Nationally recognized authority in hysteroscopic surgery, high risk obstetrics and reproductive health with a professional experience of three decades. A gold medalist at every PG examination and a Young Gynecologist awardee of the Asian Federation of OBGYN. His academic pursuits include 15 publications edited, 50 chapters and 35 articles published and 16 orations and over 500 presentations at conferences.
He is the Scientific Chair of the XXII World Congress of Obstetrics and Gynecology of the International Federation of OBGYN and serves as a Board Member of the Guttmacher Institute and Centre for Catalysing Change. He is the Past Secretary General of the Federation of OBGYN Societies of India and Past President of the Mumbai OBGYN Society. He is included in the list of Mumbai's Top Docs and is a recipient of the Dr. Desai Excellence award, Dr. Ganatra Community Service Award and the Mr. and Mrs. Pandit Women's Empowerment Award.
Today I shall speak to you about high-risk pregnancy. Pregnancy is considered to be one of the most normal happenings in a woman's life, and yet 15 to 20 percent of pregnancies will be classified as high risk by a combination of factors that happen during the pregnancy.
Today we are seeing many new high-risk factors, we are seeing women who are coming at an older age, we are seeing women who conceive after treatments which require advanced infertility management, and we are seeing women with extreme obesity.
These conditions induce certain risk factors for the woman and require very close care and monitoring to have a safe outcome, and then there are the medical factors women who suffer from diabetes either before pregnancy or developed gestational diabetes during pregnancy, women who are hypertensive before pregnancy, or who develop pregnancy-induced hypertension during pregnancy, other medical conditions, respiratory, gastrointestinal all can get aggravated during pregnancy as well.
Now these conditions have implications gestational diabetes can lead to a higher incidence of abnormalities in the fetus, can lead to very large babies being born, very immature babies being born, and also increased the risk of stillbirth.
Hypertension in pregnancy can risk the mother having conditions, like stroke, or convulsions during pregnancy called eclampsia could lead to growth restriction of the fetus by interfering with the blood supply to the fetus and could also lead to fetal demise each of these conditions needs to be identified early, managed well and wherever possible also be prevented.
There are other surgical risk factors for women who've had previous surgeries, such as a cesarean section or removal of fibroids from the uterus. In this situation the scar on the uterus can put her pregnancy at risk and requires close care and monitoring these patients can deliver normally. but require very close monitoring because of the risk of uterine rupture and this can only be done in a well-equipped obstetric unit and then there are the risk factors during labor where labor can have abnormalities such as being prolonged such as being obstructed. During labor, you can have fetal distress because of a number of reasons, and at this point in time Recognition, and management will make a difference.
Now, what can we do for high-risk pregnancies? well, the first thing we need is a well-equipped obstetric unit a multi-specialty hospital and a backup of intensive care facilities for the mother and the fetus. All these things we have at the Holy Family Hospital a dedicated obstetric floor with dedicated operation theaters, excellent backup from a team of surgeons, and physicians, medical intensive care units, and neonatal intensive care units.
I can say that over the years this has made a difference, in saving the lives of many mothers from the most dangerous medical conditions such as amniotic fluid embolism, and many babies born with extreme prematurity and having gone home healthy thanks to the skilled care of our neonatologists.
I'm often asked whether a pregnancy will be normal or whether it will be complicated, well firstly wherever possible we have to identify high-risk factors. These women have to be watched closely identified their follow-ups are more frequent, their investigations both in terms of monitoring as well as ultrasound have to be performed from time to time to our cells fetal well-being and finally when it comes to delivering the best possible mode of delivery on the best possibility has to be assured, however, we can only say whether a pregnancy has been normal when everything is over and when the mother and baby are discharged healthy and happy from the hospital because remember any pregnancy at any point in time can have a change. This is why there is a responsibility for you, the mother, her spouse, and her family to nurture and take care of that pregnancy so that we have a happy healthy outcome.