WHAT ARE HIGH RISK PREGNANCIES?

The term risky pregnancy refers to pregnancies that carry vital risks for the mother and the baby when left to their natural course. The main purpose of all routine monthly and sometimes more frequent pregnancy checks is to detect risky pregnancies and combat the problems that have occurred or may occur. p>

Studies in this field have been the most important area of ​​endeavor for obstetricians from history to the present. Nowadays, with the developing information technology, brand new methods are used in the recognition, monitoring and treatment of risky pregnancies. With these developments, especially in the last 20 years, maternal and infant deaths (mortality) and mother-infant sequelae (morbidity) have been reduced considerably.

Risky Pregnancies have two dimensions: risks arising from the mother and risks arising from the fetus. However, the mother and the fetus are in such a close relationship that the risks of one during pregnancy generally carry a high risk for the other.

Risks Originating from the Mother: Pregnancy is an additional risk for the expectant mother. It is a physical and mental burden. For this reason, while men can have children at the age of 70, women's fertility disappears after the age of 40. Because even with today's technological opportunities, if 50-60 year old women could get pregnant, many of them would lose their lives; Risks arising from the mother are divided into two: those that exist before pregnancy and those that develop during pregnancy;


1-Pre-Pregnancy Risks:


-Maternal Age:The ideal gestational age is considered to be between 20-30 years old. Although the limits are being pushed by developing technology, pregnancies under the age of 18 and over the age of 35 carry a high risk. The frequency of genetic diseases increases with age, exposure to chronic diseases increases, and the mother's endurance to the increase in physical load that may occur during pregnancy decreases. Expectant mothers under the age of 18 experience pregnancy risks more intensely because they have not completed their physical and spiritual development.
-High Blood Pressure in the Mother: Mothers with high blood pressure are more susceptible to problems due to the strain on their cardiovascular systems during pregnancy. They are also complicated by pregnancy hypertension. When it occurs, it can cause vital problems for both the mother and the baby.
- Heart rhythm disorder in the mother. :Some heart rhythm disorders may become evident during pregnancy with increased physical activity or may become obvious during pregnancy.
-Diabetes in the Mother: Diabetes can prevent pregnancy, as well as the mother's discomfort during pregnancy. Disrupted metabolism creates an additional burden for the mother and increases the frequency of structural anomalies in the fetus, which can cause many problems for babies during and after birth. - Severe anemia or congenital blood diseases in the mother, Presence of other system diseases in the mother (heart, kidney, rheumatic, etc.) It has not been proven that it causes anomalies, but one thing is certain; babies of mothers who smoke have low birth weight and are born prematurely. Therefore, mothers should quit smoking during pregnancy if possible, and if they cannot quit, they should consume the least number of cigarettes possible) or those who are addicted to drugs or who use chronic medication due to their illness. women.
- Pregnancies with myoma, the size of the myoma and the relationship of the baby with its partner are very important here. Follow-up and delivery of the pregnancy with myoma are special.


B-Risks that may develop during pregnancy;


- Pregnancy blood pressure and complications that may develop due to it. One of the most important purposes of pregnancy follow-up is to recognize pregnancy-induced blood pressure early, even to determine who may have it prematurely, and to take possible precautions for both the mother and the baby. and to manage the course of pregnancy and birth almost perfectly. In this regard, it is now possible to use very advanced technologies to detect 90% of those who may develop it and guide both the mother and the fetus to overcome possible problems to a minimum.


-Gestational Diabetes:Nowadays, especially Gestational diabetes screening and follow-up, which is very controversial in our country, is recommended by scientific authorities all over the world and the World Health Organization in risky pregnancy follow-up. It occurs after the 24th week of pregnancy (gestational diabetes is not seen from the first week of pregnancy because it is in the 24th week). The hormone called "human placental lactogen" HPL, which is secreted from the placenta from the gestational week onwards, can cause gestational diabetes in some predisposed mothers, and this hormone may have an active effect after the 24th week. If gestational diabetes is not screened and followed well, the babies of these mothers may experience premature birth, large babies and the complications caused by it. The risk of birth complications, sudden infant death and gestational hypertension is higher, and these babies are more likely to encounter some metabolic problems after birth. -Multiple Pregnancies: Multiple pregnancies are high-risk pregnancies in themselves, and as the number of babies increases, risks and problems are increasing. Problems arising from increased physical load for the mother and pressure on the mother's organs due to multiple babies taking up space in the abdomen are common, and premature birth and related complications create quite a lot of trouble. In addition, identical twins or monogamous twin babies can steal blood from each other, endangering the lives of both babies. In order to diagnose this condition, the structure of multiple pregnancies should be revealed in the first 3 months of pregnancy. For this reason, multiple pregnancies have a significant increase in risk from the first week of pregnancy to the end of labor and birth and they need to be closely monitored. Early diagnosis and management of problems are very important. - Pregnancy-related forms of some rheumatic diseases. Arrival: It can cause problems in babies, from infection to widespread sepsis in the mother and respiratory distress in the baby. Mothers need to be sensitive about this issue and should report such complaints to their doctor, even if they are mild. In case of premature rupture of membranes (early water breaking), the obstetrician and the baby intensive care team are almost playing chess. Early diagnosis and correct management of the process are vital. It is vital that all pregnant women be very sensitive about this issue and warn their physicians early. Even in today's Istanbul, people can lose their babies and their lives. It is very easy to diagnose But the problems it may cause can lead to loss of life. Births in which the placenta blocks the birth paths (requiring cesarean section) are special pregnancies and births and must be performed in fully equipped hospitals and under the supervision of experienced physicians. -Congenital defects in the mother's womb. It can cause a number of problems, from miscarriages to premature births and limb defects in the fetus. With advanced ultrasound technology and surgical methods, such problems can be detected and resolved before pregnancy occurs. One of the most important benefits of being examined by an obstetrician before getting pregnant is to prepare the ground for the elimination of such problems before pregnancy. Those who have previously had a cesarean section or other uterine surgeries. This group of pregnancies are at risk of uterine rupture. It should be monitored meticulously and birth planning should be done on time. -One of the most important risk criteria is the early deletion of the birth path in the mother, which we call "cervical insufficiency", and as a result of this, screening for this serious situation, which can lead to premature birth and preterm risks and fetal loss, is the uterine length measurement. The pregnancies of mothers who have given birth prematurely are also included in the risky pregnancy class that requires special monitoring.

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