used to suck the molar tissue. Another method called dilation and curettage (D&C) is when a sharp object cuts the tissue from the womb’s lining.
      Medical treatment: this is effective for women with partial molar pregnancy and is referred to as medical management or medical evacuation. The drug will make the womb shrink to remove the abnormal cells.

      Placental abruption

      occurs when the placenta separates from the uterus before the baby is born, causing a reduction or prevention of oxygen and nutrient supply to the baby and can cause heavy bleeding in the mother. It happens without warning and is dangerous to the mother and baby. In the worst-case scenario, a placental break might cause fetal death.

      Mild: if you are less than 37 weeks into your pregnancy and your baby’s heart rate is normal, you will be hospitalized to be monitored closely. If your bleeding stops and your baby’s condition is stable, then you could be able to go home.
      Moderate or Severe: if you are after 37 weeks of your pregnancy and the placenta abruption seems very little, you can have a vagina delivery with close observation. However, an immediate C-section will be performed if the abruption gets worse or endangers you or your baby.

      Suppose you get any symptoms, you need to visit your doctor immediately for proper diagnosis and treatment. If you had any of these abnormalities in your previous pregnancy, you should talk to your doctor when you think of conceiving again. This will reduce your chances of going through this painful experience again. In addition to this, you might suffer from negative thoughts about the loss of your baby. Please talk to trusted friends, family, or mental health experts if you have difficulty copying.

      Postpartum Depression

      A new mother suffers severe depression (feels empty and sad) after giving birth that lasts longer than 2 weeks. It is a serious condition that affects your brain, behavior, physical health, and overall day-to-day life. Hormonal changes might trigger these symptoms where some mothers go through anxiety disorders. Some mothers might not feel connected to their baby, feel like they aren’t the baby’s mother, or might not love their baby.


      • Depression gets more and more intense
      • Difficult to work or get things done at home
      • Pulling back from family and friends
      • Lack of care for yourself or your baby (eating, sleeping, washing)
      • Thoughts about hurting yourself or your baby
      • Intense crying, irritability, anger
      • Insomnia or sleeping too much
      • Overwhelming fatigue
      • Feeling shame, guilt, worthlessness, or inadequacy

      Therapy: you talk to your therapist to help you figure out ways to cope with your depression and change your thoughts.
      Medicine: If your therapist believes your depression is severe, she/he will refer you to a doctor to prescribe you antidepressants (the most common medication for depression) to help relieve symptoms of depression. However, it will take several weeks to work.
      Electroconvulsive therapy (ECT): is used for extreme cases of postpartum depression.

      Your doctor might recommend you to take the treatments together or alone after discussing the benefits and concerns of treatment. Treatment is essential for you and your baby. Getting help is necessary for your overall health.