High-risk pregnancy? guide to improve maternal and neonatal outcome

High risk pregnancy treatment varies from case to case. Here's a guide to improve maternal and neonatal outcome.

Risk Factors in Pregnancy

When a woman learns she is pregnant, it can be a time of great joy, excitement and anticipation. But it can also be a time of anxiety, stress and worry if the pregnancy is considered high-risk.

Early detection and effective management of high-risk pregnancy can contribute substantially in reduction of maternal and fetal adverse outcomes. High-risk pregnancies require management by a multi-disciplinary team to help ensure the best outcome for the mother and baby.

WHAT IS A HIGH-RISK PREGNANCY?

A pregnancy is considered high-risk when there are potential complications that could affect the mother, baby or both. These complications can arise any time before, during or after delivery.

WHAT ARE THE RISK FACTORS?

Pre-existing factors:

A pre-existing heart condition.

Hypertension, Asthma, Epilepsy, kidney diseases

Obesity: BMI of 30 or higher.

TYPE 2 Diabetes

Certain Sexually transmitted infections including HIV

Autoimmune diseases like SLE

Blood disorders like sickle cell disease

Family history of genetic diseases

Age more than 35 or younger than 18

Lifestyle factors: Smoking, drinking, or using drugs

Complications in a previous pregnancy:

Risk Factors Developed During Pregnancy :

Preeclampsia: It is a serious blood pressure disorder that can affect all of the organ’s in a pregnant woman’s body.

HELLP syndrome: This is a rare condition related to preeclampsia in which red blood cells are damaged or destroyed, which can cause the liver to bleed and clotting issues.

Multiple pregnancy: Twins, triplets

Gestational diabetes

Placental complications like placenta previa, accreta, abruption which can cause severe bleeding.

Preterm labor: Delivery before 37 weeks

HOW TO IDENTIFY HIGH-RISK PREGNANCIES

The best time to assess the potential impact of medical or obstetric complications on the outcome of pregnancy is before pregnancy occurs. This is known as pre conceptional counselling. This helps in identifying a significant number of high risk pregnancies. A careful history and physical examination of every obstetric patient also helps in identifying high risk pregnancies. Regular prenatal check ups also help in identifying risk at an early stage.

HOW TO PREVENT HIGH-RISK PREGNANCY?

Staying healthy is probably the first step that one needs to do to lower the risk of having a difficult pregnancy. Consider pre conception evaluation by a health care provider to ensure fitness for a pregnancy.

Even during the pregnancy, there are steps that can be taken to reduce the risk of certain problems:

Taking at least 400 micrograms of folic acid (a type of vitamin B) every day before and during pregnancy.

Getting proper immunizations.
Maintaining a healthy weight; eating a good diet; getting regular physical exercise.
Smoking, alcohol, or drug use should be strictly avoided.

Prenatal care appointments early during pregnancy and visiting a health provider for regularly scheduled appointments throughout the pregnancy should be given prime importance.

WHEN TO SEEK IMMEDIATE MEDICAL CARE IN HIGH-RISK PREGNANCY?
Vaginal bleeding
Watery discharge from the vagina
Painful urination 
Vomiting or consistent nausea
Blurred vision 
Pain in the lower abdomen area
Fever or chills
Self-harm thoughts
Sudden swelling in the face and hands

Dr. MVR Shailaja – MS(OBG), DGO, Consultant Obstetrician and Gynecologist

Consultant Obstetrician and Gynecologist

Rainbow Children’s Hospital and BirthRight Clinic, Visakhapatnam, India

Source: The Indian Express