📢 Calling all expecting mothers

The potential complications of multiple pregnancies can be divided both for the mother and for her unborn baby. For the mother, the potential complications include anemia, gestational diabetes, preterm delivery, preeclampsia, increase in the incidence of having a complicated caesarean section and postpartum haemorrhage. The fetal risk on the other had is an increased incidence of fetal anomalies, fetal growth restriction and preterm delivery.

Teenage pregnancies are generally considered high risk pregnancies, mainly related to the social challenges of a young mother. Apart from that, ensuring that the mother is compliant, nutritionally healthy and is well supported are important considerations for her pregnancy. Management of anemia, screening for infections, prevention of preterm babies and monitoring of the fetal growth are some of the modifications that these mothers need. Ensuring that the unborn child also get optimal care and support is also essential.

This really depends on what is your actual risk and what makes your pregnancy high risk. It is best to see a high risk pregnancy expert who will be able to provide you with an advise individualised for you. Generally, folic acid pre pregnancy, vitamin D3, aspirin for prevention of preeclampsia and ensuring your vaccinations for COVID-19 and influenza are up to date are the general recommendations. As for life style, a balanced diet, mild to moderate exercise and avoidance of active and passive smoking, apart abstinence from alcohol are the general recommendations.

Dear Rose Smith, exercise has truly been proven to be beneficial for all pregnant mothers, including those considered high risk. Moderate, non weight bearing exercises, such as walking, swimming and even jogging has proven benefits to the mother and child. In fact, 140 minutes of exercise per week, or 20 mins per day is the recommended duration for a healthy pregnancy. Only extreme sports are detrimental.

Yes, it really does have a detrimental impact, not only for high risk pregnancies but any pregnancy. There is no minimum recommended safety dose of alcohol and smoking, including vape and hence, it is not recommended for all pregnant mothers to consume alcohol or be exposed to active, passive and also vaping. So even those around a pregnant mother, especially husbands, partners or those in the same household should stop smoking and vaping.

Dear Rose Smith, although having one miscarriage may have an incidence of one in six pregnancies, recurrent miscarriages, which is more then three consequent miscarriages is itself considered a high risk pregnancy and does affect the risk of a high risk pregnancy, especially if it is due to an recurrent cause which was not addressed. Similarly, preterm delivery or a past history of premature delivery itself is considered a high risk pregnancy and does add to the risk of a high risk pregnancy. Hence, mothers with recurrent miscarriages or a past history of premature delivery should ideally seek a review by an expert Obstetrician as to look for a cause as this might be identified and prevented in certain instances, especially premature delivery.

This really depends on what is the exact diagnosis or condition that makes one to be at risk. But essentially, a healthy balanced diet is what everyone needs, especially high risk pregnant mothers. The specific dietary advice is folic acid supplementation, of 5mg once a day, at least 4 weeks before pregnancy if you are high risk while most mothers only need 400mcg of folic acid. The second is 1000 Iu of Vitamin D3 supplements. Certain mothers need specific dietary requirements and it is best they speak to their Obstetrician on what is more specific to their needs, such as those who are anemic, have nutritional deficiencies, have had a bariatric surgery or those who are diabetic.

Yes Elizabeth Emerson. Stress and significant mental health issues can significantly affect any pregnancy, be it high risk of not. In fact, mental health issues may worsen during the pregnancy, especially after childbirth and hence it is important to share and reveal such conditions if any mother experiences mental health issues. There are numerous interventions that can be undertaken safely during pregnancy, such as IAPT and CBT. In fact, most medications are safe during pregnancy and childbirth as well. Red flags that one should seek immediate professional assistance is when one has new symptoms during pregnancy, feeling hopeless or low in mood, having suicidal ideations, feeling incompetent as a mother or estranged from her baby. Mental health issues are significant but can safely be managed in pregnancy if you see the right expert. Do not suffer in silence.

This really depends on what is the exact diagnosis which makes one high risk as it is often not the same for everyone. However, the general complications of a high risk pregnancies are increase in the incidence of prematurity, fetal growth restriction, pre eclampsia, venous thromboembolism and increase in the incidence of caesarean sections. However, the risk is not the same for all high risk pregnancies.

Thank you for asking this very important question. There are numerous support groups available for high risk pregnancies, depending on the exact condition. Example, there are separate support groups for mothers with heart diseases, those with cancers, those with preeclampsia, placenta accreta spectrum disorders and even those with cervical insufficiency. One website dedicated for high risk pregnancies in Malaysia is the www.obstetricmedicine.my where some up to verified date information is available, both for patients and healthcare professionals.