Is your pregnancy high risk?

A high risk pregnancy
is one in which some condition puts the mother, the developing fetus, or both
at higher-than-normal risk for complications during or after the pregnancy and
childbirth. Some pregnancies are  high
risk from the beginning for instance, if the mother has a heart problem. Some
pregnancies become high risk later on, for eg if the mother develops Pregnancy
related hypertension or diabetes.

Who is likely to have a
high-risk pregnancy?

You are at risk if you:

●    
Smoke – 
Cigarettes contain dangerous chemicals, including nicotine, carbon
monoxide, and tar.  Nicotine causes blood
vessels to narrow, so less oxygen and
fewer nutrients reach the fetus. It
can also  pass from a pregnant woman to
her fetus and  damage a fetus’s brain and
lungs. This damage is permanent .The baby is likely to be premature or growth
retarded, have severe abdominal colic and is at an increased risk of sudden infant death syndrome (SIDS).

●    
Drink Alcohol – Alcohol can interfere with the
normal growth of a fetus and cause birth
defects
. When a woman drinks during pregnancy, her fetus can develop
physical, intellectual, behavioral, and learning disabilities that can last a
lifetime.

●    
Are overweight: Obesity during pregnancy puts
you at risk for several serious health problems such as  Gestational
diabetes , Preeclampsia,  Sleep apnea ,
it
also puts the baby at risk for the following problems: Macrosomia (very large baby ), Preterm
birth and Stillbirth.

Certain pre-existing
medical conditions also increase your risk, most importantly

●    
High blood pressure- many medicines used for
B.P control are contraindicated or best avoided during pregnancy. The patient
has to be started on a safe medicine before planning pregnancy. This is  apart from the additional risks to the
pregnant mother and baby such as super-imposed pre-ecclampsia , growth retarded
fetus, etc.

●    
Pregestational diabetes , that is diabetes
existing prior to pregnancy ,if not under adequate control, may be associated
with an increased health risk to both mother and baby.

●    
Seizures – Prepregnancy assessment and advice
is essential for a woman planning a pregnancy

See a more complete
list here.

Measures to prevent
high risk pregnancy

  1. Raise awareness
  2. Pre Conception
    counselling and management
  3. Regular antenatal
    care for early  pick up of
    complications
  4. Delivery of such
    patients in a specialised centre .
  5. Good
    monitoring after delivery to avoid maternal complications

What should you expect
in a high risk pregnancy?

If you fall into a high
risk category, your gynaecologist may call you for  a check up more frequently.

You  may need to undergo

●    
Frequent Ultrasonographies

●    
Visits to other specialists like endocrinologist
or cardiologist for any problem, if present.

●    
Fetal monitoring during pregnancy and labor
with  special investigations including
CTG.     The fetus  is monitored continuously when the mother is
in late pregnancy or in  labour by
Electronic fetal monitoring (EFM) orcardiotocography [ CTG ] This technique
records changes in the fetal heart rate (FHR) in response to fetal movements or
uterine contractions via Doppler ultrasound. It is a fairly reliable screening
test to indicate a normal condition of the fetus; if the FHR and pattern are
normal, it is virtually certain that the fetus is not suffering from distress.

●    
Talk to your doctor about where he or she would
like you to give birth. Your doctor may want you to have your baby in a
hospital that offers special care for women and babies who are at risk for
problems developing during labour and delivery.

●    
If your doctor thinks that the continuation of
your pregnancy  may put either your
health or your baby’s health at risk, you may need to have the baby early

Such high risk pregnant
women need specialised care throughout their pregnancy from pre conception to
delivery ; from both their doctors as well as 
their families. During labor they should be taken care of by a dedicated
team in a specialised hospital which is equipped with all modern facilities
including state of the art  neonatal (
NICU) and adult ICUs.

So, High risk
pregnancy  is not a single disease. It
includes a group of disorders with varying modalities of treatment. The most
important aspect is to know whether you or your loved one falls in that group.
If you do, you need to follow every 
advice of the doctor very carefully, so that in the end, we get a
healthy mother and a healthy baby.

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