Before 14 weeks: Contact your GP
After 14 weeks: Contact maternity triage
Further information:
High blood pressure (hypertension) affects around 10-15% of pregnancies.
There are different types including:
- Chronic hypertension (where the high blood pressure was present before pregnancy)
- Pregnancy-related high blood pressure (gestational hypertension)
- Pre-eclampsia
Depending on the cause and severity of the raised blood pressure the care and treatment you receive will be different but it is very important that your blood pressure remains under control. You will be given additional antenatal appointments to ensure this.
It involves a rise in blood pressure during pregnancy which is accompanied by a leakage of protein from the kidneys into urine. This can be detected by testing your urine for proteins, which your midwife will check at all your antenatal appointments.
Pre-eclampsia can occur in any pregnancy but you are at higher risk if your blood pressure was already high before you became pregnant, your blood pressure was high in a previous pregnancy or if you have a medical problem such as kidney problems, diabetes or a condition that affects the immune system, such as lupus.
In mild pre-eclampsia, there may be no symptoms or signs.
However, you should contact your midwife or doctor if you develop:
- severe headaches
- problems with your vision (blurring, flashing light or spots in front of your eyes)
- upper tummy pain
- puffiness or swelling of your face, hands or feet.
If you are found to be in the early stages of pre-eclampsia, you’ll have antenatal checks more often to make sure you and your baby stay healthy.
You will be advised to rest more and may be given medication, which will be safe for your baby, to control your blood pressure.
It is important that your blood pressure is kept under control during pregnancy as it can cause a reduction in growth of the baby.
Rarely, when blood pressure cannot be controlled with medication, it may be necessary to consider delivering your baby early.
In a small number of cases the illness can develop into severe pre-eclampsia requiring immediate emergency medical care and can be life threatening for the mother and baby.
Further information:
BSUH: Pre-eclampsia and Aspirin
This causes a build-up of bile acids in your body which makes the skin very itchy but without a rash. The symptoms get better when your baby is born.
Itching is very common in pregnancy and affects around 23% of women.
Only a very small proportion of women will have obstetric cholestasis however as this is the first sign particularly when worse at night and involving the palms of the hands and soles of the feet it is important that you contact your midwife as soon as possible.
Further information:
RCOG: Obstetric cholestasis
Pre-existing diabetes
If you already have diabetes and are considering becoming pregnant it is very important to achieve good control of your glucose levels prior to conceiving to reduce the risk of miscarriage, congenital malformation, stillbirth and neonatal death. When planning to get pregnant it is important to speak to your diabetes nurse or GP to review your health, medication and plan your care in the preconception period.
When you are pregnant you will be referred to antenatal clinic and will be cared for throughout your pregnancy by a specialist multi-disciplinary team including a doctor specialising in diabetes, an obstetrician, a specialist diabetes nurse, specialist midwife and a dietician.
Further information:
NICE [NG3]: Diabetes in pregnancy: management from preconception to the postnatal period
Diabetes UK – Pregnancy and diabetes
Gestational diabetes
Diabetes that develops in pregnancy is known as gestational diabetes. It occurs because your body cannot produce enough insulin (a hormone that helps to control blood glucose) to meet its extra needs in pregnancy. This results in high blood glucose levels. Gestational diabetes is common and affects up to 18 in 100 women in pregnancy.
You are more likely to develop gestational diabetes if you have the following risk factors:
- Your body mass index (BMI) is 30 or higher
- You have previously given birth to a large baby, weight 4.5kg (10lbs) or more
- You have had gestational diabetes before
- You have a parent, brother or sister with diabetes
- Your family origin is South Asian, Chinese, African-Caribbean or Middle Eastern
If you are diagnosed with gestational diabetes you will be have specialist antenatal care from a multi-disciplinary team including a doctor specialising in diabetes, an obstetrician, a specialist diabetes nurse, specialist midwife and a dietician.
For further information:
RCOG: Gestational diabetes – Information for you
Diabetes UK – Gestational diabetes
Watch this video from our midwives about gestational diabetes
Contact details:
Royal Sussex County Hospital: bsu-tr.diabetesbsuh@nhs.net
Princess Royal Hospital: bsuh.maternitydiabetes.prh@nhs.net
Group B Strep (GBS)
GBS is one of many bacteria that can be present in our bodies and usually does not cause an harm. Most pregnant women who carry GBS bacteria have healthy babies, however there is a small risk that GBS can pass to the baby during childbirth which can cause serious complications in the newborn. This is rare; one in every 2,000 newborn babies in the UK are diagnosed with a GBS infection. Pregnant women are not routinely screened for GBS in the UK but it is sometimes detected when tests for other infections are carried out.
Further information:
RCOG: Group B streptococcus (GBS) infection in newborn babies – information for you
Genital herpes
Genital herpes is common infection caused by the herpes simplex virus. Genital herpes can cause problems in pregnancy.
If you had genital herpes before becoming pregnant
The risk to your baby is very low, even if you have recurrent episodes during pregnancy. However it is still important to inform your midwife so you can plan your care and treatment.
If you develop herpes for the first time in pregnancy
First and second trimester
If you develop genital herpes for the first time (primary infection) you will be referred to see a genitourinary doctor to confirm diagnosis and make a plan of care.
Third trimester
If you develop genital herpes for the first time during the third trimester (from week 27 of the pregnancy until birth), particularly during the last six weeks of the pregnancy, the risk of passing the virus on to your baby is considerably higher. This is because you will not have time to develop protective antibodies to pass to your baby, and the virus can be passed to your baby before or during the birth.
If you develop herpes for the first time during the last 6 weeks of pregnancy we would advise you have a caesarean section to deliver your baby at around 39 weeks. This is because if you give birth vaginally, the risk of passing the virus on to your baby is around four in 10 and can cause serious complications in the newborn.
Further information:
RCOG: Genital herpes and pregnancy – information for you
Chicken pox (Varicella Zoster Virus, VSV)
Chicken pox is a highly infectious condition which is transmitted directly via personal contact or droplet spread. Most infections occur in childhood and 90% of the adult population in the UK is immune. If you think you have come into contact with someone with chickenpox and have not had or unsure if you have had chickenpox before inform your midwife immediately. A blood test will be arranged to check your immunity and you may need an immunoglobulin vaccination. If you are diagnosed with chickenpox before 28 weeks of pregnancy you will be referred to a fetal medicine consultant.
Further information:
RCOG: Chicken pox and pregnancy: information for you
Parvovirus infection (slap cheek fever)
Parvovirus is a common, mild illness that is common in children who most often present with fiery red cheeks (resembling a slapped cheek) 2-5 days after feeling generally unwell. Most pregnant women who get parvovirus in pregnancy have healthy babies although it can cause significant complications. If you think you have come into contact with parvovirus contact your midwife. They will arrange for your booking bloods to be checked for your immunity. If you are not immune a further plan of care will be made and if you are diagnosed with parvovirus you will referred to a fetal medicine consultant for additional antenatal scans.
Further information:
NHS Choices: What are the risks of slapped cheek syndrome during pregnancy?
