Found at: http://www.anguillaguide.com/article/articleprint/3002/-1/133/
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ASK YOUR DOCTOR: High Risk Pregnancies by Dr. Brett Hodge
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The vast majority of pregnancies have a healthy, happy outcome. Pregnancy itself is not a high risk condition, but some women develop conditions that put them at an increased risk for developing problems that lead to poor outcome. 6-8% of all pregnancies are termed high risk in any defined population.
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Dr. Brett Hodge
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What is a high risk pregnancy?
A high risk pregnancy is one which presents with characteristics or circumstances that are likely to jeopardize the health of the mother and/or child. High risk pregnancies are those in which the mother, baby or both are considered at higher than average risk for complications. High risk conditions could be caused by a health condition the mother had before she was pregnant or developed during pregnancy or at delivery. It is important that all high risk pregnancies are identified very early in the pregnancy, if possible, so that appropriate interventions can be made to reduce the risk.
What are some of the conditions that can cause a high risk pregnancy?
There are many types of conditions that cause a pregnancy to be described as high risk. Most problems occur with women who have known risks, but not all problems can be predicted. The following are some conditions that may make a woman a high risk pregnancy:
Medical conditions
High blood pressure
Heart, kidney, lung or liver diseases
Sexually transmitted diseases including HIV/AIDS
Diabetes
Severe anaemia
Seizure disorders
Thyroid disorders
Obstetric
Mother’s age younger than 15 or older than 35 years
Previous birth defects
Multiple gestations (twins, triplets or more)
Bleeding, especially during the second and third trimester
Pregnancy induced high blood pressure (pre-eclampsia)
Abnormal heartbeat
Five or more previous pregnancies
Intrauterine growth retardation (fetus not growing adequately for age)
Previous stillbirth
Lifestyle
Smoking and drinking alcohol
Taking drugs not prescribed by a doctor
Poor nutrition
Lack of prenatal care
Management of high risk pregnancies
Health problems are best identified and managed before pregnancy. Women with health conditions should have a consultation with a pregnancy specialist before they plan to become pregnant. In some conditions this may occur about three or four months prior to pregnancy. In individuals with diabetes it is important that good blood sugar control is achieved prior to pregnancy to avoid various complications related to diabetes and pregnancy. Individuals on certain medications should also see their obstetrician early so that a decision can be made on whether there are safer medications that can be used when she is pregnant. Not all doctors are aware of the various drugs that should be avoided in pregnancy.
All high risk pregnancies should be referred to an experienced and qualified obstetrician. If the risk is reduced or removed then the pregnancy could be managed by the midwife or other health care providers.
All pregnant women should see a health care provider in the first 12 weeks of pregnancy especially if they had not seen one for pre pregnancy counseling and care. During the first visit to the health care provider a careful assessment should be made to determine the risk status for the mother-to-be and her partner. High risk pregnancies should receive regular prenatal care and the care should be individualised for the particular risk factor.
Is prenatal care different for the high risk pregnancy?
High risk conditions typically create more stress for the mother-to-be and her partner. Often there needs to be more frequent visits to the obstetrician or other health care provider as well as increased tests including more frequent ultrasound scans of the developing fetus.
Often care of high risk pregnancies involves a team of health professionals with the main objective being to carry out appropriate interventions to reduce the risk. Most high risk pregnancies have a good outcome but in a very small number of cases despite advances in technology and improved care the outcome may suboptimal.
Support
Couples of high risk pregnancies require a great deal of support from family members, relatives and friends in addition to the support given by health care providers. The stress of a high risk pregnancy can be tremendous and in some situations professional help is required.
Conclusion
A healthy baby and a healthy mother are the goals of all professional care for pregnant women. There are numerous conditions that cause a pregnancy to be described as high risk for developing complications that can lead to poor outcome of a pregnancy. Women with certain high risk factors should be identified very early in their pregnancy and should be referred to a trained professional so that various interventions can be instituted to reduce the risk. Once identified and correctly managed, the majority of high risk pregnancies end in healthy mothers and healthy babies.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr. Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty years in clinical practice. Dr. Hodge has a medical practice in the Johnson Building in The Valley.