Risky pregnancies and important information

Risky pregnancies and important information

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Pregnancy is one of the most special and difficult periods of a woman. For some mothers, this period is much more difficult. Problems such as diabetes, hypertension, advanced pregnancy, blood mismatch make pregnancy risky. How should such problems be prevented? We also have mind-boggling questions about it. Women Health and Diseases Specialist Alper Mumcu 'or directed.

: Which pregnancies belong to risky pregnancies?
Dr. Contact Alper directly During pregnancy, the mother or the baby's overall health status and even if there are situations that can put life risk is defined as high-risk pregnancy. In high-risk pregnancies, pregnancy may worsen an existing disease or condition in the mother, and vice versa, the present disease may adversely affect the course of the pregnancy. One of the situations where the probability of developing problems is highest is the maternal age. Therefore, advanced maternal age is an important part of high risk pregnancies. On the other hand, it is included in the high risk pregnancies class in the systemic diseases which may have serious maternal effects. The best known are diabetes, heart disease, hypertension, certain hormone diseases and nervous system diseases. Another case that may be included in high-risk pregnancies is blood mismatch between the mother and father.

: What are the precautions to be taken in advanced age pregnancies?
Dr. Contact Alper directly Among the high-risk pregnancies, it is the most well-known advanced age pregnancy among the people. Significant increases in the frequency of certain genetic diseases, especially Down's syndrome, are observed in these pregnancies. With the increasing age, there is a decrease in the number and quality of eggs produced by the woman. As a result of this decrease, a parallel decrease occurs in the pregnancy rates of older women. The genetic structure of the eggs produced is highly likely to be faulty and due to this height, either the egg cannot be fertilized or the fertilized egg cannot sustain its viability for a long time. In the end, either pregnancy never happens or even if it results in a very high rate of miscarriage. It can be regarded as a kind of nature self-protection mechanism. However, some genetic diseases are compatible with life. The best known example of this is Down syndrome. In Down syndrome, mental retardation and a number of physical and physiological disorders coexist.

On the other hand, with the increasing age, there is an increase in the incidence of systemic diseases such as heart diseases and diabetes in the mother. For all these reasons, advanced age pregnancies are accepted if we are high risk pregnancies.

As a result of the developments in the field of science, there is a big explosion in the number of women who become pregnant with assisted reproductive techniques. Many women who have not been pregnant for years can get pregnant in this way. The natural consequence of this is the increase seen in older pregnancies. On the other hand, the increasing role of women in social and work life has increased the age of marriage and becoming a mother. Compared to half a century ago, there are more advanced pregnancies today. Despite these developments, there was no significant change in the age limit meant by advanced maternal age. At present, more than 35 years of age are defined as advanced maternal age.

In the presence of advanced maternal age, there are some features in the follow-up of pregnancy. In order to reveal possible genetic diseases in these individuals, it is necessary to examine the baby's tissues by taking a sample and show that the baby does not have such an anomaly. For this purpose, cord villus sampling or amniocentesis should be performed in these individuals.

: What should be done by pregnant women who are exposed to harmful factors such as medicine, x-ray during pregnancy?
Dr. Contact Alper directly This question is one of the most common questions faced by gynecologists and obstetricians. The answer depends on the stage of pregnancy. As everyone knows, the first 12 weeks of pregnancy, or in other words the first 3 months, is the most important period in which the organ development of the baby takes place. Harmful substances or infections exposed in this circuit can cause permanent damage to the baby. But here too nature's protection mechanisms come into play. If such exposure occurs during the first 1-2 weeks after fertilization, in which the menstrual delay does not occur, or if there is a 1-2-day delay, the rule defined as hep all or nothing i┼čler works. In other words, the developing baby is either not affected at all and maintains normal development or is affected and a miscarriage occurs. To summarize, it is not necessary to take any action on exposure to harmful substances in very early pregnancies. In later events, the type and amount of substance exposed becomes important. If it is known that this substance will cause permanent damage to the developing baby, termination of pregnancy is the most rational way. If the baby is at low risk of being affected, it is allowed to continue the pregnancy by evaluating the baby's development under close follow-up.

: Diabetes, Epilepsy, Hypertension, Thyroid and Heart Disease problems of mothers during pregnancy should pay attention to what points?
Dr. Contact Alper directly The follow-up of pregnant women with such diseases is carried out in a multidisciplinary approach. For example, in a mother with diabetes, blood sugar is regulated by the endocrinologist, or in the presence of heart disease, the cardiologist monitors the pregnant woman. The treatment offered by the related branch physician is also evaluated by the obstetrician and the patient is consulted to ensure that the pregnancy is maintained in a healthy way.

: What precautions should couples with blood mismatch take?
Dr. Contact Alper directly Blood mismatch is a term used in cases where the mother's blood type is Rh negative and her father is Rh positive. In cases where the father's negative mother is positive, there is no dispute. Couples with blood mismatches cannot take measures themselves. Usually the first infants are not affected, but the situation changes if there is an abortion or miscarriage. After such procedures, if the pregnancy is more than 6 weeks, the mother should be given a protective needle. The same needle is given after birth. If the baby's blood is Rh negative, a protective needle is not required.

If there is a history of miscarriage or abortion, the couple's physicians should be informed. If no protective needles have been made after the previous procedure, some blood tests are carried out in the mother during pregnancy follow-up to determine whether the baby is affected by this conflict during certain periods. In some cases, the postnatal protective needle can also be applied during pregnancy.

: In which cases should I terminate pregnancy?
Dr. Contact Alper directly Many situations may make this undesirable. The most common condition is an anomaly such as down syndrome detected in the baby. On the other hand, structural anomalies, nervous system anomalies and other diseases of the baby that are detected during the follow-up of pregnancy may also require late termination of pregnancy.

In the early period, exposure to substances known to be effective on the development of the baby and called teratogen is the necessity of termination. For example, X-ray or computed tomography, active rubella infections, active toxoplasma infections taken from the abdominal region in the early period are such requirements. On the other hand, it may be necessary to terminate the pregnancy in cases such as heart disease, kidney disease, uncontrolled diabetes where the continuation of pregnancy will put the mother's life at risk. Presence of certain types of cancer, especially cervical cancer, such as melanoma, also requires termination of pregnancy.

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