WHAT IS HIGH RISK PREGNANCY?
Pregnancies during pregnancy, birth and puerperium, where the likelihood of any problems that endanger the life or health of the mother or her baby increase, are 'high risk'. These situations cause the physical and emotional burden of pregnancy to increase. Health problems that exist before pregnancy or occur during pregnancy may increase the likelihood of a high-risk pregnancy. Consultation from a high-risk pregnancy subspecialist (perinatologist) and other relevant specialist physicians is often required. WHAT ARE THE HIGH-RISK PREGNANCY RISK FACTORS? These risk factors can be examined under 4 main headings: 1. EXISTING HEALTH PROBLEMS High blood pressure, polycystic ovary syndrome, diabetes, kidney disease, blood diseases, autoimmune disease, thyroid disorder, infertility, obesity, depression, HIV/AIDS 2ND AGE Adolescent pregnancy, > ; First pregnancy at the age of 35 3. LIFE STYLE Alcohol, smoking, substance addiction 4. PREGNANCY SPECIFIC PROBLEMS Multiple pregnancy, gestational diabetes, hypertension during pregnancy, placenta problems, threat of miscarriage, threat of premature birth, high-risk pregnancy history, fetus with anomalies High Blood Pressure Hypertension under control It is often a problem for neither the mother nor her baby. If a patient with uncontrolled hypertension becomes pregnant, problems such as hypertensive diseases (pregnancy poisoning), kidney disease, brain hemorrhage, developmental delay in the baby, lack of water in the baby, low birth weight, and even mother/baby death may occur. Polycystic Ovary Syndrome: It may be difficult to achieve pregnancy in this group of patients. During pregnancy, the risk of miscarriage, gestational diabetes, hypertensive diseases during pregnancy and premature birth increases. Diabetes It is important to have blood sugar under control before pregnancy. In uncontrolled pregnancies, problems such as congenital structural anomalies in the baby, threat of miscarriage, difficulty in blood sugar control in the mother, need for frequent changes in drug doses, hypertensive diseases of pregnancy, premature birth, excess water in the baby, large baby, lack of progress in labor, shoulder tackling, increased cesarean section rates. it should be more. Kidney Disease It may be difficult for this group of patients to achieve pregnancy. During pregnancy, the risk of miscarriage, hypertensive diseases of pregnancy, lack of water in the baby, developmental delay in the baby, low birth weight and premature birth increases. autoimmune Pre-Disease Diseases such as lupus, multiple sclerosis, and rheumatoid arthritis are examples of this group. Some may experience a flare-up during pregnancy, while others may experience a regression. Some medications used may cause structural anomalies in the baby. Threatened miscarriage, premature birth, hypertensive diseases of pregnancy and related problems are more common in these pregnancies. Thyroid Disorders It may be difficult for this group of patients to achieve pregnancy. Thyroid functions need to be taken under control before becoming pregnant. During pregnancy, the risk of miscarriage, structural anomalies in the baby, goiter, heart failure, and low birth weight increases. Infertility: Pregnancy-related problems are more common in those who become pregnant with assisted reproductive treatments. Chief among these are vaginal bleeding and problems related to the baby's partner (placenta). Obesity It may be difficult for this group of patients to achieve pregnancy. It is recommended to lose weight before getting pregnant. During pregnancy, problems such as threatened miscarriage, gestational diabetes, hypertensive disease of pregnancy, large babies, difficult birth, and increased cesarean section rates are more common. Depression: The type, number and dosage of medication used before pregnancy should be reviewed. If possible, the number of medications should be reduced, only one medication should be used, and the least possible dose should be used. During pregnancy, the baby may have structural anomalies due to medications. There may be an increase in the severity of depression in these pregnant women. Postpartum depression is also common. It is often seen in the first year after birth. HIV / AIDS HIV virus positivity or AIDS disease suppresses the defense system in pregnant women, thus increasing the risk of infection and some cancers. It can be transmitted to the baby during pregnancy, birth and breastfeeding. This transition rate decreases with treatments. Cesarean section is recommended in patients with high viral load. With correct treatment and cesarean section, the rate of transition to a baby has been reduced to 2%. Adolescent Pregnancy < It is called pregnancies under the age of 19. Anemia, hypertension, threatened miscarriage, premature birth, developmental delay, low birth weight, stalled labor progress and increased cesarean section rates are common in pregnant women in this age group. Age First pregnancy > In those who are 35 years old, the frequency of Down syndrome, cesarean section, postpartum bleeding, prolonged labor and non-progressive labor increases. They tend to have more frequent infections during pregnancy. Pregnancy follow-up rates are lower. Alcohol Alcohol passes directly to the baby. It should not be consumed while trying to conceive or during pregnancy. The frequency of miscarriage, stillbirth, and congenital structural anomalies increases in those who use alcohol during pregnancy. 