Who do we consider as high risk?
Your pregnancy will be considered as a high risk one if you fall into any one of the following:
- First pregnancy
- Previous bad pregnancy outcome:
– Recurrent early miscarriage
– 1 late miscarriage (> 10 weeks)
– Previous premature delivery < 34 weeks
– Previous severe hypertension syndrome during pregnancy
- You have a medical condition (not limited to the following):
- Previous baby diagnosed with abnormalities.
What can we do for a high-risk pregnancy?
- First Pregnancy: The chance for hypertension syndromes is highest in the 1st pregnancy. Once complications have developed there is a 15% chance of it repeating in a subsequent pregnancy. Testing is now available at 11-14 weeks to detect those who will develop this complication. Preventive treatment will reduce the risk by > 60%.
- Previous bad outcomes: Often there are causes behind these bad outcomes. And once they have occurred the chance of a repeat in a subsequent pregnancy is increased. If they are analyzed in detail, preventive measures can be put in place. The follow up and preventive therapy plan can be outlined from the beginning. It is best to have this discussion prior to a pregnancy. If already pregnant this is best done before the 10th week of pregnancy.
- Medical condition: Medical conditions may affect a pregnancy and this is true vice versa. Medication used to control the disease may also affect pregnancy, and vice versa. Uncontrolled medical conditions may harm the pregnancy. Detailed discussions on the approach to pregnancy, treatment and monitoring will improve outcomes.
- Previous baby with abnormalities: The risk of a repeat is slightly increased compared the population risk. The back ground risk for anyone to have a baby with anomaly is 3%. A thorough program for earliest detection with the 12 and 20 weeks detailed genetic and structural scan will be reassuring. Rarely there are anomalies that can be prevented with specific measures.