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Health Problems in Pregnancy

What are health problems in pregnancy?

A health problem in pregnancy is any disease or condition that could affect your health or the health of your fetus. Some health problems may make it more likely that you will have a high-risk pregnancy. A high-risk pregnancy is one in which you, your fetus, or both are at higher risk for health problems than in a typical pregnancy.

But just because you have health problems, it doesn't mean that you, or your fetus, will have a problem during the pregnancy. Taking care of yourself and getting early and regular prenatal care from a health care provider may help you reduce pregnancy risks from health problems.

What raises my risk for health problems during pregnancy?

Every pregnancy has some risk of problems, but your lifestyle, as well as factors like certain conditions and health issues, can raise that risk, such as:

  • A health condition you had before you got pregnant
  • A health condition you develop during pregnancy
  • A pregnancy with more than one baby
  • A health problem that happened during a previous pregnancy and could happen again
  • Substance use during pregnancy
  • Being over age 35

Any of these can affect your health, the health of your fetus, or both.

Can chronic health conditions cause problems in pregnancy?

Every pregnancy is different. If you have specific risks in one pregnancy, it doesn't mean that you will have them in another. But, if you have a chronic condition, you should talk to your provider about how to minimize your risk before you get pregnant. Once you are pregnant, you may need a health care team to monitor your pregnancy. Some common conditions that can complicate a pregnancy include:

  • High blood pressure
  • Polycystic ovary syndrome (PCOS)
  • Kidney problems
  • Autoimmune disorders
  • Thyroid disease
  • Obesity
  • HIV
  • Cancer
  • Infections

Other conditions that may make pregnancy risky can develop during pregnancy - for example, gestational diabetes and Rh incompatibility.

Can health problems in pregnancy be prevented?

You may be able to lower your risk of certain health problems by making healthy lifestyle changes before you get pregnant. These can include reaching a healthy weight, not smoking, and managing any health conditions.

However, health problems during pregnancy are not always preventable. Some chronic conditions can be treated and controlled, while others aren't treatable and carry a higher risk than usual, even if the health problem is well-managed.

Share your symptoms with your provider for early detection and treatment of health problems. Sometimes, it's hard to know what's normal. Some symptoms, like nausea, back pain, and fatigue, are common during pregnancy, while other symptoms, like vaginal bleeding or a severe or long-lasting headache, can be signs of a problem. Call your provider to let them know if something is bothering or worrying you.

Healthy Aging

People in the U.S. are living longer, and the number of older adults in the population is growing. As we age, our minds and bodies change. Having a healthy lifestyle can help you deal with those changes. It may also prevent some health problems and help you to make the most of your life.

A healthy lifestyle for older adults includes:

  • Healthy eating. As you age, your dietary needs may change. You may need fewer calories, but you still need to get enough nutrients. A healthy eating plan includes
    • Eating foods that give you lots of nutrients without a lot of extra calories. This includes fruits and vegetables, whole grains, lean meats, low-fat dairy, nuts, and seeds.
    • Avoiding empty calories, such as foods like chips, candy, baked goods, soda, and alcohol
    • Eating foods that are low in cholesterol and fat
    • Drinking enough liquids, so you don't get dehydrated
  • Regular physical activity. Being physically active may help you maintain a healthy weight and avoid chronic health problems. If you have not been active, you can start slowly and work up to your goal. How much exercise you need depends on your age and health. Check with your health care provider on what is right for you.
  • Staying at a healthy weight. Being either overweight or underweight can lead to health problems. Ask your health care professional what a healthy weight for you may be. Healthy eating and exercise can help you get to that weight.
  • Keeping your mind active. Lots of activities can keep your mind active and improve your memory, including learning new skills, reading, and playing games.
  • Making your mental health a priority. Work on improving your mental health, for example by practicing mediation, relaxation techniques, or gratitude. Know the warning signs of a problem and ask for help if you are struggling.
  • Participating in activities that you enjoy. People who are involved in hobbies and social and leisure activities may be at lower risk for some health problems. Doing things that you enjoy may help you feel happier and improve your thinking abilities.
  • Playing an active role in your health care. Make sure that you get regular checkups and the health screenings that you need. You should know which medicines you are taking, why you need them, and how to take them properly.
  • Not smoking. If you are a smoker, quitting is one of the most important things that you can do for your health. It can lower your risk of several different types of cancer, certain lung diseases, and heart disease.
  • Taking steps to prevent falls. Older adults have a higher risk of falling. They are also more likely to fracture (break) a bone when they fall. Getting regular eye checkups, getting regular physical activity, and making your house safer can lower your risk of falling.

