High Risk Pregnancy

High-risk pregnancy is when a condition puts the mother, baby or
both at a higher risk. You are more likely to have a high-risk
. pregnancy if you:
. Are overweight (especially if it is by more than 22kg);
. Smoke;
. Have seizures;
. Have diabetes;
. Use drugs or alcohol;
. Are younger than 18 or older than 35;
. Have a history of genetic defects or
. You are having twins/triplets etc.
Just because you have these factors will not automatically mean
you have a high-risk pregnancy and the opposite is true, just because
you have no pre-existing health issues will not guarantee a healthy
pregnancy. You are also at more risk if you have had any of the above
issues/complications in a previous pregnancy.
If you have a pre-existing condition, you need do discuss the pros
and cons of pregnancy with your GP and/or supervising consultant.
There are many variables to consider and you need an expert to advise
There are many variables to consider and you need an expert to advise
you.

Smoking Complications:

The nicotine present in cigarettes can stunt your baby’s growth,
and even a few cigarettes a day means harmful chemicals are reaching
your baby. Smoking throughout your pregnancy can cause your baby
to have a low birth weight or you may go into premature labour. You
are more at risk of suffering a miscarriage, and smoking causes
problems with the placenta. Babies are more likely to be ill following
delivery; stay longer in hospital or even need care in the special care
baby unit.
In addition, smoking during pregnancy and after your baby’s
birth, puts them at a higher risk of ‘Sudden Infant Death Syndrome’
(SIDS). Stopping smoking prior to birth is the only safe option for
your baby. As soon as you give up, the baby will receive more oxygen.
NB: If you are planning a pregnancy or are pregnant and finding
it hard to stop smoking, talk to your doctor about places you can get
support

Alcohol:

Experts are unsure what is a safe amount of alcohol for pregnantwomen to drink, so if you are planning a pregnancy, or already
pregnant the best advice is to abstain completely. Alcohol is passed
from mother to baby, via the placenta, and it can damage and effect
the cell growth of the baby (brain cells and spinal cord cells are usually
the worst affected). It can cause ‘Foetal Alcohol Spectrum Disorders’
or the more severe ‘Foetal Alcohol Syndrome’. These cause a wide
range of behavioral, learning and physical problems, which can vary
from mild to severe. If you are having trouble quitting alcohol, talk to
your GP, so they can provide the necessary support.

Hyperemesis Gravidarum (HG):

This condition affects about 1% of pregnant women and is an
excessive form of nausea and vomiting. It is not known why some
women get it and others don’t but some evidence shows it runs in
families; and if you experienced HG in a previous pregnancy you are
more likely to get it in subsequent ones. Some tips to help alleviate
symptoms are:
. Rest;
. Staying hydrated;
. Avoiding nausea triggers;
Emotional and physical support.
Not all tips work for all women, and it can be a case of trial and
error to find the ones that work for you.
Be that as it may there are medications that can help including
Be that as it may, there are medications that can help, including
in the early stages of pregnancy e.g. anti-sickness drugs, steroids and
vitamins B6 & B12
NB: If you are unable to keep down food and fluids contact your
doctor, as you can become dehydrated very quickly when suffering
with HG, and you may need to be admitted to hospital for intravenous
fluid therapy

Gestational Diabetes:

This is caused because the placenta produces hormones that lead
to an increase of sugar in your blood. Your pancreas normally
produces enough insulin to control this. If not, then it will cause your
blood sugar to rise, and you will develop gestational diabetes.
Symptoms may not necessarily arise, but can include: feeling tired;
being very thirsty; weeing a lot; a dry mouth; infections like thrush, or
blurred vision. Please make an appointment to see your health
professional, so you can be monitored more closely. Gestational
diabetes may mean you go into premature labour, so your baby will be
monitored to make sure they do not show any signs of distress. After
birth your baby may need to have blood tests regularly, as they may
have low-blood sugar, while they adapt to making the right amount of
insulin.

Pre-eclampsia:

re-eclampsia:
This affects some women, usually in the second half of their
pregnancy, and can even happen after their baby is born. When you
see your midwife, they will monitor your blood pressure, and test a
urine sample. Pre-eclampsia is one of the things they are checking for.
Early signs are high blood pressure and protein found in your urine.
Other symptoms include excess swelling of the hands, feet, and legs;
severe headaches; vision issues. If you notice any of these symptoms,
you need to seek the advice of your midwife or GP immediately. In
most cases pre-eclampsia does not cause any problems, and it
improves after delivery.
NB: There is a risk that pre-eclampsia can become ‘eclampsia’.
These are seizures, that can put both the mother and baby at risk.
Contact your GP if you have any concerns.

