Skip to main content

Medical Problems During Pregnancy

  • Living reference work entry
  • First Online:
Family Medicine
  • 71 Accesses

Abstract

Many acute and chronic medical conditions can expose both the pregnant patient and her developing fetus to risk of poor outcomes. Certain medical conditions can have dire consequences for the mother or fetus if not recognized and treated expeditiously. Family physicians should prioritize preconception counseling, preventative measures, and patient education to minimize the risk of harm to both the pregnant patient and fetus. Commonly encountered medical problems and urgent issues seen less commonly in pregnancy will be discussed in this chapter.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  1. Bonham CA, Patterson KC, Strek ME. Asthma outcomes and management during pregnancy. Chest. 2018;153(2):515–27.

    Article  PubMed  Google Scholar 

  2. American College of Obstetricians and Gynecologists. Asthma in pregnancy. ACOG Practice Bulletin No. 90. Obstet Gynecol. 2008;111:457–64.

    Article  Google Scholar 

  3. American College of Obstetricians and Gynecologists. Assessment and treatment of pregnant women with suspected or confirmed influenza. ACOG Committee Opinion No. 753. Obstet Gynecol. 2018;132:e169–73.

    Article  Google Scholar 

  4. American College of Obstetricians and Gynecologists. Chronic hypertension in pregnancy. ACOG Practice Bulletin No. 203. Obstet Gynecol. 2019;133:e26–50.

    Article  Google Scholar 

  5. Nicolle LE, Gupta K, Bradley SF, Colgan R, DeMuri GP, Drekonja D, et al. Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 update by the Infectious Disease Society of America. Clin Infect Dis. 2019;68(10):e83–110.

    Article  PubMed  Google Scholar 

  6. Glaser AP, Schaeffer AJ. Urinary tract infection and bacteriuria in pregnancy. Urol Clin N Am. 2015;42:547–60.

    Article  Google Scholar 

  7. American College of Obstetricians and Gynecologists. Prevention of group B streptococcal early-onset disease in newborns. ACOG Committee Opinion No. 797. Obstet Gynecol. 2020;135:e51–72.

    Article  Google Scholar 

  8. Antimicrobial Therapy, Inc. Sanford Guide to Antimicrobial Therapy [Mobile application software]. (Version 4.1) Dallas, TX: Antimicrobial Therapy, Inc. (2020). [Cited 2020 Feb 19]. Retrieved from https://apps.apple.com/us/app/sanford-guide-antimicrobial/id863196620

  9. American College of Obstetricians and Gynecologists. Prenatal and perinatal human immunodeficiency virus testing. ACOG Committee Opinion No. 752. Obstet Gynecol. 2018;132:e138–42.

    Article  Google Scholar 

  10. Navér L, Albert J, Carlander C, Flamholc L, Gisslén KO, et al. Prophylaxis and treatment of HIV-1 infection in pregnancy – Swedish recommendations 2017. Infect Dis. 2018;50(7):495–506.

    Article  CAS  Google Scholar 

  11. Panel on Treatment of Pregnant Women with HIV Infection and Prevention of Perinatal Transmission. Recommendations for Use of Antiretroviral Drugs in Transmission in the United States. Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/ PerinatalGL.pdf. Accessed (15 Feb 2020) [A-9, E-15].

  12. American College of Obstetricians and Gynecologists. Viral hepatitis in pregnancy. ACOG Practice Bulletin No. 86. Obstet Gynecol. 2007;110:941–55.

    Article  Google Scholar 

  13. Centers for Disease Control. Guidelines for vaccinating pregnant women [Internet]. CDC/ATSDR. [Updated Aug 2016, cited 17 Feb 2020]. Available from: https://www.cdc.gov/vaccines/pregnancy/hcp-toolkit/guidelines.html

  14. Society for Maternal-Fetal Medicine (SMFM), Dionne-Odom J, Tita ATN, Silverman NS. Hepatitis B in pregnancy screening, treatment, and prevention of vertical transmission. Am J Obstet Gynecol. 2016;214(1):6–14.

    Article  Google Scholar 

  15. United States Preventive Services Task Force. Screening for hepatitis B virus infection in pregnant women. JAMA. 2019;322(4):349–54.

