2.58 CME

Approach to high risk pregnancy

Conférencier: Dr. Seeru Garg

Consultant Obstetrician and Gynecologist Advanced Care in Women’s Health, Mumbai, Maharashtra

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Description

Pneumothorax can occur in a variety of settings, including chronic obstructive pulmonary disease (COPD) with emphysema or after a biopsy for malignancy suspicion. In any event, it is a hazardous scenario that necessitates prompt attention and treatment. Pneumothorax is classified as either primary or secondary. Staging of pneumothorax is also critical. In our current editorial, we describe the causes and treatments of pneumothorax from a panel of pulmonary physicians, oncologists, and thoracic surgeons.

Résumé

  • Dr. Cugar, an obstetrician and gynecologist specializing in high-risk pregnancies, discussed the complexities and challenges of managing such cases. She highlighted her experience running a high-risk pregnancy clinic for several years and her affiliations with prominent hospitals in Mumbai.
  • A high-risk pregnancy threatens the health and life of the mother, fetus, or both, and necessitates specialized care, follow-up, and management. Factors contributing to high-risk pregnancies include medical conditions like hypertension, diabetes, thyroid disorders, heart disease, and kidney diseases.
  • Events during the present pregnancy, such as fetal growth restriction, threatened preterm labor, and antepartum hemorrhage also elevate the risk. Surgical disorders like fibroid uterus and previous myomectomy further complicate pregnancies.
  • Challenges in managing high-risk pregnancies are growing due to obesity, PCOS, advanced maternal age, and pregnancies achieved through artificial reproductive techniques. Past obstetric outcomes, like recurrent pregnancy loss and previous preterm deliveries, also increase risk.
  • Specific conditions like gestational hypertension, diabetes mellitus, heart disease, and obesity pose unique risks to both mother and fetus. Proper management requires a multidisciplinary team approach, including dietitians, endocrinologists, cardiologists, and neonatologists.
  • Multiple pregnancies, extremes of age, renal diseases, and infections during pregnancy all present additional challenges. Special situations, such as pregnancy after renal transplant, necessitate a multidisciplinary team approach.
  • High-risk pregnancy clinics offer education, surveillance, and management through genetic counseling, prenatal screening, advanced ultrasounds, and fetal therapy. Comprehensive antenatal, intranatal, and postpartum management, along with neonatal care, are essential components.
  • Multidisciplinary team meetings, involving various specialists, are crucial for collaborative decision-making and patient counseling. Frequent monitoring, specialized investigations, and tailored management strategies differentiate high-risk pregnancies from normal pregnancies.

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