High risk pregnancy

High risk pregnancy:

Certain conditions may affect the development of the fetus and labour outcome that may lead to increased perinatal and maternal morbidity and mortality. These abnormal conditions must be identified at the early stages and treated properly.

First trimester complications:

The following complications may arise during the first three months of pregnancy to a woman who is previously normal.

A Abortion :

Abortion is the termination of pregnancy before the viability of the fetus. It may occur spontaneously or induced.

Types of abortion :

Spontaneous abortion:

1.     Threatened abortion

2.     Inevitable abortion

3.     Complete abortion

4.     Incomplete abortion

Induced abortion:

1.     Legal abortion (medical termination of pregnancy)

2.     Illegal abortion

3.     Septic abortion

B  Hydatidiform mole or vesicular mole:

There is abnormal development and proliferation of the trophoblast as fluid filled vesicles. If the condition is not identified and terminated at the early stages the woman may develop severe bleeding and malignant changes

Management:

Evacuation of the uterine content and further follow-up is mandatory.

C Ectopic pregnancy:

Implantation and development of fertilised ovum occurs outside the uterine cavity.

Types:

1.     tubal pregnancy

2.     cervical pregnancy

3.     ovarian pregnancy

4.     abdominal pregnancy.

The abnormal type of pregnancy is identified and managed by surgical treatment.

Second trimester complications:

The following high-risk conditions may arise during the second three months of pregnancy.

Polyhydramnios: Excessive amniotic fluid present in the uterus causing pressure symptoms and other obstetrical complications such as preterm labour unengaged head, cord prolapse and postpartum hemorrhage etc.

Gestational diabetes: Some times in pregnancy hyperglycenia and glucosuria may develop to woman who is previously normal.

Pregnancy Induced Hypertension and Preeclampsia: In certain pregnancies the woman develops hypertension, proteinuria and edema after 20 weeks of pregnancy.

Third trimester complications:

A Antepartum hemorrhage :

Bleeding may occur during the last three months due to premature separation of normally implanted placenta (abruptio placenta) or due to placenta praevia ( abnormal implantation of placenta in the lower pole of the uterus).

Abruptio placenta and placenta praevia are managed by surgical interventions.

B Preterm labour:

Preterm labour is the condition where the labour process is initiated before 37 weeks of pregnancy.

Other complications that may arise during pregnancy are

1.     Anemia complicating pregnancy

2.     Premature rupture of membranes

3.     Post dated pregnancy

4.     Other medical and surgical complications associated with pregnancy etc