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Pregnancy or a pre-existing disease may lead the mother or fetus to be at serious risk. A pregnancy with these factors is called a high-risk pregnancy. High-risk factors in pregnant women can affect the puerperal phase. It is important to identify risk factors early to prevent complications and to identify factors that can lead to high-risk pregnancies through regular prenatal care and receive effective treatment and prevention.
(Source: Maternal Criteria for 19 Diseases Making Pregnancy High Risk - In 2022 Program for Support of Medical Expenses for High-Risk Pregnant Women)
A multifetal pregnancy means carrying more than one baby in the uterus at the same time, with twins being the most common. A family history of twins increases the likelihood of conceiving twins. The frequency of multiple pregnancies has recently increased due to infertility treatments.
There are two types of twins: identical and fraternal. Identical twins are formed when one fertilized egg splits into two embryos during the early stages of development and mature. They have the same genetic makeup, are the same sex, and have similar blood types and appearances. Fraternal twins are conceived from two separate fertilized eggs and grow and develop, so they have completely different genetic makeup, appearances, and may have different sexes.
In multiple pregnancies, your blood volume will increase, putting a great burden on the cardiovascular system. Your iron requirements also increase, leading to anemia. The uterus may become significantly enlarged, putting significant pressure on adjacent organs and pelvic blood vessels, and leading to more severe postpartum bleeding. Compared to a singleton carried in the uterus, multiple babies and the placenta weigh less, and there is a higher possibility that one or multiple babies will not grow well or be born prematurely. Fetal malposition, preterm birth, and associated neonatal respiratory distress syndrome are common.
You should have regular prenatal checkups, and your diet and weight should be controlled to ensure that your weight gain is within the range of a normal pregnant woman.(If you are of normal weight, your total weight gain should be 16.8 to 24.5 kg). Additionally, it is helpful to wear a well-fitting girdle to prevent back pain caused by uterine hypertrophy, or to wear elastic stockings or maternity tights to prevent varicose veins.
(Source: Korea Disease Control and Prevention Agency National Health Information Portal)
Advanced maternal age refers to a pregnancy in a woman who is 35 or older. As women age, their fertility decreases and the rate of miscarriage increases, lowering the chances of pregnancy. Even if they do become pregnant, the incidence of fetal chromosomal abnormalities(such as Down syndrome), gestational hypertension, gestational diabetes, preterm birth, and stillbirth is high.
The risk of underlying diseases in pregnancy such as diabetes and high blood pressure increases with age. If you are planning to become pregnant at an older age, especially when you have a chronic internal medical condition, it is recommended that you consult with a specialist about the impact of pregnancy on your condition and the impact of your condition on pregnancy before conceiving. It is also necessary to prevent complications caused by obesity through regular prenatal checkups and weight control. However, there's no need to worry too much. Systematic prenatal checkups and healthy habits can help minimize complications.
Preeclampsia is a disorder of pregnancy associated with hypertension that can arise due to new-onset hypertension or the worsening of existing high blood pressure. It is accompanied by systemic diseases such as proteinuria, liver and renal dysfunction, thrombocytopenia and blood coagulation disorders, pulmonary edema, and cerebral symptoms, and in severe cases, convulsions or cramps may occur. Medically, gestational hypertension is classified into the following five types depending on the time of onset of hypertension and the condition of the mother.
Symptoms of preeclampsia at the early stage include sudden weight gain and edema, which are often difficult to distinguish from normal pregnancy. However, as the disease progresses, symptoms such as headaches, vision problems, pain in the upper right abdomen, and decreased urine output may occur. Preeclampsia can be detected before severe symptoms appear by always checking your blood pressure at every regular checkup and evaluating whether proteinuria is present when your blood pressure is high. Preeclampsia can also affect the fetus, causing intrauterine fetal growth retardation, oligohydramnios, placental abruption, and in severe cases, even fetal death.
This refers to diabetes that developed during pregnancy or was first diagnosed during pregnancy. However, if gestational diabetes is not properly managed, it can lead to macrosomia, neonatal hypoglycemia, neonatal jaundice, and neonatal respiratory distress, as well as polyhydramnios, dystocia due to macrosomia, and preeclampsia. In the long term, there is a high probability that the mother or the fetus will develop diabetes after delivery.
Preterm labor refers to regular labor accompanied by cervical changes that occurs after 20 weeks of pregnancy and before 37 weeks of pregnancy. When you have regular contractions, feel amniotic fluid leaking regardless of the amount, have vaginal bleeding, or have abnormal or absent fetal movements, you should go to the emergency room. Preterm labor can present with a variety of symptoms, including a regular feeling of heaviness in the lower abdomen, a feeling of tightness and pulling in the lower abdomen similar to menstrual cramps, a feeling of the abdomen being pushed up like a balloon, back pain, a feeling of pelvic pressure and sagging, and an urge to have a bowel movement.
Bed rest is not recommended because it can cause side effects such as thrombosis. If preterm labor pain is confirmed, hospitalization is required, and in some cases, uterine tocolytics may be used.
Bleeding in early pregnancy is relatively common, but not all bleeding will result in a miscarriage. Vaginal bleeding is caused by implantation bleeding, miscarriage, and ectopic pregnancy in early pregnancy, and by placental abruption, placenta previa, and preterm labor in late pregnancy.
If you experience vaginal bleeding, visit a hospital and get examined. While you may feel embarrassed about it, it is important to know the bleeding pattern because you will need to tell the doctor about your condition when you go to the hospital. Check for abdominal pain, tightness in the abdomen, frequency, duration, amount, and color of the bleeding(bright red, light brown, or dark red), and/or foul smells or lumps in the discharge. You also should check symptoms such as nausea and vomiting, dizziness, anemia, and weakness.