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My OBGYN doctor ticked the high risk pregnancy column in my antenatal progress card and then went on to enumerate the risk factors. I got worried.
Then she explained me that I have chronic hypertension, impaired glucose tolerance and that mine is also post renal transplant case. She counselled me and my family and explained that the high risk pregnancy does not mean it is going to be more difficult and the baby will be less healthy.
High risk pregnancy implies that it requires more frequent and close monitoring with the support of other specialities in a multispeciality hospital. She explained that even with a normal pregnancy, sometimes an adverse condition might arise during delivery or postnatal. (Sonal, expecting mother, name changed to maintain confidentiality)
High risk pregnancy can be due to previously existing conditions like high blood pressure, high blood sugar, deranged kidney/ liver function, cardiac or hematological disorders, epilepsy, post / current cancer, placenta previa. Another reason can also be due to previous pregnancy with recurrent miscarriages, genetic disorder, gestational diabetes and pregnancy induced hypertension, or a case of cesarean section in the last pregnancy.
In today’s time, multiple factors contribute to pregnancy with maternal risks. These factors include – increased age of women at which they are conceiving, assisted reproductive techniques and higher order births. At the same time, expert neonatologists equipped with advanced technology have come
a long way in reducing neonatal morbidity and mortality rates.
On the other hand, a high risk pregnancy just suggests that this pregnancy needs to be managed in a multispeciality and well equipped hospital with the best expertise and technology. The core teams include 1. OBGYN and Maternal Fetal Medicine specialists with one nurse to one patient staffed labour room, 2. Tertiary care NICU with a competent team of neonatologists, 3.Expert Obstetrics and Anaesthetists for painless delivery. Various other speciality departments like endocrinology, cardiology, nephrology, hematology, hepatology, gastroenterology, dietetics , oncology and a good physician are
deemed essential to a hospital managing and conducting high risk pregnancy deliveries. The blood bank facilities to cater to different blood components is an essential prerequisite. A wellequipped 24 hrs laboratory services for various investigations for medical disorders is a must.
Being labelled as a “high risk pregnancy” does not rule out your chance of a normal delivery. Vaginal delivery should be tried in a setup with expert manpower and technology.
The risk factor in the current pregnancy does not necessarily repeat itself in subsequent pregnancies. It just means that the subsequent pregnancy requires special care in a multispeciality and well equipped setup.