High-risk pregnancies pose a significant challenge for both expectant mothers and healthcare providers, particularly when coupled with underlying blood or heart disorders. Women navigating pregnancy with these pre-existing conditions often encounter increased risks that demand specialised care, vigilant monitoring, and tailored treatment strategies. We spoke to our expert Dr Poornima Ramakrishna, MBBS, MS, MRCOG(UK), Senior Consultant Obstetrician and Gynecologist, Apollo Cradle Hospital, Jayanagar, Bangalore, who shed light on the diagnosis, associated risks, and the intricate treatment challenges encountered when managing high-risk pregnancies in women with blood or heart disorders.
Diagnosis Of High-Risk Pregnancies
The diagnosis of blood or heart disorders in pregnant women requires a multidisciplinary approach involving obstetricians, haematologists, cardiologists, and other specialised healthcare professionals. “A comprehensive evaluation before conception or during early pregnancy is crucial to assess the severity of the condition, its potential impact on maternal and foetal health, and to formulate an individualised management plan”, said Dr Ramakrishna.
For blood disorders, such as thrombophilia or clotting disorders, screening tests including coagulation profiles, genetic assays, and platelet function studies are conducted to determine the risk of thrombotic events during pregnancy.
In cases of heart disorders, such as congenital heart disease or cardiomyopathy, echocardiography, electrocardiography, and cardiac MRI scans aid in assessing cardiac function and identifying potential complications.
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Pregnancy Risks In Women With Blood Or Heart Disorders
Pregnancy imposes physiological changes that can exacerbate the complications associated with blood or heart disorders. “Women with blood disorders face an increased risk of thromboembolic events, miscarriages, placental abnormalities, and preeclampsia. On the other hand, those with heart disorders may experience heart failure, arrhythmias, or complications due to the strain on the cardiovascular system”, informed Dr Ramakrishna.
The intricate balance between ensuring maternal well-being while safeguarding foetal health remains a critical challenge. Medications commonly used to manage these conditions may pose potential risks to the developing foetus, necessitating close monitoring and adjustments to treatment plans to minimise harm.
Treatment for High-Risk Pregnancies in Women with Blood or Heart Disorders
Dr Ramakrishna listed the treatment approaches followed in case of high-risk pregnancies in women with blood or heart disorders as follows:
- Collaborative Effort: Managing high-risk pregnancies involves collaboration among healthcare professionals.
- Optimisation of Maternal Health: Treatment approaches aim to optimise maternal health while minimising risks to the foetus.
- Coordination Among Specialists: Careful coordination between obstetricians, haematologists, cardiologists, and neonatologists is essential.
- Individualised Treatment Plans: Plans may include a combination of medications, lifestyle modifications, and specialised prenatal care.
- Anticoagulation Therapy: Utilisation of anticoagulation therapy is a crucial component of managing these complex cases.
- Antiplatelet Agents: Careful use of antiplatelet agents is part of the treatment strategy.
- Monitoring Cardiac Function: Close monitoring of cardiac function is integral to the management of high-risk pregnancies.
- Frequent Antenatal Visits: Regular antenatal visits are essential for monitoring the progress of the pregnancy.
- Foetal Monitoring: Continuous monitoring of the foetus is crucial for identifying any potential issues.
- Timely Intervention: Swift intervention in case of any complications is vital for ensuring the best possible outcomes.
According to a study published in BMJ Publishing Group, Pregnancy counselling is essential since most women with congenital cardiac disease can endure pregnancy successfully, which helps identify high-risk patients and reassure many low-risk patients.
Bottomline
Dr Ramakrishna concluded, “Navigating high-risk pregnancies in women with blood or heart disorders requires a holistic approach that prioritises the health and safety of both the mother and the unborn child. Thorough pre-conception counselling, comprehensive diagnostic evaluations, and tailored treatment strategies are fundamental in mitigating risks and optimising outcomes.”
While the challenges are considerable, with proper management and collaborative efforts, we can significantly improve the prospects for women with blood or heart disorders navigating high-risk pregnancies.
[Disclaimer: This article contains information provided by a registered healthcare professional and is for informational purposes only. We advise you to not substitute with medical treatment and consult your doctor to avoid complications.]