High-risk pregnancy

Pregnancy is undoubtedly one of the greatest moment in woman’s life as she brings inside her a small life that will convey many different feelings.
Unfortunately, pregnancy can be complicated by un unlimited number of things. That means that some real or potential pathological conditions may compromise mother or baby’s health or even their life.

Risk factors

Many are the factors that may determine a high-risk pregnancy:

- mother’s age: a girl who is less than 15 years may run the risk to develop preeclampsia, a rapidly progressive condition characterized by high blood pressure, the presence of protein in the urine and water retention or the eclampsia, characterized by preeclamptic convulsions. On the same level, a woman who is more than 35 years may run the risk of an increase in blood pressure, gestational diabetes, complications during delivery or caused by anaesthesia, fibroids or the development of chromosome anomalies (like Down syndrome)

- weight-height relationship: if the mother weights less than 45 kg, the baby may born underweight. On the contrary, if the mother suffers from obesity, the baby may born overweight as well and the mother would suffer from gestational diabetes. Height is an important factor as well: if the mother is less than 1.60 cm tall, she could incur a preterm delivery as the pelvis is too small

- RH disease: if mother and foetus are both RH-negative they would not run any risk during the first pregnancy. Instead, if the next pregnancy is RH-negative too, the mother must be treated with injections of antibodies anti RH-negative to avoid haemolytic problems (meaning that the disease causes destruction of foetal red blood cells) or complications during delivery

- structural alterations of genital apparatus: ovarian or uterine anomalies may lead to abortion. Fibroids too (benign tumours of the uterus) may cause preterm deliveries, foetal malpresentation or complications during delivery

- maternal diseases: diseases like high blood pressure, kidney diseases, diabetes, congenital heart diseases, thyroids or coagulation problems, respiratory or autoimmune diseases may cause problems to pregnancy or during delivery

- teratogenic agents: namely the agents that cause a structural abnormality following foetal exposure during pregnancy. They include: radiations (X-rays, UVA, UVB), infectious agents (rubella, cytomegalovirus, chickenpox, herpes simplex, toxoplasmosis, syphilis, etc.), maternal diseases like diabetes, drugs and alcohol abuse

- abruptio placenta: the most common placental problem is when a normally implanted placenta abruptly separates or breaks away from the uterine wall too early, before delivery of the foetus. There is no known precise explanation as to the mechanism of abruptio placenta. But there are a number of identifiable factors that will raise the woman’s risk for abruptio placenta. This includes: previous history of abruptio placenta, maternal hypertension, maternal trauma (injury to the uterus like in car accident), smoking during pregnancy, maternal cocaine abuse.

In order to calculate if a pregnancy is going to be at risk, it is advisable to check the own family’s health history and consider factors like woman’s age, previous pregnancies (if there were any), the arise of diseases or genital anomalies or even the emotional component and the surrounding social/family environment.
An early recognition of a high-risk pregnancy is of paramount importance as it allows to intervene promptly, reassure the mother and offer the doctor precise directions for possible future interventions during pregnancy or at the moment of delivery.

Conduct

How should we behave if we are diagnosed with a high-risk pregnancy?
If the risk is low, it will be sufficient to strictly stick to the visits that the doctor will prescribe; on the contrary, if the risk is high the best solution is undoubtedly the hospitalization to periodically monitor pregnancy and foetal development thanks to a professional team of obstetricians, neonatologists and anaesthetists.

Prevention

Some risk conditions can be reduced thanks to a good prevention:

- before pregnancy: it is sufficient to carry out some examinations to check possible hereditary diseases, chromosome anomalies or gene mutations and monitoring pathologies like diabetes or hypertension.
- after pregnancy: it is advisable to rely on a constant medical advice and on the visits prescribed and at the same time improve the own quality of life in few simple tricks like reducing coffee consumption, avoid smoking, alcohol and physical efforts, keep a healthy diet.