Dr. Mario Awwad, D.C.

Complications of Pregnancy




Complications During Pregnancy


Bell's Palsy

This condition involves a sudden onset of painless loss of facial muscle function. Lowering the eyebrows, closing the eye or pursing the lips is not possible. Patients may also experience a loss of taste in the anterior 2/3rd's of the tongue as well as pain posterior to the ear. While this condition has currently no known cause, many believe that vertebral subluxations are at least partly responsible.

Bell's palsy is 3 times more common in the pregnant women. Hormonal changes increasing water retention, grimacing during labor and delivery, as well as ligamentous laxity are primarily responsible. In the typical presentation, the woman awakes with a painless inability to operate the facial muscles on one side of the face. This typically occurs during the 3rd trimester. The condition tends to improve over the course of many weeks to months, depending on it's severity. Many studies have shown favorable results with chiropractic care.

page toppage toppage top


Brachial Neuralgia

A large collection of nerves, the brachial plexus, from the cervical spine descend into each arm to provide sensory and motor innervation. Again, due to increases in hormonal factors, parts of the nerve plexus may become impinged or irritated. This results in radiating arm pain and may also be associated with neck pain or stiffness. Restoring cervical biomechanics and eliminating cervical subluxations is performed by the chiropractor to eliminate cervical stress and radicular symptoms.

page toppage toppage top


Breast Cancer

Breast cancer is occurring earlier and earlier in women. Breast cancer occurs in approximately 1 out of every 3,000 pregnancies. It's important to have a breast examination prior to pregnancy or early on in the pregnancy to check for its presence and establish a baseline if present.

page toppage toppage top


Carpal Tunnel Syndrome

Carpal tunnel syndrome, commonly associated with repetitive wrist movements, is also increased during pregnancy. This is because of hormonal changes which increases water retention, leading to increased pressure on the median nerve as it passes through the 'carpal tunnel' in the wrist, hence the name. Symptoms include numbness and tingling of the hand and fingers as well as achiness in the forearm and neck. Chiropractic adjustments applied to the cervical and wrist regions can help eliminate inflammation and quicken resolution. Additionally, vitamin B6 supplements have been shown to assist in eliminating the symptoms of carpal tunnel syndrome.

page toppage toppage top


Coccydynia

This condition simply refers to a painful coccyx. The coccyx bone is located on the end of your sacrum or tailbone and can become irritated and painful in pregnancy. This is especially evident in the final trimester due to the position of the baby and the lack of room for the baby to maneuver. Manual adjustment of the coccyx is often required and can be safely and successfully performed by the chiropractor.

page toppage toppage top


Ectopic Pregnancy

An ectopic pregnancy occurs when implantation and subsequent development of a fertilized ovum is outside the uterus. This most commonly occurs in a fallopian tube. As the embryo develops the fallopian tube is unable to expand like the uterus and can eventually rupture. Symptoms include cramp-like or stabbing pain in the lower abdomen. In 75% of the women vaginal bleeding will occur. This is a serious condition as acute internal hemorrhaging may occur leading to possible death.

Certain factors can increase the likelihood of ectopic pregnancies including:

  • prior IUD use
  • prior pelvic or tubal infection (certain STD's)
  • tubal abnormalities

page toppage toppage top


Headaches

Most headaches experienced during pregnancy are muscle tension headaches. These headaches are soft tissue and biomechanical in nature and respond excellent to chiropractic care. Fortunately for migraine headache sufferers, migraines are rare during pregnancy as hormones released counteract the processes involved that normally cause migraines.

page toppage toppage top


Intercostal Neuralgia

Hormonal changes during pregnancy lead to the relaxation of ligaments and joint capsule which include the joints of the ribs. Additionally, increased weight gain increases the pressure on the rib cage. These two factors lead to increased rib subluxations and increased in intercostal nerve irritation. Chiropractors adjust the rib heads to alleviate nerve irritation and restore normal positioning of the rib heads.

page toppage toppage top


Meralgia Paresthetica

This condition is a result of pressure on the lateral femoral cutaneous nerve which provides sensation to the skin of the upper lateral thigh. Increased abdominal weight and pressure as well as an increased lumbar curvature tend to place additional pressure in the area of the nerve which leads to pain, numbness and tingling in the area of the lateral upper thigh. Chiropractors commonly treat this condition successfully.

page toppage toppage top


Sciatic Neuralgia

This common condition is a result of increased pressure on the large collection of nerves in the lower back. Symptoms include back pain with symptoms of pain, numbness and/or tingling radiating down the buttock and leg(s). There are also other causes of this condition which include sacroiliac joint dysfunction, lumbar disc syndrome, lumbar facet joint irritation, and vertebral subluxations. Chiropractic care is especially effective in treating sciatic neuralgia as the treatment directly addresses the cause.

page toppage toppage top


Teratology of Drugs and other Substances

It's vital that all women who believe they may be pregnant or who are pregnant be 100% sure not to consume any drugs which may lead to birth defects or complications. It is estimated that 2-3% of all birth defects are drug-induced. One problem is damage to the embryo can occur early on prior to the woman knowing she is even pregnant. Vital systems such as the heart and nervous system develop in the embryo weeks after conception and are extremely susceptible to toxins such as drugs and alcohol.

