Description
High-risk pregnancies are the result of a medical condition present before pregnancy. In High-risk pregnancies the baby might be at increased risk of health problems before, during or after delivery. Some of the specific factors that might contribute to a high-risk pregnancy. Upcoming webinar with Dr. Uma Vaidyanathan, Senior Consultant, Obstetrics and Gynecology will be an exclusive case-based session on high-risk pregnancies with detailed evaluation and management of increased health risks for the pregnant person and unborn baby.
Résumé
- High-risk pregnancy threatens the health and life of the mother and/or fetus, necessitating specialized care, follow-up, and management. Various factors categorize pregnancies as high-risk, including pre-existing medical conditions like hypertension, diabetes, thyroid disorders, heart disease, liver and kidney diseases. Events during the pregnancy like fetal growth restriction, pre-term labor, hemorrhage, or surgical complications such as fibroids, prior myomectomy or cesarian section further elevate risk.
- Challenges in managing high-risk pregnancies include obesity, PCOS, advanced maternal age, and pregnancies achieved through artificial reproductive techniques, along with the higher incidence of multiple pregnancies. Past obstetric outcomes, like recurrent pregnancy loss, prior pre-term delivery, or previous stillbirth, mandate careful monitoring of subsequent pregnancies.
- Recurrent pregnancy loss can stem from anatomical abnormalities, thrombophilia, hormonal imbalances, or chromosomal abnormalities. Pre-term delivery may result from infections, cervical issues, or multiple pregnancies, requiring early diagnosis and management. Hypertension during pregnancy can manifest as gestational hypertension, preeclampsia, or eclampsia, necessitating monitoring of weight gain, blood pressure, and urine protein levels.
- Diabetes mellitus poses risks like macrosomic babies, neural tube defects, and birth trauma. Management involves a multidisciplinary team, dietary adjustments, and potential medication. Heart disease in pregnancy necessitates close supervision due to the risk of heart failure, demanding collaboration among specialists.
- Obesity introduces risks of miscarriage, thromboembolism, gestational diabetes, and cesarean section complications, requiring dietary and exercise interventions. Accurate BMI calculation using Asian-specific parameters is crucial. Appropriate weight gain guidelines are different for normal weight, overweight, and obese women, with recommendations for limited weight gain during pregnancy.
- Multiple pregnancies increase the risk of abortions, anemia, pre-term labor, placenta previa, and complications like twin-to-twin transfusion syndrome and twin reverse arterial perfusion syndrome. Special situations like pregnancy after renal transplant warrant a multidisciplinary approach. High-risk pregnancy clinics offer education, surveillance, and comprehensive management of at-risk pregnancies.
- Effective management hinges on a multidisciplinary team involving obstetricians, pediatricians, neonatologists, radiologists, physicians, and various specialists. Monitoring includes frequent visits, blood tests, ultrasounds, and fetal monitoring. High-risk pregnancies differ from normal pregnancies in requiring more frequent visits, close monitoring, specialized investigations, and management of underlying medical conditions.
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