15 April, 2021

High Risk Pregnancy

A pregnancy is a high-risk when there are potential complications that could affect the mother, the baby, or both. High-risk pregnancies require management by a specialist to ensure the best outcome for the mother and baby.

Risk Factors

Sometimes a high-risk pregnancy is due to a medical condition present before pregnancy. In other cases, a medical condition that develops during pregnancy causes a pregnancy to become high risk.

Maternal Age One of the commonest risk factors is the age of the mother-to-be. Women who will be under age 17 or over age 35 are at greater risk. The risk of miscarriage and genetic defects increases further after age 40.

Pre Existing Medical conditions Conditions such as high blood pressure; lung, kidney, or heart problems; diabetes; autoimmune disease; sexually transmitted diseases (STDs); or chronic infections such as human immunodeficiency virus (HIV) can be risky for the mother and/or their unborn baby. Previous history of miscarriage, problems with a previous pregnancy or pregnancies, or a family history of genetic disorders are also risk factors for a high-risk pregnancy.

Medical conditions that occur during pregnancy Two of the more common pregnancy-related problems are:

  •  Preeclampsia is a syndrome that includes high blood pressure, urinary protein, and swelling; it can be dangerous or even fatal for the mother or baby if not treated. With proper management, most women who develop preeclampsia have healthy babies.
  •  Gestational diabetes is when diabetes develops during pregnancy. Women with gestational diabetes may have healthy pregnancies and babies the treatment plan is been followed. Usually the diabetes resolves after delivery. Women with gestational diabetes are at increased risk of developing type 2 diabetes.
  • Pregnancy-related issues. Often a pregnancy is high risk because of issues that arise from the pregnancy itself and that have little to do with the mother’s health. These include:
  •  Premature labor is labor that begins before 37 weeks of pregnancy. Factors that place women at higher risk for Preterm labor- such as certain infections, a shortened cervix, or previous preterm birth.
  •  Multiple births means carrying more than one baby. Multiple pregnancies, are more common as women are using more infertility treatments, increase the risk of premature labor, gestational diabetes, and pregnancy-induced high blood pressure.
  •  Placenta previa is a condition in which the placenta covers the cervix. The condition can cause bleeding, especially if a woman has contractions.
  •  Fetal problems Approximately 2% to 3% of all babies have a minor or major structural problem in development.


  • Schedule a preconception appointment. Before palnning for Pregnancy- start taking a daily prenatal vitamin with folic acid and reach a healthy weight. If you have a medical condition, treatment might be adjusted in preparation for pregnancy. Discuss all risk factors related to a genetic condition.
  • Seek regular prenatal care. Prenatal visits can help your health care provider monitor your health and your baby’s health. You might require a specialist in maternal-fetal medicine, genetics, pediatrics or other areas.
  • Avoid risky substances. If you smoke, quit. Alcohol and illegal drugs are off-limits.
  • Getting proper immunizations
  • Getting regular physical activity, unless advised otherwise by your doctor


Specialized or targeted ultrasound might be required depending on condition. This is an imaging technique that uses high-frequency sound waves to produce images of a baby in the uterus — targets a suspected problem, such as abnormal development.

  • Prenatal cell-free DNA (cfDNA) screening-DNA from the mother and fetus is extracted from a maternal blood sample and the fetal DNA is screened for the increased chance of specific chromosome problems.
  • Invasive genetic screening. Amniocentesis or chorionic villus sampling (CVS). In amniocentesis, a sample of the fluid that surrounds and protects a baby during pregnancy (amniotic fluid) is withdrawn from the uterus. Usually done after week 15 of pregnancy, amniocentesis can identify certain genetic conditions as well as serious abnormalities of the brain or spinal cord (neural tube defects). During CVS, a sample of cells is removed from the placenta. Mainly done between weeks 10 and 12 of pregnancy, CVS can identify certain genetic conditions.
  • Ultrasound for cervical length to determine if you’re at risk of preterm labor.
  • Lab tests. Test your urine for urinary tract infections and screening for infectious diseases such as HIV and syphilis.
  • Biophysical profile. This prenatal ultrasound is used to check on a baby’s well-being. It might include only an ultrasound to evaluate fetal well-being or, depending on the results of the ultrasound, also fetal heart rate monitoring (nonstress test).

Some prenatal diagnostic tests — such as amniocentesis and chorionic villus sampling — carry a small risk of pregnancy loss.Discuss the risks and benefits with your Doctor.

