Most pregnancies are straightforward; however, a minority of women experience high-risk pregnancies. ELEANOR FITZSIMONS provides advice on how to cope with a complicated pregnancy.
Allowing for the discomfort of morning sickness, fatigue, heartburn, backache and swollen ankles, most pregnancies and births are perfectly straightforward. Spare a thought, therefore, for expectant mothers whose pregnancies are labelled ‘high-risk’ due to pre-existing conditions or complicating factors that arise during pregnancy.
A pregnancy is generally categorised as high-hisk in order to allow medical professionals to monitor progress and intervene if necessary. Developments in obstetrics have made it very likely that, with appropriate care, both mother and baby can expect healthy, successful pregnancies and will have a very happy outcome. To help allay any concerns, it is really useful to inform yourself as fully as possible about the impact of your condition on pregnancy and how it will be managed.
Risks include age, previous birth experiences and underlying medical conditions. The common factor in each case is that mother, baby, or both, are at increased risk of complications during pregnancy, birth and the period directly afterwards. Conditions such as high blood pressure or gestational diabetes can arise unexpectedly during pregnancy. Other complications relate to conditions that the expectant mother and her medical team are well aware of in advance, such as thyroid disease, diabetes and lupus. Previous birth experiences such as stillbirth, early labour and a high number of previous pregnancies (five or more) are also taken into account.
What constitutes high risk?
The following are included in the definition of high-risk pregnancy:
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Longstanding medical problems such as high blood pressure, heart disease, diabetes, TB, Crohn’s disease, lupus, asthma, AIDS or a seizure disorder. Pregnancy can cause the symptoms of conditions like lupus or kidney disease to worsen, and makes diabetes harder to control as blood sugar and the requirement for insulin generally increases.
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The expectant mother is aged under 15 or over 35, although the latter is increasingly common. Older mothers have a measurably higher risk of miscarriage, birth defects, complications and Caesarean section (C-section) delivery.
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The expectant mother is significantly overweight or underweight. In 2010 an Irish study found that 43 per cent of pregnant women were overweight, increasing the risk of medical complications. Obese women are more likely to develop diabetes or hypertension, or require a C-section.
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Multiple pregnancies are automatically classified as high-risk.
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Gestational diabetes, a condition where blood sugar is elevated, and other diabetic symptoms appear during pregnancy. In most cases, diabetic symptoms will disappear following delivery.
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Premature labour.
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A history of pregnancy complications in the mother’s health (pre-eclampsia for example) or in the health of her infant (stillbirth, a premature baby or a baby born with a birth defect such as a heart problem or genetic condition).
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During pregnancy, the expectant mother suffers from conditions such as vaginal or cervical infections or undergoes emergency surgery such as for appendicitis.
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The baby is exposed to infection including mumps and rubella, or to damaging substances or medications.
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Prenatal tests indicate that the baby has a serious health problem.
Tips on coping with a high-risk pregnancy
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Seek medical advice as soon as you realise that you are pregnant. Every major maternity hospital in Ireland has a specialist unit for high-risk pregnancies.
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Keep yourself informed as to the likely consequences and interventions related to your condition. Websites like www.keepemcookin.com are helpful.
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Network with other mums and mums-to-be who have had similar experiences. Rollercoaster.ie is an online community of mums and mums-to-be.
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If bed rest is advised then avert boredom by getting online. Social networks like Twitter and Facebook can help. Also seek medical advice on bed rest exercises, as these can help maintain muscle tone.
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In many instances, such as diabetes, your diet will be restricted. Follow your doctor’s advice closely. Pre-conception nutrition to prepare your body for pregnancy is often recommended. Maintaining a healthy weight and healthy diet will help you avoid conditions like high blood pressure and gestational diabetes.
