Things About High-Risk Pregnancy

Hi!

I am Dr. Bandita Sinha, I am the director of World of Women Clinic. I am a consultant gynaecologist and fertility specialist. Today we will discuss high-risk pregnancies. What is high-risk pregnancy and what are the complications which can create a high-risk pregnancy and how to identify high-risk pregnancy and prevent it? High-risk pregnancy is a condition where the pregnancy is complicated with certain factors which can create maternal and foetal health problem. So, a normal pregnancy which is associated with certain other kinds of health disorder can be considered under high risk pregnancy. There are certain conditions which are detected when the lady is pregnant i.e they are pregnancy induced condition. Even the lady is healthy there goes so there are chances the pregnancy can lead to certain kind of complications which is considered as high-risk cases. The high-risk cases are usually treated as a team wherein the gynaecologist and the obstetrician, the paediatrician, neonatologist and the physician in other specialities can together work to treat that pregnancy.

What are the maternal conditions or the conditions related to the pregnancy which can lead to high-risk cases? Like preterm labor. Preterm labor is any labor pain which starts before 37 weeks. Here the health of the mother has no implication on the initiation of the labor pain. The labor can start on its own, there can be the infection, there can be short cervix or sometimes because of multi-foetal gestation there is a risk of preterm labor. Preterm labor is considered as a high-risk pregnancy. It should be dealt with a team of doctors and in a special multi-speciality hospital which has a neonatal unit where we can handle the preterm baby. Second factor is there are multi foetal gestations like twin pregnancy, triplet pregnancy or multi-foetal pregnancies so there the chances of preterm labor are very high. The other factors are also there which can complicate the pregnancy.

So, multi-foetal pregnancy is also considered to be a high-risk case. There are certain patients who develop pregnancy induced hypertension. The patient was not hypertensive before she is pregnant but now due to the pregnancy condition, there is a occur increase in the blood pressure. So, increase in blood pressure along with the urine protein and swelling together we call it a syndrome which is known as preeclampsia. If these patients are diagnosed in proper time and treated in proper time so we can manage the patients very well and they can have a healthy delivery and the baby. But sometimes they are not identified and if it is not treated properly, they can be life-threatening to the mother as well as the growing baby. Then there is a gestational diabetes which is known as diabetes during pregnancy. The lady was nondiabetic beforehand and then now after the pregnancy maybe after 24 weeks or 28 weeks the sugar level goes high and they are diagnosed as a gestational diabetic patients. They are the high-risk patients which can have lot many complications if they are not treated properly, they should be under proper diet plan, we give certain medications to reduce the sugar level and at the time of delivery the sugar levels are very high then maybe insulin is required for these patients.

Babies also have certain complications of gestational diabetic patients, so it is very important to identify these mothers during the certain test in the early pregnancy and treat them adequately so at the end of the pregnancy the mother delivers a healthy child and also the mother's health is under control. Gestational diabetes patients usually come back to normal conditions after pregnancy but there are few patients who have a tendency to cut have developed type 2 diabetes after the delivery. So, if there is a strong family history of diabetes, gestational diabetic patients may become type 2 diabetics. Then the maternal age. Nowadays, there is more pregnancy happening in the 30s and sometimes we have seen patients above 35 years. So, the age of 35 years plus or the teenage pregnancy both comes under high risk pregnancy because there are a lot of medical conditions which starts happening after 35 years. These are the patients who are prone to develop hypertension, gestational diabetes and other genetic disorders related to foetal malformation or repeated miscarriages.

These patients require special attention and they are considered under high-risk pregnancies. There are a certain group of patients who have autoimmune disorders, history of previous miscarriages, history of previous birth defects so and STDs, HIV infections; all are considered under the high-risk group. There are certain diseases like lung disorder, previously detected cardiac problem, there are other health issues which are prevailing in the mother before the pregnancy and when these pregnant patients enter into pregnancy, they all come under a high-risk group, so as to treat them special and get a healthy baby. To what is the implication of high-risk pregnancy on the mother and the baby? These patients require additional attention, specialized treatment, they need to go for certain investigations which are more than the normal pregnancy, they have to go ahead with many sonographies to find out the health of the baby and if there is a risk like diabetes and hypertension, we keep the patients on certain diet which has also a very important role to control the conditions.

These patients should be managed very early right from the beginning we should counsel the patients that her medical conditions can cause the problem in the growing foetus and her health can also be involved; so, they should take proper care and should be under proper medication and routine follow up. So the once these cases are identified, we do the proper investigations, we do all the tests related to the mother and the baby and if taken care as a team I think they will have a healthy outcome and the mode of delivery does not means that C-section has to be done but then yes if the high-risk pregnancy is there, there are chances of more C-section than normal delivery is but yes if it is taken care of well and the patient is managed properly, the mother and baby both are healthy to chances of normal delivery is also there.

Thanks