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High-Risk Obstetric Care

At East Tennessee OBGYN, we understand that every pregnancy is special, but we also know that some pregnancies will require care that is even more specialized. Our office has partnered with certified perinatologists who offer testing, consultations, and treatment during high-risk pregnancies.

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Our perinatologists will diagnose and, also treat any maternal-fetal complications that could result during a pregnancy or result from the pre-existing medical conditions of the mother. Perinatologists are OBGYN physicians who have undergone extensive specialized training in maternal-fetal medicine giving them expertise in providing care throughout high-risk pregnancies.

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Examples of high-risk obstetric care might include:

  • Pre-conceptual consultations

  • Pregnancy consultations

  • Prenatal Diagnostic Services

  • Prenatal Screening

  • High-Resolution Ultrasounds

  • Genetic Counseling

  • Diabetic Counseling

Conditions treated by perinatologists include:

  • Gestational diabetes

  • Risk of pre-term labor

  • Hypertension during the pregnancy

  • Risk of a child with a birth defect

  • Cardiovascular disease during the pregnancy

  • Family history of genetic disorders or birth defects

  • Complications during previous pregnancies

  • Multiple pregnancies

  • Other pregnancy complications

  • Concerns regarding medications that are being taken during pregnancy

Some women who could benefit from the services provided by a perinatologist include:

  • Those who are concerned about the potential of their baby having abnormalities or birth defects

  • Those with medical conditions such as asthma, hypertension, diabetes, heart disease, lupus, kidney disease or a history of thrombosis

  • Complications in previous pregnancies, such as a premature rupture of membranes, pre-term labor, birth defects, recurrent loss of pregnancy, or fetal growth disturbance

  • The current pregnancy was conceived with the help of infertility treatments

  • A multiple pregnancy, such as twins, triplets, or quadruplets

To ensure those with high-risk pregnancies get the personalized care they need, they are seen in our office weekly.

Hypertension

​Some women develop high blood pressure during pregnancy. There are different kinds of high blood pressure experienced during a pregnancy:

  • Gestational hypertension – Women who have gestational hypertension have high blood pressure that develops after they have reached 20 weeks of pregnancy. There is no excess protein found in the urine or signs of organ damage. Some women who are diagnosed with gestational hypertension may develop preeclampsia.

  • Chronic hypertension – High blood pressure that was pregnant either before the pregnancy or occurring before 20 weeks of pregnancy is classified as chronic hypertension. Because hypertension usually isn’t accompanied by symptoms, it can be challenging to determine when the condition began.

  • Chronic hypertension with superimposed preeclampsia – This is a condition that occurs in women who have high blood pressure before pregnancy then develop blood pressure that worsens during the pregnancy. They have protein in their urine or suffer other health complications during their pregnancy.

Preeclampsia

A condition that occurs only during pregnancy, preeclampsia is diagnosed by the combination of high blood pressure and protein in the urine occurring after the 20-week mark of pregnancy. It is sometimes called toxemia. Gestational hypertension usually occurs before preeclampsia.

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How is preeclampsia detected?

 

Some women with preeclampsia might suffer from mild symptoms, such as protein in the urine, high blood pressure, and water retention. Severe cases of preeclampsia might include some of the following symptoms:

  • Blurred vision

  • Headaches

  • Fatigue

  • Inability to tolerate bright light

  • Tendency to bruise easily

  • Vomiting and nausea

  • Urinating small amounts

  • Shortness of breath

  • Pain in the upper right abdomen

You should contact your doctor right away if you experience blurred vision, abdominal pains, severe headaches, and/or urinating infrequently.

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At every prenatal visit, your medical provider will check your blood pressure and urine. Your provider might order blood tests to determine if you have preeclampsia.

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Who is at risk for preeclampsia?

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There are several things that could put you at higher risk of preeclampsia. These things might increase the risk of preeclampsia:

  • A first-time mother

  • Previously experienced gestational hypertension or preeclampsia during a pregnancy

  • Women whose mothers and/or sisters had preeclampsia

  • Women carrying multiple babies

  • Women who are younger than 20 years of age or older than 40 years of age

  • Women who had high blood pressure or kidney disease before pregnancy

  • Women who are obese or who have a BMI of 30 or higher

How is preeclampsia treated?

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The plan of treatment for preeclampsia depends on how far you are into your pregnancy. If you are close to your due date, and the baby has developed enough, your healthcare provider will most likely want to deliver your baby as soon as possible.

 

If you have a mild case of preeclampsia and your baby hasn’t reached full development, your doctor will probably recommend the following:

  • Increase the frequency of prenatal visits

  • Lower salt consumption

  • Drink at least 8 glasses of water daily

  • Rest while lying on your left side to take the weight of the baby off your major blood vessels

  • Change your diet to include more protein

If you suffer from severe preeclampsia, your doctor may try to treat your condition using blood pressure medication until you are far enough along in your pregnancy to deliver your baby safely, along with dietary changes, bed rest, and supplements.

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How can preeclampsia be prevented?

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There are no definitive ways to prevent preeclampsia currently. Some of high blood pressure’s contributing factors can be controlled while others cannot. It is imperative to follow your doctor’s instructions regarding diet and exercise.

  • Drink 6 to 8 glasses of water daily.

  • Don’t eat a lot of junk food or fried foods.

  • Use very little or no salt in your food.

  • Exercise regularly.

  • Get adequate rest.

  • Throughout the day, elevate your feet several times.

  • Your doctor might prescribe medications or recommend supplements.

If you are diagnosed with preeclampsia, your doctor will have an in-depth discussion with you regarding how your pregnancy and your baby will be affected by the condition. Your doctor will discuss what precautions you should take during your pregnancy and any additional testing that might be necessary. At East Tennessee OBGYN, we promise to be honest and open with you in our communication, and we expect you to ask us any questions you may have and share any concerns with us.

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