High risk pregnancy

Medically speaking, pregnancies could be either straightforward, or low risk, that need routine antenatal care, or sometimes High risk. High Risk is a term used not to scare the parents, but just to explain that high risk pregnancies are the ones that need more care and monitoring.

  • Extra antenatal visits to monitor more closely
  • Referral to a specialist in maternal-fetal medicine, genetics, pediatrics or other areas
  • Various tests, Ultrasounds, or procedures in addition to routine prenatal screening tests
  • Tertiary care hospital that offers special care and facilities like level 3 nursery, ICU,

Most women who have high risk pregnancies go on to deliver successfully and have healthy children.

What is a high risk pregnancy?

A mother could have a high risk pregnancy , if

  • Her age is under 17 or over 35
  • She has 5 or more children
  • She has become pregnanct again within 3 months of her delivery
  • Lifestyle choices: Smoking, alcohol, illegal drugs
  • If a woman has an underlying conditions like obesity, diabetes, high blood pressure, epilepsy, anemia, infection, underlying renal, mental health condition, cancer, heart disease, lupus, rheumatoid arthritis, inflammatory bowel disease, or an auto-immune disorder
  • If she has had a previous surgery on the uterus like C-section, Fibroid removal
  • She is carrying Twin or multiple Pregnancies
  • If the parents have a personal or family history of birth defects
  • If she has a personal or family history of uterine or placental abnormalities
  • If there were complications with prior pregnancies
  • There are fetal growth issues or abnormalities
  • If she suffered recurrent miscarriages or pregnancy loss
  • If she had a prior preterm delivery before 37 weeks gestation

A low risk pregnancy could turn into high risk at any time, if the mother develops complications like

  • Problems with the uterus, cervix or placenta
  • Severe morning sickness (hyperemesis gravidarum)
  • Rh (rhesus) sensitization
  • Preterm labor
  • Hypertension in pregnancy
  • Placental abruption
  • Gestational diabetes
  • Cervical incompetence
  • Placenta previa
  • Intrauterine growth restriction (IUGR)/FGR
  • Polyhydramnios/oligohydramnios
  • Overdue pregnancy

What steps can parents take as precautions to prevent/manage a high risk pregnancy?

  • Schedule a preconception appointment- Meet your gynecologist when planning pregnancy.
  • Be cautious when using assisted reproductive technology (ART) or IVF
  • Seek regular prenatal or antenatal care, dont miss your regular pregnancy checks
  • Eat a healthy diet
  • Gain weight wisely
  • Avoid risky substances
  • Stay away from people who have colds and other infections

What warning signs should I be careful of?

You should report to your doctor in case of

  • Vaginal bleeding
  • Fever, loose motions, persistent vomiting
  • Pain or burning with urination
  • Pain or cramping or pelvic pressure in the lower abdomen.
  • Watery vaginal discharge : in a gush or a trickle
  • Regular or frequent contractions — a tightening sensation in the abdomen
  • Baby has stopped moving or is moving much less than normal.
  • Changes in vision, including blurred vision
  • Sudden swelling of your face, hands, or feet
  • Persistent headaches

Dr. Astha Dayal one of the most experienced Gynecologist and Obstetrician in Gurgaon Haryana specialised in Management & Treatment of High Risk Pregnancies

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