Ectopic Pregnancy:

An ectopic pregnancy can occur when the fertilized egg implants
outside of the uterus, usually in the fallopian tube. Symptoms to look
out for are:
A missed period (some women may not know they are
pregnant)
Vaginal bleeding
Pain in your lower abdomen – on one side;
Pain in the tip of your shoulder (no one is sure why this
occurs);
Discomfort weeing or peeing.
An ectopic pregnancy may grow large enough that it causes a
fallopian tube to rupture. This is an emergency and you need surgery
to repair or remove the fallopian tube. Signs of a rupture are: feeling
very dizzy or faint; nausea or vomiting; looking very pale; a sharp,
sudden, acute pain in your tummy. Seek medical help immediately.

Placenta Previa:

This is where the placenta lies unusually low in the uterus, and it
may be near or over the surface of the cervix. Early in pregnancy it
does not cause a problem, but later it can be an issue, as it will block
your baby’s way out. They will record the position of your placenta
when you have your second scan, and if you are found to have placenta
previa they will perform another scan at around the 32-week mark. If
the placenta is low it puts you at higher risk of bleeding throughout
your pregnancy and labour, and this bleeding may be heavy, which
puts you and your baby at risk. Your consultant may recommend that
you are admitted to hospital towards the end of your pregnancy, so
they can monitor you closely and emergency treatment is at hand.
They will recommend you have a caesarian if the placenta is
completely blocking your cervix.

NB: If you experience bright red (painless) bleeding during the
last few months of pregnancy contact your midwife or doctor
immediately.

Placental Abruption:

If a placental tear occurs you may notice vaginal bleeding and
should seek medical attention. However, approximately 90% of these
tears can heal themselves but they may also put you at an increased
risk of a miscarriage, premature labour or placental abruption. This is
a complication of pregnancy that means the placenta has separated
from the wall of the uterus. It can deprive your baby of oxygen and
nutrients but also cause severe bleeding that could be dangerous to
you both.
NB: if you notice any of the following: vaginal bleeding,
abdominal pain, rapid contractions, or your ‘baby bump’ is tender
seek medical attention immediately.

Premature Labour:

Premature labour can be divided in groups:
Extremely premature: under 28 week’s gestation
Very premature: 28 to 32 weeks
Late prematurity: 32 to 37 weeks
Although it is important a baby gets as close to the due date as
possible, sometimes things happen that are outside your control.
Some factors mean you may be more at risk of premature labour.
These are:
Multiple pregnancy;
Lifestyle factors (smoking, recreational drugs, high
caffeine intake; poor diet/being underweight);
Maternal age (under 20, over 35)
Infections (chlamydia, untreated bladder infection);
Cervical incompetence (the cervix opens too soon and
labour follows).
While some of these cannot be avoided, others can. It is
important to receive good antenatal care, have regular checkups and
maintain a healthy lifestyle. If you are concerned, contact your
GP/midwife immediately.

Social Factors

Older mums

You may hear the term elderly primigravida. This is from the age
of 35, so not that old really, but pregnancy from this age may come
with additional risks

Most older mum’s these days have chosen to delay pregnancy.
Although some women have medical reasons e.g. repeated
miscarriages, fertility issues. Many older mum’s have chosen to delay
pregnancy for social/personal reasons and they tend to be better
educated, more confident and financially stable. You do however need
to be aware of associated risks, some of which are:
Decreased fertility;
Chromosomal abnormalities;
Developing high blood pressure or diabetes;
Multiple births;
Birth intervention (labour induction, forceps);
Caesarian section.
N.B: It is best to talk to your doctor, before trying to conceive.
They can give you a thorough checkup, and advice to ensure you are in
good general health, and refer you to a specialist if you have any
specific issues that need addressing

Teen Pregnancy

Most girls usually start their periods about the age of 12, and teen
pregnancy is defined as occurring between the age of 13 and 19 years.
Teens (both girls and boys) need to be educated to realise that girls
can become pregnant as soon as they begin to ovulate, so they need to
practice safe sex if they are to avoid becoming pregnant If you are a
practice safe sex, if they are to avoid becoming pregnant. If you are a
teenager, pregnant and reading this please talk to an adult you trust:
mum or dad; school counsellor/teacher, or call a support helpline.
Above all you need to get help/advice and medical support for you and
your baby, whether you choose to continue with the pregnancy or not.

Bed Rest

For some pregnant woman, they are advised to stay on bed rest
(for a short or extended period). They may be at risk of complications
such as high blood pressure; pre-eclampsia; vaginal bleeding (placenta
previa, placental abruption); premature labour; threatened
miscarriage; cervical insufficiency, or there may be growth issues with
the baby. Some women may need to reduce their activity, or reduce
their stress levels and being put on bed rest is a way to reduce
unnecessary physical activities. However, being put on bed rest is not
without its own issues. You may be more likely to experience
heartburn, constipation, or you may just feel down as your lifestyle is
curtailed. If you do find yourself feeling down, or think you me be
becoming depressed, make sure to talk to your GP, as soon as possible.
Also, ask friends and family to rally round and create a rota to visit
you. Just remember to not overdo things!

 

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