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High-Risk Pregnancy
Pregnancies first occurring before the age of 17 or after the age of 35 are classified as high-risk, necessitating close monitoring to minimize the likelihood of complications. Nonetheless, a high-risk pregnancy, as defined by this criterion, does not guarantee pregnancy-related difficulties. In most instances, pregnant women encounter no health issues and deliver a healthy baby.
Symptoms
If you have the following symptoms, your pregnancy is high risk:
- Vaginal bleeding or discharge.
- Decreased fetal movement.
- Persistent pain in your chest or abdomen.
- Continuing severe headache or blurry vision.
- Difficulty breathing (Dyspnea) or tightness in the chest.
- Acute swelling in the face, hands, and legs.
- Lightheadedness (Vertigo) or syncope.
- Excessive fatigue.
- Fever over 38°C.
- Burning sensation during urination.
- Severe nausea and vomiting.
- Thoughts about harming yourself and the fetus.
Causes
- Smoking.
- Alcohol or drug addiction.
- Exposure to toxins.
- Preexisting health issues or pregnancy-related problems
- Age: Pregnant women under 17 are less likely to undergo proper prenatal care and are prone to complications due to their physical and emotional immaturity. They have a higher likelihood of experiencing premature birth, eclampsia, and anemia. Women who become pregnant for the first time after the age of 35 may face early pregnancy loss and pregnancy-related health issues such as gestational diabetes and preeclampsia.
Risk factors
The health risks during pregnancy increase if you have had certain health problems or preexisting conditions, including:
- Autoimmune diseases.
- Coagulation disorders.
- COVID-19.
- Diabetes.
- Fibroids.
- HIV/AIDS.
- Hypertension.
- Underweight (BMI of less than 18.5).
- Mental health disorders, such as depression.
- Obesity.
- Polycystic ovary syndrome (PCOS).
- Kidney Disease.
- Thyroid disease.
Health conditions related to pregnancy that can potentially harm the well-being of both the pregnant woman and the fetus include gestational diabetes, poor fetal growth, fetal defects, multiple gestations, preeclampsia, eclampsia, a history of preterm birth or postpartum complications, and placenta previa/placenta adherents, etc.
Complications
Potential Complications of High-Risk Pregnancy:
- Cesarean delivery (C-section).
- Eclampsia (seizure from pregnancy).
- Preeclampsia (high blood pressure from pregnancy).
- Preterm delivery.
- Excessive uterine bleeding during labor, at delivery, or after childbirth.
- Low or high birth weight.
- Birth defects
- Miscarriage.
- Stillbirth.
Diagnosis
- Specialized or Targeted Ultrasound: Performed when there is a high risk of fetal birth defects.
- Cell-Free DNA Screening: Screens for specific chromosome abnormalities by extracting fetal DNA in the maternal blood to screen for sex chromosome (X and Y) abnormality, Patau syndrome (trisomy 13), Edwards syndrome (trisomy 18), or Down syndrome (trisomy 21).
- Amniocentesis and Chorionic Villus Sampling (CVS): Invasive genetic screening for chromosomal abnormalities and inherited genetic disorders.
- Amniocentesis (second trimester): Draws amniotic fluid to identify fetal chromosome abnormalities or genetic diseases such as thalassemia.
- CVS (weeks 10-12): Removes a sample of the placenta to pinpoint the risk of genetic conditions.
- Cervical Ultrasound: Assesses the risk of preterm labor.
- Biophysical Profile (BPP): Includes fetal monitoring and ultrasound to evaluate the fetal heart rate, breathing, muscle tone, movement, and the amount of amniotic fluid.
- Lab Tests: For urinary tract infections and other diseases such as syphilis or HIV.
Treatment and Management
- Regular Prenatal Appointments: Schedule regular appointments with your obstetrician to monitor fetal development and your health conditions.
- Manage pre-existing health Problems: Take proactive measures to manage any preexisting health problems.
- Blood Pressure Monitoring: Regularly check your blood pressure at home to ensure early detection of any abnormalities.
- Fetal Movement Observation: Pay close attention to fetal movement and promptly report any concerns to your healthcare provider.
- Medical Intervention: If the mother and fetus face life-threatening situations, your obstetrician may recommend labor induction or a Cesarean section (C-section) to ensure the safety of both.
Prevention
- Pre-Pregnancy Health Assessment: Identify potential health risks through a comprehensive pre-pregnancy health assessment.
- Safe Sex Practices: Practice safe sex to minimize the risk of sexually transmitted infections.
- Health History Disclosure: Inform your doctor about your personal and family health history to receive appropriate guidance and care.
- Manage Preexisting Health Conditions: Effectively manage any preexisting health conditions in consultation with your healthcare provider.
- Tobacco, Drug, and Alcohol Avoidance: Quit smoking and avoid drugs and alcohol to reduce potential risks during pregnancy.
- Maintain Healthy Weight: Achieve and maintain a healthy weight before pregnancy for overall well-being.
Regular consultations with healthcare professionals are essential for personalized guidance based on individual health circumstances.
Prognosis
While women with high-risk pregnancies may undergo pregnancy and delivery without immediate issues, they face an increased risk of future health complications. These may include postpartum depression, hypertension, cardiovascular disease, Type 2 diabetes, stroke, and other potential complications.
Additionally, high-risk pregnancies raise the chances of children experiencing breathing disorders, gastrointestinal diseases, growth and developmental delays, neurological disorders, obesity, diabetes, behavioral issues, as well as dental, hearing, and vision problems. Individuals with high-risk pregnancies need to receive thorough postpartum care and ongoing medical attention to address these potential health challenges.
A Note from MedPark Hospital
A high-risk pregnancy can stem from various factors, encompassing both age and specific medical conditions. If you are in a high-risk pregnancy situation, it is crucial to pursue a thorough diagnosis and receive appropriate treatment both before and after childbirth. It's essential to note that pregnancy-related complications may emerge even up to six weeks after the delivery. Therefore, proactive and comprehensive care is vital for the well-being of both the mother and the newborn.
