Pregnancy & Chronic Diseases: Here's What You Should Know | Dr. Radhika Reddy Y

[00:00:01][music] >> Can you have a healthy pregnancy with diabetes, >> [music] >> hypertension, or thyroid disease?

[00:00:09]So, when a woman is already suffering with diabetes or hypertension or thyroid disease before they conceive or before they become pregnant, the ideal thing is we need to manage these patients [music] in a multidisciplinary care. And before any woman plans for a pregnancy with these comorbid conditions, they should always have [music] an pre-conceptional counseling with a gynecologist and obstetrician that they are planning a pregnancy.

[00:00:44]So, what are the things which we look for in the pre-conceptional counseling?

[00:00:48]We have to see [music] whether her diabetic status is under control, her fasting, post-lunch, as well as her 3-months previous [music] diabetic status, which we tested by doing a HBA1C, should be within optimal, that is less than 6.1. [music] Once the diabetes status is under control, we need to evaluate her rest of the organs, that is the [music] eyes, the kidney, the heart, etc. Because the woman is already a diabetic and she is venturing into a pregnancy wherein her physical status has to be optimized before she becomes pregnant. The most important thing what we say to these patients who [music] are to these women who are planning for pregnancy with these comorbid conditions, we call it as a diabetes complicating pregnancy.

[00:01:41]Wherein the complications which we come across could be increased rate of miscarriages, >> [music] >> increased risk of preterm labor, premature labor, congenital abnormalities, and increased chances [music] for cesarean section.

[00:01:58]So, that is the reason why we need to optimize [music] the diabetes status.

[00:02:03]There are certain medications which we have to alter once they become pregnant.

[00:02:08]More so, the oral hypoglycemic [music] drugs can be changed to insulin, that is the injectables, and then plan for the pregnancy. So, including the hypertension. Hypertension complicating pregnancy, we call it as a chronic [music] hypertension complicating pregnancy is wherein the drugs which [music] we give has to be altered, changed to the more simple [music] medications which can be taken during pregnancy, and have [music] a joint clinic approach wherein the physician as well as the obstetricians can take care of the woman. So, in conclusion, what we need [music] to understand is a woman with comorbid conditions like hypertension, diabetes, or thyroid disease should [music] plan for pregnancy once her condition is optimized, the drugs are altered, as well as pre- [music] after pre-conceptional counseling, they can have a pregnancy, and [music] the management should be in a multi-disciplinary unit wherein a physician as well as an obstetrician can [music] take care of her for a good pregnancy outcome. Thank you.

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