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Published on July 06, 2015

What to Consider When Your Pregnancy Might be High Risk

SIOUX FALLS (July 1, 2015) – Planning for a pregnancy oftentimes is fairly typical — start taking folic acid, stop drinking alcohol, make sure your finances are in order. 

For women who have a chronic health condition such as diabetes, high blood pressure or a heart condition, getting pregnant takes a little more planning due to a fear of risking the health of both mother and baby. For these women, preconception counseling can provide the necessary details of what to do before, during and after pregnancy to promote healthy results. 

Preconception counseling is a different approach to what people know and understand about Maternal-Fetal Medicine. Typically, these specialists are called after an unexpected complication arises during pregnancy. Preconception counseling provides an opportunity for a woman to meet with a maternal-fetal medicine specialist before conception to discuss potential complications and risks and create a plan to help manage risks later in the pregnancy.

“The majority of maternal-fetal medicine care is this crisis management approach. Preconception counseling is like risk management,” said Jason Picconi, MD, PhD, of Avera Medical Group Maternal Fetal Medicine, who specializes in maternal-fetal medicine and medical genetics. “We identify the risks and then try to mitigate those risks as much as possible.

“For a lot of patients with chronic health issues, you can see possible complications coming a thousand miles away. When they have those conditions, preconception counseling gives us time to sit down and talk about what they can do to optimize their health to minimize the risk of complications.”

The discussion includes the possible effects a woman’s condition can have on her pregnancy and the unborn baby as well as how pregnancy can affect her condition.

Preconception counseling can be helpful for women who: 

  • Are 35 years or older
  • Have a chronic medical condition such as diabetes or hypertension
  • Have a heart issue or have had a transplant
    • Have had significant problems with previous pregnancies, such as preterm birth
    • Have had a previous child born with a genetic syndrome or structural anomaly
    • Are interested in screening for familial genetic syndromes

For a woman with diabetes, preconception planning could be as simple as getting blood sugar readings under control for several months prior to pregnancy. Something else to include in preconception counseling is a discussion of medications the mother-to-be is taking. Some medications are associated with an increased risk of birth defects, and some changes may be recommended, Picconi explained. 

Picconi said his job isn’t to tell a woman whether she should or shouldn’t have children. Rather, he talks with couples about the risk for complications so they can make an informed decision. 

“I will tell them these are the risks, this is how you lower the risk, these are things you can adjust, these are things you can’t. Ultimately, it’s the parents’ decision, but it’s always helpful for them to understand the risks,” he said. “If a woman does decide pregnancy is the right option, maternal-fetal medicine specialists can work together with her obstetrics provider when needed to help her experience a safe and healthy pregnancy. Our goal is the same as the mother’s – a healthy mother and healthy baby.”

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