High Risk Pregnancy Care

Whilst pregnancy is a normal and natural event in most women’s lives, for some women, their pregnancy can bring about unexpected complications.  Complications can be due to either:

  • A pre-existing medical condition, or
  • A medical condition relating to pregnancy

A high-risk pregnancy means there is a health risk to the mother, or her baby or both. Therefore women with a high-risk pregnancy may require additional care and services during their pregnancy and delivery.

Pre-existing medical conditions

Women with a pre-existing medical condition prior to pregnancy can have an increased risk for adverse complications.

Some examples of pre-existing medical conditions include:

  • Pre-existing diabetes
  • Chronic hypertension (high blood pressure)
  • Overweight or obesity
  • Epilepsy
  • Pre-existing or previous mental illness (such as depression)
  • Disorders related to immune function
  • Severe asthma
  • Being HIV positive

Women who have a complex pre-existing medical condition should be managed by a specialist obstetrician such as Dr Hong who has undergone specialist medical training in obstetrics.

Pregnancy-related medical conditions

A pregnancy may become high-risk during the course of a woman’s gestation. The three most common pregnancy-related complications that can occur include:

  • Pre-eclampsia
  • Fetal growth restriction (FGR)
  • Preterm labour

Pre-eclampsia – typically occurs in the second half of the pregnancy and is characterised by high blood pressure and abnormal kidney function.  Routine antenatal care will monitor your signs for pre-eclampsia through regular blood pressure checks as well as testing your urine for protein.

  • Women who are identified as being high risk for pre-eclampsia can be offered additional care to minimise development of the condition. Additional care methods can include:
    • Medication – such as Aspirin
    • Additional calcium – if dietary calcium intakes are not adequate
    • Increased monitoring through pregnancy
  • Once you develop pre-eclampsia, it does not resolve until your baby is born, therefore you may require an earlier delivery either via an induction of labour or caesarean section.

Fetal growth restriction (FGR) – is where a baby fails to grow and develop to its full potential in the womb.

  • Fetal growth restriction is thought to be related to half of all stillborn babies.
  • Women who are identified as being high risk for a FGR baby will have increased surveillance in the form of ultrasound scans and antenatal visits to monitor the baby’s growth.

Preterm labour – is where a woman goes into labour before 37 weeks in a singleton pregnancy.

  • Preterm labour can result in an increased risk of cerebral palsy, hearing and visual impairment as well as learning difficulties in the infant.
  • Additional screening and measurements may need to be done to assess the length of the cervix. A cervix that is short in length can increase the risk for preterm labour.
  • Cervical length assessment is conducted via a transvaginal ultrasound scan.

Additional pregnancy-related conditions can include:

  • Gestational diabetes
  • Hyperemesis gravidarum – a condition which involves excessive vomiting and nausea, weight loss and dehydration
  • Neonatal congenital conditions (such as Down Syndrome, spina bifida or heart-related conditions)
  • Pregnancy-induced hypertension (high blood pressure)

Through initial antenatal screening, early detection of risk factors which could result in pregnancy complications can be assessed and an individual care plan can be detailed and provided to you by Dr Hong.

The care usually comprises a multidisciplinary team approach with options for additional screening measures where needed and Dr Hong will discuss this with you at your consultation.

Self-care in pregnancy

Your health and wellbeing prior to and during your pregnancy has a direct impact on the health and wellbeing of your babies.

Pregnancy care measures that you can start straight away to ensure optimal health for you and your baby include:

  • Avoiding all alcohol, smoking and substance (such as illegal drugs), which pose a serious health, threat to you and your baby.
  • Ensure you are consuming a healthy and balanced diet.
  • Check with your GP or Dr Hong regarding your vaccination status, as well as additional vaccines, which are relevant in pregnancy such as the flu and whooping cough vaccines.
  • As soon as you start to plan your pregnancy it is important to take a folic acid supplement to help prevent birth defects such as spina bifida.

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