Dr. Sushma Dikhit

To solve the problem of bad obstetric history the patient should come before planning the pregnancy to the gynecologist. So we do full checkup and investigations to find out the cause of BOH and if the cause is found it should be treated before planning the pregnancy the treatment of the BOH depends on the cause of the BOH. For example if the couple has some genetic problem we can do the IVF and chromosomal test of the fertilized egg. If the mother is having any infection or any medical disorder we have to treat it before planning pregnancy. If mother is having any Anatomy IAL disorder in the uterus ovary or cervix surgically we can treat it before planning pregnancy. Lifestyle changes in the mother like good exercises healthy diet and the pre-pregnancy folic acid supplementation if she is taking some drugs for blood pressure they are harmful to the baby we can change it to better drugs. If sugars are not control and HBC is high we should control the sugar and bring HBC less than 6 similarly if patient is hypothyroid we give thyroxin to bring the TSH approximately around 2.5. If patient is having high BMI we should reduce it by exercise and diet to less than 25. If patient is underweight BMI is less than 80 we have to increase her weight to get a better results of the pregnancy.

"Hypertension in pregnancy is the condition for which we are always worried about. This can be before pregnancy also or during pregnancy the first time hyper-attension appears. So if blood pressure was present before the pregnancy we have to treat the blood pressure properly and buy the medicines which are not harmful to the baby. If blood pressure increases after pregnancy that is known as pregnancy-induced hypertension or PRH. In this case, we have to treat the mother for blood pressure and the complications caused by this blood pressure to the baby and mother we have to keep an observation. So this blood pressure during pregnancy may become severe in the form of preeclampsia in which the protein appears in the mother's urine or it may end up in eclampsia which means when the mother has convulsions with high blood pressure in pregnancy. The other form of pregnancy-induced hypertension which is a severe form of PIH is HELLP syndrome in which liver abnormalities appear along with the decreased count of platelets. It's a severe condition of the mother and the next type of severe hypertensive disorder of pregnancy is HUS in which mainly the kidney is affected and this is again a severe condition ending in high morbidity and mortality to the mother and baby"

Fetal growth restriction or IUGR is a condition when baby does not grow properly according to her or his age in the uterus and this is quite common condition its incidences are around 10% and it is diagnosed by the clinical examination.

When blood pressure is high in pregnancy and if it is severe like more than 160/110. It is very harmful for the mother and baby. In mother it can cause fits or convulsions which we call it as a Eclampsia. There may be sometimes the blurring of vision severe epigastric pain or altered consciousness.

So if mother comes with the history of Habitual abortion or recurrent pregnancy loss we have to do the full checkup of the mother to find out any abnormality in maternal health. Similarly we have to do few investigations in the mother like she should not suffer from any medical disorder like blood pressure, diabetes, hypothyroidism hypoprolactinemia.

Habitual abortion or recurrent pregnancy loss are the same thing. And by definition we call it habitual abortion when the number of the abortions are more than two or more than three by some guidelines and its incidence is around 1%.