Unpredictable Risks in Pregnancy

Introduction: Dear Reader,

After making a few posts on my challenge in pregnancy, I decided to give you a little information on some of the other conditions that could risk pregnancy. While some are avoidable, others could be unpredictable. Be mindful that in each of these, not only the mother but the baby is at risk.

Maternal mortality remains a pressing issue worldwide. According to the World Health Organization, about 287000 women died in 2020 due to pregnancy and birth-related complications with Sub-Saharan Africa carrying about 95% of this burden. While some causes are avoidable with the right resources and timely interventions, others, despite best efforts, arise due to complex, often unexplained origins. This newsletter sheds light on both categories—emphasizing the importance of early diagnosis, specialized care, and the need for enhanced healthcare support in our communities.

"Every mother’s life is a journey of hope yet unexpected risks lie ahead for some. We must ensure she receives the care needed to overcome them safely"

A. Unpredictable Causes of Maternal Mortality

Certain conditions develop with little warning and can affect any expectant mother, yet they disproportionately impact women of African descent. Early detection and specialized care are critical to manage these conditions and mitigate their risks.

1. Preeclampsia

• Definition: A hypertensive disorder occurring after the 20th week of pregnancy, leading to high blood pressure, protein in urine, and potential organ damage.
• Origins: The cause remains unclear, but genetic and racial factors may play a role.
• Impact: Untreated preeclampsia can progress to eclampsia, which can be life-threatening.
• Solution: Prioritize early diagnosis through routine prenatal checkups and manage symptoms with medications and regular monitoring.

2. HELLP Syndrome

• Definition: A severe form of preeclampsia that affects liver function, blood platelets, and red blood cells.
• Origins: Like preeclampsia, HELLP's cause is not well-understood, and it can rapidly progress, affecting mothers and babies alike.
• Impact: Without intervention, HELLP can lead to serious complications such as liver rupture, bleeding, and even death.
• Solution: Immediate medical intervention is required. Increasing the availability of intensive care units and skilled healthcare personnel can save lives.

3. Placental Abruption

• Definition: A condition where the placenta detaches prematurely from the uterine wall, cutting off the baby’s oxygen and nutrient supply.
• Causes: Risk factors include high blood pressure, abdominal trauma, substance abuse, and certain maternal health conditions.
• Symptoms: Sudden bleeding, abdominal pain, and uterine tenderness.
• Solution: Emergency medical response with close monitoring and, in some cases, immediate delivery can help ensure the best outcomes for mother and baby.

B. Avoidable Causes of Maternal Mortality

These causes are largely preventable with adequate resources, skilled personnel, and effective healthcare systems. Addressing them requires robust healthcare policies and resources, especially in Sub-Saharan Africa.

1. Postpartum Hemorrhage

• Definition: Excessive bleeding following childbirth.
• Causes: This may be due to uterine atony, retained placental tissue, poor delivery techniques or trauma during delivery.
• Solution: Skilled healthcare providers and the availability of medications such as oxytocin can prevent complications from hemorrhage.

2. Severe Infections (Sepsis)

• Definition: Life-threatening infections that can occur during or after childbirth.
• Causes: Often due to poor hygiene, delayed or inadequate medical attention, and untreated preexisting infections.
• Solution: Ensuring clean delivery practices and timely intervention with antibiotics is essential.

"Maternal health is not just about survival; it’s about anticipating risks and empowering mothers with the care they deserve".

Call for Improved Resources and Specialized Care

It is possible to give women a good pregnancy and delivery experience and improve outcomes. The availability of human and material resources—trained obstetricians, intensive care units, and routine screenings—can be life-saving. Sub-Saharan Africa, particularly, stands to benefit from investment in maternal healthcare infrastructure.

Together, we can advocate for a future in which no mother faces preventable risks in childbirth. Let us push for resources and policies that allow every mother to receive the care and support she deserves.

Be informed, Be Safe

Verena Achick-Muyu

The Health Evangelist