Some common substances and drugs that can produce adverse effects on the growing embryo/fetus include:

  • Artificial Sweetener - Aspartame
  • Caffeine
  • Aspirin
  • Smoking
  • Antihistamines
  • Antibiotics
  • Recreational Drugs (marijuana, cocaine, etc.)
  • Antidepressant Drugs
  • Antiepileptic Drugs
  • Acne Drugs - accutane
  • Cardiovascular Drugs

page toppage toppage top


Toxemia of Pregnancy - Eclampsia

This fatal condition can develop in the 2nd half of pregnancy and has no known etiology, although some believe it results from poor nutrition. In the early stages (pre-eclampsia) signs include high blood pressure (hypertension), protein in the urine (proteinuria), and excessive edema (not always present). If eclampsia develops, the following may develop:

  • epilepsy
  • subarachnoid/cerebral hemorrhage
  • preexisting brain tumors may fulminate
  • uremia
  • liver failure
  • placental necrosis
  • glomerular (kidney) and tubal necrosis

page toppage toppage top




Complications During Birthing Process


Insufficient Power

Sufficient power and coordinated contractions are essential for a smooth uncomplicated labor. When the power of the contractions are weak or the pattern of contractions disorganized, the mother is more likely to become exhausted. This can cause fetal distress resulting in fetal harm and/or c-section. The following are causes of insufficient power or improper contractions:

  • disordered uterine action
  • colicky uterus
  • constriction ring - Bandl's ring
  • rigid cervix
  • edematous cervix
  • annular detachment

page toppage toppage top


Passage Obstruction

Passage way obstructions (pelvic, uterine, cervix, etc.) can complicate the birthing process. These include:

  • tumors
  • cysts
  • fractures
  • subluxations
  • flat male-like pelvis (android)
  • physiological changes (degenerative joint disease, tuberculosis, rickets, osteomalacia)

page toppage toppage top


Baby Malpositions

Malpositioning of the fetus can lead to abnormal birth presentations. Some of the more common malpositioned birth presentations include:

Upside Down Presentation - This presentation occurs in approximately 13% of births and involves a presentation where the baby presents in an "upside down" or "sunny side up" position. If the baby does not turn to the proper position or turns late, the newborn will generally develop "cone head". This position also produces what is known as "back labor". This can be significantly reduced in women who receive regular chiropractic care during their pregnancy.

Breech Presentation - In a breech presentation, the feet or buttock present first as opposed to the head. This presentation occurs in about 1 out of every 40 births. Possible complications can be serious and include:

  • intracranial bleeding
  • neck dislocation
  • shoulder dislocation
  • hip dislocation
  • clavicle fracture
  • internal organ disruption
  • genital edema
  • premature placental rupture
  • prolapsed cord
  • uterine rupture

Face Presentation - Face presentation occurs approximately every 3,000 births. In this presentation, the baby presents face first with the neck in extension. Causes include a lax uterus, flat pelvis, multiple fetus, anencephaly, or neck spasms of the fetus. This is stressful on the cervical spine and usually results in a cervical subluxation in the newborn. Chiropractic care by a chiropractor trained in adjusting newborns is crucial for the continued proper growth of the spine.

Shoulder Presentation - The shoulder presentation occurs in every 200-300 births and involves a "shoulder first" delivery. The causes include:

  • twin birth
  • hydramnios - excess of amniotic fluid
  • placenta praevia - part of the uterus presents before the fetus due to placental malposition
  • multiparity - a women who has had 3 or more children
  • sub-septae uterus
  • unusual fetal shape
  • undue mobility of the pelvis

page toppage toppage top


Forceps Delivery

In the event there is fetal or mother distress, or the labor is not going as planned, forceps assistance may be used. As forceps can cause a number of problems, forceps should only be used in absolutely necessary situations. The following injuries can result from improper/inappropriate forceps use:

  • skull fractures
  • birth marks
  • doctor-induced torticollis
  • brachial plexus damage

page toppage toppage top


Cesarean Section

Although c-sections were becoming very popular a short while back, experts now recommend avoiding this procedure unless the mother or fetus are in extreme distress. This is due to the invasiveness of the procedure and unnecessary stresses placed on the baby. The indications for cesareans are:

  1. placenta praevia - part of the uterus presents before the fetus due to placental malposition
  2. fetal distress
  3. maternal distress
  4. failure for labor to progress

page toppage toppage top