Complex & High-Risk Pregnancies
Pregnancy can be a time of joy and excitement as parents begin to prepare for their journey into parenthood, but for some women, it may also present unique challenges. Dr Lanziz Homar is a highly experienced obstetrician with special interests in managing complex and high-risk pregnancies, ensuring both the mother and baby receive the best possible care. He is able to take patients for complex and high-risk pregnancies at any time during their pregnancy term.
Whether due to pre-existing medical conditions, complications arising during pregnancy, or multiple pregnancies, TOAG is equipped with the expertise and resources to provide comprehensive, personalised care to every expectant mother.
What is a Complex Pregnancy?
A complex or high-risk pregnancy is one in which potential complications could affect the health or well-being of the mother, baby, or both. These pregnancies may require specialised care, close monitoring, and advanced interventions to ensure the best outcomes. While many pregnancies progress smoothly, certain factors can increase the risk of complications, making early identification and management crucial.
Types of Complex Pregnancies
There are several types of complex pregnancies, each requiring specialised care and attention. Some common examples include:
- Multiple Pregnancy (Twins, Triplets, or More): Pregnancies involving more than one baby carry higher risks due to increased likelihood of preterm birth, low birth weight, and other complications.
- Gestational Diabetes: Some women develop diabetes during pregnancy, which can lead to issues such as large birth weight, preterm birth, or delivery complications.
- Preeclampsia: This is a condition marked by high blood pressure and damage to organs, usually the liver and kidneys, and can be life-threatening for both mother and baby if not treated promptly.
- Placenta Previa: This occurs when the placenta covers the cervix, leading to bleeding and potential delivery complications.
- Preterm Labor: A pregnancy is considered high-risk if there are signs of labour before 37 weeks, potentially leading to complications for the baby due to underdeveloped organs.
Health Conditions that Can Impact Pregnancy
A variety of pre-existing medical conditions and lifestyle factors can increase the likelihood of a complex pregnancy. Common conditions that may affect pregnancy include:
- Hypertension (Chronic or Gestational): High blood pressure before or during pregnancy can lead to complications such as preeclampsia and preterm birth.
- Diabetes (Type 1, Type 2, or Gestational): Managing blood sugar levels is crucial to avoid complications such as large babies, birth injuries, or preterm birth.
- Obesity: Women with a high body mass index (BMI) are at greater risk of gestational diabetes, preeclampsia, and complications during labour.
- Autoimmune Disorders: Conditions like lupus and rheumatoid arthritis can increase the risk of preterm birth, low birth weight, and stillbirth.
- Thyroid Disorders: Both hypo- and hyperthyroidism can affect foetal development and increase the risk of miscarriage, preterm birth, and developmental issues.
- Age (Teen or Advanced Maternal Age): Women under 17 or over 35 are more likely to experience complications such as preterm birth, chromosomal abnormalities, and high blood pressure.
Types of Births for High-Risk Pregnancies
The types of high-risk births include those that are influenced by maternal, foetal, or pregnancy-related conditions. Some common types of high-risk pregnancy births include:
A preterm birth is a birth that occurs before 37 weeks of gestation. Babies born prematurely may face respiratory distress syndrome, underdeveloped organs, feeding difficulties, and increased susceptibility to infections and developmental delays. Preterm labour can be triggered by conditions like preeclampsia, infections, or multiple pregnancies.
A caesarean section (C-section) is a surgical procedure where the baby is delivered through an incision in the mother's abdomen and uterus. C-sections may be planned or emergency procedures when vaginal delivery is too risky. Common reasons include foetal distress, placenta previa, placental abruption, breech presentation, or previous complicated births. While C-sections can be lifesaving, they carry risks like infection, blood clots, and longer recovery times.
A breech birth is when the baby is positioned feet or buttocks-first instead of head-down at the time of delivery. Breech presentations increase the risk of complications during vaginal delivery, such as umbilical cord prolapse or head entrapment. Breech births often result in a C-section, though some breech deliveries can be done vaginally under specific conditions with close monitoring.
A post-term birth is a pregnancy that continues beyond 42 weeks of gestation. Post-term births can increase the likelihood of a large baby, placental insufficiency, and meconium aspiration (where the baby inhales stool passed during labour), often necessitating induction of labour or a C-section.
A vaginal birth after caesarean (VBAC) is a vaginal birth in a woman who has previously had a C-section. While many women can have a successful VBAC, there is a risk of uterine rupture, where the scar from the previous C-section may tear during labour, which can be life-threatening for both the mother and baby. Close monitoring and contingency planning are required.
Signs and Symptoms of a High-Risk Pregnancy
While some women may be classified as high-risk due to pre-existing conditions, others may develop issues during pregnancy. It’s important to monitor for any unusual signs and symptoms, including:
- Severe headaches or vision changes, which may signal preeclampsia.
- Decreased foetal movement, especially in the third trimester.
- Persistent bleeding or cramping that may indicate placental issues.
- Sudden weight gain or swelling (particularly in the face, hands, or legs), which could point to preeclampsia or gestational hypertension.
- Contractions before 37 weeks, indicating possible preterm labour.
If you experience any of these symptoms, contact TOAG for immediate support.
Can You Reduce the Risk of Having a Complex Pregnancy?
While not all complex pregnancies can be prevented, taking proactive steps before and during pregnancy can help reduce the risk. Some key ways to lower your risk include:
- Preconception Planning: If you have a pre-existing medical condition, discussing your plans for pregnancy with your doctor beforehand can help identify potential risks and allow for better management of your health.
- Healthy Lifestyle Choices: Maintaining a balanced diet, staying physically active, and avoiding harmful substances like tobacco and alcohol can improve overall pregnancy health.
- Prenatal Care: Regular prenatal visits allow your obstetrician to monitor your health and the baby’s development, ensuring that any complications are addressed early.
- Managing Existing Conditions: Properly managing chronic conditions such as diabetes or high blood pressure can significantly reduce the likelihood of complications.
- Taking Prescribed Medications: If your doctor has prescribed medication for a specific condition, taking it as directed can help control health issues during pregnancy and reduce risks.
Dr Homar takes a comprehensive, patient-centred approach to managing complex pregnancies, and the TOAG team work together to ensure that you and your baby receive the best care possible. TOAG is committed to providing expert care for women with complex and high-risk pregnancies. Whether you’re concerned about your pregnancy or have a pre-existing condition, we’re here to offer the guidance and support you need. Contact us today to schedule a consultation with Dr Homar.