By Iris Farrou
17 Oct, 2023
Health Conditions and Pregnancy, New Moms, Parenting, Pregnancy, Prevention, Women's Health
blood pressure, early pregnancy health care, fact, genetic testing, geriatric pregnancy, Gynecologist, heart rate, high risk pregnancy, HIV, how to take care of my body when pregnant, level, Prenatal Health, prenatal visit, Rh, Screening, STD, STI, weight, when should I see a doctor after positive pregnancy test, when to see OBGYN
Finding out you are pregnant is often very exciting, and it may come with a ton of questions as to what happens next, how you should take care of your body and your baby, how to prepare for their arrival, and all the combinations of both nervousness and excitement! Taking care of your baby begins the moment you find out you are pregnant, and seeking professional prenatal care early is key to a healthy pregnancy and successful delivery.
What Do I Do?
Very good question! Most mothers have asked the same, so here is a basic checklist:
- If you suspect you are pregnant, make an appointment with your OBGYN as soon as possible. If you don’t have a regular OBGYN, call your insurance and see which experts in your area accept your insurance. If you don’t have insurance, before you look into applying, contact family planning clinics and community health centers close to you–those do provide basic prenatal care either free of charge or at a low cost.
- Your first prenatal appointment usually happens when you are 8 weeks pregnant, when a review of your medical history will take place and possibly a urine and blood test as well.
- For uncomplicated pregnancies, expect to see your prenatal healthcare provider once a month up until the 28th week, twice a month for weeks 28-36, and weekly from week 36 until delivery.
How Does this Help my Baby?
During your prenatal visits your doctor or nurse will check both your health and the health of your baby: your blood pressure and weight need to be monitored, measuring your abdomen to determine your baby’s growth is important, and your baby’s heart rate will also be checked at every visit.
Studies have shown that babies of mothers who receive no form of prenatal care whatsoever are three times more likely to have birth complications or low birth weight. It is understandable that if your insurance doesn’t cover the cost of all suggested prenatal exams and tests, you may not be able to afford them all. Some tests are screening tests, meaning that they detect risks of possible health problems; based on their results, your doctor may suggest diagnostic tests to get more accurate results.
What are some of the tests?
First and foremost your doctor needs to know your blood type and Rh factor, as well as any STIs, infections, or HIV. Genetic testing may be suggested to diagnose birth defects or possible genetic conditions, tests for chromosomal abnormalities, gestational diabetes test, glucose tolerance test, as well as regular urine tests and ultrasounds.
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By Iris Farrou
17 Oct, 2023
Health Conditions and Pregnancy, Pregnancy, Prevention, Procedures
amnioscentesis, amniotic fluid test, fetal lung test, genetic disorders, genetic predisposition, genetic testing, gestation, Healthy pregnancy, high risk pregnancy, pregnancy health conditions, tay-sachs disease, Ultrasound
The majority of expectant parents want to ensure their baby is as healthy as possible. Along with pre-genetic tests that determine certain genetic traits or risks parents may pass to their offspring, prenatal testings are quite common. These help you carry a healthy pregnancy to term, and check in on the baby’s health. Amniocentesis is one of these prenatal tests: it diagnoses genetic disorders and other health issues in a fetus:
- Fetal infection can be determined through amniocentesis, along with other illnesses
- Fetal lung testing is rarely done, but if a delivery is planned to happen sooner than 39 weeks amniotic fluid helps see if a baby’s lungs are mature enough for birth
- Sometimes there is an amniotic fluid build-up in the uterus–polyhydramnios–and it is drained through amniocentesis
What is the procedure?
It is normal to be nervous about any medical procedure, much more so if you are pregnant! The goal of amniocentesis is to extract amniotic fluid from your uterus, and most procedures happen between 15-20 weeks of gestation. Here’s what you should expect on the day of your appointment:
- You will lie on your back, just like you would prepare for a routine ultrasound. That’s the first step, as the ultrasound will show where your baby is in your uterus that particular day and time.
- The ultrasound will remain on screen as your healthcare provider inserts a very thin needle through your stomach wall and into the uterus. The needle is removed swiftly as amniotic fluid is drawn into the syringe.
- There is no sedation or numbing used, and it is important that you stay still. Even after the needle is removed, the ultrasound will remain in use to monitor your baby’s heart rate.
- You may experience mild cramping during the procedure, and/or shortly after, but you should be able to resume your normal activities after the test.
