High-risk pregnancy and child at risk

Proven content

A high-risk pregnancy is a pregnancy in which there are factors that increase the likelihood of miscarriage, premature birth, intrauterine growth restriction, diseases of the fetus and newborn, birth defects or other damage to the fetus, or even death. We diagnose a high-risk pregnancy on the basis of a medical history with the mother concerning the course of the pregnancy.

High-risk pregnancy and child at risk

Taking into account the importance of medical history, a high-risk pregnancy can be diagnosed in 10-20% of pregnant women; less than half of the perinatal mortality and morbidity are associated with these pregnancies. While prenatal risk assessment is important to reduce perinatal mortality and morbidity, some women do not develop a high risk until delivery, and careful monitoring of pregnancy is essential for the course of delivery.

Identifying a high-risk pregnancy is very importantas it is the first step towards preventing pregnancy abnormalities and taking treatment to reduce the risk to the fetus and newborn.

Causes of high-risk pregnancy and baby risk

High-risk pregnancy is of great importance maternal factors. The lowest mortality occurs among newborns of mothers aged 20–30 years. Both pregnancies in adolescents under the age of 20 and in women over 35, especially the infant, carry an increased risk of intrauterine growth restriction, heart rate fluctuations and intrauterine death.

Also check out: What Happens at Week 39 of Pregnancy?

High-risk pregnancy and baby at risk genetic factors are essential. The presence of chromosomal abnormalities, congenital abnormalities, metabolic diseases, mental retardation or family diseases in closely related individuals increases the risk of the same disease in the newborn and its manifestation later in life.

Mother’s diseases during pregnancy, how:

1. heart defects,
2. diabetes,
3. thyroid diseases (endemic goiter, Graves’ disease),
4. hyperparathyroidism,
5. obesity,
6. drug addiction and others,

contribute to disorders of the development of the fetus. Infections occurring in a pregnant woman can cause disease of the fetus and newborn baby.

Danger to the fetus may occur before or during labor. Before giving birth, the threat is revealed as intrauterine growth restriction or fetal hypoxia running with mixed respiratory and metabolic acidosis. Obstetric conditions are important, and the most common cause of antenatal risk to the fetus is uteroplacental insufficiency.

Newborns delivered by caesarean section are also a problem, possibly related to the unfavorable obstetric conditions that led to the operation, or to prolonged maternal anesthesia. Narcosis and anesthesia affect both the fetus and the mother. The lack of progress in labor and the consequent prolongation of labor, as a consequence, may lead to fetal hypoxia.

WARNING!

Babies born of high-risk pregnancies should be diagnosed for their health status as soon as possible in order to reduce neonatal and early-infancy morbidity and mortality. The term high-risk child mainly refers to infants born of at-risk pregnancy. These children should be under close observation and care of an experienced medical and nursing team for at least the first 6 months of life. About 9% of high-risk neonates require intensive care in the first days of life and an assessment of the gestational age at birth.

High-risk pregnancy and risk child – factors

Early, careful and systematic neurological and psychological monitoring is necessary in children at risk, because they often suffer from diseases of the central nervous system, including cerebral palsy, and, consequently, disorders in psychomotor development. Early detection of the possibility of specific developmental disorders, immediately after birth, is important for the early implementation of treatment procedures and early rehabilitation. Therefore, parents should be aware of possible risk factors.

The risk factors for childbirth include:

1. obstetric complications such as incorrect position of the fetus,
2. faulty structure of the pelvis of a pregnant woman,
3. quick delivery,
4. prolonging the term of childbirth.

Threatening bleeding, miscarriage and the leading placenta also have an unfavorable effect on the development of the fetus. Some abnormalities are predictable and can be prevented by appropriate prophylaxis and treatment of the mother.

Complications in high-risk pregnancy

Many mothers with complications require hospitalization, and the children born under these circumstances require special care. This group of children includes newborns with unfavorable phenomena related to the gestational period or after their birth, e.g. newborns born in asphyxia, with green amniotic waters, with features of prematurity, with low birth weight below 2500 g or with too much weight. large, over 4500 g, with premature amniotic fluid loss and from a twin pregnancy. Preterm births, stillbirths, miscarriages and more are also important.

The unfavorable family arrangements include:

1. no compliance in the main blood groups AB0,
2. Rh incompatibility between the fetus and mother,
3. chromosomal abnormalities (genetic), e.g. Down’s syndrome.

The effects of harmful environmental factors are different and largely depend on the period of pregnancy in which they were affected. Embryo damage occurs in the first 3 months of pregnancy and leads to the formation of malformations referred to as embryopathy. If the harmful factor becomes active in the fetal life beyond the third month of pregnancy, the fetus is damaged with the formation of fetopathy. There may also be a miscarriage or premature birth. Many of these babies suffer from disturbances in the basic functions of life: respiration and circulation, and consequently, oxygen deficiency in the body. Hypoxia leads to brain damage very quickly.

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