Having a baby is one of life’s most blissful and exciting experiences, but there are many things you have to learn when planning for childbirth. Good prenatal care and medical treatment during pregnancy helps to prevent most complications. No matter how healthy you are, pregnancy can be unpredictable. Plans should be ready for unexpected, to help ensure your transition from pregnancy to motherhood is safe and smooth. In India about 20-30% women go through a high risk pregnancy, so its important to understand the management and prevention of high risk pregnancy.
What is a high-risk pregnancy ?
As the name implies a high-risk pregnancy is a pregnancy, during which a condition puts the mother, developing fetus or both at a higher risk for health complications.
Who is likely to have a high-risk pregnancy?
You are at risk if you have following factors:
Lifestyle – your life style has important impact on yourchild’s health and life
•Smoking
•Are overweight (bmi >30)
•Use drugs.
•Drinking alcohol
Its important to discusswith your doctor, to prevent the implications of these on pregnancy:
Maternal age and Family history
•Having family history of genetic defects.
•Having family history of multiple pregnancy
•Age 35 or younger than 18.
Underlying health issues
•High blood pressure
•Thyroid disorder
•Blood disorders
•Diabetes
•Asthma
•Epilepsy
•Auto immune disorder
•cancer
•organ transplant
•sexually transmitted infections
•weight loss surgery.
Complications in previous pregnancy
•pre-eclampsia,
•gestational diabetes
•preterm labor and/or delivery.
•Birth defects
•Problems in babies growth
•Multiple pregnancy
Having any of above risk factor makes your pregnancy high risk, because of its impact on health of mother and baby henceforth its important to consult.
What is the prevention of High risk pregnancy?
Preconception counselling: One of the most important and beneficial pregnancy planning activities for a woman is to consider preconception counselling with an obstetrician. The doctor will take a complete history of the mother and her family and the baby’s father and his family before pregnancy to determine any factors, illnesses or conditions that may affect them other or the fetus, such as a genetic defect or risks of preterm deliveries. By understanding their health and possible risk factors, couples have the clarity of deciding whether and when to start a family.
If you have an underlying medical condition, you should ask your doctor:
• What is the effect of my medical condition on the pregnancy and baby?
• How will pregnancy affect my long-term health?
This also recommends lifestyle modification such as Stopping smoking and drinking, increase physical activity, reduce weight, take prenatal vitamins.
A woman’s health before conception and during pregnancy is very important factor to determine outcome of pregnancy. It is necessary for women to keep any preexisting medical conditions under control before and during pregnancy.
Prenatal genetic testing: Many families have a history of genetic disorders .These families may require further information about how this condition could affect pregnancy and the baby. Genetic testing may also be offered to couples without a family history of genetic disorders who have other risk factors. Discussing these with your doctor is important.
Several tests can be done pre pregnancy todetermine the risk of baby, having a geneticdisorder, such as Down syndrome, cystic fibrosisor a neural tube disorder. Tests can also be doneduring pregnancy to detect these disorders.
Options include:
• Chorionic villus sampling (CVS) – Between 11and 13 weeks, a sample of tissue is taken fromthe placenta and tested.
• First trimester screening – At 11-13 weeks, thepregnancy is evaluated with an ultrasound andblood test
• Amniocentesis – At 15-20 weeks, a small sampleof amniotic fluid(fluid that surrounds thebaby) is collected and tested.
• Quadscreen – Between 16 and 18 weeks, bloodis taken and tested.
If any of these tests show that you may be a high-risk patient, your obstetrician will refer you to Fetal medicine specialists for more invasive tests.
Lifestyle modification it is important to change your life style:
•Stop smoking and drinking
•Increase physical activity
•Reduce weight
•Take prenatal vitamins
Who are involved in care of a high-risk obstetrics program?
• Physicians specializing in maternal-fetal medicine
• Ultrasound unit
• Nutritionists
• Pediatric surgeons and cardiologists
• Neonatologists
• Geneticists
What should you expect with a high-risk pregnancy?
•Multiple visits to the doctor.
•Frequent monitoring of baby’s health.
•Diagnostic testing, if required
•Possible hospitalization during pregnancy.
•Frequent ultrasounds.
•Possible visits to other specialized doctors based on your condition.
What are included in Management of High-Risk Pregnancy?
The incidence of high-risk pregnancy is very common and increasing. Each pregnancy is unique and also its prenatal care. Your ob-gyn for high-risk pregnancy will carefully monitor your health. Based on your health conditions, they indicate certain tests or screenings. These include:
- Targeted ultrasound: A targeted ultrasound is same as a regular ultrasound except that it targets to screen abnormalitiesin the baby. This ultrasound is important if the fetus shows signs of deformities.
- Prenatal cell-free DNA screening: It is a type of DNA test that helps to see the presence of chromosomal abnormalities in the fetus.
- Biophysical profile: Along with targeted ultrasound, the doctor may do a nonstress test to examine the heart rate of your baby. This test is done to complete health profile of the fetus.
- Lab tests: Lab tests such as urine tests and blood tests helpsto identifyif the fetus has caught any infections like UTI, HIV or more.
- Measuring the cervix length: Your gynaecologist may also ask you to undergo an ultrasound to measure the cervical length of the baby. This scan helps to determine if you are prone for preterm delivery or not.
What Is the High-Risk Pregnancy Treatment?
High-risk pregnancy treatment varies in each case. The type of treatment offered depends upon the disease type, its effect on the baby, the patients health condition and more. Most of the complications can be treated effectively if the condition is detected in the early stages. Hence it is more important to have regular prenatal care.
When to Seek Immediate Medical Care for a High-Risk Pregnancy?
High risk pregnancy is a crucial time for expecting parents. You should take extra precautions and look out for any problems. You should consult your healthcare provider in case you have:
•Vaginal bleeding
•Pain during urination
•Vomiting or nausea
•Blurring of vision
•Pain in lower abdomen
•White discharge in excess
•Fever or chills and rigor
•Selfharm thoughts
•Sudden swelling in hands and face
Be aware of your risk factors, meet your health care provider early and have healthy, happy pregnancy.
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