    Article  Google Scholar 

  16. Centers for Disease Control. Hepatitis C questions and answers for health professionals [Internet]. CDC/ATSDR. [Updated 13 Jan 2020, cited 8 Feb 2020]. Available from: https://www.cdc.gov/hepatitis/hcv/hcvfaq.htm#section1

  17. Society for Maternal-Fetal Medicine (SMFM), Hughes BL, Page CM, Kuller JA. Hepatitis C in pregnancy: screening, treatment, and management. Am J Obstet Gynecol. 2017;217(5):B2–B12.

    Article  Google Scholar 

  18. Centers for Disease Control. Diseases characterized by urethritis and cervicitis [Internet]. CDC/ATSDR. [Updated 4 Jun 2015, cited 20 Feb 2020]. Available from: https://www.cdc.gov/vaccines/pregnancy/hcp-toolkit/guidelines.html

  19. American College of Obstetricians and Gynecologists. Management of herpes in pregnancy. ACOG Practice Bulletin No. 82. Obstet Gynecol. 2007;109:1489–98.

    Article  Google Scholar 

  20. Stafford IA, Berra A, Minard CG, Fontenot V, Kopkin RH, Rodrigue E, Roitsch CM, et al. Challenges in the contemporary management of syphilis among pregnant women in New Orleans, LA. Infect Dis Obstet Gynecol. 2019;2019:2613962.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Lin JS, Eder ML, Bean SI. Screening for syphilis infection in pregnant women: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2018;320(9):918–25.

    Article  PubMed  Google Scholar 

  22. United States Preventive Services Task Force. Screening for syphilis infection in pregnant women. JAMA. 2018;320(9):911–7.

    Article  Google Scholar 

  23. American College of Obstetricians and Gynecologists. Cytomegalovirus, parvovirus B19, varicella zoster, and toxoplasmosis in pregnancy. Obstet Gynecol. 2015;125:1510–25.

    Article  Google Scholar 

  24. Mülleger RR, Häring NS, Glatz M. Skin infections in pregnancy. Clin Dermatol. 2016;34:368–77.

    Article  Google Scholar 

  25. Nguyen HT, Pandolfini C, Chiodini P, Bonati M. Tuberculosis care for pregnant women: a systematic review. BMC Infect Dis. 2014;14:617.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Malhamé I, Cormier M, Sugarman J, Schwartzman K. Latent tuberculosis in pregnancy: a systematic review. PLoS One. 2016;11(5):e0154825.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  27. American College of Obstetricians and Gynecologists. Pregestational diabetes mellitus. ACOG Practice Bulletin No. 201. Obstet Gynecol. 2018;132:e228–48.

    Article  Google Scholar 

  28. O’Neill SM, Kenny LC, Khashan AS, West HM, Smyth RMD, Kearney PM. Different insulin types and regimens for pregnant women with pre-existing diabetes. Cochrane Database Syst Rev [Internet]. 2017 [cited 27 February 2020];(2). Available from: https://doi.org/10.1002/14651858.CD011880.pub2/full

  29. American College of Obstetricians and Gynecologists. Gestational diabetes mellitus. ACOG Practice Bulletin No. 190. Obstet Gynecol. 2018;131:e49–64.

    Article  Google Scholar 

  30. American College of Obstetricians and Gynecologists. Thyroid disease in pregnancy. ACOG Practice Bulletin No. 148. Obstet Gynecol. 2015;125:996–1005.

    Article  Google Scholar 

  31. Earl R, Crowther CA, Middleton P. Interventions for hyperthyroidism pre-pregnancy and during pregnancy. Cochrane Database Syst Rev [Internet]. 2013 [cited 8 March 2020];(11). Available from: https://doi.org/10.1002/14651858.CD008633.pub3/full

  32. American College of Obstetricians and Gynecologists. Anemia in pregnancy. ACOG Practice Bulletin No. 95. Obstet Gynecol. 2008;112:201–7.

    Article  Google Scholar 

  33. Pavord S, Daru J, Prasannan N, Robinson S, Stanworth S, Girling J. UK guidelines on the management of iron deficiency in pregnancy. Br J Haematol. 2020;188(6):819–30.

