What is high-risk pregnancy and how to avoid it?
For the vast majority of women, pregnancy follows a routine course. Some women, however, have medical difficulties related to their health or the health of their baby. These women experience what is called a high-risk pregnancy.
High-risk complications occur in only 6 per cent to 8 per cent of all pregnancies. These complications can be serious and require special care to ensure the best possible outcome.
Here is an excerpt from a video interview of Dr Kali Kumari, Senior Obstetrician and Gynaecologist, OMNI RK Hospitals, Visakhapatnam on High-risk pregnancies and measures that can be taken to keep it at bay.
Q. What is a high-risk pregnancy?
A. Pregnancy is a physiological condition occurring in a woman during a reproductive age group. Usually, healthy pregnancy should end in a healthy mother and baby duo.
Unfortunately, this doesn’t always happen due to complications in the woman’s reproductive cycle history. These factors jeopardise the health of the mother and the baby which results in a high-risk pregnancy.
For example, if a woman is suffering from diabetes, hypertension, cardiovascular diseases, renal diseases etc. before getting pregnant, these factors may interfere with her health during pregnancy, which may result in a high-risk pregnancy. Sometimes, when a woman develops the above medical conditions during the pregnancy, even then it might result in a high-risk pregnancy.
Q. How to handle a high-risk pregnancy?
A. This kind of pregnancy needs to be handled very carefully with frequent visits to the doctor at every stage of the pregnancy.
Q. What steps can be followed for a healthy pregnancy?
A. Exercising before getting pregnant is a key factor to have a healthy pregnancy experience. Regular exercise balances blood pressure and other body functions.
Prenatal supplements like folic acid must be taken before pregnancy to allow for a healthy pregnancy.
Another way to allow for a healthy pregnancy is to consult a doctor even before conceiving to regulate all body functions as opposed to consulting a doctor after getting pregnant.
Q. How do reduce complications during and before pregnancy?
A. To avoid complications, firstly the woman needs to identify any underlying issues that she is facing. Underlying issues can be diabetes, hypertension, repeated pregnancy losses or a history of second-trimester abortion. Once the issue has been identified, necessary precautions can be taken to treat them.
For example, if the woman is suffering from hypertension, anti-hypertension drugs in proper doses need to be taken to balance body functions. If the woman is suffering from diabetes, sometimes, it can be controlled with a balanced diet alone, if not, hypoglycemic drugs can be taken to control diabetes.
If a woman has suffered a second-trimester abortion, this might be mostly due to cervical incompetence. To avoid this complication, two weeks before the time when she suffered the previous miscarriage, she would require a cervical stitch to avoid further miscarriage again.
Q. What lifestyle can be followed to allow for a healthy pregnancy?
A. Due to the food we eat nowadays, obesity can be a very common condition. Hence, following a balanced diet and exercising regularly way before conceiving can help avoid a lot of complications.
Q. Are there any specific tests to detect a low risk and a high-risk pregnancy?
A. Yes, some tests are performed on every pregnant woman during all the three trimesters to constantly gauge if is low risk or high-risk pregnancy.
During the first trimester, an ultrasound scan is done to detect the risk of pregnancy. During the second trimester, a Tiffa scan is done to detect the risk of pregnancy. And during the third trimester, a 38-week growth scan is done to detect the risk of pregnancy.
If a woman is diagnosed with a high-risk pregnancy during any one of these scans, special tests are done to detect the underlying issue causing the high-risk pregnancy which is then treated carefully.
In a few cases, even the father of the baby has to undergo certain tests to detect the abnormal genes to avoid the recurrence of the complication during the next pregnancy.
Q. Is thyroid harmful during pregnancy?
A. Yes, thyroid can cause harm during pregnancy. There are two thyroid conditions – and Hypothyroidism and Hyperthyroidism. In the former, the production of the hormone is less while in the latter it is the opposite.
If proper medication is taken before and during pregnancy to correct the thyroid levels, there will be no complication and harm to the mother and baby’s health.
Q. Can a woman work during pregnancy?
A. Absolutely! A woman can work her way through a normal routine as usual but will require a little more rest compared to a non-pregnant woman.
Although, if a woman has previously suffered from repeated abortions or is suffering from hypertension etc., she is suggested to rest more and work less.
Q. What signs and symptoms indicate risk in pregnancy?
A. While symptoms are felt by the mother, signs are detected by the doctor. There are many signs and symptoms to identify a high-risk pregnancy.
1. Bleeding of any sort during pregnancy is abnormal and an indication of hormonal imbalances.
2. Pain in the abdomen is a risk symptom and needs a doctor consultation.
3. A severe headache may indicate high blood pressure and needs to be taken care of.
4. Loss of fetal movements or decreased fetal movements indicates reduced oxygen supply to the baby. This symptom requires immediate attention and care.
Q. What is a premature rupture of membrane?
A. The baby is usually protected by two layers of membrane called ‘amnion’ and ‘chorion’ inside the mother’s womb. An early rupture of the membrane indicates a hole in the membrane which causes the amniotic fluid to leak outside the amniotic sac. The amniotic fluid protects and supplies the baby with essential nutrients.
A woman can identify this when there is an unusually huge amount of liquid discharge. This condition requires immediate medical care and attention to avoid any sort of infections to the mother and the baby.
Q. What are the risk factors for gestational diabetes?
A. Diabetes that has been diagnosed for the first time during pregnancy is called gestational diabetes. Diabetes most often leads to a high-risk pregnancy and hence needs proper treatment and care.
If the woman is suffering from diabetes, sometimes, it can be controlled with a balanced diet alone, if not, hypoglycemic drugs can be taken to control diabetes.
Q. How to handle premature labour?
A. The baby is usually protected by two layers of membrane called ‘amnion’ and ‘chorion’ inside the mother’s womb. An early rupture or premature labour of the membrane indicates a hole in the membrane which causes the amniotic fluid to leak outside the amniotic sac. A woman can identify this when there is an unusually huge amount of liquid discharge.
If this condition occurs after 37 weeks of pregnancy, then there is no risk to the health of the baby and it can be delivered without much hassle. If this condition before 37 weeks of pregnancy, immediate medical care and is required to avoid any sort of infections to the mother and the baby.