Complications and problems during pregnancy.

Causes of pregnancy complications

The first group includes endocrine diseases (endocrine pathologies occupy a leading position during the period of pregnancy).
These include:

• diabetes mellitus type 1, 2 and gestational;
• diffuse toxic goiter;
• thyrotoxicosis.

Of cardio-vascular system:

• arrhythmia;
• hypertonic disease.

Nephrological reasons:

• pyelonephritis;
• glomerulonephritis;
• proteinuria (leads to preeclampsia).

Gynecological:

• abnormalities of the reproductive organs;
• underdevelopment of the birth canal;
• history of endometriosis, salpingitis and ectopic pregnancy.

There are other equally significant causes of complications during gestation and childbirth:

• multiple pregnancy;
• a large number of births;
• the age of the woman or her partner;
• ruptures and scar on the uterus left during previous births;
• chromosomal abnormalities;
• genetic mutations;
• immunological problems;
• blood diseases;
• neglectful eating and obesity;
• complications that developed after intrauterine manipulations: intravascular transfusion of blood components, amniocentesis or cordocentesis;
• diseases of viral and infectious etiology.

The gestational period is the time when existing chronic diseases enter the subcompensatory stage, and some anomalies are detected for the first time.

Due to the reduced defenses of the body, the risk of infection with influenza or ARVI viruses increases.

Depending on one reason or another, pregnant women are identified as a high-risk group, and they are closely monitored.

The consequences of pathologies have a disastrous prognosis:

• the risk of early abortion increases;
• recurrent miscarriage develops;
• placenta previa;
• deep prematurity;
• early or premature birth;
• high and low water levels;
• late gestosis and toxicosis.

Difficult pregnancy

Advice from lawyers:

1. Can a husband be drafted into the army if his wife has a difficult pregnancy?

1.1. If it's twins. Get a certificate from the antenatal clinic.

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2. I am 12 weeks pregnant, the work is hard. I was in confinement after being discharged from the hospital and asked for a consultation to extend my sick leave, but they refused, explaining that if I was discharged it means I was fit for work, they gave me a certificate for light work, but there is no light work in my work and there are no other positions. I work hard, can I go on maternity leave early?

2.1. Hello. If the employer does not have the opportunity to transfer you to light work, then he is obliged to remove you from work for the entire period of pregnancy while maintaining your average earnings, Article 254 of the Labor Code of the Russian Federation.

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3. They closed a store of a large chain. I worked there as a director, I am 3 months pregnant, they want to transfer me to a lower position since there is no free position in which I worked, but the lie below is much more difficult and I will need to work for 10-12 hours in general physically and mentally difficult. What to do in this situation? After all, the organization does not have easy positions for me.

3.1. Hello! Without your consent, you cannot be transferred to a lower position and the employer has no right to fire you, since you are in a position. If your rights are violated, contact the labor inspectorate.

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3.2. Dear Polina! Your question is not simple, and you need little information to explain it objectively. Firstly

You need to carefully read Articles 72, 72.1, 72.2, 253-261 of the Labor Code of the Russian Federation (in short - the Labor Code of the Russian Federation) in order to better know your labor rights.
Secondly
, in this case, the employer has the right to transfer you to another position only with your consent in accordance with Articles 72, 72.1 of the Labor Code of the Russian Federation.
In order to explain to you in more detail the question of what you should do, we need more complete information from you about your work, the employment contract and the employer. An employer can dismiss you without your consent, based on the provisions of Articles 81, 261 of the Labor Code of the Russian Federation, only upon liquidation of an organization, its branch or a separate division in compliance with Articles 180, 178, 84.1 of the Labor Code of the Russian Federation
. All the best.

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4. I work as an on-site debt collection specialist, the work is associated with negativity and is mentally exhausting. Is this work considered hard work by law? Now I’m 2.5 months pregnant, I’m planning to get a certificate for light work, but I don’t know how to negotiate with the employer.

4.1. Good afternoon No is not.

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5. A woman had a mini-abortion in a paid clinic and in the evening of the same day she was taken from her home to the hospital in serious condition. It turned out to be an ectopic pregnancy and a large loss of blood; one and a half liters of blood were pumped out. What should I do?

5.1. Hello. Contact the investigative committee. This could be negligence. The Investigative Committee classifies this crime.

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6. Due to a difficult pregnancy, I am on sick leave from 6.02. The sick leave will be closed on 14.04. Will I be able to take administrative days at my own expense? Or vacation at your own expense before maternity leave?

