A high-risk pregnancy is one where there is a higher risk to the mother or her fetus than an uncomplicated pregnancy.

Pregnancy is a normal physiological process, a phase of life to be enjoyed and to be cherished. However, pregnancy is also a stressful condition for the body, both physically, mentally, and can be emotionally challenging. While most pregnancies go smoothly, a few underlying health issues or some new development can make it high risk, requiring special care, rest, investigations, etc.

 

  1. MATERNAL AGE – Pregnancies at the extremes of age like teenage pregnancy or beyond the age of 35 are at higher risk of developing complications. There is a higher chance of miscarriage and birth defects, especially if you are above the age of 35. Mothers who are more than 35 years of age are also at risk of developing gestational diabetes, pregnancy-induced hypertension, preterm labor.
  2. PRE EXISTING MEDICAL CONDITIONS – If you already have any pre-existing medical conditions like diabetes, high blood pressure, heart disease, etc., you are at a higher risk of developing complications. Some of these problems worsen in pregnancy and may impact fertility. These issues will also require expert medical control even at the time of conception. Some of them may also need a change in medication when fertilization occurs.
  3. PREVIOUS BAD OBSTETRIC HISTORY – if you have had past abortions, preterm deliveries, stillbirth, intrauterine death, etc., your pregnancy will require expert handling and intensive care. The care should start before pregnancy. You may need further investigations to understand the cause of such a loss, folic acid supplement, treatment of any pre-existing medical condition, etc. during pregnancy; you may need rest, injections, and supportive therapy.
  4. ISSUES DURING THE CURRENT PREGNANCY – Certain conditions in this pregnancy will increase the risk in this pregnancy, like developing high blood pressure, gestational diabetes (developing diabetes in the pregnancy), twins, low lying placenta, etc, these pregnancies require extensive care and multidisciplinary approach.

 

Preventive Steps One Must Take To Avoid High-Risk Pregnancy

At times, you may have a high-risk pregnancy because of an existing medical issue or a medical condition may emerge during pregnancy which may lead the pregnancy to become high risk for you or the baby or both. So you must take certain extra precautions…

• Get a preconception appointment scheduled with an expert High-risk pregnancy doctor in South Delhi

If you are planning to become pregnant, you should definitely talk to an experienced gynecologist with expertise in high-risk pregnancy cases. She may advise you to attain a healthy weight before pregnancy begins and may ask you to start having folic acid along with a prenatal vitamin every day. If you possess a medical concern, the doctor might adjust your treatment or change your treatment to prepare you for pregnancy. Besides that, the gynecologist will explain in detail about the risks for you and the baby. 

Treat your pre-existing medical condition

If you already have a medical issue such as lupus, kidney disorder, high blood pressure, heart disorder or diabetes, it is vital that you plan a pregnancy only after you have made sure that these underlying medical problems are getting proper treatments and you are in the best health for getting pregnant. For example, if you have diabetes, make sure that the sugar levels are controlled or if you have hypertension, ensure that it is treated suitably. To achieve the optimum possibilities of pregnancy, it is better to ensure that your pre-existing medical concerns are well managed before conceiving. 

• Test for genetic disorders and birth defects

 At the very beginning of your pregnancy, have a detailed discussion with your gynecologist regarding the tests available to rule out any abnormalities in the baby.  Some non-invasive tests and ultrasounds help in the early detection of any problem. Folic acid can help lower the risk of some forms of birth defects if taken before or during your early pregnancy. 

Prevent complications you have developed before

Pregnancy-associated complications such as birth defects, preterm labor, or preeclampsia are quite unpredictable in the case of a first pregnancy. But you can take some precautionary measures for preventing recurrence in your subsequent pregnancies. For example, aspirin can be started early if you have had preeclampsia, progesterone can help decrease preterm birth risks. Certain lifestyle changes can also make a different example you may be asked to stop smoking

• Improve your lifestyle

Take the following lifestyle measures to lower your high-risk pregnancy possibilities:

    • Have a healthy diet

You would require more iron, calcium, folic acid, and other important nutrients during pregnancy. Please ensure that you maintain all these nutrients in your diet. 

    • Avoid risky substances

You must quit smoking altogether. Fully avoid substances such as illegal drugs, alcohol, and tobacco. Discuss with your gynecologist regarding any prescribed or non-prescribed supplements or medications that you are currently taking.

    • Check your weight

Proper weight gain can aid in supporting your baby’s health and growth. Consult your doctor regarding the ideal amount of weight gain and try to maintain your weight within that limit.

    • Go for regular prenatal visits

Regular visits help in the monitoring of your and the baby’s health. Problems, if any, can be detected early. The doctor may recommend visiting an expert in pediatrics, maternal-fetal medicine, genetics, etc. as per your condition. 

• Sensible use of technology

If you require Assisted Reproductive Technology (ART),  consider the number of embryos to be transferred. IVF can result in multiple pregnancies which can cause complications.

Signs and Symptoms that you must not ignore

If you have a high-risk pregnancy and you develop any of the following signs and symptoms, you should visit a gynecologist with expertise in high-risk pregnancy cases.

