Most pregnancies end in healthy outcomes, but some pregnancies suffer from early complications.
This may be a miscarriage, an ectopic pregnancy (pregnancy outside the womb), pregnancy of unknown location or gestational trophoblastic disease (GTD).
Miscarriage is the most common complication of early pregnancy. Among women who know they are pregnant, the miscarriage rate is roughly 10-20 per cent.
The reasons why a patient would miscarry can be various: It may be due to advanced maternal age (above 35 years old); poorly controlled endocrinological disorders such as diabetes and thyroid disorders; infections before or after conceiving (eg toxoplasma, rubella, cytomegalovirus); patients diagnosed with polycystic ovarian syndrome, antiphospholipid antibodies syndrome or a couple with genetic disorders; and getting pregnant with a foetus carrying a chromosomal defect.
In many cases, the cause of a miscarriage is not known and we would not be able to prevent it. However, there are ways to lower the risk of miscarriage.
These include not smoking during pregnancy, eating a healthy, balanced diet with at least five portions of fruit and vegetables a day, making attempts to avoid infections and avoiding certain foods during pregnancy, which could harm the mother or the baby. Being of a healthy weight before getting pregnant is important too.
In the UAE, 1 -2 in 100 pregnant women have an ectopic pregnancy and it occurs most commonly in one of the tubes. The risk may be as high as 4 in 100 with assisted conception.
Look out for symptoms and signs such as lower abdominal pain localised to one side or both sides, vaginal spotting, shoulder pain or dizziness.
A tubal ectopic pregnancy could distend the tube and can eventually rupture causing internal bleeding and shock. Therefore it is essential to seek medical attention if pregnant ladies suffer from bleeding or lower abdominal pain.
Blood tests and ultrasound scans can diagnose or exclude an ectopic pregnancy. It can be handled safely and successfully with either expectant management where the pregnancy resolves spontaneously or with medical and surgical management.
Pregnancy of unknown location is when there is a positive urine test, however an ultrasound can’t confirm the location. This pregnancy needs close monitoring until a diagnosis is made to exclude ectopic pregnancy.
GTD is a group of conditions that may occur when a pregnancy does not develop properly. This includes complete and partial molar pregnancy.
It is an uncommon condition. The incidence of molar pregnancy in the UAE is in the range of 1 in 400 pregnancies.
Complete moles usually occur when a single sperm fertilises an empty egg, which has no genetic material inside and then divides to give the fertilised egg a normal number of chromosomes, all of which have come from the father.
Complete moles can also occur when two sperm fertilise an empty egg.
Partial moles occur when two sperm fertilise a normal egg and the developing pregnancy then has three sets of chromosomes or more. In a partial mole, there are usually some early signs of development of a foetus on ultrasound but it is always abnormal and cannot develop into a baby.
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In Dr Sulaiman Al Habib Hospital, Dubai, we have the laboratory facilities and the most recent imaging technologies required to diagnose early pregnancy complications.
Moreover, we have the surgical expertise to manage all forms of early pregnancy complications using advanced minimal access techniques allowing same-day discharge when required.
It is essential that all pregnant women seek medical attention if they develop any of the symptoms mentioned.
