Conditions that threaten women’s lives in childbirth & pregnancy

Pregnancy and symptoms

This website is about severe maternal illnesses, women who are about to, or have just given birth. These illnesses could lead to the mother’s death without urgent medical intervention. These are sometimes known as ‘near misses’. As described in ‘What is a life threatening condition in childbirth these illnesses are rare, and can be caused by several different conditions (e.g. placental disorders, blood pressure, thrombosis - the formation of a blood clot inside a blood vessel, septicaemia - blood poisoning). The onset and symptoms of these illnesses will therefore vary greatly.
 
Here we describe what women told us about their pregnancies and early symptoms, if they had any. Some women had symptoms and a diagnosis before their baby was born, such as pre-eclampsia (high blood pressure) or placenta praevia (the placenta may be partly or completely covering the cervix/birth canal), which meant they realised they were at high risk before the birth. Others developed their illnesses after the birth (see ‘Pulmonary embolism (PE) and deep vein thrombosis’, ‘Hysterectomy’, ‘Haemorrhage’). Few of the women realised their conditions were so life-threatening.
 
Pregnancy
Experiences of pregnancy vary from woman to woman. While some women had problems from the early weeks, others sailed through their pregnancies with no symptoms or warning signs that anything might go wrong. Many of the women we spoke to described normal pregnancies with no signs of illness until very late in pregnancy. People can develop life-threatening complications even if they have had a normal pregnancy and a healthy lifestyle.
Natalie, who also haemorrhaged (heavy uncontrolled bleeding) after delivering her son, said “It was my first pregnancy, and it went really well”. Helen and Kate both developed HELLP syndrome (a combined liver and blood clotting disorder) and were shocked as they had both had very healthy, active pregnancies. Helen said, “I was having a completely normal pregnancy. I felt well. I was going to yoga, I was going swimming 2km a week, everything was completely normal. I was having a lovely time.” Kate also said she had a “model pregnancy” up until the 34th week.
 
Other women had more problematic pregnancies. Alison T had pneumonia during her pregnancy and was admitted to hospital. While she was there doctors discovered she had developed blood clots in her lungs (pulmonary embolisms, PEs) in her chest. She was told to drink lots of water, and was given anticoagulant injections to try and prevent clots. The rest of her pregnancy was closely monitored.
Onset of symptoms
Some women developed symptoms of their illnesses during their pregnancy and so were aware they had complications. Sometimes this led to the baby being delivered very quickly, in other cases it meant that they were monitored closely for the rest of their pregnancy.
 
Pre-eclampsia and HELLP syndrome
Doctors or midwives may pick up early signs of pre-eclampsia or HELLP syndrome through monitoring women’s blood pressure and measuring protein in their urine. Women who develop these conditions may need to have their babies delivered by emergency caesarean. Sometimes women will be monitored for a while, because the longer the pregnancy can be continued the better it is for the baby, but if symptoms become severe the baby needs to be delivered quickly for the sake of the mother’s health.
The women we spoke to who developed HELLP syndrome had high blood pressure and doctors also measured their liver functions. All these women had their babies early.
Placental disorders
One of the causes of severe maternal illnesses is haemorrhage (heavy uncontrolled bleeding) that can be caused by disorders of the placenta (the organ responsible for providing nutrients to the fetus). For some women, haemorrhage developed unexpectedly during or after childbirth (see ‘Haemorrhage – heavy uncontrolled bleeding’ summary). Some women we spoke to had warning of problems with their placenta from scan results. Cate’s scans during her third pregnancy showed she had developed placenta praevia (the placenta may be partly or completely covering the cervix/birth canal). Doctors scheduled her for an elective caesarean. She was disappointed that she couldn’t have a home birth but it was quite a relief to have the decision taken away from her.
Alex was diagnosed with the most serious type of placenta praevia grade 4 (the placenta completely covers the cervix/birth canal) and was kept in hospital for 8 weeks as doctors feared that she would haemorrhage before her baby was born. Her baby was born at 34 weeks.
Thrombosis
Some women developed blood clots during pregnancy or after giving birth. (See summary on ‘Pulmonary Embolism (PE) and deep vein thrombosis (DVT)).
 
Sepsis
We interviewed a few women who had developed sepsis (an infection) or septicaemia (where the infection spreads to the blood stream) after giving birth. Again, this can develop very quickly or can take a while to build up.


Last reviewed April 2016.

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