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The importance of identifying and managing high-risk pregnancies

Natalie's story

During her first two pregnancies, Natalie suffered from pre-eclampsia, a pregnancy disorder that causes high blood pressure, and can lead to impaired kidney and liver function, as well as an increased risk of poor outcomes for both mother and baby. While Natalie felt unwell, she recovered well after the pregnancies. When Natalie fell pregnant for a third time, she was aware of the risk that she could suffer from pre-eclampsia again and raised her concerns with the medical staff treating her, who she believed would take her prior experiences into consideration in planning her pregnancy management.

Throughout her pregnancy, Natalie had felt unwell and at 33 weeks she started to feel worse and suspected something wasn’t right. Contacting the hospital, she was advised to visit her GP. After examining Natalie and finding her blood pressure was raised and the baby had a faint heartbeat, her GP gave her a letter and told her to go straight to the emergency department.

Once there, Natalie was forced to wait a while until she was seen by emergency department staff. The expectant mum was then told to go to the birthing suite, where she was left to wait yet again. Natalie says the nurses didn’t seem to be concerned despite her current symptoms, and prior history. When Natalie was assessed sometime later, she was rushed to surgery for an emergency caesarian.

After the surgery, it took up to 20 minutes for Natalie’s newborn daughter Amy to be resuscitated before she was transferred to another hospital for specialist treatment. When Natalie was finally well enough to visit her daughter, she was told that Amy was severely brain damaged. Amy spent her first three months in and out of hospital, with her family by her side, before she passed away.

Natalie and Amy’s story highlights how important proper management and care of high-risk pregnancies is to ensure a safe delivery of a healthy baby. In Natalie’s case, it appears her high risk of pre-eclampsia wasn’t taken seriously and her symptoms of developing pre-eclampsia were not acted upon. If her antenatal care had been improved there would have been a very different outcome for Amy.

High risk pregnancies

Pre-eclampsia is just one condition that makes a pregnancy high risk. Others include:

  • polycystic ovary syndrome
  • diabetes
  • kidney disease
  • autoimmune disease
  • thyroid disease
  • mature first-time mothers (35 years and over)
  • large babies for gestation age
  • illness or infection in pregnancy

For women who do have what is considered a high-risk pregnancy, it’s essential that a treatment and management antenatal plan is put into place, to ensure the ongoing health of mother and baby during pregnancy and birth. In most cases, extra monitoring and additional tests to the regular pregnancy screenings are required. In some instances, medication may be needed to treat or prevent conditions from occurring.

Ways to protect yourself

It’s important to inform your doctor or midwife about any concerns you may have. Your medical history must be taken into consideration so that a management plan can be devised to allow for the best possible outcome for yourself and your baby.

If you’re pregnant and are experiencing any of the following issues, ensure that seek urgent medical advice.

  • Vaginal bleeding
  • Severe headaches
  • Changes in vision, such as blurred vision
  • Abdominal pain or cramping
  • Regular or frequent 'tightening’ of your stomach
  • The baby movements are decreased
  • Pain or burning with urination

Written by Shine Lawyers. Last modified: September 26, 2019.

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