Risk factors present before pregnancy

There are certain physical and social risk factors, problems of previous pregnancies, and certain pre-existing disorders in women before they become pregnant, which may pose problems during pregnancy and subsequent deliveries. Physical characteristics such as age, weight, and height of women also have an effect in the risks involved in pregnancy. Young mothers in age group of 13 to 15 years have increased chances of giving birth to underweight or undernourished babies. Women above 35 years have more chances of getting gestational diabetes, high blood pressure, and complicated labor. Underweight women have small and underweight babies and obese women have large babies with difficult deliveries. Any structural defects in the reproductive organs may lead to miscarriages because weak cervix tends to open as the fetus grows. Women from lower socio economic backgrounds have more problems and risks during pregnancy because they aren’t eating a proper and healthy diet and also have bad living habits such as smoking and drinking.

If you had any problems in the previous pregnancy, then these problems may recur in the subsequent pregnancies also. Problems such as premature baby, underweight baby, and baby with birth defects, a late delivery, and Rh incompatibility, which requires blood transfusion may all recur during the next pregnancy and need to be handled with care and precautions.

When a woman, who already has a pre-existing disorder, becomes pregnant, the risk factor during pregnancy increases. They should consult their doctor and try to be in the best physical condition before pregnancy. After conception they should follow the advice of their consultant team, which may include an obstetrician, a disorder specialist, and other health care practitioner. The various disorders may include –

  • High Blood Pressure – During pregnancy the blood pressure problem increases and worsens causing an untimely detachment of placenta from the uterus, stillbirth, undernourished growth of fetus and preeclampsia. For women with blood pressure higher than 150/100 mm Hg, treatment with anti-hypertensive drugs is done. This reduces the risk of stroke and related complications. High blood pressure at times also causes damage to the kidneys. Pregnant women need to be monitored to check the blood pressure, proper functioning of kidneys and fetal growth. Stillbirth can be avoided by going in for premature deliveries.
  • Kidney problems – During pregnancy kidney functions become worse. There may not be proper growth of the fetus and the problem of high blood pressure also becomes worse. A proper monitoring of the fetal growth and early delivery are the appropriate solutions to this problem
  • Seizure Disorders – The frequency of seizures does not change during pregnancy and you may have to increase the dosage of the anticonvulsant to treat them. Taking an anticonvulsant increases the chances of birth defects and should therefore be taken in consultation with the doctors.
  • Sexually transmitted diseases – Women infected with this disease can have a preterm labor or early rupture of membrane of the fetus. Some of the diseases like Syphilis cause severe birth defects and can be transmitted to the baby from the placenta.  The HIV virus can also be passed on to the baby. Hence necessary precautions under the care of a health care provider and a specialist are advised.
  • Heart Diseases – The heart needs to work harder during pregnancy and its condition may worsen during pregnancy due to more pressure on it. If the heart is not in a fit condition, it may lead to death of the woman or the fetus. Women with heart disease have a tough time and need to limit their activities as they tend to become tired quickly. Even post delivery the condition of the heart may not be totally fit, depending upon the heart disease and its intensity. But most of the women with heart problems can give birth to healthy babies without any ill effects to their heart.
  • Diabetes – Diabetic women have a higher risk in pregnancy and may suffer from problems like high blood pressure and kidney damage. The level of sugar in the blood needs to be controlled and kept as normal as possible so that the risk factor can be reduced. A well planned diet, exercises, and insulin should be started before pregnancy. Badly controlled diabetes increases the chances of miscarriage, birth defects, still birth, large fetus causing delivery problems. Also such a fetus has large lungs which develop very slowly causing complications.
  • Liver and Gall bladder disorders – The chances of miscarriage or premature deliveries for women with cirrhosis of liver or viral hepatitis are very high. These women suffer from varicose veins and have more chances of bleeding from these veins especially during the third trimester. Gall bladder stones may necessitate surgery which is quite safe for the woman and the fetus.

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