P
regnancy is undoubtedly an exciting journey and often regarded as the most cherished experience, especially for first-time mothers.
However, expectant mothers must not overlook the importance of maintaining their health as well as the well-being of their unborn child throughout the pregnancy.
However, some women may face high-risk pregnancies, depending on factors such as their overall health, genetics and family history.
Hence, adopting the best care practices is crucial to minimise pregnancy complications and ensure the well-being of the baby.
FIRST TRIMESTER
Dr Nor Elyana Noordin, a consultant obstetrician and gynaecologist at Sunway Medical Centre Velocity (SMCV) here, said pregnancy care is particularly critical during the first trimester as it lays the foundation for a healthy pregnancy and ensures proper foetal development.
“In this early stage (first trimester), the baby’s organs and structures begin to form, including the heart, brain and spinal cord. The first trimester is a sensitive period and the pregnancy process significantly impacts the baby’s development.
“Miscarriages are also more common during the first trimester, that is, within the first 12 weeks. Studies indicate that about 10 to 20 percent of pregnancies end in miscarriage,” she told Bernama.
Dr Nor Elyana explained that several factors contribute to miscarriages, including genetic abnormalities, hormonal imbalances in the mother, unhealthy lifestyle and environment, uterine structural issues, and infections caused by specific bacteria or viruses like rubella and cytomegalovirus, which can hinder foetal development and lead to miscarriage.
She noted that although various factors contribute to miscarriages, it is essential to recognise that most occur randomly and are not solely attributed to the mother’s health conditions.
Apart from miscarriages, there are also cases where the foetus dies in the womb or it fails to develop properly.
“They are usually caused by problems with the placenta. When the placenta fails to deliver sufficient oxygen and nutrients to the foetus, it can result in poor foetal development or even foetal demise.
“Conditions like placental insufficiency (where the placenta cannot provide adequate oxygen and nutrients to the foetus) or placental abruption (where the placenta detaches prematurely from the uterine wall) are the usual causes (of poor foetal development or foetal death),” she added.
CHRONIC DISEASES
Dr Nor Elyana added that pregnant women with chronic health conditions such as uncontrolled diabetes, obesity, thyroid disorders, heart disease and hypertension are at higher risk of experiencing complications that can adversely affect foetal development.
Women diagnosed with uncontrolled diabetes during early pregnancy face an increased likelihood of their baby developing neural defects, heart anomalies, digestive system issues and other physical deformities.
“If the mother’s blood sugar levels are not well-regulated, it can also heighten the risk of foetal developmental problems, such as intrauterine growth restriction (IUGR), where the foetus grows at a slower rate, and in more severe cases, can lead to stillbirth,” she said.
Similarly, obesity during pregnancy raises the risk of delivering larger babies, which may result in complications during childbirth.
Obesity is also linked to risks of neural tube defects and congenital heart defects in babies, stemming from hormonal and metabolic imbalances that disrupt foetal development.
“Serious heart conditions in the mother can also impair the oxygen supply to the foetus. Reduced oxygen levels can hinder foetal growth and elevate the risk of IUGR.
“Mothers with heart diseases also face a higher likelihood of premature delivery, which increases the chances of health issues in the baby, such as underdeveloped lungs,” she added.
As for pregnant women with thalassemia – a genetic disorder that affects haemoglobin production – Dr Nor Elyana said they are prone to developing anaemia (low red blood cell count) during pregnancy, which can lead to difficulties throughout the nine-month gestation period.
“If the mother or both parents are thalassemia carriers, the baby is at a higher risk of inheriting the disease, which could result in severe anaemia in the foetus, potentially impacting its development and health.
“In cases of severe thalassemia or thalassemia major, the foetus can develop hydrops fetalis, a condition characterised by excessive fluid accumulation in the foetus’ body. This condition often leads to a high risk of stillbirth,” she said.
FOETAL DEFECTS
Dr Nor Elyana also said women undergoing high-risk pregnancies require special attention due to their susceptibility to foetal abnormalities and stillbirth.
She advised these women to undergo regular antenatal check-ups under the supervision of a medical specialist.
“Women at lower risk generally fall within the 20 to 35 age group and are not obese and have no prior medical history.
“... and in cases involving foetal abnormalities, congenital heart defects are among the most commonly identified issues. These include a hole in the heart wall, valve malfunctions or abnormal blood vessels,” she said.
Other recorded birth defects include neural tube defects (like Spina Bifida and Anencephaly), Down syndrome, cleft lip and palate, cerebral palsy, digestive system malformations and limb deformities.
She also warned that maternal exposure to harmful chemicals and the use of illicit drugs during pregnancy are significant contributors to physical and mental defects in babies.
“Birth defects can also occur among mothers who smoke or consume alcohol during pregnancy. Such habits have detrimental effects on the foetus, including impaired development and a higher risk of preterm birth,” she added.
PRENATAL SCREENINGS
Stressing the importance of prenatal care check-ups to mitigate pregnancy risks, Dr Nor Elyana said records show that older pregnant women are at a greater risk of delivering babies with genetic abnormalities, such as Down syndrome and other chromosomal anomalies. This is because the likelihood of genetic mutations increases with maternal age.
Through prenatal check-ups, medical specialists can recommend additional screening tests, including non-invasive prenatal testing (NIPT), to detect potential genetic abnormalities.
She explained that NIPT can be performed as early as the 10th week of pregnancy using a sample of the mother’s blood to identify issues that may arise during pregnancy.
“Blood tests can identify risk factors indicating potential abnormalities, including genetic markers such as trisomy 21 (Down syndrome),” she said.
A balanced diet and the intake of essential nutrients such as folic acid, iron and calcium are crucial for foetal development, she pointed out.
“Equally important is the emotional support from those around the mother. Sharing feelings and concerns throughout the pregnancy can help reduce stress, providing mothers with the best possible pregnancy experience,” she added.
