The majority of pregnancies will result in the birth of healthy babies, but all patients require appropriate care with regular examinations, investigations and obstetric planning.The view that pregnancy is “always a normal process and that all will be well”, is not always correct. It is essential to monitor all patients, look for problems and treat if necessary.
A patient’s medical and family history will set the framework of the pregnancy by identifying areas of special interest and potential concerns. History, examination and investigations will establish what problems if any exist. All patients should have all the relevant screening tests, which will identify previously unrecognised problems that can affect the pregnancy.Appropriately targeted further tests to diagnose, investigate and monitor mothers and baby’s well-being are the essence of high quality care.
Complex Pregnancy Care
Some pregnancies have the potential to be complicated due to a variety of risk factors. It is important to anticipate problems and be prepared.At the first antenatal visit a comprehensive history will alert Dr. Hatzikostas to specific high-risk areas of concern. It may become apparent that an individual patient has a personal or family history of a medical condition that can adversely affect a pregnancy. A poor past obstetric history willnecessitate special care. Risks require special attention, withtargeted monitoring and treatment to reduce the potential of complications. This will improve pregnancy outcomes.Some patients may not have any abnormal history, but as the pregnancy progresses problems may develop and they will also require specialised complex obstetriccare.
Some women have had a previous caesarean section and are keen to try for a vaginal delivery in their next pregnancy. Some of these women have no contra indications to attempting a VBAC. It is important that all these women should be given the chance to achieve a vaginal delivery if they wish. Unfortunately there are also some women who should not consider VBAC because of high risk factors. There arestrict guidelines that need to be followed. These guidelines exist to reduce the risk of serious potential complications associated with VBAC.
Each request for a VBAC needs to be considered on its merits.The risks and benefits will be discussed in detail in every case. If it is planned to proceed with a VBAC a special VBAC consent form needs to be signed.
Mode of delivery
Most women prefer to have an uncomplicated vaginal delivery.Some pregnancies must be delivered by caesarean section because there is no other choice.Occasionally some women elect to have a planned caesarean section for their own personal reasons. That is O.K. as long as these patients understand the risks and benefits of a caesarean section.The birth of a baby is a major life experience for all women.It is important as much as possible that a woman’s expectations are met.Ultimately it is the safety of mother and baby that matters.
Postnatal care is important to establish that all is well with mother and baby.
It is necessary to have:
- A postnatal examination to ensure that all is well.
- APap smear test if this is due.
- A discussion about contraceptive options.
- A discussion of problems that were identified during the pregnancy.
Women can still have problems after the birth of their baby and this need to be assessedand managed appropriately.