HIGH RISK PREGNANCY MANAGEMENT
Ensuring that your pregnancy completes a full-term, and you deliver a healthy baby, is the cornerstone of our aim at Wif Hospital. High risk pregnancy cases, which can cause complications during pregnancy, or during childbirth, require a very different kind of care, which our specialists are trained to diagnose and treat.
A critical part of managing high-risk pregnancies can ascertain the cause, or the risk factors that can cause complication. High-risk pregnancy factors can broadly be split into four different categories. This include:
- Maternal age
- Lifestyle choices
- Pregnancy conditions
- Medical history
Letâ€™s look at each of these in some detail:
1) Maternal Age: One of the common risk factors that can cause complications during your pregnancy is your age. Woman who are over the age of 35, when their baby is due, are at a greater risk of complications. These complications can include having a caesarian delivery, prolonged labour, labour that does not advance or an infant who may suffer from a genetic disorder. Other delivery complications, like excessive bleeding during labour, may also be faced.
2) Lifestyle Choices: Lifestyle choices like drinking alcohol or cigarette smoking can adversely affect your pregnancy. The former, when consumed, passes directly to the fetus, through the umbilical cord. Studies suggest that women who drink during pregnancy are more likely to suffer from a miscarriage, or in extreme cases, a stillbirth.
Other risks of alcohol consumption during this period include a greater chance of congenital disabilities or Fetal Alcohol Spectrum Disorder. The latter is a term used to describe a category of fetal disorders that can be caused by alcohol consumption. These disorders can include abnormal facial features, height problems, low body weight, hyperactivity disorder, intellectual disabilities or vision and hearing problems.
Cigarette smoking during pregnancy can put your baby at risk for preterm birth, birth defects and sudden infant death syndrome (SIDS). Secondhand smoke can also be dangerous for you and your baby, and can put you at an increased risk for health problems.
3) Pregnancy Conditions: The state of your pregnancy can also increase the risk faced.
Multiple Gestation: In circumstances where multiple gestation occurs, i.e. a pregnancy with twins, triplets, or more, can increase the risk of your babies being born prematurely. Having three or more infants can increase your chances of needing a cesarian section. Twins or triplets are also more likely to be smaller in size when compared to babies born from a singleton birth. Your babies may also have more difficulty in breathing.
Gestational Diabetes: Also known as diabetes during pregnancy, this complication, if not adequately controlled, increases the risk of preterm labour and delivery and high blood pressure.
Preeclampsia: Your pregnancy can also result in you facing a sudden increase in blood pressure, after the 20th week of your pregnancy. A syndrome, known as Preeclampsia, this medical condition can affect your kidneys, liver or brain. If this is left untreated, this condition can cause long-term health problems, or even prove fatal to the health of both you and your baby. A severe form of preeclampsia called Eclampsia, is also a risk, as this syndrome results in you suffering from seizures or even going into a coma.
4) Medical History: Your pregnancy can also be affected by some pre-existing health conditions. These can include:
High Blood Pressure â€“ Uncontrolled blood pressure can result in damage to your kidneys, or increase the risk for a low birth weight.
Polycystic Ovary Syndrome (PCOS) â€“ This disorder can interfere with your ability to get pregnant, or to have a full-term pregnancy. PCOS can also increase your chance of suffering from a miscarriage, and increase the likelihood of premature delivery, preeclampsia or gestational diabetes.
Diabetes â€“ High blood sugar levels when you are pregnant can cause birth defects in your baby during the first few weeks of your pregnancy.
Kidney Disease â€“ You may find it tough to conceive if you are suffering from a kidney disease. Your pregnancy also faces a significant risk of miscarriage.
Autoimmune Disease â€“ Certain autoimmune diseases, like Lupus, can increase the risk of preterm birth or even stillbirth. The treatment that you may be undergoing to tackle this can also be harmful to your baby, making it essential to check with your doctor while planning your pregnancy.
Thyroid Disease â€“ An uncontrolled Thyroid disease, such as an overactive or an underactive thyroid, can cause problems for your baby, like heart failure, poor weight gain or other birth defects.
Obesity â€“ Excess weight can make your pregnancy more difficult, and also increase your chances of developing diabetes during pregnancy. Excessive weight can also result in a difficult birth. Being underweight can also be a treat, both for you and your baby.
