Gynecology and Maternity Division

Guide for Hospitalization in the Maternal and Fetal Medicine Unit

Toxemia, premature labor, early water breaking, etc. These are the reasons that pregnant women require hospitalization and observation during their pregnancy. Find all the information in the following article.

Pregnancy is a blessing, however, you must take into consideration that there might be complication that require increased medical observation, due to a maternal or fetal medical condition. Medical intervention in the right timing may assist in decreasing the possible complications and promote the health, both for mother and fetus.

This is the reason for the maternal and fetal medicine (high-risk pregnancy) unit, in the Kaplan Medical Center. The unit includes 12 beds and a multi-disciplinary staff, including doctors, nurses, a social worker and a nutritionist. The staff is available for pregnant women to treat, observe, assist and answer any question and to ease the stay in the unit.

These are the common reasons for hospitalization in the unit:

Premature Labor
Naturally, labor are supposed to start during the final weeks of pregnancy, when their character, intensity and frequency are different with each woman. However, it happens when the labor occurs earlier than expected (before the completion of 37 gestational weeks), when the fetus has not yet matured for life outside the uterus.

Signs of premature labor are:

  • Cramps much like these who appear during your menstrual period, in the lower abdomen.
  • Pressure or pain in the pelvis or groin
  • Dull pain in your lower back or pressure in your back
  • Abdominal cramps or diarrhea
  • Increased vaginal secretions or bleeding

Hospitalization due to premature labor is done for the following reasons:

  • Receive treatment according to the doctor’s orders, which might include fluids, steroids for the fetal lung maturation (in case a premature birth does develop) and providing drugs to stop the premature labor.
  • Search for possible causes for premature labor.
  • Monitor your progress, and you dilation, and also the fetal activity and condition and the uterine activity.
  • Perform blood and urine tests and a cervical culture, in order to diagnose a possible infection.

Early Water Breaking
The breaking of water is one of the signs for the beginning of the delivery process, however, when the water breaks before the beginning of an active delivery in time or before its time, meaning, before 37 complete weeks of pregnancy, it can be a dangerous situation.

The main concern in an early water breaking is an amniotic fluid infection or a vaginal and cervical infection, that might endanger the fetus and set off a premature delivery.

Apart for infection, there are various other reasons for early water breaking, such as:

  • Cervical insufficiency
  • Premature labor
  • Multi-fetus pregnancy
  • Smoking
  • Etc.

Therefore, when you identify that your water broke, go urgently to the maternal emergency room, to determine whether you should be delivered, or hospitalized for close follow up, provide (oral or venal) antibiotics, monitor the situation of the fetus, provide you with a shot for lung maturation in case of an early delivery and decrease the risk for early delivery and a premature baby.

Hypertension and Toxemia
Hypertension during pregnancy may become toxemia. Hypertension is diagnosed when the test values exceed 140/90 in at least two measurements, which are conducted 6 hours apart. In most cases, when discussing pregnant women, it is possible to follow up and treat in lowering the blood tension using drugs which are permitted during pregnancy.

However, the main concern is, a deterioration of the situation.

Toxemia is a unique syndrome which is expressed after 20 weeks of gestation, and might be dangerous for mother and fetus. The disease is diagnosed by common complaints and lab results: severe hypertension, disruption of liver and kidney function, severe edema, headaches, blurred vision etc.

Among the risk factors of toxemia:

  • Chronic hypertension
  • Tendency for blood clotting
  • Kidney disease
  • Multi-fetus pregnancy
  • History of toxemia
  • Etc.

There are a few levels of severity for toxemia, and there are situations in which the baby should be urgently delivered, by inducing birth or by Caesarean section. Therefore, in most cases of diagnosis, we have to admit the mother in order to hold constant observation, stabilize her condition and deliver, if necessary.

Bleeding during pregnancy
Bleeding during pregnancy is a common situation for about 20% of the women. Usually this is a situation that testifies for the rooting of the fetus in the uterus, and for other natural reasons. However, it could be a sign for a natural abortion.

Bleeding during the second half of pregnancy might be caused due to an open placenta: a condition in which the placenta is in the lower part of the uterus, covering or blocking the cervix, and may prevent vaginal birth. Other reasons are placental separation or a sign of a premature labor.

Therefore, in any case of fresh bleeding you must come to the maternal emergency room to be diagnosed. It is important to note, that even if the bleeding has stopped, it is recommended to be tested and diagnosed in order to decide about hospitalization, inducing labor or the need for an emergency Caesarean section.

Urine Tract Infections
During pregnancy, urine tract infections become more common mostly due to the growing of the uterus and hormonal influences that might induce a few changes in the urine system. Urine tract infections during pregnancy during pregnancy requires care and observation in order to prevent risks for both mother and baby.

The disease appears in various levels:

  • Minor level: expressed in a burning while urinating, urgency in urinating, fever, hip pains and a sense of incomplete emptying.
  • Severe level: expressed in a severe fever disease which might harm the kidney function and induce the spread of a bacterial infection in your blood. The highest severity of urine tract infection may cause premature labor – giving birth to a premature baby or a low weight baby.

Hospitalization will be done in the following instances:

  • When the urine culture shows an oral antibiotics resistant bacteria
  • When there is a concern that the infection arrived at the upper urinal tracts, the kidneys.
  • In cases of high fever
  • If the infection does not improve and there is no reaction for oral antibiotics.

Multiple fetus pregnancy
When a woman carries two or more fetuses, the risk for complications is higher. The reasons for admittance is fear of harm to the maternal or fetal health mostly due to the following reasons:

  • Risk for toxemia or hypertension
  • Risk for premature labor
  • Disturbance in the growth of one or both fetuses, or other complications according to the twins type (similar or dissimilar).