High Risk and Pregnancy Essay

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Prenatal care is an important aspect of pregnancy and can result in positive outcomes for both mother and infant. Low-risk pregnancies have different recommendations for prenatal care than high-risk pregnancies. Low risk pregnancies begin with medical checkups that include screening tests. This will help the mother know if the baby is healthy and if she is healthy while pregnant. Prenatal care also involves some aspect of counseling as well as education on how to handle various facets of pregnancy. Patient education could involve topics like healthy eating, any additional screening tests needed, and level of physical activity. They may also include as part of prenatal care, what to expect during labor plus after delivery.

The first trimester for a low-risk pregnancy as previously stated, involves tests, labs, and screenings. The first thing they do is determine the expectant mother's blood type and Rh factor and to look for signs of immunity to chicken pox and rubella. They also focus on screening for any STDs. This means testing for Hepatitis B, Gonorrhea, Chlamydia, and HIV antibody testing. There is also an antibody screening, urine testing, and if appropriate, cervical cytology. Along with these tests/screenings, the doctor may also consider additional testing. Such tests may include Vitamin D, PPD, early glucose challenge, varicella antibody test, and genetic screening. This is due to some patients potentially have genetic problems that could be passed down to their children.

Procedures possibly done during the first trimester is a dating ultrasound if the expectant mother does not know when her last period was, and to check for size-dates discrepancy. From 11-13 weeks an additional ultrasound and maternal serum screening may be performed. From 16-18 weeks, the obstetrician may recommend a maternal serum alpha fetal protein and/or a quadruple marker serum screening for any potential chromosomal abnormalities.

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From 18-20 weeks a fetal anatomy ultrasound may be recommended. This makes up the second trimester in a low-risk pregnancy.

The third trimester from 28 weeks to 41 weeks, involves additional tests and screenings. For example, there may be additional antibody testing, CC, syphilis screening, and glucose challenge test. Prenatal care may also include during this period administration of anti-D immune globulin if the expectant mother requires it. After 36+ weeks, there is determination of fetal presentation and screening for Group B. Streptococcus. Should the pregnancy last for more tha 41 weeks, there is an offer available for induction of labor.

While high risk pregnancies essentially include all of this, high-risk pregnancies may require additional rescreening in the 3rd trimester. But what is a high-risk pregnancy? High risk-pregnancies are any pregnancies that have a higher risk for complications. Although high-risk pregnancies may mean an increased chance for complications, the labor and delivery may transpire without any problems.

Those that are considered high-risk pregnancies are the very young, women over the age of 35, women underweight or overweight, previous problematic pregnancies, any pre-existing health conditions such as diabetes, high blood pressure, HIV, and cancer. Although cancer is rare during pregnancy, it can happen. "The diagnosis of cancer during pregnancy is uncommon. It is estimated that 1 in every 1000 pregnant women is diagnosed with cancer. Breast, melanoma and cervical cancers are those most commonly diagnosed during pregnancy, followed by haematological malignancies" (Peccatori et al., 2013, p. vi1160). Some women may develop conditions during pregnancy that could make them high-risk such as preeclampsia. High-risk pregnancies require additional prenatal care and may mean receiving care from a specialist like a maternal-fetal medicine specialist. They also….....

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