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There are many reasons that pregnancies can become high-risk. The ability to properly monitor and care for the growing infant is within the doctor’s control.
It is not uncommon for women to start families in their mid-30s or older. Doctors must be aware of potential risks involved in pregnancies for women over the age of 35. One of the most common risks is Down Syndrome, a common chromosomal birth defect that causes affected children to have varying degrees of mental logistical problems. When older women face problems conceiving they may turn to in vitro fertilization, which can also increase the risk of pregnancy. Likewise, pre-existing health conditions such as high blood pressure, diabetes, kidney and heart problems increase potential pregnancy risks. Physicians must properly monitor women of advanced age who have other risk factors for a high-risk pregnancy.
Diabetes of the mother occurs when a mother’s body is unable to process sugars in the blood, resulting in abnormally high blood glucose levels which can harm the growing fetus. Doctors should recognize any signs or symptoms of diabetes and run proper tests in order to detect it. Failing to diagnose and treat maternal diabetes can result in brain injury and fetal death. Maternal diabetes can also result in too much glucose in the fetus causing the infant to become too large for a safe birth, increasing risks for brachial plexus injuries, Erb’s palsy and cephalopelvic disproportion. Infants who are born large for gestational age (LGA), especially full-term or post-term infants, are at risk for perinatal morbidity and potentially long-term metabolic complications.
In general, LGA is defined as a birth weight greater than the 90th percentile for age. Using a national reference based on single live births in the United States, infants born at 40 weeks gestation at the 90th percentile had birth weights greater than 4000 g (8.8 lbs). Macrosomia refers to excessive intrauterine growth beyond a specific threshold regardless of gestational age. This condition usually is defined as a birth weight greater than 4000 or 4500 g. The American College of Obstetricians and Gynecologists supports use of the 4500 g (9.9lbs) threshold for diagnosis of macrosomia because morbidity increases sharply beyond this weight.
The baby’s size should be carefully monitored before birth to determine if a C-section will be needed. Vaginal delivery of a large baby can lead to shoulder dystocia, Erb’s palsy, brachial plexus injuries and even death. A physician’s negligence to perform a C-section for an abnormally large fetus, who suffered from shouldered dystocia or brachial plexus injuries, may be the basis for a medical malpractice claim.
Although many multiple pregnancies result in healthy babies, any pregnancy involving more than one baby is considered high risk. Because it is high risk, doctors should closely monitor for all potential problems. If problems arise, they should take steps to prevent harm. Doctor error can lead to fetal injury and even death.