6.1. Yes, you can take a vacation at your own expense. But only with the consent of the employer.

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7. On September 12, 2019, Petrova E.Yu., 34 years old, gave birth to twins. The birth was difficult and as of January 10, 2020, she was diagnosed with group 2 disability. IPK Petrova E.Yu. is 34 points. She did not receive any payments other than maternity benefits.

7.1. What is the question?

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8. I work at ZAO Tander as a salesperson, I found out I was pregnant, provided a certificate for light work, the director replied that there was no light work and offered to sit at the checkout for 12 hours! This is difficult for me and problems have arisen in pregnancy, can I demand from the director an order to release me from work until the birth while maintaining average earnings and what is required for this?

8.1. No. You don’t have positions where you can be transferred.

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9. I am a pregnant orphan, 19 years old. I've unlearned it. After studying, I joined the stock exchange and stood for a month. yats, without receiving the full benefit, I left to work on a shift. After working for 3 months, I quit on my own initiative, because the pregnancy was difficult. I arrived and got back to the stock exchange. Do I have a swear word for today? From somewhere. help? Additional question: Can I enroll in distance learning and receive an orphan scholarship?

9.1. Elizabeth! Why do you write on the website and not contact the social protection department at your place of registration or residence? Check the information at the exchange - they are obliged to clarify questions. Orphans are entitled to housing - submit a written application (in two copies) to the administration (through the public reception). For training, call educational institutions and ask for more information!

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10. If I have hard work, then at what point or soon during pregnancy should I be transferred to light work? And what about night shifts? If I’m pregnant for 5 weeks, I have to work 12-hour night shifts.

10.1. No, you don't have to. Provide a certificate of pregnancy, Article 254 of the Labor Code of the Russian Federation.

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10.2. Hello. The employer is obliged to transfer you to light work in accordance with medical regulations. conclusion from the moment of its presentation, including the removal of night shifts, Article 254 of the Labor Code of the Russian Federation.

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11. I'm on vacation now. The vacation was divided into 2 parts. I’m finishing up my first vacation now; I have to go to work in 5 days. It's 24 weeks of pregnancy. I will need to work almost 6 more weeks, but since I divided the vacation, I will take the second one closer to 30 weeks - 15 days remaining. The work is hard, and you have to work 3-4 weeks. If I take a salary without saving, will it greatly affect the payment of maternity benefits?

11.1. Let them take the salary for 2018-2019 to calculate sick leave according to the BIR, then vacation without salary will not have any effect at all.

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12. I can take my husband out of the army early if I’m pregnant with my 2nd child, I have a difficult pregnancy, I had an operation, I live in my own house, I have no parents, I’m an orphan, and my husband’s parents can’t help, because my dad works 24 hours a day, and my mother can't walk.

12.1. Christina, Please clarify, is your husband doing military service under conscription or under contract?

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12.2. Yes, the husband has the right to early dismissal from military service, but only after the birth of a child on the basis of a birth certificate. Federal Law of March 28, 1998 N 53-FZ (as amended on December 16, 2019) “On Military Duty and Military Service” (as amended and supplemented, entered into force on January 1, 2020) Article 51. Grounds for dismissal from the military service 4. A soldier undergoing conscription military service has the right to early dismissal from military service if circumstances arise during the period of conscription military service, provided for in subparagraph “b” of paragraph 2 of Article 23 and subparagraphs “b”, “b. 1", "c", "g"

and “e”
of paragraph 1 of Article 24 of this Federal Law.
Clause "g" clause 1 of Art. 24 of the Law specifically speaks of the right to a deferment from military service if there are two or more children. There is no mention of pregnancy with a second child.

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13. I work hard on doors. I'm pregnant, I can transfer to light work, but I need a certificate of pregnancy; they haven't given it yet; the ultrasound doesn't see the fetus and can't confirm the pregnancy, but it's hard for me to work. What to do? Can I be fired while I'm waiting for a certificate and don't go to work?

13.1. If you do not come to work based on your application, then you cannot be fired.

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14. Pregnancy 14 weeks. I work as a sales representative all day while driving, moving from point to point throughout the city and region. Mileage per week is 1130 km per week. Is this considered hard work?

14.1. Good afternoon, it is better for you to contact the doctor who is observing you.

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15. My daughter, who is 8 months pregnant, is studying at school, but her dean’s office is forcing her to take away her documents, saying it’s hard for her to go to school.

