Motherhood is special and for some it may be complicated either because of pre-existing medical disorders or due to development of obstetric problems. In a “high-risk” pregnancy, a woman’s chances of having a preterm (early) birth or experiencing health issues for herself or her unborn child are increased by one or more factors.
RISK FACTORS FOR HIGH RISK PREGNANCY
- Maternal age
The age of the expectant woman is one of the most frequent risk factors for a high-risk pregnancy. Complications are more likely to occur in women who are under the age of 17 or above the age of 35 than in those who are in their late teens or early twenties.
- Medical conditions that exists before pregnancy
- 1. High blood pressure
- 2. Lung, kidney, or heart problems
- 3. Diabetes
- 4. Depression
- 5. Obesity
- 6. Autoimmune disease
- 7. Sexually transmitted diseases (STDs)
- 8. Long-term (chronic) infections such as human immunodeficiency virus (HIV)
- Medical conditions that occur during pregnancy
- 1. Preeclampsia
- 2. Gestational Diabetes
- 3. Depression
- Pregnancy related issues
- 1. Premature labor
- 2. Multiple pregnancies
- 3. Placenta previa
- 4. Fetal problems
HIGH RISK PREGNANCY CARE AT MMHRC
The department of obstetrics and high risk pregnancy unit is committed to providing individualized tertiary care and we ensure that most of the women approaching us for maternity care go home safely with a well-baby.
The journey of pregnancy and childbirth is special for women with medical disorders. With advances in medicine in recent days, women with chronic illness like corrected congenital cardiac manifestations, valve replacements, renal diseases including post renal transplant, chronic hypertension, epilepsy & other neurological conditions, pre-existing diabetes, auto immune disorders like SLE etc contemplate pregnancy. While these conditions increase the risk of pregnancy, progression of the underlying disease adds on the trouble.
Our obstetric HDU which was started in 2003, and the availability of all specialists-medical & surgical superspeciality departments, critical care team, radiologists and neonatologists enable us to hand hold these women as they embark upon the arduous journey of pregnancy and child birth.
Women with medical disorders and adverse obstetric events like still births, IUGR, abortions, pre-term labor, antepartum and post partum haemorrhage, PIH & eclampsia, jaundice during pregnancy, severe anemia & thrombocytopenia etc are encouraged for a pre-pregnancy counseling. This ensures that the pregnancy is planned at an optimal time when the underlying medical disorder is under control. Similarly the cause for the previous adverse obstetric outcome is evaluated and corrected if possible prior to planning pregnancy. Likewise women with obesity are advised to reach optimal BMI and associated disorders like diabetes controlled in pre-pregnancy period.
FETAL MEDICINE UNIT
Universal aneuploidy screening, targeted screening for fetal anomalies & fetal ECHO are done for all antenatal mothers to ensure that the fetus is in good health.
Amniocentesis, chorionic villous sampling, cardocentesis are done for the needy and appropriate testing is done along with pre-test & post test counseling.
Fetal interventions like intra uterine transfusions are done for Rh iso – immunized pregnancy and fetal anemia associated with parvo infection with good neonatal outcome. Similarly pleural effusion tapping, selective termination of anomalous fetus by RFA (Radio frequency ablation) and multifetal reductions are done in liaison with the interventional radiologist.
Multiple pregnancies increasing in recent days following assisted conception, through exciting for the couple raise special concerns especially in mono chorionic twins. The mother too faces increased obstetric complications like pregnancy induced hypertension (PIH), post partum hemorrhage (PPH) etc. The vast experience of the obstetric and neonatology team at MMHRC comes handy in managing these pregnancies.
Couple with increased risk of inherited disorders, those with abnormal aneuploidy screening results and with anomalies in the present & past pregnancies are managed with appropriate advise from the geneticist, who visits our centre once a month.
Thus the department of obstetrics is a one-stop clinic for all maternal & fetal needs.