The unfavorable obstetric history They are previous experiences related to a complicated pregnancy, which has not occurred as planned, or unsuccessful pregnancies.
In our experience, this type of situation can generate stress or some anxiety in couples when they have to face future pregnancies.
The specialized management of our obstetricians, along with adequate psychological support, will help you in times of difficulty.
For this reason, in the Barcelona Institute of Obstetrics and Gynecology, by Dr. Gómez Roig we give importance to the emotional state of couples with an unfavorable obstetric history.
In our department of psychology and sexology, we offer work tools to those women and their partners who have gone through unwanted experiences.
Our medical services they contemplate the emotional health of our patients and their families with a bad obstetric history. The team accompanies you giving confidence and security in exciting and critical moments at the same time.
What is an unfavorable obstetric history?
The unfavorable obstetric history They are situations experienced related to pregnancy complications or unsuccessful pregnancies.
These experiences increase, in most cases, the risk in pregnancies future.
For this reason, couples must face situations that generate concern when planning new pregnancies.
In this group of previous pathologies we include some such as:
- Previous repeat abortions.
- Premature births
- Fetuses with intrauterine growth retardation.
- Cases of fetal or neonatal death.
- Malformations, or defects in the chromosomes, in previous children.
- Serious associated maternal pathologies, for example: preeclampsia, and gestational diabetes who require insulin, among others.
Women who have had problems in previous pregnancies often wonder what the problem is. time interval What to wait to get pregnant again.
This interval worries them, in the sense of whether it can influence future risk.
How long will it take to decide on a new pregnancy?
How long a woman should wait for decide to have another pregnancy, in cases where the previous one has had complications, it is not well established.
A determining factor in recommending the waiting time will be the real cause of the complication.
The cases of preeclampsia that has affected the mother's health are not the same as a previous child with chromosome alterations.
There is talk of intergenic period like the time between two pregnancies. This period can be classified into:
- Short birth interval: It has been defined as less than 3, 6, 9, 12 or 18 months according to the different studies. There is no standardized definition. A time of less than 6 months is usually associated with adverse results, but some studies have found correlations with periods of less than 3 months and others less than 18 months.
- long intergenic period: it is defined if the time between gestations is greater than 60 months.
Several hypotheses have also been proposed to explain the relationship between the interpregnancy interval and adverse outcome. But none have been tested.
What is the future prognosis in cases of repeat abortions?
The future prognosis in cases of repeat miscarriages it is somewhat less successful if we compare it with cases without the antecedent. But never limiting a favorable final result.
In cases with a history, the increased risk of recurring loss it occurs from the beginning of the pregnancy, until the moment in which the previous miscarriage occurred.
An international study evaluated the feasibility of pregnancies in women with a history of spontaneous abortions recurring.
With a population of 987 women, 67% of the women had a live birth.
Increasing maternal age, and a greater number of spontaneous abortions at the time of the initial visit, were associated with a significant decrease in the probability of having a miscarriage. successful pregnancy.
Another similar study showed that 167 of the 222 women studied with unfavorable obstetric history had a successful pregnancy after 24 weeks of gestation: 75%.
Does the timing of the loss influence the prognosis?
At the time that the abortion may influence subsequent risk.
It is not the same thing that happens at the beginning or at the end of the pregnancy.
In women with recurrent pregnancy losses in the first trimester, the presence of fetal heart activity on ultrasound is reassuring and a good prognostic factor for the evolution of the pregnancy.
Despite this, in this population with this history, the risk of loss continues to be higher than that of the general population.
A review of existing studies evaluated the rates of fetal loss after viewing fetal cardiac activity by ultrasound.
In women with recurrent spontaneous abortions, abortion occurred in 7-15% of infertile populations and in 3-6% of pregnant women without this history.
La second trimester pregnancy loss is associated with a higher risk of recurrent loss in the same trimester. This later loss is also associated with an increased risk of preterm birth.
Women with this history, and who become pregnant, may be at increased risk of developing other obstetric complications. In this population, the risk of having a child with fetal growth restriction and preterm birth increases.
On the other hand, no association has been found between this history and pregnancy-induced hypertension, nor gestational diabetes.
Education and prenatal care
La education and prenatal care They are basic in monitoring couples with unfavorable obstetric history.
Educating women about the risks of pregnancy, associated with various factors, is the cornerstone of a good approach to prevention and adequate medical follow-up.
The management of the pregnancy is carried out according to the risk factors.
For this reason, obstetricians classify pregnancies as low or high risk. Depending on the type defined, we adapt the number of visits and controls.
Women who have previously had an unfavorable history, depending on its characteristics, this implies a greater or lesser risk of recurrence of the problem in the new pregnancy. These are called risk pregnancies.
Risk pregnancies are more frequently associated with emotional changes that require specialist support.
For this reason, carrying out integrated care, medical and psychological, is necessary to ensure good handling.
Obstetric management will depend on the cause of the unfavorable obstetric history, infertility, or repeated miscarriages. Despite this, this cause is not always known.
Specialized Obstetric and Psychological Support
It is very important to have the specialized obstetric and psychological support, in these cases in which the future future is not defined.
Accompaniment by a specialized psychologist or psychologist will ensure emotional well-being.
Stability in feelings and emotions will help you better manage adverse situations and make the most appropriate decisions.
El joint management of the couple, and sometimes from the family environment, also helps in the correct care of the pregnancy.
On Institute of Gynecology and Obstetrics of Dr. Gómez Roig, Located in Barcelona, there are specialists in risk pregnancies and bad obstetric history.
Integrated care with our psychologist helps to carry out a humane and professional management in cases with bad obstetric history.
More related entries
Couple problems
Postpartum depression
Gynecological and Neoplastic Diseases
- About the Author
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Head of the Obstetrics and Gynecology Service at the Sant Joan de Déu Hospital in Barcelona. Associate Professor of Obstetrics and Gynecology and Coordinator of the Sixth Course of Medicine at the University of Barcelona, UB. Director of the Dra. Gómez Roig Institute and Coordinator of Obstetric and Gynecological Processes at the Corachan Clinic in Barcelona.