15.1. If your daughter intends to study and it is not difficult for her to travel, let her not listen to anyone and study.

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15.2. Nobody can force you. But they can be expelled for poor performance.

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16. I work in a large supermarket as a receptionist, the work is physically difficult. Pregnancy is 12 weeks, they offer to move to another gender department, reduce hours and salary, do they have the right to this?

16.1. Dear Veronica! Naturally they have the right, only with your consent.

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17. They refused to continue the pregnancy at 22 weeks because an ultrasound scan allegedly showed a chromosomal pathology of the fetus and a heart defect. My son was born at 26 weeks; he suffered a cerebral hemorrhage; there were no congenital anomalies. Two months in serious condition in intensive care.

17.1. What is your question to lawyers?

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18. I work on a rotational basis, I am 11 weeks pregnant. How can I request a certificate that I cannot go on shift? It’s far and difficult to get there, I’m afraid of losing the baby, plus there are dangers, since I work with acid. I would like to go on maternity leave in peace.

18.1. Hello. You need to present your employer with a certificate for light work - honey. conclusion. Get it from the doctor where you register for pregnancy and childbirth.

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19. There was a frozen pregnancy, they did vacuum aspiration. Can my gynecologist extend my sick leave, because the work is physically difficult and hazardous.

19.1. The question is more likely for your doctor.

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20. I have a difficult pregnancy of 15 weeks, I work 2/2 for 15.5 hours, I have a certificate of light work, I do not lift heavy objects, I asked to be transferred to half-time work, I was told to be patient for 2 months, and then go on sick leave and on maternity leave or today they offered a month. I can’t sit at home without pay, I went on sick leave.

20.1. According to Art. 254 of the Labor Code of the Russian Federation: Pregnant women, in accordance with a medical report and at their request, have production standards and service standards reduced, or these women are transferred to another job that excludes the impact of adverse production factors, while maintaining the average earnings for their previous job. Until a pregnant woman is provided with another job that excludes exposure to adverse production factors, she is subject to release from work with the preservation of average earnings for all working days missed as a result at the expense of the employer.

Thus, you need to obtain an appropriate medical report from a doctor and send an official letter to the employer notifying you of the inability to continue working in your previous position due to health reasons and requesting a transfer to easier work. You are required to transfer, retaining your earnings. You don’t have to lose money while on sick leave. Of course, this is only relevant if you have an official salary, and not “in an envelope”.

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If I have a difficult life situation and I am 29 weeks pregnant with my second child. Can I join the labor exchange during this period?

I’ve only been working for a month, I’m on sick leave for almost the entire month, I’m pregnant.

Can I go on vacation at my own expense until maternity leave? Pregnancy is difficult.

I serve in a military sanatorium as a massage therapist. I am now 12 weeks pregnant.

At 34 weeks of pregnancy, I developed severe preeclampsia and as a result the child was stillborn.

They issued a pregnancy certificate for work (11-12 weeks). It does not talk about transferring to light labor. Is such a certificate suitable? I'm very worried, the work is hard!

I work as a maid in a five-star hotel. 12 hours a day 2/2. Physically it is very difficult.

I'm going on a business trip soon. Can I take sick leave so as not to go on a business trip?

Can a pregnant girl be expelled for missing 350 hours of work? Since this first pregnancy is very difficult,

My brother was deceived by his friend. At first, allegedly from him, she became pregnant,

I have a question, I’m a police officer, and I’m in a situation right now. I brought a certificate from the antenatal clinic about my release,

Classification

Changes can be observed not only in the mother, but also in the fetus.

Based on this, it was attempted to classify various deviations during childbearing:

• Changes have occurred in the mother's body. These are somatic and systemic pathologies, anatomical abnormalities, and hormonal disorders.
• Pathological changes occurred in the fetus. These include: hypotrophic or dystrophic abnormalities, genetic abnormalities, hypoxia, antenatal death, incorrect position.
• According to the mother-fetus system: conflict according to the ABO system or due to incompatibility of the Rh factor, violation of the MPC.
• Failures that occurred during embryogenesis: placenta previa, pathological changes in the umbilical artery or amniotic membranes.

In addition, complicated gestations are classified according to the moment of development:

• In the early stages, no later than the 1st trimester. In most cases, they end with spontaneous termination of gestation.
• At a later date. They account for about 11% of cases. Late complications negatively affect the health of the mother, the intrauterine development of the fetus and the course of labor.

Toxoplasmosis.