Following these tips can help you to stay healthy as you age. Even if you have never done them before, it's never too late to start taking care of your health. If you have questions about these lifestyle changes or need help figuring out how to make them, ask your health care provider.

Healthy Living

What is healthy living?

Healthy living means taking care of your body and mind by making choices that support your overall wellbeing. Many things affect your health. Some you can't control, like your genetic makeup or your age. But there are many daily habits you can change to help you feel your best.

Creating new healthy habits takes time, but small, steady changes are easier to maintain and can become part of your everyday routine.

Why is healthy living important?

Healthy living can help you feel better, boost your energy, and lower your risk for serious health problems such as heart disease, cancer, and stroke.

What steps can I take toward healthy living?

You don't have to change everything at once. Start with a few steps to build a foundation for a healthier lifestyle. These can include:

  • Get the screening tests recommended for you, including those specific to women's health and men's health
  • Stay up to date on vaccines to protect yourself from disease
  • Maintain a healthy weight that's right for you
  • Eat a variety of healthy foods, and limit calories, added sugar, and saturated fat
  • Be physically active, even small amounts of exercise can be helpful
  • Keep your blood pressure and cholesterol in a healthy range
  • Don't smoke, or take steps to quit if you do
  • Protect your skin from too much sun
  • Limit alcohol, or choose not to drink at all
  • Get enough sleep each night to help your body and mind recharge
  • Manage stress and work on improving your mental health, such as by practicing meditation, relaxation techniques, or gratitude
  • Protect yourself from sexually transmitted infections (STIs)
  • Visit your health care provider regularly for checkups
  • See your dentist and eye care specialist for routine care
  • Stay connected with friends, family, or community groups, and do activities you enjoy

Healthy living is a lifelong journey. Over time, small steps can add up to big health benefits.

Heart Failure

What is heart failure?

Heart failure means that your heart can't pump enough oxygen-rich blood to meet your body's needs. Heart failure doesn't mean that your heart has stopped or is about to stop beating. But without enough blood flow, your organs may not work well, which can cause serious problems.

Heart failure can affect one or both sides of your heart:

  • With right-sided heart failure, your heart is too weak to pump enough blood to your lungs to get oxygen.
  • With left-sided heart failure, your heart can't pump enough oxygen-rich blood out to your body. This happens when the left side of your heart becomes either:
    • Too weak to pump enough blood.
    • Too thick or stiff to relax and fill with enough blood.

Left-sided heart failure is more common than right-sided heart failure.

What causes heart failure?

Heart failure can start suddenly after a medical condition or injury damages your heart muscle. But in most cases, heart failure develops slowly from long-term medical conditions.

Conditions that can cause heart failure include:

  • Arrhythmia (a problem with the rate or rhythm of your heartbeat)
  • Cardiomyopathy
  • Congenital heart defects or other types of heart diseases that you are born with
  • Coronary artery disease
  • Endocarditis
  • Heart attack
  • Heart valve diseases
  • High blood pressure
  • A blood clot in your lung
  • Diabetes
  • Certain severe lung diseases, such as COPD (chronic obstructive pulmonary disease)
  • Obesity

Over time, left-sided heart failure can lead to right-sided heart failure.

Who is more likely to develop heart failure?

Heart failure can happen at any age. It happens to both men and women, but men often develop it at a younger age than women. Your chance of developing heart failure increases if:

  • You're 65 years old or older. Aging can weaken and stiffen your heart muscle.
  • Your family health history includes relatives who have or have had heart failure.
  • You have changes in your genes that affect your heart tissue.
  • You have habits that can harm your heart, including:
    • Smoking
    • Eating foods high in fat, cholesterol, and sodium (salt)
    • Having an inactive lifestyle
    • Alcohol use disorder (AUD)
    • Illegal drug use
  • You have other medical conditions that can affect your heart, including:
    • Any heart or blood vessel conditions, including high blood pressure
    • Serious lung diseases
    • Infection, such as HIV or COVID-19
    • Obesity
    • Diabetes
    • Sleep apnea
    • Chronic kidney disease
    • Anemia
    • Thyroid disease
    • Iron overload disease
    • Cancer treatments that can harm your heart, such as radiation and chemotherapy
  • You are African American. African Americans are more likely to develop heart failure and have more serious cases at younger ages than people of other races. Factors such as stigma, discrimination, income, education, and geographic region can also affect their risk of heart failure.
What are the symptoms of heart failure?