When is it necessary?
As one of many prenatal testings, amniocentesis provides details on certain genetic conditions and issues that other procedures may not fully address. It can detect chromosomal, genetic disorders, or congenital disabilities such as down syndrome, Tay-Sachs disease, neural tube defects, and Rh disease.
If the results of a routine prenatal screening test are worrisome, your doctor may suggest amniocentesis to rule out another diagnosis. If you’ve had a pregnancy with a genetic condition, amniocentesis will look for that condition in your current pregnancy. If the parents are carriers of a genetic condition, or have a family history, amniocentesis shows whether your baby is affected by it. Unusual ultrasound findings are another reason for further testing. Babies born to people over 35 have a higher risk of chromosomal conditions, so if you’ve had a prenatal cell-free DNA screening that came back positive, amniocentesis will shed light into possible conditions.
Even if your doctor suggests amniocentesis, and explains why, the final decision is up to you; as with any healthcare issue, you always have the right to seek out other professional opinions!
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No couple wants to hear the term “high-risk” associated with their pregnancy. An OBGYN may tell either first-time moms or couples expanding their families that their pregnancy is high-risk for a variety of reasons, but it doesn’t mean that without proper care and close collaboration with your OBGYN that you can’t deliver a full-term, healthy and beautiful baby. Whether you just found out you are pregnant, or you are hoping to become pregnant, it’s critical to understand the factors that may make a pregnancy high-risk.
The term “high-risk” may be used to describe any pregnancy in which there are potential complications that could impact either the mother, or the baby, or both. Factors that could result in a high-risk pregnancy include:
- Preexisting Conditions. If you are managing a chronic condition before you become pregnant, your OBGYN will want to monitor your pregnancy closely. Such conditions include high blood pressure; lung, kidney, or heart problems; diabetes; autoimmune disease; sexually transmitted diseases (STDs) or chronic infections such as human immunodeficiency virus (HIV).
- Maternal Age. Women under 17 or over 35 are at a higher risk of a complication, making any pregnancy high-risk. After age 40, women face a higher risk of miscarriage or giving birth to a child with genetic defects.
- Previous Pregnancy Complications. Women who have experienced complications with a previous pregnancy, or have had a miscarriage, are at a higher risk for future complications.
- Family History. If you have a family history of genetic disorders, your baby could be at higher risk of also being born with an inherited medical condition, such as Down syndrome, cystic fibrosis, or Huntington’s Disease.
- Medical Complications During Pregnancy. Your pregnancy may become high-risk if you develop a medical condition such as preeclampsia (a pregnancy complication characterized by high blood pressure) or gestational diabetes (a condition in which women develop high blood glucose levels during pregnancy).
- Fetal Development Problems. Babies that develop with a minor or major structural problem are considered high-risk. If there is a history of fetal development issues in your family, you may be at a higher risk of experiencing an issue with your baby.
- Multiple Births. The conception of twins, triplets, quadruplets, and more multiples has increased as more couples are utilizing infertility treatments to become pregnant. Carrying multiples increases the risk of premature labor, gestational diabetes, and pregnancy-induced high blood pressure.
- Premature Labor. Even after several months of a seemingly healthy pregnancy, premature labor can put you and your baby in a high-risk scenario. A premature labor is considered one that begins before 37 weeks of pregnancy. Women at a higher risk of premature labor include those with a shortened cervix or who have experienced previous preterm births.
- Placental Previa. A pregnancy condition in which the placenta covers the cervix and can cause bleeding, particularly during contractions. It may require a cesarean section to reduce bleeding risks to mother and baby.
A high-risk pregnancy doesn’t have to mean dire consequences. Whether you know going into your pregnancy that you will be at higher risk, or a pregnancy complication develops unexpectedly, the best thing you can do is work closely with your OBGYN and follow the treatment plan that he or she prescribes to keep both you and your baby safe throughout your pregnancy.
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If you’re pregnant or about to become pregnant, your number one priority is carrying your baby safely and healthily to full-term. No matter what your current state of health, or how prepared you feel you are to have a healthy pregnancy, every new mom should understand the warning signs of high-risk pregnancies.
What is a high-risk pregnancy?
Generally, a pregnancy is defined as high-risk if you or your baby has an increased chance of facing a health problem. Such problems could be caused by one of several underlying conditions, including:
These conditions put you and your baby at risk for complications like slowed fetal growth, a preterm labor, preeclampsia, or issues with the placenta.