Understanding the risk factors that can cause a high risk pregnancy is only the first step towards ensuring a healthy delivery. Our experts merge expertise, experience and the latest technology to diagnose and treat. Book an appointment with one of our specialists today!
High risk pregnancies can be diagnosed in a number of ways by a medical practitioner. The below tests will help in the identification of high risk pregnancy, and will be prescribed by your doctor depending on your condition or symptoms.
1) Amniocentesis â€“ During this test, a sample of the amniotic fluid, which surrounds your baby, is harmlessly extracted for tests. Typically conducted after the 15th week of your pregnancy, as part of high risk pregnancy diagnosis, to test for genetic conditions like neural tube defects, or brain and spinal cord abnormalities.
2) Cordocentesis â€“ Typically conducted after the 18th week of pregnancy, this test is able to identify certain fetial chromosomal abnormalities, blood conditions and viral or bacterial infections.
3) Ultrasounds â€“ A number of ultrasounds are used for high risk pregnancy diagnosis. These include targeted ultrasounds, which can construct an image of your child in the womb, and target a suspected issue, like an abnormal fetal development.
4) Chorionic Villus Sampling â€“ This test is typically suggested to test abnormalities, in the event that your doctor suspects a fetal genetic conditions. Conducted between the 10th and 12th week of your pregnancy, the cells of the placenta are harmlessly removed and tested.
5) Laboratory Tests â€“ In case you have had a history of pre-term labour, your doctor may suggest that a sample of your vaginal fluid be tested for fetal fibronectin. This is a glue-like substance that helps connect the fetal sac to your uterine lining. If the test comes back positive, this could be a sign of an early delivery.
6) Blood Testing â€“ A routine blood test may also be diagnosed, as it can indicate that you have an underlying condition, such as gestational hypertension. This can place you and your child at risk, and will require prenatal monitoring and treatment.
7) Urinalysis â€“ Conditions like preeclampsia can be diagnosed through this test, as it can detect excess protein in the urine.
8) Fundal Height Measurement â€“ Fundal height is the measurement which indicates the distance between the pubic bone and the top of the uterus. A measurement that is too large can indicate a macrosomic, or an overly large fetus.
9) Fetal MonitoringÂ â€“ An unborn baby that is thought to be unduly large can be monitored through non-stress testing. This test will measure your babyâ€™s heart rate, in response to their movements, and may also be conducted if your doctor feels that the child may have a condition that can cause fetal distress during delivery.
It is essential that you get in touch with an experienced medical practitioner to help conduct your tests. Schedule an appointment with Wif Hospitalâ€™s team of experts today, if you feel that you are exhibiting any symptoms of a high-risk pregnancy.
When you learn that you are pregnant, consult your doctor about the possibility of a high-risk pregnancy. Openly discuss any pre-existing medical conditions, how they can be managed and the possible consequences on the same on labour and delivery. Our expert team at Wif Hospital has laid out some of the signs and symptoms of high-risk pregnancy to look out for.
If you experience any of the following signs of high-risk pregnancy, it is essential to get immediate medical attention:
- You lose consciousness â€“ It wouldnâ€™t be possible for you to take any action in this situation. Brief your partner, neighbour or colleague in advance of what to do in such a situation
- You experience vaginal bleeding
- You experience unbearable pain in your pelvis or belly
- You have fluid leaking from your vagina â€“ This could be because the umbilical cord is bulging into your vagina. Call for emergency help immediately. Meanwhile, get down on your knees so that your rear end (buttocks) is higher than your head. This will help reduce the pressure on the cord until help arrives.
- You experience persistent pelvic pressure or back pain
- You observe that your baby is moving less than normal or not moving
- You experience signs of pre-eclampsia such as sudden swelling of your hands, feet or face; vision problems such as dimness or blurring; a severe headache
During pregnancy, it is critical to stay vigilant and watch out for any signs that indicate that your pregnancy is not progressing as it is supposed to. Not all signs would mean that you have a problem, but it is always advisable to stay alert and consult your doctor at the slightest sign of distress.
A high-risk pregnancy occurs due to one or more of the following reasons:
- A pre-existing medical condition in the mother such as diabetes or hypertension
- A pregnancy-related problems that lead to complications such as premature labour
- Age of the expecting mother, and
- Lifestyle disorders
Any of these three factors could increase the risk of adverse effects for the mother, baby or both. The good news is that there are certain measures you can take for each of this situation to lower the risk of high-risk pregnancy.