Red Flag signs

Contact your Doctor immediately if –

  • Vaginal bleeding or watery vaginal discharge
  • Severe headaches
  • Pain or cramping in the lower abdomen
  • Decreased fetal activity
  • Pain or burning with urination
  • Changes in vision, including blurred vision
  • Sudden or severe swelling in the face, hands or fingers
  • Fever or chills
  • Vomiting or persistent nausea
  • Dizziness
  • Thoughts of harming yourself or your baby


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25 October, 2021

Pelvic Pain

Pelvic Pain Pelvic pain is pain in the lower part of the abdomen and pelvis. It can stem from multiple causes. Pelvic pain arises from the conditions associated with reproductive, urinary or digestive systems, or from muscles and ligaments in the pelvis. Pelvic pain can be due to irritation of nerves in the pelvis. Chronic pelvic pain is constant or intermittent pelvic pain for six months or more. Pelvic pain may spread to lower back, buttocks or thighs. Pelvic pain can also be situational, such as while using the bathroom or have sex. Causes More than one condition can lead to Pelvic pain. Common causes of acute pelvic pain Ovarian cyst– it is fluid-filled bubble arising from an ovary and causes pelvic pain when it ruptures or becomes twisted Acute pelvic inflammatory disease– a bacterial infection of the reproductive organs, which often follows a chlamydia or gonorrhoea infection and needs immediate treatment with Antibiotics. Ectopic Pregnancy (or other pregnancy-related conditions) Miscarriage or intrauterine fetal death Menstrual cramps (dysmenorrhea) Mittelschmerz (ovulation pain) Appendicitis â€“ a painful swelling of the appendix which usually causes pain on the lower right-hand side of your abdomen Peritonitis– inflammation of the peritoneum; it causes sudden abdominal pain that gradually becomes more severe and requires emergency treatment Urinary tract infection – it will cause pain or a burning sensation while urination Kidney stones Constipation or
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21 September, 2021

Bleeding in Pregnancy

Bleeding during pregnancy is relatively common, but it can be a dangerous sign. Visit your doctor even if its spotting or it stops. What causes bleeding early in pregnancy? Having sex- mostly due to pregnancy changes in cervix An infection Smoking Implantation Bleeding- When a fertilized egg (embryo) attaches to the lining of the uterus (womb) and begins to grow. Usually occur 10-14days after conception. It is harmless. Invasive testing like Amniocentesis and Chorionic villus sampling- done to check genetic abnormalities. Hormone changes. Medical conditions- Bleeding disorders Changes in your cervix. Occasionally bleeding or spotting in the first trimester can be due to a serious problem, like: Miscarriage- loss of pregnancy before 20weeks. Almost all women who miscarry have bleeding or spotting before the miscarriage. Bleeding can be along with pain abdomen. Ectopic pregnancy-fertilized egg implants outside uterine cavity and begins to grow.  Molar pregnancy- it is growth of abnormal tissue in the uterus, instead of a baby. Molar pregnancy is rare. What causes bleeding in the Second and Third Trimesters? Abnormal bleeding in late pregnancy is considered more serious because it
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24 September, 2021

Bacterial Vaginosis

Bacterial vaginosis is a vaginal infection caused by bacteria. It is the most common cause of abnormal vaginal discharge that happens in reproductive-age women. It can cause a “fishy” odor and vaginal irritation in some women. Others may not have any symptoms. SYMPTOMS Most of the females with bacterial vaginosis will not have any symptoms but when they have, it includes- Burning feeling while micturation Fishy smell mostly after sex Itching Thin white, gray, or green discharge RISK FACTORS It is rarely seen in females who are not sexually active. It most commonly affects- Pregnancy Unprotected Intercourse Have an intrauterine device (IUD) Have multiple sex partners Have a new sex partner Have a female sex partner Use douches Smoking Perfumed bubble baths, vaginal deodorants, and few scented soaps Washing underwear with strong detergent CAUSES BV is due to an imbalance of natural vaginal bacterial flora. Why this happens is not clear. The role of bacteria Bacteria is present allover our bodies, but some are beneficial while others are harmful. These bacteria become infectious when number of harmful bacteria increases. The vagina is house for mostly “good” bacteria and some harmful bacteria. BV occurs when the harmful bacteria outgrows the good bacteria in number. A vagina should contain bacteria called lactobacilli. These bacteria produce lactic acid, making
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