Giving birth to a newborn is the natural process. After experiencing all three trimesters of the pregnancy, a woman reaches the due date or near the labor time, and lastly the delivery. From here, there is a beginning of a new phase “mother-baby”.
However, the pregnancies of most women do not go smoothly. Some undergo what an obstetrician refers to as a “high-risk pregnancy”, a state of pregnancy when there are major complications. The risks can be before, throughout, or after childbirth. The outcomes can adversely impact the health of the woman and the growing infant.
So, high-risk pregnancy cases need advanced care by professionals to ensure the best result for a newborn and mother. Keep reading the article to know further.
The Advanced High-Risk Pregnancy Care By Obstetrician
When it is a high-risk pregnancy case, women have to visit a best obstetrician more often. There will be additional tests and close monitoring to ensure the good health of a mother and baby. Many private, as well as public healthcare centers, provide proficient maternal-fetal specialists for the advanced care.
The professionals give proper care and treatment for high-risk pregnancies which includes:
Preconception Counseling And Genetic Testing
When a woman diagnoses with a high-risk pregnancy, an obstetrician considers preconception counseling. It helps in the proper preparation of a healthy pregnancy. A specialist discusses the family history, medical conditions, lifestyle, and risk factors.
The aim of preconception counseling is the right health education and promotion, risk estimation, and prevention before pregnancy to lower the possibilities of poor perinatal results.
On the other hand, genetic testing identifies the risks and lets the doctors make the proper decisions. It provides information about the health after reviewing the health history, family history, and prior-pregnancy history.
The purpose of genetic testing is to:
- Monitor the woman’s health for the risk of having a child with certain health issues.
- Explain what are the causes of all those health problems and how it is genetic.
- Discuss what types of tests are available.
- Handle all the health needs of a woman.
- Treat every health issue.
A woman might need genetic counseling for any of the following aspects of high-risk pregnancy:
Family History Factors: The health problems are due to genetics, which means someone in the family is suffering from them. Those includes:
- Intellectual disabilities
- Heart disorders
- Hearing or eyesight problems
- Mental health issues
- Cystic fibrosis or phenylketonuria
- Short height
- Neural tube defects, such as anencephaly(brain defect) and spina bifida(spinal cord defect).
- Chromosomal abnormalities like Down syndrome, autism, Edward’s syndrome, and many more.
- Facial abnormalities like cleft lip or palate
- Learning disabilities
Pregnancy Factors: These includes:
- Maternal age over 35
- Abnormal prenatal testings or ultrasound exam results
- Miscarriages, stillbirths, or infant deaths in a previous pregnancy
- Parents exposed to alcohol, smoke, drugs, chemicals, or infections.
- Old aged father
- Mother with hemophilia disorder, autoimmune disorders, high blood pressure, diabetes, thyroid problems, blood diseases, etc.
Amniotic fluid is the clear and yellow color liquid that surrounds the growing baby during pregnancy. It protects the fetus from infections and injuries. In addition, this fluid allows proper fetal development and movement.
An obstetrician suggests “amniocentesis” in case of a high-risk pregnancy to check for any birth defects. It is a medical process in which a sample of the fluid is taken from the amniotic sac for testing. During the procedure, doctors check the heart rate of the fetus, position of the placenta and umbilical cord, and find a sack of amniotic fluid.
After that, OB/GYNs inject a numbing drug to numb the uterus area. Next, they take a small dose of amniotic fluid with the help of a syringe. The sample is tested in the laboratories.
During the testing, alpha-fetoprotein, a protein present in amniotic fluid, produced by the fetus is estimated to detect neural tube defects(spina bifida or anencephaly). Additionally, genetic or metabolic disorders may also be diagnosed.
An amniocentesis is done during the second or third week of pregnancy. It will be offered in the second trimester in some conditions which include:
- Family history or previous baby with a metabolic disorder or genetic diseases, like Down syndrome, Tay Sachs disease, or cystic fibrosis.
- Maternal age above 35 years
- Abnormal screening tests
Besides this, there might be the chances of amniocentesis procedure during the third trimester to analyze:
- Maturation of the fetal lungs
- Uterus infection
- Rh disease
First Trimester Screening
The first trimester screening includes an ultrasound of the growing baby and blood tests of the mother. An obstetrician performs it in the first trimester especially, during the 1 to 12 weeks. This testing helps to examine the risk of an infant having some birth defects.
First trimester screening includes:
- Ultrasound Test For Nuchal Translucency Of Fetus: In this test, OBs check the back of the fetus’ neck portion through ultrasound. It analyzes the thickening of skin or increase in the volume of fluid which may indicate genetic defects.
- Blood Tests: The blood tests estimate two substances present in the blood of women during pregnancy:
Pregnancy-Associated Plasma Protein-A: During the early stage of pregnancy, the placenta builds this protein for the healthy implantation process. The abnormal levels of this essential nutrient can lead to an increased risk of chromosomal abnormalities.
Human Chorionic Gonadotropin: This hormone is also produced by the placenta which increases the production of essential pregnancy hormones-estrogen and progesterone. They thicken the lining of the uterus and increase the supply of blood so that it enters the growing embryo and feeds it. The abnormal levels of this hormone can lead to unhealthy pregnancy and poor development and growth of an infant.
- Cell-Free Fetal DNA Screening: This test is for examining the DNA(which is in the blood of a mother) of the child. It analyzes specific abnormal chromosomes. In addition, through this screening, you can check for fetal sex chromosome abnormalities.
If the test results of the first trimester screening are abnormal, the pregnant woman might need additional testing for diagnosis. It may include another ultrasound or chorionic villus sampling.
Fetal Blood Sampling
In the fetal blood sampling process, a blood sample from the blood vessels in the umbilical cord is taken. This procedure is specially performed by obstetricians who specialize in care of infants in high-risk pregnancies. Doctors prefer this blood sampling only when other testing does not work or is not possible. They perform the tests during the 18th week of pregnancy or later.
A fetal blood sampling is to:
- Examine and treat an extremely low quantity of red blood cells in an infant
- Analyze and diagnose blood problems, like Rh disease
- Check for oxygen levels in a fetus
- Test for infection in a fetus
- Analyze chromosome abnormalities
Fetal blood sampling benefits in understanding specific information about the health of an infant. Also, if any severe blood diseases are found, the right treatment can be given before birth.
Pre-Delivery (Antepartum) Care
Healthcare providers use advanced monitoring machines, tools, and approaches to look after pregnant women and growing babies. The team of an obstetrician, maternity nurses, and sonographers keep an eye on every personal detail related to pregnancy and provide effective care and treatment.
The high-tech facilities in reputed hospitals provide OBs with the best monitoring abilities in a setting designed for the privacy, well-being, and comfort of patients. Whether women need long-term or short-term stay in the healthcare centers, the doctors give the possible convenience.
Thus, every pregnant woman has a calm state of mind knowing that they will get all the maternal-fetal services in an appropriate manner.
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High-risk pregnancies may have ups and downs. So, every woman should stay positive to promote a healthy and safe pregnancy. Reduce the risk of complications by visiting an obstetrician for proper and advanced care.
The right prenatal care will help pregnant women maintain good health for themselves and their growing babies.