What is a high-risk pregnancy?

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A high-risk pregnancy is a pregnancy with multiple risk factors that adversely affect the health of the mother, fetus, and newborn. There are many factors that contribute to a high-risk pregnancy including: maternal health during pregnancy, obstetric history, problems with the fetus and its appendages, and socioeconomic conditions that influence affect the mother's health and psychology....

1. What is a high-risk pregnancy?

A high-risk pregnancy is a pregnancy in which factors can affect the health of both mother and baby. High-risk pregnancy is a fairly common condition that can occur at any gestational age. It can cause diseases, birth defects while in utero, or delay the baby. underdeveloped at birth. A high-risk pregnancy increases maternal, fetal, and neonatal mortality.

2. Classification of high-risk pregnancy groups

Based on clinical characteristics, high-risk pregnancies are divided into 4 groups, each group has its own characteristics that need to be detected early for timely intervention.
2.1 Group of risk factors related to anthropometrics This group includes factors such as maternal age, height, weight, socioeconomic status and genetic factors.
Maternal age If the mother becomes pregnant at a very young age (under 18 years old), there is a risk of preeclampsia, fetal growth retardation, threatened preterm birth, premature delivery, maternal malnutrition and the spread of infectious diseases. sexually. If the mother becomes pregnant when she is over 35 years old, there is an increased risk of gestational hypertension, preeclampsia, obesity and other medical diseases. In addition, babies born to older mothers have a higher risk of diseases caused by chromosomal abnormalities. Mother's weight Mothers who weigh less than 40kg during pregnancy, the fetus is at risk of intrauterine growth retardation, fetal distress, fetal asphyxia, low birth weight babies, hypoglycemia, and body weight loss. heat, high mortality and morbidity. In mothers who weigh more than 70 kg, the most common complications are blood pressure disorders before and during pregnancy, the frequency is 4-7%. Other common complications are diabetes, urinary tract infections, phlebitis, etc. Obese mothers often give birth to babies with large birth weight, unclear fetal position, high rate of cesarean section. and high risk of postoperative infection. Mother's height Mothers with a height of less than 1m45 have a risk of narrow pelvis, so there is a risk of abnormal position, difficult birth. Inherited diseases Are diseases passed on from parents to children such as trisomies syndrome 21 (trisomie) causing Usker syndrome in young children with symptoms of retinal pigment degeneration, deafness, amyotrophic lateral sclerosis. The most common syndrome is Down's syndrome with abnormalities in appearance and severe mental retardation. Down syndrome is common in women who are old, women who are too young or have small bodies.

Socio-economic conditions If pregnant women live in low material living conditions, have to do hard labor, live in an unsanitary and cramped living environment, they are always mentally fatigued and stressed. high-risk pregnancy with poor fetal growth and a high rate of preterm birth. Nutritional factors The mother's diet during and during pregnancy can affect the rate of development of the fetus. Folic acid deficiency can cause neural tube defects. Vitamin D deficiency can cause hypocalcemia and tetany in infants. Maternal Vitamin B1 deficiency has been associated with several acute infant deaths with congestive fetal heart conditions. 2.2 Group of factors related to common diseases: Mother has infectious diseases Mother's infection is a high-risk pregnancy factor. The rate of miscarriage, stillbirth, premature birth increases, the fetus is at risk of many dangerous diseases such as:
In the early pregnancy, if the mother has some viral diseases such as influenza, rubella, dengue fever, Infection with Toxoplasma parasites,... the fetus can have malformations such as hydrocephalus, abdominal cavity, cleft lip and palate,... Complete pregnancy period: bacteria, viruses, parasites from the mother easily permeates through the diaphragm of the fetus causing diseases to the fetus such as hepatitis, encephalitis, syphilis, pneumonia,... Kidney diseases Kidney diseases, pyelonephritis, high blood pressure will often worsen When a woman is pregnant, it will cause many dangers to the mother and fetus such as: eclampsia due to arteriospasm, placental abruption, small placenta, underdeveloped fetus, stillbirth,... Need intensive treatment extreme for the mother, in some cases the pregnancy must be terminated to save the mother. Cardiovascular diseases The state of the mother's cardiovascular diseases often worsens during pregnancy, because the fetus is always in a state of hypoxia, so the development is underdeveloped. Lack of oxygen in the uterine muscles will cause premature birth, miscarriage and death in the fetus. The risk in the mother is heart failure, pulmonary edema and death, so in some cases, the pregnancy must be terminated because the mother's medical condition is too severe. If one parent has a congenital heart defect, the odds of a child being born with a congenital heart defect are 10-20%.