    Article  PubMed  Google Scholar 

  34. Govindappagari S, Burwick RM. Treatment of iron deficiency anemia in pregnancy with intravenous versus oral iron: systematic review and meta-analysis. Am J Perinatol. 2019;36:366–76.

    Article  PubMed  Google Scholar 

  35. Cines DB, Levine LD. Thrombocytopenia in pregnancy. Blood. 2017;2017:144–51.

    Google Scholar 

  36. American College of Obstetricians and Gynecologists. Thrombocytopenia in pregnancy. ACOG Practice Bulletin No. 207. Obstet Gynecol. 2019;133:e181–93.

    Article  Google Scholar 

  37. American College of Obstetricians and Gynecologists. Thromboembolism in pregnancy. ACOG Practice Bulletin No. 196. Obstet Gynecol. 2018;132:e1–17.

    Article  Google Scholar 

  38. Sethi NK, Wasterlain A, Harden CL. Pregnancy and epilepsy – when you’re managing both. J Fam Pract. 2010;59(12):675–9.

    PubMed  Google Scholar 

  39. Weston J, Bromley R, Jackson CF, Adab N, Clayton-Smith J, Greenhalgh J, et al. Monotherapy treatment of epilepsy in pregnancy: congenital malformation outcomes in the child. Cochrane Database Syst Rev [Internet]. 2016 [cited 15 March 2020];(11). Available from: https://doi.org/10.1002/14651858.CD010224.pub2/full

  40. Ha H, Gonzalez A. Migraine headache prophylaxis. Am Fam Physician. 2019;99(1):17–24.

    PubMed  Google Scholar 

  41. Mayans L, Walling A. Acute migraine headache: treatment strategies. Am Fam Physician. 2018;97(4): 243–51.

    PubMed  Google Scholar 

  42. Osterman M, Ilyas AM, Matzon JL. Carpal tunnel syndrome in pregnancy. Orthop Clin N Am. 2012;43:515–20.

    Article  Google Scholar 

  43. Clemente-Fuentes RJ, Pickett H. How can pregnant women safely relieve low-back pain? J Fam Pract. 2013;62(5):260–8.

    PubMed  Google Scholar 

  44. Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev [Internet]. 2015 [cited 1 March 2020];(9). Available from: https://doi.org/10.1002/14651858.CD001139.pub4/full

  45. Padua L, Di Pasquale A, Pazzaglia C, Liotta GA, Librante A, Mondelli M. Systematic review of pregnancy-related carpal tunnel syndrome. Muscle Nerve. 2010;42:697–702.

    Article  PubMed  Google Scholar 

  46. Yonkers KA, Wisner KL, Stewart DE, Oberlander TF, Dell DL, Stotland N, et al. The management of depression during pregnancy: a report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists. Obstet Gynecol. 2009;114(3):703–13.

    Article  PubMed Central  Google Scholar 

  47. Ecker J, Abuhamad A, Hill W, Bailit J, Bateman BT, Berghella V, et al. Substance use disorders in pregnancy: clinical, ethical, and research imperatives of the opioid epidemic: a report of a joint workshop of the Society for Maternal-Fetal Medicine, American College of Obstetricians and Gynecologists, and American Society of Addiction Medicine. Am J Obstet Gynecol. 2019;221(1):PB5–B28.

    Article  Google Scholar 

  48. American College of Obstetricians and Gynecologists. Obesity in pregnancy. ACOG Practice Bulletin No. 156. Obstet Gynecol. 2015;126:e112–26.

    Article  Google Scholar 

  49. American College of Obstetricians and Gynecologists. Bariatric surgery and pregnancy. ACOG Practice Bulletin No. 105. Obstet Gynecol. 2009;113:1405–13.

    Article  Google Scholar 

  50. Dixon JB, Dixon ME, O’Brien PE. Birth outcomes in obese women after laparoscopic adjustable gastric banding. Obstet Gynecol. 2005;106:965–72.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Matthew Halfar .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Science+Business Media LLC

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Halfar, M. (2020). Medical Problems During Pregnancy. In: Paulman, P., Taylor, R., Paulman, A., Nasir, L. (eds) Family Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0779-3_151-1

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-0779-3_151-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-0779-3

  • Online ISBN: 978-1-4939-0779-3

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics