Perth obstetrician for high-risk pregnancy
Have you been told to find a Perth obstetrician who has a special interest in high-risk pregnancies as your pregnancy may require extra care? It’s normal to feel worried and to have strong emotions when you are pregnant. And when a doctor mentions that your pregnancy may be high risk, these emotions can even feel more intense. At Joondalup Obstetrics and Gynaecology Group, we are here to help you safely deliver your baby and to make your pregnancy a time as joyful as possible, even if you are considered high risk.
- A pregnancy is considered high risk when there are potential complications that could affect you as a mother, your baby, or both.
- At Joondalup Obstetrics and Gynaecology Group, you are in safe hands in case your pregnancy is high risk. Our Perth obstetricians are highly trained to manage your pregnancy. Our aim is always to deliver your baby as healthy as possible, also with the most healthy outcome for you as a mum.
Perth obstetrician explains High-risk pregnancy
What are high-risk pregnancies?
We call a pregnancy high risk you as the mum-to-be and your foetus are facing a higher-than-normal chance of experiencing any problems. In essence, these types of pregnancies require extra and specialised care. This may mean we see you more often, to lower your risk and create the best chance of a healthy and joyful pregnancy.
Many factors can make a pregnancy high risk and we will go over the most common ones.
High-risk Perth obstetrician
High-risk factors of pregnancy
In some cases, a pregnancy is a high risk because of a maternal condition that is present before your pregnancy. As part of your antenatal routine visits and consultations, you would always find out at the very start of your pregnancy when we go over your medical history in full detail, during your first antenatal consultation.
In other cases, a medical condition can develop during your pregnancy.
Pre-eclampsia
Pre-eclampsia is a serious disorder and it can affect different organs. You may be diagnosed with pre-eclampsia if you have high blood pressure, as well as protein in your urine, and fluid retention. Pre-eclampsia usually develops after 20 weeks. There are different variants. For example, if it develops prior to 34 weeks, it can be called early-onset pre-eclampsia. It can also develop in the weeks after you have given birth.
Pre-eclampsia is dangerous because it can lead to seizures and strokes. It can also lead to HELLP syndrome. This is a medical emergency.
We will discuss this with you as it depends on how the condition affects you. It varies from one patient to another. The goal is always to optimise your own health as a mother and the health of your baby.
- You may need a few more antenatal visits compared to the normal routine if you had not had the condition.
- You may also need to monitor your blood pressure at home.
- You may need regular blood tests.
- Your baby will be assessed by regular ultrasound scans.
It is not clear why some women develop pre-eclampsia. Factors that may put you at risk of developing this condition include:
- Previous history of the disease
- Multiple order pregnancy (twins etc)
- Diabetes
- Chronic hypertension
- Autoimmune conditions such as lupus
- Kidney disease
Prevention involves managing the risk factors. In some instances, low-dose aspirin may be recommended as well.
Pre-eclampsia can cause your placenta to not function as well as it should, and this can affect your baby.
Yes, there is a higher risk of kidney and heart disease as well as stroke and high blood pressure.
Gestational hypertension
Gestational hypertension is a form of high blood pressure in pregnancy. It’s different from chronic hypertension, which is high blood pressure that was already present before you were pregnant.
Gestational hypertension can develop into pre-eclampsia. Families often ask me what the difference is between the two. You must think of these as a continuum of the same disease, with gestational hypertension being hypertension in isolation, seen in pregnancy with no other organ involvement.
Like pre-eclampsia, there is the long-term risk of kidney or heart disease and stroke, especially if it develops into essential or chronic hypertension.
Most women are initially asymptomatic. In severe cases, an unrelenting headache may be noticed.
You will be closely monitored with visits as frequently as weekly, depending on how severe your hypertension is. You may also require medications to help control your blood pressure.
We will take our time to help you understand the condition and the reasons behind our treatment recommendations.
The aim is to try and prevent pre-eclampsia and to prevent your blood pressure from getting too high which can lead to complications such as a stroke.
