How to deal with high-risk preg­nan­cies?

India Today - - ASK THE EXPERT - Dr Puneet Bedi, Se­nior Con­sul­tant, Ob­stet­rics and Gy­nae­col­ogy, Apollo Hos­pi­tals, Delhi

I’m 35 and plan­ning to con­ceive. How can I be screened for a high-risk preg­nancy?

arund­hati ra­manan, ban­ga­lore Ma­ter­nal risk is as­sessed at the first meet­ing with the doc­tor. All high-risk fac­tors such as obe­sity and older age are noted, and dis­eases like anaemia, heart dis­ease, epilepsy, asthma, di­a­betes, thy­roid, kid­ney dis­ease or high blood pres­sure are ruled out. Fam­ily his­tory for ge­netic disor­ders are also iden­ti­fied. All preg­nant women are ad­vised blood tests to rule out in­fec­tions like Hepati­tis B, HIV and Syphilis and tests to en­sure im­mu­nity to Rubella. To rule out fe­tal ab­nor­mal­ity, two ul­tra­sound ex­am­i­na­tions should be done. One at 11 to 14 weeks to see the thick­ness of the nuchal fold (neck) and a de­tailed one at 18 to 22 weeks to see de­tailed fe­tal struc­tures. A blood test, dou­ble or triple marker at 11 to 14 weeks and 16 to 18 weeks is done in all cases to rule out chro­mo­so­mal ab­nor­mal­i­ties.

What steps can one take to stay healthy and calm dur­ing a high-risk preg­nancy?

bin­jal shah, mumbai The la­bel of high-risk should not be used as an emo­tional pres­sure to un­dergo ex­pen­sive tests and treat­ments, or used to jus­tify the cur­rent rate of Cae­sarean sec­tions which have reached epi­demic pro­por­tions. All coun­selling should be non-alarmist and re­as­sur­ing to en­sure a happy healthy preg­nancy. A bal­anced diet with vi­ta­mins, min­er­als and an­i­mal pro­teins, which come from fruits, veg­eta­bles, nuts and white meat at the time of con­cep­tion and through­out preg­nancy, is es­sen­tial. This de­ter­mines not only the fe­tal health but the long term health of the baby. Vi­ta­min D3 and folic acid is also pre­scribed to women plan­ning a preg­nancy.

I am two months preg­nant and so far my preg­nancy has been going good. Can I skip get­ting tests done in the fu­ture?

ridhi mehta, delhi Tests and treat­ments ad­vised these days cost a lot and lead to un­due anx­i­ety, but are es­sen­tial. While only 10 per cent preg­nan­cies re­quire close med­i­cal su­per­vi­sion, it is im­por­tant to visit the doc­tor reg­u­larly to rule out any risks. Dur­ing the course of preg­nancy, the fe­tus may be at risk be­cause of in­fec­tions, ex­po­sure to smok­ing, al­co­hol, and drugs, there­fore it is vi­tal to get reg­u­lar check-ups done.

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