The symptoms of heart failure depend on which side of your heart is affected and how serious your condition has become. Most symptoms are caused by reduced blood flow to your organs and fluid buildup in your body.

Fluid buildup happens because the flow of blood through your heart is too slow. As a result, blood backs up in the vessels that return the blood to your heart. Fluid may leak from the blood vessels and collect in the tissues of your body, causing swelling (edema) and other problems.

Symptoms of heart failure may include:

  • Feeling short of breath (like you can't get enough air) when you do things like climbing stairs. This may be one of the first symptoms you notice.
  • Fatigue or weakness even after rest.
  • Coughing.
  • Swelling and weight gain from fluid in your ankles, lower legs, or abdomen (belly).
  • Difficulty sleeping when lying flat.
  • Nausea and loss of appetite.
  • Swelling in the veins of your neck.
  • Needing to urinate (pee) often.

At first you may have no symptoms or mild symptoms. As the disease gets worse, your symptoms will usually bother you more.

What other problems does heart failure cause?

Fluid buildup and reduced blood flow to your organs can lead to serious problems, including:

  • Breathing problems from fluid in and around your lungs (also called congestive heart failure)
  • Kidney or liver damage, including cirrhosis
  • Malnutrition if fluid buildup makes eating uncomfortable or if your stomach doesn't get enough blood flow to digest food properly
  • Other heart conditions, such as irregular heartbeat and sudden cardiac arrest
  • Pulmonary hypertension
How is heart failure diagnosed?

To find out if you have heart failure, your health care provider will

  • Ask about your medical history, including your symptoms
  • Ask about your family health history, including relatives who have had heart failure
  • Do a physical exam
  • Likely run heart tests and blood tests, including a brain natriuretic peptide (BNP) test

In some cases, your provider may refer you to a cardiologist (a doctor who specializes in heart diseases) for tests, diagnosis, and care.

What are the treatments for heart failure?

Your treatment will depend on the type of heart failure you have and how serious it is. There's no cure for heart failure. But treatment can help you live longer with fewer symptoms.

Even with treatment, heart failure usually gets worse over time, so you'll likely need treatment for the rest of your life.

Most treatment plans include:

  • Taking medicine
  • Eating less sodium and drinking less liquid to control fluid buildup
  • Making other changes, such as quitting smoking, managing stress, and getting as much physical activity as your provider recommends
  • Treating any conditions that may make heart failure worse

You may need heart surgery if:

  • You have a congenital heart defect or damage to your heart that can be fixed.
  • The left side of your heart is getting weaker and putting a device in your chest could help. Devices include:
    • An implantable cardioverter defibrillator.
    • A biventricular pacemaker (cardiac resynchronization therapy).
    • A mechanical heart pump (a ventricular assist device (VAD) or a total artificial heart).
  • Your heart doctor recommends a heart transplant because your heart failure is life-threatening and nothing else is helping.

As part of your treatment, you'll need to pay close attention to your symptoms, because heart failure can worsen suddenly. Your provider may suggest a cardiac rehabilitation program to help you learn how to manage your condition.

Can heart failure be prevented?

You may be able to prevent or delay heart failure if you:

  • Work with your provider to manage any health conditions that increase your risk of developing heart failure
  • Make healthy changes in your eating, exercise, and other daily habits to help prevent heart disease

NIH: National Heart, Lung, and Blood Institute

Hemophilia

What is hemophilia?

Hemophilia is a rare bleeding disorder in which the blood does not clot properly. This can lead to problems with bleeding too much after an injury or surgery. You can also have sudden bleeding inside your body, such as in your joints, muscles, and organs.

