Medical Problems in Pregnancy

Medical Problems in Pregnancy

Is it possible to have a baby with a complex medical problem in the mother?

It can be dangerous to give birth if the mother has a pre-existing illness like heart disease, chronic kidney problems, diabetes, high blood pressure, rheumatic conditions or thyroid problems. It can endanger the life of both mother and baby. However, with the successful application of maternal medicine, it is possible to have safe deliveries now even with a complicated medical condition in the mother.

In case a prospective mother has congenital heart disease – what to do?

In some cardiac conditions, pregnancy is completely contraindicated. Optimizing the heart condition with medications before pregnancy is important for success. Pre-pregnancy echocardiography may be helpful to decide and monitor. Continuous monitoring of fetomaternal conditions in the higher centers is paramount. Delivery should take place in a center with a good ICU and NICU.

I was detected to have diabetes during pregnancy – what shall I do?

Awareness is most important in diabetes management. Blood sugar should be strictly controlled before and during pregnancy. Otherwise congenital problems may arise in the fetus. Babies are usually big and pre-term delivery is more common. Unexplained fetal death may happen in poorly monitored cases.

What to do in pregnancy in case of Chronic kidney disease in the mother?

Pregnancy may reduce the function of a damaged kidney further. There is also a high incidence of blood pressure problems during pregnancy. The safety of being pregnant should be assessed first at the pre-pregnancy stage, along with the adjustment to safe medications during pregnancy.

Is pregnancy dangerous with Rheumatic disease?

Not all medications used in rheumatic conditions are safe in pregnancy and thus need adjustments. There is also a high incidence of recurrent pregnancy loss.

I am on Thyroid medications and got pregnant – what to do?

In Hypothyroid, usually doses need to be increased. In Hyperthyroid, special attention should be given to the fetus

Is pregnancy safe for someone with Hypertension?

Blood pressure should be adequately controlled with appropriate medicines before pregnancy as not all blood pressure medications are safe in pregnancy. Babies may be growth restricted, pre-term or may die inside the uterus. So careful fetal well-being assessment is important. Mother can get critical because of eclamptic fit.

In all these complicated pregnancies – what is the best thing advised?

Care should take place in a maternal medicine unit with a multi-disciplinary team. Pre-pregnancy counseling with optimization of medical conditions and medicines should be done.