What is a high-risk pregnancy - and how do you get through it safely?

Prof. Liran Hirsch, director of the high-risk pregnancy department at Lis, is sure that pregnancy is not a disease but a wonderful and beautiful situation, but he has also come across quite a few challenging cases.

He was a guest on the "Expert Clinic" podcast to explain how to help women who are dealing with complex medical conditions during pregnancy

Iris Cole

25/09/2022

Sunday, September 25, 2022, 06:29 Updated: 07:16

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Prof. Liran Hirsch explains what a high-risk pregnancy is and in which cases it is necessary to preserve the pregnancy (Walla system!)

Pregnancy is always a complex and challenging situation, but there are quite a few women for whom it is a double challenge.

Prof. Liran Hirsch, director of the high-risk pregnancy department at Lees Maternity Hospital, was a guest on the "Expert Clinic" podcast to explain what a high-risk pregnancy is, in which cases pregnancy preservation is necessary, and how to make it easier for women who are hospitalized for long parts of their pregnancy.

At the beginning of his remarks, Dr. Hirsch sought to clarify that "pregnancy is not a disease", and also the term "pregnancy at risk" in many cases only indicates the need for additional supervision, and not, God forbid, the fact that there is a serious problem. Therefore, many hospitals in Israel have changed the term to "Maternal and fetal medicine", although most women still refer to these departments as high-risk pregnancy departments.

"Most pregnancies will pass in a healthy and normal way throughout their duration, our job - the pregnancy monitoring doctors and the obstetricians - is to help the woman in case there are problems or things that come up," explained Prof. Hirsch.

More complex pregnancies, or when the woman has underlying diseases, are divided into low-risk pregnancies and high-risk pregnancies, and each of the types required a different type of follow-up.

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"Many women are afraid of the title 'high-risk pregnancy,'" said Prof. Hirsch, but not every classification of high-risk pregnancy is the same - it can range from slightly high blood pressure, to a kidney transplant woman who needs close monitoring.

"This is very difficult, and not every classification of a high-risk pregnancy requires the same consideration. There are women for whom the risk to the mother and to the fetus is really much greater, and those who have a slightly increased risk compared to normal pregnancies, but our expectation as doctors is that everything will go well, only us There to keep and see that things go smoothly, and to notice that if there is a deviation from what we expect, we can intervene in time or give birth a little earlier. Don't be afraid of the title."

Who is admitted to the at-risk pregnancy department?

There are two types of women who come to be hospitalized in maternal and fetal medicine departments.

"One type is not really a pregnancy at risk, but prenatal. Women who have to undergo induction of labor for all kinds of reasons, then they are hospitalized until labor arrives and they move to the delivery room," explained Prof. Hirsch, "The other part of the department, the bulk, are women That we don't want them to give birth now, but we need to monitor and see more regularly than what can be done at a health fund."

Every day you have to decide anew whether the fetus is healthier inside or outside.

A pregnant woman is hospitalized (Photo: ShutterStock)

For example, women who are at risk of premature birth, premature labor or cervical shortening are hospitalized.

In these cases, the mother is given an injection that will ripen the lungs of the fetus, in case it is born early, and they also work to delay the birth.

Other cases that are hospitalized in the department are those of pregnancy hypertension, or preeclampsia.

"A combination of several symptoms, mainly that the placenta has not rooted well, and the lack of rooting causes the placenta to throw substances into the blood that raise blood pressure," explained Prof. Hirsch.

Women with hypercoagulable syndromes are also at higher risk, and of course also women with underlying diseases.

"The big question for him is always whether the uterus is healthier than outside - is it better for the fetus to be inside or outside. This is a question that we have to decide every morning during a morning visit to the ward, including whether it is better for the mother that the placenta and the fetus come out or whether it is better for her not to. And based on that, we make the balance and decide ", said Prof. Hirsch, "Therefore, follow-up is very important, you always have to make the decision, and in some cases you can also treat it."

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• pregnancy

• high risk pregnancy