Your blood contains many proteins called clotting factors that can help form clots to stop bleeding. People with hemophilia have low levels of one of these factors, usually either factor VIII (8) or factor IX (9). How severe the hemophilia is depends on the amount of factor in the blood. The lower the amount of the factor, the more likely it is that bleeding could happen and might lead to serious health problems.

What are the types of hemophilia?

There are several different types of hemophilia. The most common are:

  • Hemophilia A (classic hemophilia), which is caused by a lack or decrease of clotting factor VIII (8)
  • Hemophilia B (Christmas disease), which is caused by a lack or decrease of clotting factor IX (9)
What causes hemophilia?

Most types of hemophilia are inherited. They are caused by change in one of the genes (also called a mutation) that provides instructions for making the clotting factor proteins. The change may mean that the clotting proteins don't work properly or that they are missing altogether.

These genes are on the X chromosome. You may have one or two X chromosomes:

  • People who are born male have one X chromosome (from the mother) and one Y chromosome (from the father). They can get hemophilia if their one X chromosome has the gene change.
  • People who are born female have two X chromosomes, one from the father and one from the mother. They usually only get hemophilia if:
    • Both X chromosomes have the gene change OR
    • One X chromosome has the gene change and the other X chromosome is missing or inactive.

    People who are born female who have the gene change on one X chromosome are a "carrier" of hemophilia. Sometimes they may have some symptoms of hemophilia. They can pass the gene change on to their children.

Hemophilia that is not inherited is called acquired hemophilia. It is rare. It happens when your body makes specialized proteins called autoantibodies that attack and disable a clotting factor. This can happen because of pregnancy, immune system disorders, cancer, or allergic reactions to certain medicines. Sometimes the cause is unknown.

Who is at risk for hemophilia?

Hemophilia is much more common in people who were born male since they can get it with a change to the gene on one X chromosome. People who have a family history of hemophilia are also at higher risk.

What are the symptoms of hemophilia?

The signs and symptoms of hemophilia are:

  • Bleeding into the joints. This can cause swelling and pain or tightness in the joints. It often affects the knees, elbows, and ankles.
  • Bleeding into the skin (which is bruising).
  • Bleeding into the muscle and soft tissue, which can cause a build-up of blood in the area (called a hematoma).
  • Bleeding of the mouth and gums, including bleeding that is hard to stop after you lose a tooth.
  • Bleeding after circumcision.
  • Bleeding after having shots, such as vaccinations.
  • Bleeding in the head of an infant after a difficult delivery.
  • Blood in the urine or stool.
  • Frequent and hard-to-stop nosebleeds.

In some cases, severe hemophilia may cause bleeding in the brain. This may cause brain damage and can be life-threatening.

How is hemophilia diagnosed?

To find out if you have hemophilia, your health care provider will:

  • Ask about your medical history, including your symptoms and other health conditions you may have.
  • Ask about your family history, to find out if you have relatives who have or had hemophilia.
  • Do a physical exam to look for signs of hemophilia, such as bruising.
  • Do certain blood tests to show if your blood is clotting properly. If it does not, then you will have clotting factor tests to diagnose the cause of the bleeding disorder. These blood tests would show the type of hemophilia and the severity.

There is genetic testing for the factor VIII (8) and factor IX (9) genes. This testing may be used in people who have a family history of hemophilia to:

  • Identify people who are carriers before they make decisions about pregnancy
  • Test a fetus for hemophilia during pregnancy
  • Test a newborn for hemophilia
What are the treatments for hemophilia?

The best way to treat hemophilia is to replace the missing clotting factor so that your blood can clot properly. This is usually done by injecting replacement clotting factor into a vein. The replacement clotting factor may be made from donated human blood. Or it may be made in a lab; this kind is called a recombinant clotting factor.

Replacement clotting factor can help treat a bleeding episode. In more severe cases of hemophilia, you might get the factor on a regular basis to prevent bleeding. You can learn how to inject the factor so that you can do it yourself at home.

There are other medicines to treat hemophilia. They may work by releasing factor VIII (8) from where it is stored in the body tissues, replacing the function of factor VIII (8), or preventing clots from breaking down.

If bleeding has damaged your joints, physical therapy may help them function better.

Good quality medical care from healthcare professionals who know a lot about the disorder can help prevent some serious problems. Often the best choice for care is to visit a hemophilia treatment center (HTC).

Centers for Disease Control and Prevention

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