Having a baby is a very natural and fulfilling experience for a woman.But all pregnancies are not very smooth. Some have complications with mother,baby or both and are referred to as “high risk pregnancies” ( 5-10%).They require management by qualified specialists at a well quipped hospital for a safe delivery.Can be grouped as-
• Pre existing factors
• Pregnancy specific factors
• Factors aggravated by pregnancy
• Age risk- teenage mothers or mothers over 35 years
•Medical conditions-Mothers with high BP,cardiac disease,diabetes,kidney problem, autoimmune disease,anemia,hormonal disorder, obesity, epilepsy, infections etc can develop complications
• Smoking,alcohol or drug use
• Preeclampsia– It is a multi organ syndrome in which mother can suddenly develop high BP,urinary protein and swelling of body. It is very dangerous and needs admission and institutional delivery for optimal results.
• Gestational diabetes is derangement of blood sugar in pregnancy and usually resolves after delivery
• Miscellaneous- multiple pregnancy,preterm labour,previous LSCS,placenta previa,bad obstretic history,IUGR,Rh negative, previous baby with genetic disorder etc
How to deal with High Risk Pregnancy?
• Preconceptional counselling – Meeting your doctor before becoming pregnant is essential to detect and treat certain disorders.Your doctor will take proper history,physical examination and conduct certain tests.Many problems like high BP,deranged sugars,anaemia,infections,thyroid problem can be diagnosed and treated.Rubella status can be known.Folic acid supplements are started to prevent many nervous system disorders in the fetus. Dietary counselling for proper nutritional and weight management. Genetic counseling if needed.
• Regular antenatal care– we have now come a long way in advanced care of pregnant woman and many complications can be avoided with regular care.Take all medicines regularly,do not miss your appointment with the doctor.All tests should be done on time because certain tests are done according to gestational age of fetus.Report any unusual and alarming symptom to the doctor.
• Eat healthy
• Avoid unnecessary weight gain
• Anomaly scan- Imaging technique which uses sound waves to detect any structural anomaly in fetus
• Amniocentesis-Sample of amniotic fluid is taken from the uterus after 16 weeks to detect genetic defects in baby
• CVS-Between 10-12 weeks cells from placenta are taken to identify genetic disorders
• Cordocentesis-Umbilical blood sampling after 18 weeks to look for fetal diseases
• Biophysical profile
• Non stress test
Conclusion is that though high risk pregnancy is scary for both the family and the doctor,with multidisciplinary approach (obstetrician,neonatologist,fetal medicine consultant,psychologist) ,holistic and individualized treatment good results are achievable.