High Risk Obstetrics

MEDICAL DISORDERS COMPLICATING PREGNANCIES

All medical disorders complicating pregnancies are considered as high risk. These women will be requiring a premarital counseling, preconceptional counseling, prenatal screening and contraceptive counseling. A long with the above a regular antenatal checkups and admission for observation may be required as and when advised by the consultant.

Heart disease:

When a woman becomes pregnant with already existing heart disease is termed as Heart disease complicating pregnancy. For these women regular ANC and simultaneous cardiologist consultation is required.

Thyroid disorders:

Woman with abnormal thyroid levels is known to be having either Hypothyroid or Hyper thyroid. It is a must to keep the thyroid levels in control. Either a physician or an Endocrinologist consultation is required to achieve normal thyroid levels. It is important to maintain the levels as there may be complications leading to Abortions, preterm labor, increased risk of pre eclampsia, cardiac failure, thyrotoxicosis and so on in the mother. And in fetus - Fetal growth restriction, still births, neonatal mortality, fetal goiter, perinatal mortality and so on may occur.

Chronic Renal Disease:

It is the kidney disease in pregnancy. The risk is depending upon the severity of the kidney disease. It may be worse for a woman with hypertension and women with pre eclampsia. Preconceptional counseling , preconceptional screening, regular antenatal checkups and regular investigations are to be done.

Epilepsy:

Seizures during pregnancy due to disorders in the central nervous system with abnormal discharge with or without loss of consciousness is called Epilepsy.Its effects on pregnancy are various like increased frequency of malformations in the fetus, abortions, fetal growth restriction, less liquor during pregnancy and sometimes death of the fetus inside the uterus. Regular antenatal checkups, admission in hospital, close monitoring, antiepileptic medication are required.

Liver disorders:

Liver disease caused during pregnancy are obstructive cholestasis, acute fatty liver, Hyperemesis gravidarum induced liver damage (excessive vomiting), liver damage due to pre eclampsia, eclampsia, HELLP Syndrome, Jaundice and soon. Preconceptional counseling, regular antenatal checkups are required.

Pregnancy associated liver disorders:

Acute viral hepatitis, chronic hepatitis, liver cirrhosis, liver tumors and so on are termed in this category. In these conditions there will be increased risk of premature labor, fetal growth restriction, meconium stained liquor, fetal distress during labor and so on occure. These women are counseled about various risks in detail. Liver function tests, clotting time, should be monitored regularly. Regular antenatal checkup is a must. Labor is induced at 38 weeks of gestation depending upon the adequacy of the pelvis. Vitamin K is given to mother post delivery to reduce the risk of PPH.

Autoimmune conditions:

It is a condition where our body cells are acting against our own body organs and lead to damage of the fetus developing inside the uterus. Immunosupression medication may be given to the mother.

Acute Viral and Bacterial illness:

Infection in the body may be viral or bacterial and can spread anywhere in the body. Timely blood tests, complete urine examination are done and reviewed with the consultant. A pregnant woman should maintain good hygiene to prevent herself from infections.

Blood disorders complicating pregnancies:

The most common blood disorder during pregnancy is anemia where the hemoglobin levels of the mother is low. Regular blood test and regular intake of iron and folic acid medication is a must.

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