Obstetrics & Gynecology

Managing your health during pregnancy

If you have a chronic condition like hypertension, diabetes or asthma, a healthy pregnancy will necessitate that you work closely with your physician and obstetrician. If you’re planning to become pregnant, make an appointment to consult with your physician to discuss your underlying medical conditions and the additional stress that pregnancy may place on your body. The key will be to understand how your body might react to pregnancy and the risks to your baby if you do not manage your chronic medical condition while pregnant.

Hypertension (high blood pressure) is a common health condition and one that can cause complications during a pregnancy. If you are hypertensive, your physician may need to adjust or change your medications. During pregnancy, hypertension affects blood flow to the placenta, decreasing the supply of nutrients to the baby and increasing the risk of premature delivery.

Another serious health risk associated with hypertension is a condition called preeclampsia, which usually develops in the third trimester and affects about five percent of all pregnancies. Left untreated, preeclampsia can be detrimental to both the mother and baby, so your physician will closely monitor you for any signs of this condition, including severe headaches, sudden swelling of the hands, feet, or face, fluid retention, a sharp rise in blood pressure or an excess of protein in your urine. Preeclampsia is more common in first pregnancies, when the mother is diabetic or when she is pregnant with twins.

For expectant mothers with diabetes, managing tlood sugar levels is essential for a healthy baby. If you are diabetic and planning to become pregnant, talk to your physician first to discuss how to reach specific blood sugar levels before you attempt to conceive. Maintaining proper blood sugar levels early in your pregnancy is particularly important to reduce the risk of birth defects, particularly to the baby’s brain, spine and heart. If you take medication to control your diabetes, it may be necessary for your physician to change that medication while you are pregnant.

Predicting the impact of asthma or allergies on pregnancy is a bit of a guessing game. About one-third of women will experience a noticeable improvement in symptoms, another one-third will have worse symptoms and the remaining one-third will see no change in their condition.

If you experience seasonal allergies and you are trying to become pregnant, you may want to try to limit this guesswork by timing your pregnancy so that your first trimester doesn’t coincide with the season that causes your allergies. That will limit your need to rely on medications to control allergy symptoms during this initial phase of your baby’s development. Although any medication you take while pregnant can affect your baby’s health, many of the medications to control allergy and asthma are safe to take. Still, you should first check with your physician. Keep in mind that if you are taking medication for asthma symptoms, controlling those symptoms is an important priority during pregnancy.

Your physician may recommend a change in medication, but poor asthma control during pregnancy has been linked to preterm births and low birth-weight babies.

In most cases, having a chronic medical condition should not keep you from enjoying a healthy pregnancy. But you will need to keep a close eye on your underlying medical condition and to work closely with your physician to make sure you give yourself the best opportunity to deliver a healthy baby.

Originally Published in The University Doctors' MedicaLink - 3/08

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