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GYNECOLOGICAL CARE

INSTITUTE

High Risk

Pregnancy Clinic


Every pregnancy has some risks, but there are more dangers to your health and the health of your fetus with a high risk pregnancy. The causes can be conditions you already have or conditions you develop. They also include being pregnant with more than one baby, previous problem pregnancies, or being over age 35. If you have a chronic condition, you should talk to your doctor about how to minimize your risk before you get pregnant. Once you are pregnant, you may need a health care team to monitor your pregnancy. At the High-risk Pregnancy Clinic, we aim to optimize the outcome of pregnancy. Apart from the health care we provide, we also encourage you to be up-to-date with the information and knowledge about these issues.

Transverse lie

Meconium Stained liquor

Placenta covering The os

Placenta Previa

Breach Presentation

Classifying pregnancies as “Normal” or “High-Risk” is an effective way to alert couples of the care that must be taken. Some mothers-to-be may be at-risk from the very beginning of her pregnancy, with disorders such as diabetes or with a history of a premature delivery. Others may start with normal pregnancies but subsequently develop risk factors, such as ruptured membranes or pregnancies-induced hypertension, which may develop suddenly. Therefore, it is critical to be able to identify complications quickly and have a protocol for management. If your doctor detects that there are some risk factors which are likely to harm you or the baby, you will be advised necessary treatment or hospitalization. It is in your interest to listen to the doctor, follow the advice and not ignore it. Clinic Timings - Monday (5:00 – 7:00 pm)


Risk Factors in Pregnancy Mothers with the following groups need more attention in pregnancy and delivery. Remember - complications can arise in any pregnancy, at any time.

Before Pregnancy Age

: Less than 18 years; over 35 years

Height

: Below 145 cm

Weight

: Below 40 kg

Parity Birth Interval

: Primi or grandmulti (4 or more previous children) : Less than 2 years

Previous History

: i) Previous abortions/ premature or still born babies. ii) Previous difficult delivery of caesarian section, hemorrhage after delivery.

During Pregnancy Pallor or anemia (Hemoglobin below 10 gm) ¤ Diabetes ¤ Poor weight gain ¤ Jaundice ¤ Swelling of legs, hands and face ¤ Twins, breech, transverse lie ¤ High blood pressure ¤ Prolonged pregnancy ¤

Risk in motherhood Developed world India

- 1:2800 - 1:175

1 in 5 maternal deaths occur in India (1.25 lac approximately) Due to: 75% : Hemorrhage; Abortion; Eclampsia; Sepsis; Obs. Labour 20% : Anemia


The womb is no longer considered to be an isolated and dark chamber. The fetus is easily accessible today with tools such as ultrasonography, magnetic resonance imaging, chorion villus sampling, amniotic fluid studies; and Doppler blood flow studies. The concept of the fetus as the 'The unborn patient' has elevated the importance of prenatal diagnosis and treatment. Electronic fetal monitoring of fetal heart is a major breakthrough and very patient friendly procedure

Lab Work: Blood tests: Hemoglobin; Hematocrit; and PB Smear; VDRL (both partners); Blood group and Rhesus factors (both partners); HbsAg; HIV; GIT (20-24 week); SGOT; SGPT and Serum Creatinine. TSH; TPO; T4; Thalassemia screening. Urine R/E & C/S; Pap Smear; Wet smear

Ultrasound is a safe, non invasive, accurate, fast and cost-effective diagnostic test. A high risk pregnant woman usually undergoes 4 scans. 1. Dating cum Viability Scan (6-8 weeks) 2. First trimester – Fetal morphology scan (11-14 weeks) 3. Anomaly scan (18-20 weeks) 4. Fetal wellbeing scan (34-35 weeks) Level II Scans are more targeted examinations of fetal anatomy with a focus on major body systems like brain, spine, GIT including stomach and bowel, KUB area (kidney and urinary bladder) and limbs. Fetal echocardiography (18-22 weeks) is invariably done in high risk cases. Safety of Ultrasound: Unlike X rays, ionizing radiation is not present during ultrasonography and hence there are no embryotoxic effects. The World Health Organization (WHO) recommends the prudent use of ultrasonography when there is a clear indication.


Most importantly, we must remember that diagnostic machines cannot substitute a good gynecologist. A High Risk mother is in a sensitive phase of her life and therefore an excellent rapport and an empathetic attitude are most essential. Counseling is an important aspect of management of a high risk pregnancy as your compliance and cooperation is essential for good results. In most of the high risk pregnancies, good antenatal care, and close monitoring of the factors arising during pregnancy, labour, delivery and the time just after, give rewarding results.

Pushpanjali Crosslay Hospital has a technically modern centre with sophisticated monitoring tools, for both mother and child and an experience team of gynecologists to offer you the best care during this difficult period.

The Team Dr Sharda Jain - HOD Dr Uma Rai – Unit Chief Dr Raj Bokaria – Unit Chief Dr Jyoti Aggarwal

Dr Sushma Dikhit

Dr Debasis Dutta

Dr Rini Goyal

Dr Jyoti Mishra

Dr Anita Jain

Dr Ila Gupta

Dr Pawan Bhasin

Visiting Consultants Dr Aruna Saxena Dr Shubha Saxena Dr Nalinee Garg Dr Manju Barik Dr Archana Verma

Anjana Singh Sangeeta Goel Dr Pooja Gupta Dr Jigyasa Govil


Location Map

Gynecology OPD No.: 0120 - 4173360 0120 - 4173361

Pushpanjali Crosslay Hospital W 3, Sector-1, Vaishali, Ghaziabad-201012, UP, India 24X7 Emergency Services: 0120-4188188 24X7 PCH Helpline: 0120-4173000, 4188000, 3133000 Email: info@pch.co.in Website: ww.pch.co.in


High Risk Pregnancy