  • You fall unconscious., in this case, you would not be able to take any step. Therefore, you need to inform your partner, friend, or neighbor, beforehand, what to do, if such a situation arises.
  • You experience vaginal bleeding.
  • You experience a burning sensation or pain while urinating. 
  • You experience persistent nausea or vomiting. 
  • You have signs of dizziness.
  • You experience chills or fever.
  • You experience intolerable pain in the pelvis or cramping in your lower abdomen.
  • Fluid leakage takes place from the vagina
  • You have persistent back pain or pelvic pressure.
  • You find that your baby’s movements have stopped or are less than normal (less foetal activity).
  • You develop symptoms of pre-eclampsia such as an extreme headache, vision issues like blurring or dimness, or a sudden swelling of the face, feet, or hands. 
  • During pregnancy, you must be essentially careful and look out for any abnormal signs.
  • You develop unhealthy thoughts of harming the baby or yourself. 

There are several ups and downs which a mother experiences in a high-risk pregnancy. An expert gynecologist may help you remain positive and take steps to improve your chances of a healthy pregnancy. 

 

Diagnosis

According to your condition, your gynecologist with expertise in high-risk pregnancy may recommend:

  • Targeted or specialized ultrasound This kind of foetal ultrasound is an imaging method that employs high-frequency sound waves for generating images of the baby in your uterus. It helps in the diagnosis of any unusual development.
  • Prenatal cell-free DNA screening This is a simple blood test. There are foetal blood cells in the mother’s blood. From these foetal cells, foetal DNA is taken out. This DNA is used to check for the presence of chromosomal abnormalities in the baby
  • Invasive genetic screening The Gynaecologist may recommend you to go for CVS (chorionic villus sampling) or amniocentesis. CVS involves the extraction of a sample of cells from your placenta. It’s normally carried out between the 10th and 12th weeks of your pregnancy. It can help in the detection of particular genetic disorders.  Amniocentesis involves withdrawing a sample of your amniotic fluid from your uterus. It’s generally performed after the 15th week of pregnancy. It helps detect specific genetic problems.
  • Ultrasound for cervical length During prenatal visits, the gynecologist may take the help of ultrasound for measuring the length of your cervix. This helps to check if you have any risks of preterm labor.
  • Laboratory tests The gynecologist will carry out your urine test to check for any urinary tract infections. Other laboratory tests may be required depending on your particular case
  • Biophysical profile It’s a form of prenatal ultrasound. It is carried out to determine the well-being of your baby. It may include an ultrasound for the evaluation of the foetal health or, as per the outcomes of the ultrasound, the monitoring of the foetal heart rate (non-stress test) could be done.


Just to Summarize, Some General Tips For High-Risk Pregnancy

  • Schedule a pre-pregnancy visit
  • Pre-pregnancy folic acid supplement
  • Control any pre-existing medical condition
  • Chose an excellent and approachable High risk pregnancy doctor in south Delhi
  • Follow instructions and have a regular antenatal check-up.
  • Regular exercise, if allowed, and a healthy diet go a long way.
  • Delivery should be planned in a proper set up with adequate facilities and excellent nursery support.

If you want to consult High risk pregnancy doctor in South Delhi, then you may book an appointment with Dr. Madhu Goel. She is an expert in handling all high-risk pregnancies cases like patients with recurrent abortion, hypertension, diabetes, etc. Dr. Goel is favored by patients due to her distinct guidance and approachability, As an expert, she uses the latest treatment technology in this field and has given fantastic outcomes with very difficult and high-risk cases.

  F&Q

A high-risk pregnancy is characterized by a heightened risk of health disorders of the expectant mother and her baby preceding, during, or following the child’s delivery. It generally requires special medical care and monitoring throughout pregnancy. Pregnancies may turn high-risk while progressing or may have pre-existing risks.

First-trimester screening is commonly performed between 11th-14th pregnancy weeks.

It includes:

  • A blood test for measuring HCG and PAPA called double marker test
  • An ultrasound exam for measuring nuchal translucency and the presence of nasal bone

The quad-screen test involves a prenatal examination for measuring the levels of the following substances in an expectant mother’s blood:

  • AFP (Alpha-fetoprotein) produced by the developing foetus 
  • HCG (Human chorionic gonadotropin) produced by the placenta
  • Estriol produced by the fetal liver and the placenta
  • Inhibin A produced by the placenta

A chromosomal issue in pregnancy takes place when your fetus has structurally defective chromosomes or an inaccurate quantity of DNA within a chromosome or an erroneous count of chromosomes. These anomalies may eventually lead to miscarriage, diseases like Down Syndrome, or birth defects.

A major risk factor for a high-risk pregnancy is maternal age. Expectant mothers below 17 years or above 35 years of age are at heightened risks of complications than the ones between late teenage and initial 30s. The risk of genetic deformities and miscarriage further rises after 40 years.

The following pregnancy conditions require instant medical support:

  • Vaginal bleeding
  • Excruciating headaches
  • Lower abdomen pain or cramps
  • Watery vaginal discharge— in a trickle or surge 
  • Frequent or regular contractions, i.e., abdominal tightening sensations
  • Reduced fetal activity
  • Pain or a burning sensation with urination
  • Changes in vision, such as blurred vision

Preconception genetic or carrier screening is a kind of genetic examination done to determine whether the expectant mother is having a specific genetic problem or not. It can make you aware of any risk of giving birth to a child with a genetic problem.

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