📢 Calling all expecting mothers

The treatment really depends on what is the exact diagnosis which renders the mother high risk. For example, aspirin is the prefered medication to prevent preeclampsia. For mothers with SLE, most SLE medications are safe and can be taken during pregnancy as to ensure optimal pregnancy outcomes. In fact, for those with breast cancers, chemotherapy and surgery can also be performed during pregnancy. Hence, the treatment really depends on what is the exact diagnosis which makes one high risk.

Although each and every individual is unique, age beyond 40, obesity or a BMI of above 40 kg/m2, multiple pregnancies such as twins, having an infection, anemia, diabetes or IVF pregnancies are some common risk factors associated with high risk pregnancies.

This is a wonderful question Julia S. The first key is for patients to appreciate that they are high risk, either because of a previous pregnancy complication or because they have an underlying medical disease or complication. Such patients should ideally see an expert obstetrician, ideally a maternal fetal medicine specialist who is an expert in high risk pregnancies before embarking on a pregnancy for a review, modification and optimisation. Secondly, pre pregnancy care is the most essential step for all high risk pregnant mothers as to optimise their health as much as possible. Thirdly, exercising, having a balanced diet and also being up to date on their vaccinations are other measures to reduce the implications of high risk pregnancies. Finally, reducing other comorbidities such as obesity, avoidance of active and passive smoking and leading a healthy lifestyle are key considerations to reduce potential risk. If one is unsure, it is best to seek an advice from an expert as to redu

An important and crucial step in managing high risk pregnancies is actually prenatal or pre-pregnancy care. It is extremely important as to ensure that the patient embarks on a pregnancy, being as healthy as possible and that she takes medications which are proven to be safe during pregnancy at the best possible dose. It is also important to ensure that she is on appropriate supplements, has achieved near normal BMI, does not have other additional co-morbidities and is also up to date on her vaccinations. It is also important to ensure that her partner is also as healthy as possible and these vital measures can only be undertaken in the prenatal period.

Although the implications of gestational diabetes is not as significant as diabetes mellitus, gestational diabetes does have an impact if it is not monitored or is poorly controlled. Having said that, 80% of patients with gestational diabetes can be controlled via diet, exercise and lifestyle modifications alone and hence, should not have a significant fetal impact if this is monitored and managed optimally.

Thank you for your very kind words.

There are various conditions that will render your pregnancy to be a high risk pregnancy. Some common examples are having pre-eclampsia, IVF pregnancies, twins, previous preterm deliveries, diabetes or any medical diseases or complications in pregnancy.

Your midwife or obstetrician should be able to advise you if your pregnancy is of high risk. Some patients may have diseases before pregnancy which may have been diagnosed, while some may develop complications later midway in the pregnancy. If unsure about your pregnancy, you may seek an advise from your obstetrician or a maternal fetal medicine specialist who will be able to guide and advice.

Obesity, especially morbid or class III obesity, such as those with a BMI of beyond 40 kg/m2 does have a significant impact on high risk pregnancies. In increases the risk of gestational diabetes, preeclampsia, venous thromboembolism, caesarean section and postpartum haemorrhage apart from the risk of developing OSA which is known as Obstructive Sleep Apnoea. That is why we now recommend Bariatric Surgery before pregnancy as one of the options to reduce the implications of obesity on the pregnancy.