1) Treat the pre-existing condition â€“ If you have a pre-existing condition such as diabetes, heart disease, high blood pressure, kidney disease or lupus, it is extremely important to plan a pregnancy only after ensuring that your underlying medical condition is being treated appropriately and youâ€™re health is optimum for pregnancy. For instance, if youâ€™re diabetic, ensure that your blood sugars are under control or if youâ€™re hypertensive, make sure it is being treated appropriately. To have the best chance of a healthy and successful pregnancy, it is best to ensure that pre-existing conditions are under control before you conceive.
2) Test for birth defects and genetic conditions â€“ Fetal problems including genetic conditions such as chromosomal abnormalities and birth defects can complicate pregnancies. While the risk of these issues increases with family history, age and ethnicity, any woman could have an affected child. At the very outset of your pregnancy, discuss in detail with your doctor or genetic counsellor to know about the risks and test options. Latest technology ultrasounds and non-invasive tests can detect any issues early on. Prenatal vitamins and in some cases, additional folic acid prior to and during early pregnancy can help reduce the risk for many types of birth defects.
3) Prevent complications you have had before â€“ In a first pregnancy, pregnancy-related complications such as preeclampsia, preterm labour or birth are difficult to predict. However, in following pregnancies, you should be proactive and take measures to prevent those complications from re-occurring. For instance, progesterone can help reduce the risk of preterm birth or aspirin can help prevent the recurrence of preeclampsia. Taking preventive measures early on will help improve outcomes.
4) Improve your lifestyle â€“ There are some common lifestyle measures that you can take to reduce your chance of a high-risk pregnancy such as:
Eat a healthy diet â€“ You would need more folic acid, calcium, iron and other essential nutrients during pregnancy. Make sure that all these are factored in your diet.
Stay away from risky substances â€“ Substances such as tobacco, alcohol and illegal drugs should be completely avoided.
Watch your weight â€“ The right amount of weight gain will help support your babyâ€™s growth and health. Know from your doctor as to what is the ideal weight gain and aim to be within that limit.
Regular prenatal visits â€“ Regular visits will help your doctor to monitor the babyâ€™s and your health. Issues, if any, can be arrested timely. Your doctor may refer you to a specialist in genetics, maternal-foetal medicine, paediatrics or any other field depending on the circumstances.
5) Be careful when using ART (assisted reproductive technology) â€“ If you plan to get pregnant using ART, carefully consider how many embryos you want implanted. Multiple pregnancies are prone to higher risk of preterm labour.
Depending on the risk factors that you are diagnosed with, high-risk pregnancy treatment will be prescribed. At Wif Hospital, we are well-equipped with state-of-the-art infrastructure and a highly skilled and experienced team of professionals to give you the best possible care for every type of high-risk pregnancy situation.
Listed below are some common methods of treatment of high-risk pregnancies:
Gestational Diabetes â€“ This condition can increase the risk of complications in pregnancy. However, you can have a healthy pregnancy and birth by following a diet and treatment plan prescribed by a doctor. Some elements of a gestational diabetes treatment plan are:
- Keeping track of blood sugar levels by testing multiple times in a day
- Having a diet with smaller and frequent meals throughout the day that are low in carbohydrates, sugars and high in fibre
- Keeping track of overall weight gain and weekly rate of weight gain
- Recording daily physical activity, food intake and blood sugar levels
In addition, you may also be prescribed medication to manage your diabetes. This condition generally disappears post-delivery.
High blood pressure â€“ During pregnancy, some changes to blood pressure medication may be recommended. Lifestyle changes such as limiting salt intake and regular exercise may also be prescribed for the treatment of this condition.
Preeclampsia â€“ If you are experiencing mild symptoms, bed rest may be prescribed. You may also be asked to take vitamins E and C. Generally, this condition ends post-delivery.
Placenta Previa â€“ If the bleeding is light, your doctor may simply monitor you carefully. In most of the cases, the placenta moves away from the cervix by itself. If the placenta blocks your cervix completely, you may be asked to take complete bed rest. Recurring bouts of bleeding could require hospitalisation.
Pre-term labour â€“ While the treatment varies from case-to-case, treatment measures such as bed rest and drinking plenty of fluids may be recommended.
Whatever may be your high-risk pregnancy situation, we at Wif Hospital are committed to making your pregnancy journey as comfortable as possible.