You will require regular frequent visits to see your obstetrician / midwife and you may require regular blood tests.
Managing risk factors with general good lifestyle choices may help reduce the risk.
Gestational diabetes
Gestational diabetes is diabetes that is diagnosed in pregnancy when there is no history of diabetes prior to the pregnancy.
You will be tested for gestational diabetes between 24-28 weeks. This can be earlier if you have specific risk factors.
During your pregnancy, your body is not able to produce enough insulin to keep your blood sugar levels within a safe range.
Yes, gestational diabetes is very common.
No, you did not cause it and often gestational diabetes is beyond your control. Your body is just not able to produce the right amount of insulin.
Twin / multiples pregnancy
In case you find out you are having twins or multiples, your pregnancy is automatically considered high risk. Twin pregnancies present particular challenges and require close monitoring especially if they are monochorionic twins (identical twins that share a placenta). Twin-to-twin transfusion (TTTS), for example, is a syndrome that can occur in monochorionic twins in which one twin is getting more of the placenta’s blood supply than the other. This then results in the two foetuses growing at different rates.
Preterm birth is the most common complication when expecting twins or multiples.
We are not very sure about this, but we do know that it tends to occur earlier and that it can be more severe.
Generally speaking, most complications in pregnancy are more common in twin pregnancies.
There are however some specific complications that only occur in some twin pregnancies. One good example of this is TTTS which can occur in monochorionic twins as explained above.
Full-term does not change based upon the number of babies however it is true that most twin pregnancies and higher-order multiples will deliver before their due date.
This will depend on how the pregnancy is progressing. Whether there are any complications and what type of multiples pregnancy you carry.
If suitable, labour is not really different until after the birth of the 1st twin. The biggest consideration I would imagine is the risk of vaginal birth for one baby and a caesarean for the next.
Yes, you should build in some form of exercise. Staying healthy and active is vital. However, you should probably avoid strenuous and high-impact exercises. We will guide you as your pregnancy progresses.
Yes, you are. It is important that you monitor how you feel and discuss this with your care provider if you have intense feelings of hopelessness, anxiety, despair etc.
Yes, you are encouraged to.
Maternal age
Luckily, your maternal age is not a condition. But maternal age plays a role when we talk about pregnancy and high risk. We think that a woman’s best fertility years are in her twenties and early thirties. As you get older your fertility naturally declines and by the age of 45 natural conception is unlikely.
We know that older women face a higher risk of pregnancy complications such as gestational diabetes and pre-eclampsia. There also seems to be a higher risk of foetal growth restriction and other foetal complications.
One reason is that older women tend to have developed more health complications compared with younger women which can increase the risks of complications.
It is also true however that even in relatively healthy older women, their pregnancies seem to suffer more complications.
The risk of chromosomal disorders is much higher in older women but the overall risk remains low.
It is recommended but not required.
Previous premature pregnancy
When you have had a previous preterm birth, your current one will be seen as a high-risk pregnancy. Unfortunately, a previous premature pregnancy puts you at risk of this happening again and will need close monitoring with possible treatment.
- Abdominal/back pain
- Pelvic pressure
- Vaginal bleeding or fluid loss
- Regular uterine contractions
Generally, it is not.
12 excellent reasons to choose Joondalup Obstetrics and Gynaecology Group
Care for the whole family, organising work certificates for partners.
Providing safe care and birth options (experience as a rural GP obstetrician).
A limited number of private patients to allow us the ability to provide patients with the service they deserve.
Make the time for patients, understand what they want/expect from their journey, available 24/7 (when on leave you will be covered during those times).
Blood pressure management.
Foetal growth assessment.
Maintaining a close relationship with your GP.
In-house access to allied health services such as physiotherapy and lactation consultants.
Free online antenatal classes.
About
JOGG
We are Joondalup Obstetrics and Gynaecology Group, in short JOGG. We are a Joondalup-based private obstetrics and gynaecology practice, and cater for mums, women and families across the Perth metro area.
