One of the biggest dreams of couples is to have a child. Therefore, pregnancy, a physiological process, begins with sweet excitement and high expectations. All emotions, both positive and negative, intertwine and offer the expecting parents a unique experience that they will remember for the rest of their lives.
Especially in today's conditions, with the advancement of science and technology, most pregnancies and births proceed smoothly. However, it should be known that all pregnancies are at risk. Each pregnancy is a developmental process in itself and carries potential risks at any stage of this development. Therefore, early diagnoses, proactive approaches, and timely interventions are crucial to preventing any negative situations that may arise. For this reason, it is very valuable to follow the pregnancy monitoring plans from the moment of conception and to carry out systematic check-ups.
Genetic Problem Detection
Although pregnancy is a natural process, in many pregnancies that continue without complications, the situation can change at any moment due to various reasons. The prenatal period is the phase that starts with fertilization and continues until birth. This phase includes the first cell division after fertilization, the differentiation and development of organs and systems, and ends with birth. One of the most risky periods during pregnancy is the first 12 weeks. A significant portion of pregnancies that end during the first 12 weeks are due to genetic problems and blood clotting disorders. After completing the 12th week, the risk of miscarriage decreases along with all other factors. After the 20th week of pregnancy, the risk of preterm birth further reduces.
From the beginning of pregnancy, the evaluation of whether the pregnancy is progressing healthily can be done with different criteria during the first, second, and third trimesters. During the first trimester, the nuchal translucency of the fetus and other ultrasound data are compared with the mother's age and certain parameters in her blood in the first trimester screening (double test). The double test has an approximate prediction rate of about 80%. During this statistical evaluation, the presence of genetic disorders, especially Down syndrome, is investigated. In this period, for pregnancies in a high-risk group, chorionic villus sampling (CVS) may be preferred, which is a genetic test performed on a sample taken from the placenta, the structure that nourishes the baby.
In this field, ff-DNA tests emerge as a very valuable alternative. By studying genetic material from the baby obtained from a blood sample taken from the mother’s arm, problems can be predicted with over 95% accuracy.
In the second trimester screening, a triple or quadruple test is performed by evaluating ultrasound findings in comparison with the mother’s age and certain parameters in her blood. These tests have mechanisms quite similar to the double test, and their predictive capabilities are also comparable. At the end of this process, in high-risk pregnancies, if necessary, a sample may be taken from the fluid surrounding the fetus for genetic testing (amniocentesis). It is also recommended that a detailed ultrasound evaluation of the fetus be performed during this period, and the official reporting is done by a perinatologist or radiologist. If necessary, the process is managed in cooperation with the perinatology team. These situations are very rare.
In the third trimester, pathological conditions related to the fetus’s growth, amniotic fluid, placenta, and many other parameters can be investigated. During this period, if a genetic evaluation is required, genetic testing can be performed by taking blood from the umbilical cord (cordocentesis).
Other Risky Conditions
One of the most important factors that increase medical risks during pregnancy is age. Especially pregnancies occurring before the age of 17 and after 35 are associated with a higher risk of pregnancy loss, hypertension, and gestational diabetes. The likelihood of genetic anomalies also increases. Starting pregnancy with a high weight or gaining excessive weight during pregnancy due to carbohydrate consumption can raise pregnancy-related blood pressure.
Any organ system-related issues that can occur in women who are not pregnant may also emerge during pregnancy, and in fact, may occur at a higher rate. These include viral or bacterial infections as well. Past surgeries, adhesions related to these surgeries, and any resulting aesthetic or functional issues may also affect pregnancy.
Another risk area during pregnancy is related to the placenta. Under normal conditions, the placenta attaches to the uterine wall in a way that does not erode the muscles. If the placenta attaches to the lower segment of the uterus and blocks the birth canal entrance, this is known as placenta previa. This can present as a cause of bleeding, especially in later stages of pregnancy. In cases where the placenta deeply attaches to the muscle, it may not detach, leading to serious bleeding.
What is Perinatology?
Perinatology is a branch of medicine that focuses on the health of both the mother and fetus during the pregnancy process, including the prenatal and perinatal periods (the period before and during birth). It deals with providing treatment, interventions, and long-term follow-up options for high-risk patients. A perinatologist is a specialist in obstetrics and gynecology who has completed further specialization in Perinatology, also known as Risky Pregnancy Expertise. In the management of high-risk pregnancies, perinatology services, such as reporting, may be crucial in certain special cases.
For information and support regarding the monitoring of high-risk pregnancies, please contact our clinic.
