9 Risk Factors for High-Risk Pregnancy
In recent years, significant progress has been made in parallel with the development of information and technology regarding these problems, which require much more attention and follow-up compared to normal pregnancies. In fact, about 90 percent of some risks that can be encountered in 10-15 percent of all pregnancies today are controlled and end with a healthy pregnancy.
Despite all the developments, the most important point in high-risk pregnancies is to do the necessary controls before getting pregnant, so that the risks should be revealed. For this, it is necessary to become pregnant in a planned manner, to be under regular and close follow-up during pregnancy and to fully comply with the treatment.
1. Medical, physical and genetic characteristics of the mother
Mother-related factors are one of the most important risk factors in pregnancy. These factors can affect the development of pregnancy, the health of the baby and the way of delivery. However, it is possible for expectant mothers, whose risks will be determined before pregnancy, to give birth to a healthy baby with some support and medication arrangements that will balance the situation and direct it to the positive side.
The most important risks are listed as follows:
- Maternal age below 17 and above 35,
- If the mother’s height is less than 150 cm and her weight is in the obese category,
- Having a history of smoking, alcohol, drug or drug use,
- Having a consanguineous marriage,
- Genetic or familial history of disease,
- Presence of systemic disease of the expectant mother,
- Number of advanced pregnancies (4 and above),
- History of previous surgery.
2. Gestational blood pressure (preeclampsia)
Although pregnancy is defined as a physiological event, it affects every organ in the woman’s body and causes some changes. And since these changes cannot be accepted as normal by every woman, some problems may arise. Gestational blood pressure is the most common and the most important one among them.
This problem, also known as “pregnancy poisoning” among the people, occurs when the blood pressure of the expectant mother rises due to the changes in the vascular structure during pregnancy. Since it has different characteristics from the high blood pressure seen in old age, it can cause very serious problems such as cerebral hemorrhage, intra-organ hemorrhages, separation of the spouse from the mother and death of the baby in the womb.
When serious conditions are encountered in gestational blood pressure, which is seen in 4-5 percent of pregnancies and requires regular follow-up and treatment, the only treatment is delivery of the baby.
3. Gestational diabetes
This condition, seen in 10 percent of pregnancies, is caused by changes in insulin metabolism. It is important in terms of creating risks such as disability in the baby, large baby, premature birth, difficult and interventional birth. Diagnosis is 24-26 days of pregnancy. It is determined by sugar loading tests to be done in the next weeks. Afterwards, the blood sugar level can be balanced with diet or medication and it is possible to eliminate all of these negative situations.
4. Early birth
The onset of labor before the expected time (36 weeks) is defined as preterm birth, and 10 percent of pregnancies result in preterm birth. Although the causes such as uterine deformities, the size of the baby, excess water, and the cessation of the baby’s development are listed as the factors leading to premature birth, the most common cause is infections. Premature birth can be prevented in expectant mothers who have these problems, with pre-pregnancy controls and a correct and proper follow-up during pregnancy.
5. Placenta (baby’s partner) placement problems
These problems are one of the most worrying issues for the expectant mother and her doctor during pregnancy. Placental location problems are encountered in 1-2% of pregnancies. The placement of the spouse by closing the cervix can cause frequent and severe bleeding. Bleeding usually begins in the second trimester of pregnancy and may recur until delivery. For this reason, both normal birth becomes impossible and the possibility of premature birth increases. Pregnant women in this group must be followed closely in a full-fledged hospital.
6. Multiple pregnancies
Multiple pregnancies are one of the most important risk factors that may arise during the development of the baby in the mother’s womb. In this case, the risks increase with the number of babies. Premature birth, developmental disorders, disabilities, maternal blood pressure and diabetes are some of the most common problems in multiple pregnancies.
7. Developmental delay
Growth retardation, which can be defined as the baby being smaller than expected and the deterioration of nutrition in the mother’s womb, is seen in 4-5 per thousand of pregnancies. However, it requires close follow-up as it carries serious risks such as premature birth or death of the baby in the womb.
8. Too little or too much water (oligohydramnios-polyhydramnios)
The lack or excess of water in the baby, which protects it against traumas and enables it to develop and grow, is also among the causes of premature birth and developmental disorders. In the absence of water, the baby’s lung development and growth can be delayed. In excess of water, premature birth and baby’s arrival position abnormalities may occur. Necessary precautions can be taken by controlling and monitoring the amount of water with monthly controls and some tests performed on the mother.
9. Mental and physical disabilities
Detection and treatment of mental and physical disabilities that may occur in the baby is one of the most advanced topics today. Mental and physical disabilities can be a problem in 3-4 percent of pregnancies.
Mongolian (Down) baby and similar chromosomal diseases, which are known by everyone, especially with mental retardation, are now 11-14. It can be recognized by genetic ultrasound performed by risky pregnancy specialists during gestational weeks and by genetic screening and diagnostic tests performed afterwards.
In addition, with detailed ultrasonography performed at 18-22 weeks of gestation, the organ and structural development of the baby can be checked, and if there are disabilities, necessary precautions or treatment can be planned. In some cases, some interventions or surgical procedures can be applied to babies before they are born.