High-Risk Pregnancy
In India, about 20-30% of pregnancies belong to the high-risk category, which is responsible for 75% of perinatal morbidity and mortality. Early detection and effective management of High-Risk Pregnancy can contribute substantially to the reduction of maternal and fetal adverse outcomes.
City Medi Fertility provides world-class care for women who are pregnant or considering becoming pregnant. Each pregnancy is unique.
Following warning signs require an immediate visit to your doctor:
- Fever >101.3°F/for more than 24 hours
- Headache, blurring of vision
- Palpitations, easy fatigability, and breathlessness at rest
- Generalized swelling of the body and puffiness of the face
- Vaginal bleeding / watery discharge
- Pain in the abdomen
- Reduced fetal movements
Some common causes of high-risk pregnancy are:
- Maternal age: Early childbearing is a risk for both mother and newborn.
- Advanced maternal age: childbearing in a woman over 35 years of age.
- Medical conditions that exist before pregnancy
- The medical condition that occurs during pregnancy.
- Alcohol, tobacco, and substance use.
- Multiple births.
- Zika infection:
- Obesity.
Delivery
The most common way of childbirth is vaginal delivery It involves three stages of labor: the shortening and opening of the uterus mouth ( Cervix)during the first stage, descent and birth of the baby during the second stage, and the delivery of the placenta during the third stage.
The first stage begins with crampy abdominal or back pain that lasts around half a minute and occurs every 10 to 30 minutes. The pain becomes stronger and closer together over time.
The second stage ends when the infant is fully expelled.
In the third stage, the delivery of the placenta,
As of today, all major health organizations advise that immediately following vaginal birth, or as soon as the mother is alert and responsive after a Caesarean section, that the infant is placed on the mother’s chest, termed skin to skin contact, and the baby should be breastfed as early as possible.
Most babies are born head first however about 4% are born feet or buttocks first, known as breech.
During labor, a woman can generally eat and move around as she likes.A number of methods can help with pain, called painless delivery. While making a cut to the opening of the vagina, known as an episiotomy is common, and helps in easy delivery and prevents recto vaginal complications of normal delivery.
Each year, complications from pregnancy and childbirth result in about 500,000 maternal death seven million women have serious long-term problems, and 50 million women have negative health outcomes following delivery.
Specific complications of delivery include obstructed labor, postpartum bleeding, eclampsia, amniotic fluid embolism, and postpartum infection, etc.
Complications in the baby may include lack of oxygen at birth, birth trauma, premature birth, and infections, etc
Painless deliveries
Pain management during childbirth is the treatment or prevention of pain that a woman may experience during delivery. The amount of pain a woman feels during labor depends partly on the size and position of her baby, the size of her pelvis, her emotions, the strength of the contractions, and her outlook. Tension increases pain during labor. Virtually all women worry about how they will cope with the pain of labor and delivery. Childbirth is different for each woman and predicting the amount of pain experienced during birth and delivery can not be certain.
Some women do fine with “natural methods” of pain relief alone. Many women blend “natural methods” with medications and medical interventions that relieve pain. Building a positive outlook on childbirth and managing fear may also help some women cope with the pain. Labor pain is not like pain due to illness or injury. Instead, it is caused by contractions of the uterus that are pushing the baby down and out of the birth canal.
Medical and pharmaceutical methods of pain control include
1 Opioid 2 Epidural analgesia and spinal block 3 Pudendal block out of which epidural analgesia is the most commonly used for pain relief during labor
An epidural is a procedure that involves placing a tube into the lower back, into a small space below the spinal cord Small doses of medicine can be given through the tube as needed throughout labor. With a spinal block, a small dose of medicine is given as a shot into the spinal fluid in the lower back. Spinal blocks usually are given only once during labor. Epidural and spinal blocks allow most women to be awake and alert with very little pain during labor and childbirth. With an epidural, pain relief starts 10 to 20 minutes after the medicine has been given. The degree of numbness felt can be adjusted. With spinal block, good pain relief starts right away, but it only lasts one to two hours.
Although the movement is possible, walking may not be if the medication affects motor function. An epidural can lower blood pressure, which can slow the fetal heart rate, Fluids given through IV are given to lower this risk. Fluids can cause shivering. But women in labor often shiver with or without an epidural. If the covering of the spinal cord is punctured by the catheter, a bad headache may develop. Treatment can help the headache. An epidural can cause a backache that can occur for a few days after labor. An epidural can prolong the first and second stages of labor. It might be hard to push when the time comes. An epidural increases risk of assisted delivery.