Other factors that could result in a high-risk pregnancy include:
- If you are under 17 or over 35
- You use alcohol or illegal drugs
- You smoke
- You have an infection, such as HIV, hepatitis C, syphilis, cytomegalovirus (CMV), chickenpox, rubella, or toxoplasmosis
- You are having a multiple pregnancy
- You have had three or more miscarriages
- Your baby has been diagnosed with a genetic condition such as Down syndrome, or a heart, lung, or kidney condition
- You have been diagnosed with a serious condition such as heart valve problems, sickle cell disease, asthma, lupus, or rheumatoid arthritis
- You have had a serious problem with a previous pregnancy, such as a preterm labor, preeclampsia, or seizures (eclampsia)
- You are taking certain medications such as lithium, valproic acid, or carbamazepine
High-risk pregnancy treatment
Your OB-GYN will be able to diagnose whether or not your pregnancy is high-risk. If you are diagnosed as being high-risk, you should expect more frequent visits to your doctor than women whose pregnancies are not high-risk. Your OB-GYN will likely want you to receive more frequent ultrasound tests to confirm your baby is developing and growing at the proper rate. Your doctor will also closely monitor your blood pressure and more frequently test your urine for a protein that indicates preeclampsia or a urinary tract infection. If you have diabetes, asthma, or high blood pressure, your doctor may prescribe medications to help monitor such conditions.
Keep in mind that just because your pregnancy has been defined as high-risk does not mean that your baby will definitely be born with health issues. Under the care of your OB-GYN, and by following your prescribed treatment plan, you can welcome your new, healthy baby into the world without worry.
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Gestational diabetes is a form of the metabolic disease that impacts pregnant women who do not have a previous history of diabetes, but who have high blood glucose levels during their pregnancy. The Centers for Disease Control and Prevention (CDC) estimate that in 2014 as many as 9.2 percent of pregnant women suffered from this condition. If you are pregnant or trying to become pregnant, understand the risks and treatment options available to help ensure a safe and healthy pregnancy.
Causes
The causes of gestational diabetes are not completely known, however it is believed that hormones from the placenta that help the infant during development begin to block the action of the mother’s insulin into her own body. When proper insulin levels decline, glucose cannot leave the blood to be converted into energy, instead building up in the blood in unsafe levels, a condition known as hyperglycemia.
Risk Factors
All pregnant women are at risk of developing gestational diabetes, however some women are at a higher risk. Risk factors for gestational diabetes include:
- Age. Women age 25 or older during their pregnancy are more likely to develop gestational diabetes.
- Weight. Women with a body mass index (BMI) of 30 or higher are more likely to develop gestational diabetes.
- Family history. Women who have a close relation, such as a parent or sibling, that has previously been diagnosed with type 2 diabetes are at a greater risk for gestational diabetes.
- Personal health history. Those who have suffered from prediabetes are at a greater risk of gestational diabetes. Prediabetes is a condition defined by slightly elevated blood sugar that may be a precursor to type 2 diabetes. Women are also at a greater risk if they were diagnosed with the condition during a previous pregnancy, if they delivered a stillbirth, or if they delivered a baby who weighed more than nine pounds.
- Race. While experts are uncertain of the reason, women who are African American, Hispanic, American Indian, or Asian are more likely to develop gestational diabetes.
Potential Impact to Mother and Baby
Gestational diabetes impacts the mother in late pregnancy after the baby’s body has been formed. Untreated or poorly controlled gestational diabetes can have serious consequences on infants. Women with gestational diabetes experience an overuse of the pancreas as it works to produce insulin that is ultimately ineffective in lowering blood glucose levels. The high levels of blood glucose are eventually transferred to the baby through the placenta, causing the baby’s pancreas to overproduce insulin as well. Eventually, the extra, unneeded energy is stored by the baby as excess fat, a condition known as macrosomia.
Babies with macrosomia face several potential health risks, including damage to their shoulders during birth, low blood glucose levels at birth due to extra insulin levels, and breathing problems. Later in life, the babies are at a higher risk of suffering from obesity and type 2 diabetes.
Testing
Your OBGYN will likely evaluate your risk factors for gestational diabetes early in your pregnancy. Based on those factors, he or she will help determine a screening frequency to identify any risk factors early. For example, women at high risk may be tested at their very first prenatal visit, while women at average risk will likely be screened during the second trimester.
