High Risk Obstetrics
Pregnancy is an exciting time for any women, but complications may develop sometimes even in healthy women. Most pregnancy complications can easily be detected and prevented with routine prenatal care. There are many health issues that can create a risk to you and your baby. A pregnancy that has no maternal or foetal complications is considered to be a low risk pregnancy.
A pregnancy is said to be high risk pregnancy if mother have certain medical conditions or other factors that threaten the development of foetus and/or increases the risk of complications for mother. The factors that may put the mother at a high risk of complications during or after the pregnancy include:
- Age– less than 15 or more than 35 years
- Weight– weight under 100 lb before pregnancy or overweight
- Height– under five feet
- Difficult pregnancies in the past
- Chronic medical conditions such as diabetes, high blood pressure
- Family history of genetic conditions
- Rh incompatibility
- Multiple foetuses
- More than five previous pregnancies
- Quick labours in the previous pregnancies
- Prenatal tests indicating that the baby has a serious health problem
In addition to above factors, women who have had difficult pregnancies in the past may have similar problem in future pregnancies. If you have any of these risk factors a pre-pregnancy visit to your doctor is essential. Women with a high-risk pregnancy should be under care of a perinatologist, an obstetrician specialized in the care of high-risk pregnancies. Your doctor may refer you to a perinatal care centre in which a woman with a high-risk pregnancy is managed with specialized attention. In these centres obstetricians and a newborn intensive care unit work together to render best care for you and your baby.
Various medical conditions that may complicate the pregnancy include systemic lupus erythematosus, kidney problems, heart disease, sickle cell anaemia, thyroid abnormalities and clotting disorders. If you are suffering with kidney disease or lupus your ability to supply oxygen and nutrients to the baby through the placenta is affected. In women with these diseases, the babies may not be able to grow and gain appropriate weight and also have an increased risk of stillbirth.
Diabetes can lead to miscarriages, birth defects, and stillbirths. Continuous monitoring and maintaining blood sugar levels under control levels minimises the complications. High blood pressure in late pregnancy may show a serious threat to the mother and the baby and hence need to be treated appropriately.
Medical conditions such as asthma, epilepsy and ulcerative colitis normally do not interfere with pregnancy, but may be worsened by pregnancy, and therefore need to be monitored throughout pregnancy. Your doctor may perform an ultrasound every few weeks to see the baby's growth and health.
Women with structural defects such as a double uterus or a weak cervix may have higher risk of miscarriages. Therefore your doctor may order diagnostic surgery, ultrasound scans, or x-rays before pregnancy to reveal the cause. Non cancerous growths in the uterus that are more common in older women can increase the risk of miscarriage, preterm labour, difficulties during labour, unnatural presentation of the foetus and abnormal position of the placenta.
General risk factors that may affect your pregnancy include exposure to substances such as radiation, chemicals, drugs, or infections, smoking and alcohol. Preterm (early) labour is another major concern in women with high risk pregnancy. Preterm labour may be caused by past uterine surgery, bleeding, stress, structural defects, a multiple pregnancy, pneumonia, kidney infection, and appendicitis. To prevent preterm labour your baby is monitored with electronic heart monitoring and ultrasound scanning.
With frequent visits to doctor, women with high risk pregnancy can enjoy a healthy and successful pregnancy. Having quality prenatal care is necessary to minimise the risks to both you and your baby.