How is it decided whether my pregnancy is Low-Or High-Risk
There are certain factors that constitute a risk to you and/or your baby. Some of these you can do something about, such as stopping smoking or not taking street drugs. Other factors, such as twins or a large baby, you can do nothing about. However, by careful antenatal monitoring the likelihood of unexpected complications is reduced, should something unforeseen happen, your professional carers will be prepared. In pregnancy care, there is an adage that ”the best predictor of the future is the past”, this means that if you had a problem in a previous pregnancy, the same problem, may recur.
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General risks that may affect your pregnancy
- Alcohol abuse.
- You are very thin or very large.
- You have a restrictive diet or are malnourished.
- You take street drugs such as heroin or cocaine.
- You have a medical condition requiring drugs.
Risks that mean you need close antenatal care
- Previous pre-term delivery(before 37 weeks).
- Baby in previous pregnancy had an abnormality.
- You have diabetes and/or high blood pressure.
- Previous thrombosis(blood clot).
- Very large baby (estimated weight over 4kg/8(1/2 ) lb).
- Very small baby (estimated weight less than 2.5kg/5(1/2) lb).
- Breech baby.
- A previous delivery by Caesarean section.
- Previous problems in delivery such as haemorrhage (excessive bleeding).
- High blood pressure during pregnancy (pre-eclampsia).
- If none of the risks listed above applies to you, and any previous pregnancy and delivery were normal and uneventful, it is unlikely that you will have a problem that needs special care. It is nevertheless essential to attend all your antenatal appointments so that your health and the health of your baby can be regularly monitored.
What Do The Routine Blood Tests Show
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Your Blood Group And Rhesus (RH) Status
- It is important for your doctor to know which blood group you belong to in case you need a blood group you belong to in case you need a blood transfusion during the pregnancy or labor. The most common is group O, A, B, and AB is much less common. Your Rhesus status is either positive or negative so that you may be O negative or A positive and so on. Rhesus positive simply means that there is a special identifying label on your blood cells, which is not there if you are Rhesus negative. If you are Rhesus negative, a further test will be done to check if any antibodies are present, the tests will be repeated at intervals during your pregnancy. If there are antibodies present, your partner will also need to give blood for testing.
Your Haemoglobin ( red blood cells) levels
- Red cells contain iron and carry oxygen, if the test shows that the level of red cells is low, you are anaemic, and you will be advised to eat foods with a high iron content, or you may have to take iron tablets. Anaemia can cause you to feel very tired and it will also be a problem if you bleed during your pregnancy or at delivery.
Rubella (German Measles)
- A blood test shows whether you are immune to the disease. If you aren’t you could contract rubella in early pregnancy, this could cause blindness, deafness, and heart defects in your baby.
- Because it is now so easily cured, this sexually transmitted disease is rare these days. However, if the disease is present and untreated in pregnancy, it could cause the baby to have congenital and developmental problems.
- This liver disease, caused by a virus, can be passed to the baby and cause serious liver damage in the baby.
Other Blood Tests
- You may be offered other blood tests.
Special Investigations During Pregnancy
Why Might Need Special Investigations
- You will normally be offered further tests if there is a significant reason to suspect your baby might be suffering from a disease or an abnormality. The decision may be made on the basis of your age (over 35). If your routine scan shows a problem if you and/or your partner suffer from a hereditary disease, or if you have previously had a baby with an abnormality.
What Test Will I Have
- There are several sorts of tests which detect or rule out problems. Initially, tests on your blood may detect a problem in the baby such as Down’s Syndrome or Spina bifida or problem you have, such as diabetes. An ultrasound scan may reassure you that the baby seems to be normal and is growing well, it will also reveal any major defects. If the blood tests or scan do detect a problem, then further tests such as amniocentesis may be offered this involves taking a sample of fluid from inside the womb.
What Abnormalities Can Be Detected
- These are three kinds of abnormalities that occur, congenital, chromosomal, and genetic. Congenital abnormalities can usually be detected on an ultrasound scan at 18 to 22 weeks. Chromosomal and genetic abnormalities are detected by invasive tests such as amniocentesis, cordocentesis, and CVS.
What Are Congenital Abnormalities
- This term means that the baby has developed a physical abnormality, such as harelip, heart and brain defects, spina bifida, absent limbs or extra digits, in the womb. There is no genetic or chromosomal reason for this and often no cause whatsoever is found, it happens rarely when, for instance, the mother contracts an infection such as rubella (German measles). Congenital abnormalities can also be the result of dietary imbalances (such as a lack of folic acid), or because a harmful drug was taken in early pregnancy.
What Happens If A Congenital Abnormality Is Discovered
- The less severe abnormalities such as harelip, clubfoot, and extra digits can usually be dealt with surgically after the baby is born, often the baby is otherwise completely normal. Severe abnormalities such as major heart and central nervous system (brain and spinal cord) malformations often result in miscarriage or death of the baby before 24 weeks. In either situation, you will be referred to a consultant to discuss all the options.
Do I Have To Have Special Tests
- The most difficult aspect of medical intervention is that it tells you facts about your pregnancy that you might have preferred not to know, and you may not wish to proceed with further tests.
- There is little point in having screeing for any abnormality unless you have carefully thought through what you would do if the results were positive. Once you know there is a problem, and realize the severity of the condition, you will have to decide whether to continue with the pregnancy or not.
- Whether to terminate the pregnancy on the basis of what tests show is a question about which medical and popular opinion is divided. Some couples want only a completely ”normal” baby and so would wish to have a termination. Others are prepared to continue with the pregnancy and raise a child with special needs, some cannot consider a termination. Knowing how you feel about this issue will help you and your medical advisors should a difficult decision be necessary.