Women diagnosed with gestational diabetes will require frequent checkups, especially during the final trimester. During these exams, and possibly even in between visits through self-testing, their blood sugar will be monitored. Your OBGYN may also prescribe insulin to help control your blood sugar.
Directly after the birth, your OBGYN will likely check your blood sugar and will want to test it again in six to 12 weeks to determine if levels have returned to normal. Even with an eventual normal reading, women who have been diagnosed with gestational diabetes should receive a diabetes screening at least every three years.
Treatment
In addition to constant monitoring of blood sugar levels, there are treatment options available for women to manage gestational diabetes, including:
- Following a healthy diet high in fruits, vegetables, and whole grains.
- Receiving regular exercise, which helps lower blood sugar by stimulating the body to move glucose into cells and use it as energy.
- The use of insulin, which is prescribed for 10 – 20 percent of women suffering from gestational diabetes.
Every woman strives for a healthy pregnancy. Talk to the doctors at Chouchani, Sayegh and Bagnarello about the factors that may impact your risk for developing gestational diabetes. Our doctors will work with you to help identify any threats early to keep you and your new loved one safe and healthy.
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What if your doctor tells you you’re considered a high-risk pregnancy? What does that mean, and what can you do about it?
Being called “high-risk” may sound scary, but it’s just a way for doctors to ensure that you get special attention during your pregnancy. It usually means that you or your baby has an increased chance of a health problem—not that you or the baby will definitely have one.
What kind of conditions will put you in the high-risk category?
- You have a health problem such as diabetes, cancer, high blood pressure, kidney disease, heart valve problems, sickle cell disease, asthma, lupus, rheumatoid arthritis or epilepsy
- You smoke or use alcohol or illegal drugs
- You are younger than 17 or older than 35
- You are pregnant with more than one baby
- You’ve had three or more miscarriages
- Your baby has a genetic condition, such as Down syndrome, or a heart, lung, or kidney problem
- You’ve had past problems such as preterm labor, preeclampsia or eclampsia
- You’ve already had a baby with a genetic condition
- You have an infection, such as HIV, hepatitis C, cytomegalovirus (CMV), chicken pox, rubella, toxoplasmosis or syphilis
Will my doctor treat me differently for a high-risk pregnancy?
You’ll have more regularly scheduled visits to the doctor, and you may have more ultrasound tests to keep an eye on your baby’s growth. Genetic testing may also be done, especially if you are 35 or older or had a genetic issue in a past pregnancy.
Can a pregnancy become high risk later?
Yes. Sometimes a medical condition develops during pregnancy for either mom or baby causes a pregnancy to become high risk. Some complications include:
- problems with the uterus, cervix or placenta
- severe morning sickness
- too much amniotic fluid
- too little amniotic fluid
- Rh (rhesus) sensitization, which can occur if your blood type is Rh negative and your baby’s blood type is Rh positive
What can I do to stay healthy during a high-risk pregnancy?
- Seek regular prenatal care so your health care provider can monitor your health and your baby’s. Visit a specialist in maternal-fetal medicine, genetics, pediatrics or other areas if necessary.
- Establish a good relationship with your doctor and with other doctors in the practice. You’ll want to feel comfortable discussing any concerns you might have and know that any of them can treat you if necessary.
- Eat a healthy diet. A daily prenatal vitamin can help fill any gaps. Consult your health care provider if you have special nutrition needs due to a health condition, such as diabetes.
- Gain weight wisely. Work with your health care provider to determine what’s right for you.
- Avoid risky substances. If you smoke, drink alcohol or do illegal drugs—quit. But get your health care provider’s OK before you start or stop taking any medications or supplements.
- Talk to your doctor about any health problems you have and any medications you are taking.
At Chouchani, Sayegh and Bagnarello, we pride ourselves on providing personal and friendly care to each and every patient. If you have any questions or concerns about your pregnancy or your prenatal or postnatal health, call us any time at 716.633.6363.
Disclaimer: The medical information provided in this article is of a general nature and cannot substitute for the advice of a medical professional.
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Finding out you are pregnant is often very exciting, and it may come with a ton of questions as to what happens next, how you should take care of your body and your baby, how to prepare for their arrival, and all the combinations of both nervousness and excitement! Taking care of your baby begins the moment you find out you are pregnant, and seeking professional prenatal care early is key to a healthy pregnancy and successful delivery. 