'Fetal alcohol syndrome' is seen due to alcohol. This is a condition in which facial anomalies, low birth weight, hyperactivity, intellectual disorders, vision and hearing problems are observed. Smoking increases the risk of miscarriage and premature birth, congenital structural anomalies, the risk of sudden death, low birth weight, and the risk of childhood lung diseases. The same risks apply to passive smokers. Multiple Pregnancy: The frequency of multiple pregnancies increases in those who become pregnant with assisted reproductive techniques. In multiple pregnancies, all pregnancy-specific problems are increased. As the number of fetuses increases, the risks also increase. The most common complications are premature birth and related problems, diabetes, hypertension, and developmental delay. Hypertensive Diseases of Pregnancy While other findings may be added to pre-existing hypertension, hypertension may develop for the first time after the 20th week of pregnancy. If left untreated, they can cause vital organ damage in the mother such as brain, liver and kidney, maternal/fetal death, developmental delay, premature birth, low birth weight and long-term health problems. Gestational Diabetes is a diabetes condition that develops during pregnancy. With regular follow-up, diet, controlled weight gain, fasting and post-prandial blood sugar monitoring and exercise, most pregnant women have a problem-free pregnancy. Possible risks that increase in frequency in uncontrolled gestational diabetes are: Premature birth, hypertensive diseases of pregnancy, large baby, excess amniotic fluid, non-progressive labor, shoulder occlusion, frequent cesarean section, neonatal metabolic problems. WHAT IS THE HIGH RISK PREGNANCY RATE? As risk factors increase, the rate of high-risk pregnancy also increases. There is statistical data for some risk factors: Hypertension: It is seen in 6-8% of pregnant women. For 70% of them, it is their first pregnancy. Preeclampsia: It is a condition seen after the 20th week of pregnancy, in which some laboratory or clinical findings are added to hypertension. It is seen in 5-10% of pregnant women. Most develop in the last 3 months. Gestational Diabetes: It is seen in 2-10% of all pregnant women. HOW IS HIGH-RISK PREGNANCY DIAGNOSED? A good pregnancy follow-up helps identify potential risks. A proper medical history and initial physical examination determine initial risks, while follow-up Regular check-ups ensure early recognition of conditions that may develop during pregnancy. When necessary, support is also received from relevant branch experts. HOW DO I KNOW IF I AM RISKY? If you are planning pregnancy or are pregnant, contact your doctor. Your doctor will take your history, perform a physical examination, order the necessary tests and determine whether you are a high-risk pregnancy candidate. Your doctor will ensure that precautions are taken to minimize these risks and a follow-up plan is created. CAN HIGH-RISK PREGNANCY BE PREVENTED? Being and staying healthy is the first and most important condition for protecting against risky pregnancies. Pre-pregnancy counseling will determine your health status and risks. Start taking 400 µg of folic acid per day. Get your vaccination status checked, especially for rubella and hepatitis B. Be at your normal weight and maintain it. Do not smoke or drink alcohol. If you take medication regularly, consult your doctor. Start pregnancy monitoring early. HOW CAN I BEST CARE FOR MYSELF AND MY BABY? Eating healthy throughout pregnancy, staying away from smoking and alcohol, exercising regularly, going for regular pregnancy follow-up and listening to your doctor's advice will provide the best care for you and your baby. HOW DOES BEING A HIGH-RISK PREGNANCY AFFECT MY FOLLOW-UP? Your pregnancy follow-up will be more frequent. You may be referred to a high-risk pregnancy subspecialist. In the presence of additional problems, it may be necessary to consult relevant specialties. The frequency of follow-up and multidisciplinary approach will vary depending on the problem you and your baby have. HOW WILL A HIGH-RISK PREGNANCY AFFECT MY BABY? It is very natural to worry about your baby's health in high-risk pregnancies. It is very possible to have a healthy baby with good pregnancy follow-up. Regular follow-up and listening to your doctor's recommendations will ensure this. If you have a health problem that requires you to use medication, consult your doctor. Sometimes the drug can be stopped for a while, sometimes the dose can be reduced, sometimes it can be switched to another one. As the frequency of premature birth increases, it is necessary to be prepared for neonatal problems. DOES BEING HIGH-RISK PREGNANCY AFFECT THE BIRTH? You should give birth in a center where you and your baby can be closely monitored and where there are relevant specialties. high risk pregnancy The rate of premature birth is high in women. Neonatal intensive care is often required. In some cases, you may also need to have a cesarean section. By discussing all of this with your doctor in advance, you can best prepare for the process that awaits you. SUMMARY Pregnancies during pregnancy, birth and puerperium, where the likelihood of experiencing any problems that endanger the life or health of the mother or her baby are increased, are 'high risk'. Risk factors include pre-existing health problems, age, lifestyle and pregnancy-specific problems. As risk factors increase, the rate of high-risk pregnancy also increases. Being and staying healthy is the first and most important condition for protecting against risky pregnancies. Pre-pregnancy counseling will determine your health status and risks. A good pregnancy follow-up helps identify potential risks. While a proper medical history and initial physical examination determine initial risks, regular follow-ups ensure early recognition of conditions that may develop during pregnancy. If necessary, support is also received from relevant branch experts and a high-risk pregnancy specialist. Eating healthy throughout pregnancy, staying away from smoking and alcohol, exercising regularly, going for regular pregnancy follow-up and listening to your doctor's advice will provide the best care for you and your baby. It is recommended that you give birth in a center where you and your baby can be closely monitored and where there are relevant specialties.
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