Pregnancy is a social and medical event. Having an uncomplicated pregnancy and delivery of a healthy uncompromised child is the dream of every pregnant lady, her family and the obstetrician. However an increasing number of pregnancies (5-10%) are have factors which highlight an increase in the risk of pregnancy to the mother &/ or child. This type of pregnancy is labelled as ‘High Risk Pregnancy’. Late marriage, lifestyles diseases (obesity, diabetes, hypertension), unhealthy diets and habits etc are contributing to this trend.
Prevention tips to avoid High Risk Pregnancy:
The best policy would be to encourage Pre-conceptional counselling to pick up and take preventive steps. Testing for blood group, Rubella status, PAP Smear, Anemia, High BP, Thyroid Disease, Diabetes etc can be done and Pre- natal supplements can be given besides evaluating risk factor well in time.
Ideally all deliveries should take place in well equipped centres with qualified doctors. High risk Pregnancy must be delivered in a dedicated High Risk mother and child care unit to prevent (if possible) and treat complications. High risk factors have to be evaluated are numerous, to mention some important ones –
Family History – Diabetes, High BP, twins, Child with birth effects/ Mental retardation, Thalassemia etc.
Personal History – Smoking, Alcohol, Drugs, profession.
Age < 18 yrs, > 35 yrs (esp > 40 yrs)
Pre existing Diseases – High BP, Diabetes, Thyroid Disease, Heart Disease, Asthma, Epilepsy.
Obstetric History – History of complications in previous pregnancy, Abort/Ectopic, abnormal child, Caeserian Section etc.
Present Pregnancy – IVF Pregnancy, Twin Pregnancy, H/O Bleeding / Fever, Placenta low lying, abnormal child, genetic test report, sudden rise of BP, Blood sugars, Liver enzymes suddenly become a high risk pregnancy.
Carry home message is to encourage pre-natal and good quality pregnancy care and delivery of a high risk pregnancy in specialized units for better outcomes for the mother and the child.