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29.12.2014


Your pregnancy is called high-risk if you or your baby has an increased chance of a health problem. The conditions listed below put you and your baby at a higher risk for problems, such as slowed growth for the baby, preterm labor, preeclampsia, and problems with the placenta.
You are taking certain medicines, such as lithium, phenytoin (such as Dilantin), valproic acid (Depakene), or carbamazepine (such as Tegretol). You will have more visits to the doctor than a woman who does not have a high-risk pregnancy. Tests for genetic or other problems also may be done, especially if you are 35 or older or if you had a genetic problem in a past pregnancy. Gynaecologist in Kolkata Dr.Sankar DasMahapatra will prescribe any medicine you may need, such as for diabetes, asthma, or high blood pressure.
Talk to Best gynecologist in Kolkata about hospitals performing laparoscopic surgery in Kolkata.
If your gynaecologist thinks that your health or your baby’s health is at risk, you may need to have the baby early. You must visit Top gynaecologist in Kolkata Dr.Sankar DasMahapatra who is adequately experience in high-risk pregnancies.
If you have a medical condition, it’s important to consult pregnancy specialist in Kolkata before you decide to become pregnant. Preeclampsia is a syndrome that includes high blood pressure, urinary protein, and swelling; it can be dangerous or even fatal for the mother or baby if not treated.
Multiple births means you are carrying more than one baby (twins, triplets, quadruplets, etc.). Down’s syndrome is a chromosomal defect caused by the presence of an extra copy of chromosome 21. Anyone can have a pregnancy affected by Down syndrome, but the risk increases with advancing mother’s age. The individual risk (eg your own risk) for Down’s syndrome is given as a figure, also supported by a qualifying phrase as ‘low risk’ or ‘high risk’.
For those deemed as high risk, discussion with a fetal medicine expert is recommended so that options of conservative management or invasive tests, and the risks thereof, are discussed so that the most appropriate choice may be made for the individual and her family.
For those who are at ‘high risk’ for Down’s syndrome or those who are anxious about the risk of Down’s syndrome and wish for a definitive answer, either of the two following invasive tests is available for diagnosis.
Prenatal care (also known as antenatal care) refers to the regular medical and nursing care recommended for women during pregnancy. A 40 yr old female, came to our emergency in March, 2012, with respiratory distress due to left ventricular failure (LVF) and hypertension, along with 18 weeks of pregnancy.
Her antenatal progress was satisfactory even with mild Pulmonary Artery Hypertension (PAH) until at 36th week she developed acute LVF and was admitted in our ICU with severe respiratory distress. She was treated for diabetes in our High risk pregnancy clinic, to keep her euglycemic throughout the first trimester of her pregnancy and minimize the chances of foetal congenital anomaly. The Birthplace is affiliated with maternal-fetal medicine specialists (perinatologists) from Massachusetts General Hospital who care for women with high-risk pregnancies. This test is used within the first trimester as a screening tool to identify those babies who are at risk for chromosomal abnormalities. This very thorough ultrasound is used for cases where there is a potential for genetic defect or an in utero complication for your baby. NSMC Heart Center Named one of the nation's 100 Top Hospitals® for cardiovascular care by Thomson Reuters. Sankar Dasmahapatra Gynecologist & Obstetrician is the most trusted name among high risk pregnancy specialists in Kolkata West Bengal India. Other infections that can cause a problem include cytomegalovirus (CMV), chickenpox, rubella, toxoplasmosis, and syphilis.
These include heart valve problems, sickle cell disease, asthma, lupus, and rheumatoid arthritis. Your doctor may want you to have your baby in a hospital that offers special care for women and babies who may have problems.
Don’t take any vitamins or medicines (including over-the-counter medicines) without talking to your doctor first.