Liver diseases Liver diseases such as acute liver failure and cirrhosis reduce liver function, increasing the risk of bleeding, coma and death at birth. If the mother is a carrier of the hepatitis B virus, 2% of the babies will be born chronically infected with the virus and will be at risk of severe liver damage. Blood diseases Mothers experiencing anemia due to inadequate diet, poor absorption or hookworms will make the fetus less developed, the risk of premature birth, miscarriage or stillbirth. Anemic mothers are at increased risk of heart failure during pregnancy and birth complications such as increased risk of embolism and infection. Other diseases Endocrine diseases such as diabetes, basedown, addison cause high risk of preterm delivery, fetal malnutrition, pregnancy toxicity and increase maternal mortality. Severe low levels of estrogen and progesterone hormones cause an increased rate of miscarriage. Uterine malformations such as fibroids, open waist, .. cause miscarriage or premature birth. Occupational diseases such as lead poisoning, mercury poisoning, radioactive toxins, smoking, alcoholism will increase the rate of malformations, miscarriage, stillbirth or premature birth. 2.3 Group of factors related to obstetric history High-risk pregnancy when the mother has a history of multiple consecutive miscarriages, multiple premature births or stillbirth. When a woman has a history of 3 or more consecutive miscarriages, the chance of giving birth alive is only 30%, the risk of preterm birth is 20% higher than normal.
2.4 Group of high-risk pregnancy factors related to pathology occurring during pregnancy: Pre-eclampsia - eclampsia The mother has pre-eclampsia or eclampsia will make the fetus grow poorly, increase the risk Premature birth, placental abruption, sometimes fatal to both fetus and mother Placental causes Placenta placenta : common in women who are malnourished, have abortions or have given birth many times. The fetus is often born prematurely, in severe cases, a caesarean section is required to save the pregnant woman. Placental abruption: causes the fetus to be deprived of oxygen, the pregnant woman loses a lot of blood, threatening the life of both mother and child. Fibrosis: the placenta is underdeveloped, the exchange of oxygen nutrients between the mother and the fetus is reduced, leading to poor fetal growth, premature birth or stillbirth. Causes due to amniotic membrane Amniotic fluid leak, premature rupture of membranes causing amniotic infection, fetal infection. Amniotic fluid causes Polyhydramnios includes acute polyhydramnios and chronic polyhydramnios. Acute polyhydramnios is uncommon, usually appearing in the 4th or 5th month of pregnancy, causing difficulty breathing in the mother. Acute polyhydramnios often causes fetal malformations. Chronic polyhydramnios is more common, usually appearing in the last months of the fetus, the disease progresses slowly, the fetus has a high risk of malformations, premature birth, abnormal fetal position. Lack of amniotic fluid Cause of pregnancy Disease and infection fetus: fetus with genetic diseases, infection often stillbirth, premature delivery or miscarriage. Multiple pregnancy: twins or triplets are often born prematurely, difficult to give birth. Postpartum mothers are prone to bleeding. Blood group incompatibility between mother and fetus: common Rh factor incompatibility causes neonatal jaundice, hemolysis, nuclear jaundice. Premature pregnancy: placental degeneration is reduced ability to provide nutrients and oxygen to the fetus leading to fetal distress, impaired fetal functions, high risk of stillbirth or death within weeks. postpartum head. Thus, there are many factors that contribute to a high-risk pregnancy. High-risk pregnancy affects pregnancy and childbirth, poses many risks to the health of the mother, fetus and newborn. Pregnant women need to have early and regular antenatal check-ups on a regular basis to be examined and perform necessary clinical tests to detect risk factors early. Pregnant women with high-risk pregnancies will be monitored and have timely treatment and intervention measures to ensure the safety of both mother and baby.
At Vinmec International General Hospital, there is a package maternity service as a solution to help pregnant women feel secure because of the companionship of the medical team throughout the pregnancy. When choosing Maternity Package, pregnant women can:
The pregnancy process is monitored by a team of qualified doctors Regular check-up, early detection of abnormalities Maternity package helps to facilitate the process. birthing process Newborns get comprehensive care

Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.

Reference source: National Guidelines for Reproductive Health Services, Ministry of Health