Introduction:
Pregnancy is a critical phase that carries the risk of threatening one’s life. Not all pregnancies are the same. Some expectant women are more susceptible to developing complications and risks, while some follow the typical childbirth process. Pregnancy can equally influence the health of the mother and the baby in the womb. It is a multifactorial phase where several external and internal factors influence the pregnancy outcome. With the emergence of advancement in obstetrics, expectant women are offered enhanced perinatal care, which warrants favorable pregnancy outcomes.
What Are High Risk Pregnancies?
Every pregnancy has its risks and challenges. However, certain expectant women possess obvious risk factors that eventually bring in complications during pregnancy and childbirth. Such pregnancies are categorized as high-risk pregnancies. High-risk pregnancies are concerned with potential health risks for the expectant women and babies in the womb. High-risk pregnancies often warrant close surveillance and special attention. With advanced perinatal care and treatment modalities, high-risk pregnancies also result in safe and healthy childbirth without posing health risks to the maternal body.
Certain factors are considered while categorizing pregnancy as either high-risk or low-risk. Some of those factors that are more likely to precipitate complications in pregnancy involve the following:
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Maternal Age: Being too young and too old for conception can bring various complications. Expectant women under the age category of 17 and over the age category of 35 years are more susceptible to precipitate pregnancy complications.
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Maternal Health Status: Expectant women’s health status can directly affect pregnancy outcomes. The presence of underlying disease conditions like enhanced blood sugar level, blood pressure, and obesity (overweight) potentiates the pregnancy risk. Maternal infections like human immunodeficiency virus infections can also pose challenges to pregnancy status.
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Multiple Pregnancies: The presence of more than one baby in the womb is another factor that is capable of triggering labor much before the intended date, resulting in the premature birth of the baby.
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Deleterious Habits: Expectant women with smoking, alcohol consumption, and drug usage are considered to be high-risk pregnancies, as these habits can potentially deteriorate the pregnancy and can bring adverse complications.
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Parental Genetic Conditions: If the paternal or maternal family history reflects close association with any genetic conditions that can be transferred from one generation to the other through genes (genetic material), the resulting babies born to such couples are more susceptible to developing genetic or inborn conditions. However, with technological advancements, preconception genetic screening tests came into existence, successfully detecting the risk associated with each couple.
The risk factors that can bring in pregnancy complications are not restricted to those mentioned above. However, these are frequently reported factors concerning high-risk pregnancies.
What Are the Perinatal Care Strategies for High Risk Pregnancies?
High-risk pregnancy necessitates special care and attention throughout the gestational period. The perinatal care strategy for each pregnancy is different. For a high-risk pregnancy, the perinatal care and management strategy is largely determined by taking into account the associated risk factor concerning that particular expectant woman.
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Close Surveillance: High-risk pregnancy mandates close surveillance as per the advice from the concerned doctor to keep track of any undesirable pregnancy outcomes. Ultrasound aids in exposing premature cervical ripening, which can potentially guide into an early birth.
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Integrative Consultation: High-risk pregnancies often require specialist consultations who are well-versed and experienced in tackling complicated pregnancies. In addition to maternal-fetal medicine specialists, it often necessitates a collaborative and integrative treatment approach inclusive of specialists like gynecologists, neonatologists, and many more.
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Routine Fetal Evaluation: The baby in the womb will be subjected to close monitoring, especially in case of high-risk pregnancy. Any abnormality or deviation from what is normal warrants periodic monitoring at close intervals to ensure the safety of the mother and baby in the womb. Since high-risk pregnancies have a close connection with various pregnancy complications, it is imperative to adhere to the follow-up routine specified by concerned doctors. Fetal evaluation is often done with the help of ultrasound scans, which provide better visualization of the baby in the womb, encompassing the baby’s position and growth status.
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Pre-existing Illness Management: If the expectant woman has pre-existing ailments, the status of the disease condition needs to be tracked. Prompt therapeutic intervention aids in keeping the condition under control; however, the pregnancy status precludes the use of certain medications. Hence the medicine choice needs to be modified in such a way as to minimize drug-induced deleterious impact on the baby in the womb.
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Patient Counseling: Making the expectant women aware of the potential complications and the possibility of immediate delivery induction enhances patient compliance and aids in treatment success. Proper knowledge and understanding of the risks concerning their pregnancy keep expectant women vigilant, enabling a positive pregnancy experience.
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Home-Based Vital Sign Evaluation: Expectant women who are categorized with high-risk pregnancies are often advised to keep track of their vital signs regularly. It is done with the help of digital equipment, which aids in detecting any deviation in the vital signs indicating a threat to the mother or baby or both.
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Emotional and Mental Support: Being a high-risk pregnancy does not necessitate precipitation of pregnancy complications. Such women are more susceptible to pregnancy complications when compared with other expectant women who are free of associated risk factors. Proper emotional and mental support for the expectant women helps them subjugate the tough times. Therapeutic interventions, when coupled with non-therapeutic interventions, can effectively modify the pregnancy outcome and can bring positive results.
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Post-delivery Care: The care for expectant women needs to be extended even to the post-delivery period because such women are more susceptible to post-delivery issues like postpartum depression (unexplainable sadness following childbirth), heart diseases, and complications in subsequent conceptions.
Conclusion
High-risk pregnancies mandate special perinatal care and attention, as it can jeopardize the baby’s and mother’s life. However, with proper perinatal care, even expectant women who are marked as high-risk can result in a positive pregnancy experience with a healthy mother and baby. Therapeutic interventions, when coupled with non-therapeutic interventions, can effectively modify the pregnancy outcome and can bring positive results in high-risk pregnancies. It demonstrates the significance of perinatal care in dealing with high-risk pregnancies. The pregnancy outcome is largely guided by the timely detection of the associated risk factor and the execution of appropriate interventions. Technological advancements in the medical field have contributed immensely to the range of perinatal care offered to high-risk pregnancies. With proper monitoring and treatment planning, high-risk pregnancies can also bring out a healthy baby and mother.