Toxoplasmosis is a parasitic infection that can be transmitted from cat feces or soil, or from eating raw or undercooked meat that contains the parasite.

• Symptoms: Mild flu-like symptoms or possibly no symptoms.
• Consequences: Toxoplasmosis can be passed on to the baby, and if it occurs in early pregnancy, it causes serious birth defects. Infection later in pregnancy can increase the risk of miscarriage and stillbirth, as well as babies born with brain damage.
• Diagnosis: blood test. If the mother is infected, the fetus may be tested using amniocentesis (a test of amniotic fluid to diagnose certain birth defects) and ultrasound.
• Treatment: If the fetus has not yet become infected, the mother may be given an antibiotic, Spiramycin (to help reduce the severity of the newborn's symptoms). If the fetus is suspected of being infected, the mother can be given two drugs: pyrimethamine and sulfadiazine. Infected children are treated at birth and during the first year of life with these drugs.

Symptoms

The clinical picture of developing anomalies during the gestational period has similar features, regardless of the causes of the pathology:

• nagging pain in the lower abdomen;
• frequent fatigue;
• apathy;
• change in the nature of mucous discharge from the vagina;
• headache;
• decreased appetite;
• loss of consciousness.

Nausea and bouts of vomiting appear if the cause is toxicosis.
In the later stages, a pregnant woman may notice a lack of movement, or frequent painful tremors. With endocrine pathologies, there is a constant feeling of dry mouth and nervousness. Hyperthermia, hypertension, and dizziness cannot be excluded.

In case of any pathological abnormality, you should immediately seek qualified medical help.

Diagnostics

Since there are many pathological phenomena, it is impossible to list them all. But complications of gestation are diagnosed using known methods:

• gynecological examination with or without speculum;
• ultrasound diagnostics of the pelvic organs or fetus and child's place;
• Dopplerography;
• intrauterine MRI method;
• laboratory tests: HIV, coagulogram, general blood and urine test, biochemical study, tests for STIs;
• tank examination of vaginal discharge;
• Fetal CTG;
• consultation of narrow specialists: endocrinologist, nephropathologist, cardiologist;
• invasive and non-invasive tests: amniocentesis, cordocentesis, biopsy.

Diagnostic manipulations will allow us to identify concomitant pathologies and prescribe adequate treatment.
Despite the large number of diagnostic procedures, the main place belongs to ultrasound and laboratory tests.

Treatment

Therapy depends on the identified anomaly and the cause of the gestational complication. Treatment is prescribed by the doctor depending on the type of pathology and intensity of the disease.

In 95% of cases, conservative therapy is carried out. 5% are intrauterine operations and surgical interventions to preserve maternal health (epidectomy, for example).

• Drug therapy is carried out using the following drugs:
• antibiotics for infectious and inflammatory processes (Amoxiclav or Flemoklav). Therapy is carried out after identifying the type of pathogen;
• hormone therapy involves oral or parenteral administration of hormonal drugs to prolong pregnancy;
• sedatives;
• vitamins;
• antispasmodics and tocolytics;
• painkillers intramuscular injections;
• drugs to enhance the synthesis of pulmonary surfactant.

In case of systemic blood diseases, therapy with antiplatelet and antianemic medications is not excluded.

For various deviations in the biochemical composition of the blood, hepatoprotectors and enterosorbents become additions to the main treatment.

An obstetrician-gynecologist evaluates the pathology and prescribes a treatment regimen. In case of severe illnesses and conditions, the pregnant woman is placed in a hospital under round-the-clock supervision.

Due to the fact that the statistics of complicated pregnancies has increased significantly, enhanced measures have been developed when examining a pregnant patient.

Types of research that were not previously conducted have been added. In addition, when determining a risk group, additional tests are prescribed.

Premature birth.

Early or premature birth occurs after 20 weeks but before 37 weeks of pregnancy.

• Symptoms: contractions, either painful or painless, that occur more than four times an hour; menstrual-like cramps that come and go; abdominal pain with or without diarrhea; dull back pain that may radiate around the abdomen; increase or change in color of vaginal discharge.
• Consequences: If labor cannot be stopped, babies face many potential complications, depending on how prematurely they are born.
• Diagnosis: Monitor uterine contractions by wearing an elastic belt around the waist that holds a transducer or small pressure-sensitive recorder.
• Treatment: lie down with your legs elevated; drink 2 or 3 glasses of water or juice. If symptoms do not go away within one hour, contact your doctor. Medicines called tocolytics or magnesium sulfate may be needed to stop contractions.