Pregnancy. It’s a time of promise, hope and excitement. But for some women it can also be a time of stress, anxiety and physical problems that a woman has never encountered before. ______________________________________________________________________
Dr. Raymond Powrie, MD answers some questions about medical problems in pregnancy.
Question: If a woman is pregnant and has a medical problem as well, what should she do?
Answer: If a woman in our region is pregnant and has a medical problem – either one that she knew about before she became pregnant or one that came about during her pregnancy – she is in luck. Women & Infants is privileged to have a multidisciplinary team of practitioners who work with the community obstetricians to care for high-risk pregnant patients.
Our obstetric medicine specialists are medical doctors/internists with special training in medical problems in pregnancy and what these medical problems might mean for a woman’s health throughout life. We work closely with the team of maternal-fetal medicine specialists, obstetricians who specialize in the diagnosis, treatment, and ongoing care of expectant mothers and their unborn babies, either or both who may have medical or surgical problems during pregnancy. Both specialties bring a slightly different view that enhances the care of patients at Women & Infants, and together we work with our community obstetricians to assure the best possible outcomes. We are the only hospital in the region with such a team.
Question: Is it important for a woman with a medical problem to speak with someone before becoming pregnant?
Answer: The quick answer to this is, “Yes!” There are a number of medical problems that can affect – and be affected by – a pregnancy, including hypertension (high blood pressure), diabetes, lupus, heart disease, thyroid disease, blood clots (especially in the legs or lungs), kidney problems. Women with these medical disorders should definitely receive pre-conception counseling. But women who have a family history of these and other medical illnesses would also benefit from speaking with a specialist before becoming pregnant. And if you have had a prior pregnancy that was complicated by one of these issues, you should speak with a specialist before becoming pregnant again.
Through pre-conception counseling, health professionals can help any woman optimize her health and also help get her medical condition under control. This may involve medication management to ensure that the medication is both the most effective for the mother’s condition and has the best safety data for the baby, weight control, or smoking cessation. For some illnesses such as diabetes, having the disease in good control prior to conception can protect against birth defects a well as keep the mother healthy.
Question: Can some of the issues that arise during pregnancy predict future medical problems?
Answer: Definitely. For instance, hypertension or preeclampsia in pregnancy has been associated with an increased risk of developing heart disease, as has the delivery of a very low birth weight baby. And many women with gestational diabetes will go on to develop type 2 diabetes in later years. Pregnancy and the postpartum period are wonderful opportunities to try to reduce the risk of these diseases before they occur. We are developing cardiac risk reduction programs for women identified during pregnancy.
If you need services for a high-risk pregnancy, speak with your doctor or midwife. For the name of a doctor or midwife on Women & Infants’ staff, call the Health Line at 1-800-921-9299.