HAVING a baby is a special time in a woman’s life, a period that is meant to be filled with excitement and delight. However, bringing new life into the world is a delicate process and a level of caution is required to avert pregnancy-related conditions that can risk the lives of the expectant mother and her unborn baby.
Shockingly, Nigeria is one of the countries with the highest maternal mortality rates in the world, accounting for nearly 20 per cent of all global maternal deaths. According to the World Health Organisation (WHO), the risk of dying during pregnancy, childbirth, or a few weeks after childbirth for a Nigerian woman is one in 22, compared to one in 4,900 in developed countries.
Various factors put pregnant women at risk for death from any cause related to or aggravated by the pregnancy or its management during pregnancy and childbirth or within 42 days of termination of pregnancy, including blood clotting – also referred to as venous thromboembolism or VTE.
A blood clot that forms in a deep vein, usually the leg, groin, or arm, is called deep vein thrombosis (DVT). Signs to look out for include pain or tenderness, often starting in the calf, swelling on the ankle or thigh or the affected limb, redness or noticeable discolouration, and warmth around the affected area.
If part of that clot breaks free and travels to the lungs, it can block blood supply and cause a pulmonary embolism (PE), which may be fatal. Signs of a PE include unexplained shortness of breath, rapid breathing, chest pain (which may be worse upon deep breaths), rapid heart rate, and light-headedness or passing out.
Everyone is at risk for developing a blood clot, also called venous thromboembolism, but pregnancy increases that risk fivefold and about 20 times in the period immediately after childbirth. Unfortunately, in a population-based study in southeastern Nigeria, awareness of venous thromboembolism among the general population of adults was low.
In addition, this study in the Journal of Preventive Medicine and Hygiene indicated that a good number of them did not know the risk factors and the symptoms of this blood clot problem.
Dr Helen Okoye, medical expert and spokesperson for the World Thrombosis Day (WTD) campaign in a release declared that expectant women are at risk of experiencing blood clots during the pregnancy, at childbirth, or up to three months after delivering their baby and, while anyone can develop blood clots, they should be aware of the risks that are associated with this condition during pregnancy.
According to the Centers for Disease Control and Prevention (CDC), pregnant women are five times more likely to experience blood clots compared to women who are not pregnant. There are various reasons for this.
During pregnancy, a woman’s estrogen levels are higher than normal, which increases the chance of developing a clot, and a pregnant woman’s blood contains higher levels of clotting proteins and lower levels of anti-clotting proteins. This is the body’s way of safeguarding against too much blood loss during childbirth.
Dr Okoye added that other clotting risk factors include the fact that blood vessels around the pelvis area are pressed upon by the growing baby, resulting in less blood flowing to the legs. This is a common phenomenon at the midpoint of pregnancy.
Also, another key issue is a restricted movement towards the end of the pregnancy, or if the mother has to undergo bed rest after delivery, especially if she has had a C-section. A C-section is a surgery that could cause some damage to blood vessels, thereby increasing the risk of a blood clot.
If a pregnant woman has a personal or family history of blood clots or a blood clotting disorder, or any long-term medical condition such as hypertension, lupus, sickle cell disease, diabetes, or lung and heart-related ailments, she must highlight it to her doctor or midwife at the onset of the pregnancy, cautions Dr Okoye.
She added, “Expectant women and new mothers should do regular visits to their antenatal and postnatal clinic and be as open as possible with their obstetrician/gynaecologist or midwife up until a few weeks after delivery. Raise any medical concerns – this way, the medical team will be able to address possible threats and reduce the risk of clotting. This is especially relevant for first-time moms, who may not know what to look out for.”
“It’s easy to get so caught up in what is going on during a medical check-up that you could forget to address pertinent issues. Don’t be afraid to speak up about things that are bothering you. Even if it seems like a small issue, it’s important that you have peace of mind, and stay safe, during your pregnancy.”
In addition to medical care, some several activities and exercises can be done while pregnant to promote body fitness and mental wellness. For instance, take brisk walks in the neighbourhood or engage in a well-structured fitness plan designed by a qualified fitness instructor in consultation with one’s doctor, to keep fit, healthy and feeling upbeat.
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