High-Risk pregnancies are defined as those pregnancies that have an increased risk of maternal and/or fetal complications during the gestation, delivery, and postpartum course. There are many reasons to label a pregnancy high-risk and each pregnancy requires an individual level of care and testing parameters.
Maternal complications include medical problems of the mother prior to pregnancy and those that are acquired during pregnancy. Fetal complications include those that are genetic, acquired, and related to maternal conditions.
Maternal factors that have been associated with an increased risk of poor pregnancy outcome include basic maternal health issues like Diabetes & Hypertension, Thyroid disease, and connective tissue disorders (i.e. Lupus). This also has come to include many new found problems that can cause recurrent miscarriage and later pregnancy losses and poor outcomes. These include the Hypercoagulability syndromes. All of these can lead to fetal complications, preterm delivery and poor outcomes if uncontrolled and not followed closely.
Fetal Factors that raise pregnancy risk include multiple gestations which have become more common with the advent of fertility interventions. It also includes many fetal anomalies and placental and membrane abnormalities as well. These conditions include fetal malformations like heart defects, abdominal wall anomalies, umbilical cord complications, placenta previa, & fluid abnormalities (low or high). With the advances in ultrasonography many undetectable abnormalities in the past can now be visualized and appropriate measures taken.
High-risk pregnancies are typically followed more closely thru the first 2 trimesters with visits every two weeks instead of four. After 28 weeks, typically visits become weekly or biweekly and fetal testing ensues at this time. At Bossier Healthcare For Women we offer comprehensive in office fetal testing with 2 Non-Stress test machines and the latest GE 4D™ Ultrasound machine. Since this testing is time consuming for the patient, our Non-Stress test station has recliners and a television and stereo for patient comfort and our Ultrasound is hooked up to a widescreen high definition LCD television to allow for the patient and family to easily view the fetus while the U/S tech and physicians can view the built in monitor. The separate site for fetal testing explains the different tests and their purpose in detail.
We also coordinate care with dieticians, diabetic educators, our local Maternal-Fetal medicine specialists, and the NICU’s to optimize patient and baby outcomes. Although we strive for full term deliveries in each of our pregnancies, sometimes this is not possible and delivery can then be accomplished at one of the area hospitals that have a NICU present. Willis-Knighton also has an advanced NICU transfer system to transfer babies in a mobile NICU environment when this is needed.
Dr’s Blanton and Robertson both trained at tertiary care centers that provided high-risk maternal and fetal care for large surrounding areas. We also keep up to date on the latest techniques, testing and interventions available to provide care for mothers and babies. With the recent expansion of Willis-Knighton Bossier’s labor and delivery unit, this has allowed the addition of a new fetal monitoring system that allows us to have remote access to view fetal and maternal status like never before. As always, we strive to maintain the best possible care for our Obstetric patients to optimize everyone’s outcome.