If this happens, immediately get down on your knees so your rear end (buttocks) is higher than your head. This means that you have 8 or more in 1 hour or 4 or more in 20 minutes after you change your position and drink fluids. One of the most common risk factors for a high-risk pregnancy is the age of the mother-to-be.
Your doctor may run tests, adjust medications, or advise you of precautions you need to take to optimize the health of you and your baby. Even if you are healthy when you become pregnant, it is possible to develop or be diagnosed with problems during pregnancy that can affect you and your baby. Women with gestational diabetes may have healthy pregnancies and babies if they follow the treatment plan from their health-care provider. Often a pregnancy is classified as high risk because of issues that arise from the pregnancy itself and that have little to do with the mother’s health. Although there is no way to know which women will experience preterm labor or birth, there are factors that place women at higher risk, such as certain infections, a shortened cervix, or previous preterm birth. Multiple pregnancies, which are more common as women are using more infertility treatments, increase the risk of premature labor, gestational diabetes, and pregnancy-induced high blood pressure. Approximately 2% to 3% of all babies have a minor or major structural problem in development. Down’s syndrome has a wide range of manifestations and is predominantly characterised by mental retardation of varying severity and unusual facial characteristics. However, if a mother has had a pregnancy affected by Down’s syndrome, her risk of Down’s syndrome in a subsequent pregnancy would be higher. Screening, as recommended by the NHS, should comprise of nuchal scan and blood tests at 11 to 13+6 weeks of pregnancy. I offer both invasive diagnostic tests, chorionic villus sampling (CVS) and amniocentesis, related loss rates for both CVS and amniocentesis (miscarriage rate due to the procedure) is only 0.5% which is half the nationally quoted risk of 1%. Prenatal care is a type of preventative care with the goal of providing regular check-ups that allow doctors or midwives to treat and prevent potential health problems throughout the course of the pregnancy while promoting healthy lifestyles that benefit both mother and child. The wife was treated for infertility and she eventually became pregnant through IVF technique at the ripe age of 44. He was pale, with no respiratory effort and slow heart rate and needed extensive resuscitation. Both of them were handed over to their mother at around 3 weeks of life, breast feeding and gaining weight.
The first trimester of her second pregnancy was also normal until she developed LVF during 18th week of pregnancy.
She was also educated that gestational diabetes is associated with multiple congenital anomalies of the foetus and sudden unexplained foetal death. Taking folic acid before and during early pregnancy reduces your chance of having a baby with a neural tube defect or other birth defects.
Women who will be under 17 or over 35 when their baby is due are at greater risk of complications than those between their late teens and early 30s. A history of miscarriage, problems with a previous pregnancy or pregnancies, or a family history of genetic disorders are also risk factors for a high-risk pregnancy.
If the placenta still covers the cervix close to delivery, the doctor may schedule a cesarean section to reduce bleeding risks to the mother and baby. Sometimes there may be a family history of fetal problems, but other times these problems are completely unexpected. All measurements and other risk factors are entered into a complex mathematical calculation to determine the person’s individual risk for Down’s syndrome. During check-ups, women will receive medical information over maternal physiological changes in pregnancy, biological changes, and prenatal nutrition including prenatal vitamins.
During gestation she was suffering from Hypothyroid and Pregnancy induced Hypertension (PlH).
She was very compliant and regularly visited our clinic for proper monitoring of her RHD and pregnancy. She was properly counselled for reduction of body weight and strict control of diabetes for safe delivery of a healthy baby in future.


Through this program most of our high-risk pregnancy patients are able to deliver their babies safely at our Birthplace. But it’s just a way for doctors to make sure that you get special attention during your pregnancy. The risk of miscarriage and genetic defects further increases after age 40.Risk of downs syndrome increases with advanced materal age.
However women with gestational diabetes are at increased risk of developing type 2 diabetes. Recommendations on management and healthy lifestyle changes are also made during regular check-ups. At 29 weeks of pregnancy (roughly 7 months) she developed urine infection and subsequently went into labour. He was taken off ventilator after 48 hours and was started on CPAP machine and gradually oxygen was reduced. Serial ultrasound scans were performed to determine adequate foetal growth and it was found that her left adnexal mass was gradually increasing in size.
She was not in labour but we immediately decided to perform the emergency caesarean Section after initial resuscitation of the mother.
Patients who require more advanced care can be transitioned seamlessly to Massachusetts General Hospital as needed. The availability of routine prenatal care has played a part in reducing maternal death rates and miscarriages as well as birth defects, low birth weight, and other preventable health problems. His gut was very immature and he was given parenteral nutrition through central line which was placed from elbow up to his heart.
A live female baby of 3 kg was delivered with one episode of apnoea after birth so it was immediately transferred to NICU for proper resuscitation.
Foetal anomaly scan to rule out any spinal defect and foetal echocardiography to rule out any cardiac anomaly were performed. Post operatively she developed broncho spasms along with severe hypertension and was subsequently put on elective ventilation under the supervision of the ICU team. For the first few days his blood sugar, serum Sodium, Potassium and Calcium levels were all abnormal needing correction and close monitoring. After bringing her respiratory distress under control she was discharged in stable condition after a week. As the patient was obese, oral drugs were not totally effective in controlling diabetes and she required high doses of insulin.
Feeding was established very slowly to prevent the dreaded complication namely necrotizing enterocolitis. Strict CBG monitoring and foetal monitoring by CTG was regularly done as our expert team was cautious about sudden IUFD in this pregnancy profile. At around 37th week, one Sunday she complained of pain in abdomen and slow foetal movements. Despite all this, he had to be closely monitored and often physically stimulated to keep him breathing appropriately.
She was rushed to the OT for emergency caesarean section and she delivered a healthy baby of 3 kg. Post delivery, maternal blood sugar level was within normal limits and no insulin was required.
In spite of so premature birth, nutritional aspect was taken care of appropriately and he did not lose weight, which was quite remarkable. Both mother and child were discharged from the hospital in stable condition after five days.
Her post natal follow up confirmed fasting and post prandial blood sugar level to be within normal limits. It is obvious that a healthy baby can be delivered in high risk cases too, if the expecting mother gets registered at a safe and well equipped healthcare centre from very early stages of pregnancy or even before.



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