A high-risk pregnancy is one that threatens the life of the mother or her fetus. For most women, early and regular prenatal care promotes a healthy pregnancy and delivery without any complications. But some women are at increased risk for complications even before they get pregnant for a variety of reasons. Pregnancy including labour and delivery itself is a high-risk event. If treatment is started in time, it is possible to save the life of both mother and baby. Research highlights that at least 2 in 10 women suffer from High-Risk Pregnancy issues. These are due to age, pre existing health conditions, pregnancy induced health issues, earlier miscarriages, infertility aspects, to list a few. It is important for each pregnant mother to be informed about her health and her baby’s health. Preparation and knowledge about the risk also help prepare them for the choice of delivery.
Social- Low income group, inadequate financial resources for food.
Physical- Age at delivery- <19 years, more than 36 years, elderly prime age, short stature (<145 cms), weight- less than 40 or more than 80 kgs.
Problems related to previous pregnancies– Low birth weight (LBW) baby, overweight baby, birth defects, cesarean section, still birth, RH incompatibility, miscarriage, post-term pregnancy.
Problems during pregnancy– drugs, radiation, infection, chemicals and pregnancy complications.
Medical factors– Anaemia, diabetes, heart disease, PIH, Eclampsia.
Other factors– APH, PPH, Grand multi para, multiple pregnancies, abnormal presentation, polyhydramnios, previous caesarean, retained placenta, prolonged labour, recurrent abortion, ectopic pregnancy.
Numbers against High-Risk Pregnancy :
Maternal mortality is 10 in 1 lakh pregnant women in India, making it a major issue. The leading causes of maternal mortality are Haemorrhage, Hypertension, Infection, Pre-Eclampsia.
High-risk cases according to WHO are those that include any of the given features in pregnancy:
Elderly grand multipara
Twins and hydramnios
Previous still birth, IUD, manual removal of placenta
History of previous c-section and instrumental delivery.
Pregnancy associated with medical diseases
Management of Labour for High-Risk Pregnancy:
In some high-risk cases, elective c-section is done. Some cases need induction of labour after 37-38 weeks of gestation. Those cases who go into labour spontaneously or after induction needs close monitoring during labour.
It is necessary that all expectant mothers are cared by the obstetric service of a particular area.
ANM and health workers should be given primary care and screening in rural and urban and semi-urban areas.
Cases with significant high risk should be referred to specialised referral centres.
Proper training of residents, nursing personal and community health workers.
Seminars and refresher courses should be arranged for the health workers.
Improvement of economic status, literacy and health awareness of the community.
If you can opt for the best hospital that is equipped with a High-Risk Pregnancy Expert and a NICU.