Is your pregnancy high-risk? (Expert interview)

Pregnancy can be a tricky time for both the mother and baby. Here is post on high risk pregnancies, and how you can identify them.

By: Pavitra Sampath | | Updated: October 19, 2013 2:18 pm

Pregnancy can be a difficult time for most women. With morning sickness and nervousness all rolled into one, the stress of having a healthy baby can wreak havoc in a woman’s life. According to the UNICEF, 247 women died during child birth out of 100,000 live births between the year 2004-2006 in India and an equally large number of babies perished at birth as well. A number of reasons have been attributed to this sad statistic including prolonged labour, ill health, early pregnancies and malnutrition. So what could be going wrong? We spoke to Dr Uma Vaidyanathan, a renowned gynaecologist, about high risk pregnancies, how they are caused and how you can help identify and possibly prevent them from occurring. Here are excerpts from the interview: Also Read - Avoid sexual dysfunction: Having multiple partners may actually be good for you

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A high risk pregnancy means a situation where there are certain factors that increase the likelihood of harm to mother or baby. There is no universally accepted definition of a ‘high-risk pregnancy’, but this is what it can be broadly defined as.

What section of women are more prone to it?

Any woman can have a risky pregnancy but it generally occurs in women who are younger than 18 years and those older than 35 years of age. What a mother has to remember is that they should not live in the false belief that because they do not fall into the bracket I mentioned, they are not prone to the risks. It can happen to other women also. That is why they need to get checked by a doctor often during their pregnancy.

(Read: Dangers of adolescent pregnancies)

How does a normal pregnancy become a high risk pregnancy?

If a woman gets regular checkups, it is possible that her gynaecologist will detect the presence of impending complications. There are some red flags that should tip off the physician as well as the patient. They are:

If the patient has associated health problems such as diabetes, high BP, kidney disease, epilepsy etc.
If the lady is having twins or triplets.
If she has a history of multiple miscarriages or an infection such as HIV, hepatitis C etc.
If the baby has a genetic condition such as Down’s syndrome or problems with its heart, lungs or kidneys.
If the lady has been taking medicines such as dilantin, valparin or tegretol which are known to cause defects in the unborn baby.
If the mother has associated heart valve problems, sickle cell disease, asthma, lupus, or rheumatoid arthritis.
If the patient experienced problems such as seizures or pre-term labor during previous pregnancies.

Under all these cases the pregnancy may be classified as high risk

What care should pregnant mothers take to avoid such a condition?

Regular visits to the gynaecologist are the norm. The doctor will be able to look for development of any symptoms of medical disorders. Regular monitoring of the pregnancy by ultrasound and investigations helps detect such problems at an early stage. A mother-to-be should also remember to maintain a healthy lifestyle, have healthy eating habits, rest adequately and avoiding stress.

(Read: Why women need folic acid during pregnancy)

How is a high risk pregnancy diagnosed?

Once the gynaecologist identifies that the mother has some of the pre-existing conditions where she is likely to have a complicated pregnancy, he/she will screen the patient and the unborn child for any conditions that could complicate issues at the last moment.

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What are the complications of such a pregnancy?

If a woman is diagnosed with having a serious medical condition during her pregnancy there are chances that she may have a miscarriage, there could be poor growth of the developing fetus, premature delivery and other complications.

Can certain types of medication complicate a pregnancy? What should a mother avoid during this phase?

There are certain medications like anti epileptic drugs which can cause genetic defects in the baby. I advise my patients to get pre-conceptional counseling. This is usually done by a by a gyaenacologist. A gynaecologist screens the patient prior to pregnancy for potential problems which may cause complications during the pregnancy and make sure they are managed prior to conception. Some of the common things that are done; is to replace more toxic drugs with milder ones prior to pregnancy so that the baby is affected as little as possible. If the patient is diagnosed with diabetes prior to pregnancy, treatment can be initiated so that during pregnancy things are under control with regular and close monitoring.

Often people say that doctors do a caesarean section without allowing for a normal birth. How does a doctor decide between the two?

This is not true. No doctor would like to do an unnecessary caesarean. Even we realize the potential complications of surgery in any patient. We decide to go for a caesarean based on the maternal condition during labor, if there are any associated high risk factors, if the baby is responding well to labor pains or showing signs of distress etc. Please remember a well planned and a well timed caesarean is any day better than a badly conducted vaginal delivery where the mother as well as the baby are in trouble due to prolonged labour.

(Read: Exercises during pregnancy can prevent emergency C-section)

For more on pregnancy, check out our pregnancy section. You can also watch videos on pregnancy and maternal health on our YouTube page.