Dealing with a High-risk Pregnancy

Reviewed on : 22 March 2016

These days, several expecting women have a high-risk pregnancy owing to advanced age of conception and increased health problems. Many pregnant women also tend to ignore the need of a healthy state of mind, which is equally important for a healthy pregnancy and birthing process.  

Pregnant women who are considered to be at high risk need to be monitored closely by their doctors and may require special attention as compared to women with a normal pregnancy. A high-risk pregnancy can lead to slow growth of the baby, pre-eclampsia, preterm labour and placenta related problems. Being at high risk does not automatically mean that the baby will face any problem but only highlights the need to take extra precautions. Therefore, pregnant women who are experiencing a high-risk pregnancy rather than panic should strive to work closely with their specialists to mitigate the risk enhancing factors.

Diagnosing High-risk Pregnancy

A pregnancy can be diagnosed as high risk if the expecting mother has problems like diabetes, anemia, high blood pressure, epilepsy or kidney disease. Some cases of high-risk pregnancies include cases of consumption of alcohol, illegal drugs or smoking by the expectant woman. Girls who get pregnant before the age of 17 and women who get pregnant after the age of 35 are also considered at high risk. Additionally, if a pregnant woman is carrying twins or triplets, it can further raise the chances of complications during gestation and/or delivery.

Expectant mothers, who have faced three or more miscarriages in the past, also need to be bracketed under the high-risk segment. Mothers-to-be whose unborn babies are diagnosed with Down syndrome, heart ailments, lung disorders or kidney problems, are also considered at high risk. Pregnant women who have experienced preterm labour or pre-eclampsia during their previous pregnancy are also at high risk.

Women infected with HIV, Hepatitis B or C, cytomegalovirus (CMV), chickenpox, rubella, toxoplasmosis, and syphilis are considered as high-risk cases. Taking medicines, such as lithium, phenytol, valproic acid or carbamazepine, also ups the risk for expecting mothers.

Women in danger of a potentially high-risk pregnancy should make preconception appointments in order to get informed about the dos and don’ts in their case even before they conceive and also go in for prenatal visits. Women who conceive with the help of assisted reproductive technology (ART), involving fertility medication, artificial insemination, in-vitro fertilisation and surrogacy, need to be extra cautious. Also, such expectant mothers need to be careful about the number of embryos implanted, as a multiple pregnancy can increase the risk of preterm labour.

Pregnant women who are considered at high risk need to visit their doctors not only regularly but also more frequently. They also need to get more tests done as compared to an expecting woman with a normal, low-risk pregnancy. Doctors may also suggest to the moms-to-be, who are at high risk, a more frequent ultrasound imaging and blood pressure testing to make sure that the baby is growing normally. Urine tests are also advised to make sure that the expecting mother does not have a urinary tract infection or pre-eclampsia. Moreover, a woman with a high-risk pregnancy might also need to undergo tests for genetic and other related problems. In such cases, doctor would also recommend for a hospital birth rather than a home birth, in order to keep delivery complications at bay and have support to handle any potential complications during delivery.

Many doctors like to recommend specialised tests for high-risk pregnancy cases in order to diagnose potential problems early on. Amniocentesis may be carried out to identify any genetic disorder, as well as neural tube defect. It involves taking a sample of the the fluid that surrounds and protects the baby during pregnancy. Another test to identify genetic disorders is chorionic villus sampling (CVS). Cordocentesis is conducted to diagnose any chromosomal defect, and blood disorders and infections in the baby.

Women who are already pregnant should not miss any recommended and/or scheduled visit to their doctor or skip any test. It is advised that pregnant women who fall in the high-risk category should regularly consult their maternal-fetal specialists and/or perinatologists.

Pregnant women at high risk need to be extra careful about their diet and should consume the recommended amount of fruits and vegetables. Also, medications, that have been prescribed by a doctor, should be taken on time. No medication should be taken without prior consultation with the doctor.

Expecting women should accommodate folic acid  in their regular diet. It is a form of vitamin B and is present in cereals, flour, breads, pasta, bakery items, cookies and crackers. Leafy vegetables (spinach, broccoli, lettuce, okra and asparagus), fruits (bananas and melons), lemons, beans, yeast, mushrooms and orange or tomato juice are rich sources of natural folate. Folic acid is known to reduce the chances of neural tube defect or other birth defects in the baby. Pregnant women should also seek and follow their doctor’s advice on working out. They should avoid any strenuous physical activity that can put strain on the uterus or its supporting structures.

Expecting mothers who smoke should immediately and completely abstain from it, especially if they fall under the high-risk category. They should also stay away from any potential source of passive smoke. Moreover, these mothers should try to maintain a safe distance from people who have contracted cold or any other infection.

Health care experts have suggested that a high-risk pregnant woman should watch out any unusual change in her body. They should contact their doctor as soon as possible if they suspect or experience vaginal bleeding, severe pain in the belly/pelvis or loss of consciousness.

High-risk pregnant women should reach out to and consult with their doctor if they have fever, before opting for any medication. Continuous regular contractions (8 or more in 1 hour or 4 or more in 20 minutes) can point towards a problem and the mom-to-be should contact the doctor immediately. Fluid discharge from the vagina and a perceptible decrease in the movements of the baby are also signs of potential trouble for both the mother and the baby.

A high-risk pregnancy only requires increased awareness, proper care and greater attention. A mom-to-be with a high risk pregnancy only needs to stay focused on the best course of action as suggested by their doctor to minimize the impact of the risk factors.

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