HIGH RISK PREGNANCY

Article written by
Dr Rahul Sen
DGO, MRCOG (Lond.), MRCP (Ireland),
Consultant Gynaecologist & Obstetrician

Q1) What is high risk pregnancy?

A pregnancy when associated with potential complications that could affect the mother, the baby, or both is called high risk pregnancy. High-risk pregnancies require management by a specialist best outcome for the mother and baby.

Q2) What are the risk factors for High-Risk Pregnancy?

Age Of The Mother – Women under the age of 17yrs or over 35yrs are at greater risk of complications. The risk of miscarriage and genetic defects further increases after they cross 40.

Existing Medical Problems Before Pregnancy – Conditions such as high blood pressure; lung, kidney, or Heart problems;diabetes; autoimmune disease; sexually transmitted diseases (STDs); or chronic infections such as human immunodeficiency virus (HIV) can invite risks for the mother and/or her unborn baby. Previous miscarriage, problems with a previous pregnancy or pregnancies, or a family history of genetic disorders are also risk factors for a high-risk pregnancy. If one has a medical condition, it’s important that she consults a gynecologist before planning to conceive. The consultant may run tests, adjust medications, or advise her of precautions she needs to take.

Medical Problems During Pregnancy – Even if one conceives healthy, it is possible to develop or be diagnosed with problems during pregnancy. Common pregnancy-related problems are:

• Preeclampsia includes high blood pressure, urinary protein, and swelling; it can be dangerous or even fatal for the mother or baby if not treated. With proper management, however, most women who develop preeclampsia have healthy babies if treated properly.
• Gestational diabetes develops during pregnancy. Usually the diabetes resolves after delivery. However women with gestational diabetes are at increased risk of developing type 2 diabetes. But with proper treatment healthy babies are born.

Q3) When do we identify a Pregnancy to be a High Risk Pregnancy?

Often a pregnancy is classified as high risk because of issues that arise from the pregnancy itself and that have nothing much to do with the mother’s health. These include:

• Premature Labor is labor that begins before 37 weeks of pregnancy and may be termed as premature labor. There are factors that place women at higher risk, such as certain infections, a shortened cervix, or previous preterm birth.
• Multiple Births means they are carrying more than one baby (twins, triplets, quadruplets, etc.). Multiple pregnancies, increase the risk of premature labor, gestational diabetes, and pregnancy-induced high blood pressure.
• Fetal Problems – Approximately 2% to 3% of all babies have a minor or major structural problem in development but these problems are completely unexpected.

Q4) Preventing and Treating Pregnancy Complications:
Even if a mother does not have an existing health problem, many consultants recommend a preconception appointment before she becomes pregnant. At this appointment her doctor may recommend steps that take to reduce the risk of certain problems. These include:

• Getting the right dose of folic acid daily beginning before and continuing through pregnancy
• Getting proper immunizations
• Eating a healthy diet and maintaining proper weight
• Getting regular physical activity as per recruitment
• Avoiding cigarettes, alcohol, and drugs (except for medications approved by the doctor)
• Regular doctor consultations and necessary investigations.

High Risk Pregnancy can be managed with a favorable outcome if few principles are followed:

1. Follow doctors advice tip to toe.
2. Stay alert for any kind of warning symptoms.
3. Be prepared to handle any kind of medical emergency anytime.