Pregnancy affects every single organ in your body. For most people, your body adapts and manages the effects well and you have a healthy pregnancy. If you have a pre-existing medical condition, you may need some extra care in your pregnancy to help to keep both you, and your baby well during this time.
When you book for your pregnancy care at Darent Valley Hospital, a midwife will assess you at your booking appointment, and if necessary, they will refer you to one of our teams who specialises in looking after people with medical complications. The team members include; obstetricians (doctors who specialise in pregnancy), midwives and anaesthetists.
Most of the time the pregnancy is straight forward, but it is important to ensure we give you the right care to help keep you safe.
The most important things to remember if you have a pre-existing medical condition and are planning a pregnancy or newly pregnant are;
DO NOT STOP ANY MEDICATIONS WITHOUT SPEAKING TO A DOCTOR.
SPEAK TO A DOCTOR OR SPECIALIST BEFORE YOU BECOME PREGNANT IF POSSIBLE
SELF REFER FOR PREGNANCY CARE AS EARLY AS YOU CAN
Below is some information on a few of the most common conditions that we see.
Heart disease can be something you were born with, or something that has happened later in your life. Your heart has to work 50% harder in pregnancy as the amount of blood you have increases, this can put a strain on your heart. Whatever the cause of your heart disease, it is important to have specialist care early on in your pregnancy, or even before you become pregnant if possible.
If you are under the care of a specialist team already; you could speak to them, or you can speak to your GP.
It is very important that you do not stop taking any medications without consulting a doctor first.
For more information, please visit: https://www.nhs.uk/pregnancy/related-conditions/existing-health-conditions/
Respiratory disease is varied, but for most women it is because they have asthma. Being asthmatic doesn’t affect your chance of getting pregnant, and you are likely to have a straight forward pregnancy.
Pregnancy affects your lungs in two ways. As your baby gets bigger, the space for your lungs gets smaller, and this can put extra strain on your lungs, also, the pregnancy hormones can affect your airway, which can make you more susceptible to asthma attacks.
It is very important to make sure your inhaler is in date and you carry it around with you at all times. Also, to try to avoid your triggers for an attack. It is a good idea to speak to your asthma nurse so that they can monitor your asthma more closely if needed.
Most asthma medications are safe to use in pregnancy, but it is important to let us know what you are taking so that we can be sure it is safe.
For more information, please visit: https://www.tommys.org/pregnancy-information/planning-a-pregnancy/health-conditions-and-planning-a-pregnancy#asthma
Your kidneys have to work extra hard in pregnancy as they have to process all the extra fluid that you have. If you already have an underlying kidney problem, you will need specialist care to ensure you stay well. Getting early specialist support reduces your risk of complications.
Depending on your condition, it is very important to speak to your specialist before pregnancy so they can advise you on the best pathway and medications. Please do not stop any medications without speaking to a doctor.
For more information, please visit: https://www.kidneycareuk.org/about-kidney-health/living-kidney-disease/pregnancy-and-sexual-health/pregnancy-and-chronic-kidney-disease/
Your pregnancy can be more complicated if you have type I or type II diabetes as the effects of the pregnancy can alter how your body manages the diabetes. It is very important to access pre-conception care to help plan your pregnancy safely. If you are already pregnant, please speak with your diabetes team as soon as possible. Your medications may need altering and it may be suggested that you take some additional medications.
For more information, please visit: https://www.tommys.org/pregnancy-information/planning-a-pregnancy/are-you-ready-to-conceive/planning-pregnancy-type-1-or-2-diabetes
Pregnancy affects you mentally, as well as physically. If you already have a diagnosed mental health condition, you may find the emotional changes that occur in pregnancy more challenging to cope with. We have a specialist team at Darent Valley Hospital, to help you manage your condition, or any new conditions that arise during pregnancy. It is a time of massive uncertainty and extra support is often needed. What is very important is that you do not stop any medications without speaking to your specialist or GP. Some medications will need to be changed, but most are safe. There is greater risk to you if you stop medications abruptly.
For more information, please visit: https://www.tommys.org/pregnancy-information/planning-a-pregnancy/planning-a-pregnancy-and-mental-illness/planning-pregnancy-mental-health-condition
Most people with epilepsy go on to have a healthy pregnancy and baby. But having epilepsy does increase your risk in pregnancy, so it is important to have the right care.
Some medications used to treat epilepsy are not recommended in pregnancy, it is very important to speak to your specialist or GP before you become pregnant or as soon as possible after finding out. You must not stop any medications without speaking to someone first.
For more information, please visit: https://www.nhs.uk/pregnancy/related-conditions/existing-health-conditions/epilepsy/
These are all rarer conditions, but would all require specialist input and enhanced care. Your specialist team or obstetrician would advise you on any additional care or tests that may benefit you or your baby during your pregnancy.
If you have any letter from your GP or specialist regarding your condition, please bring them along when you see the obstetrician as it may provide them with specific information relating to you and your condition.
For all women, it is recommended that you optimise your health before you become pregnant in order to reduce the risk to you or your baby.
This includes:
- Achieving a healthy weight- by adopting a healthy diet and achieving a healthy BMI you; increase your chance of falling pregnant and, decrease your risk of blood pressure problems, diabetes, blood clots and miscarriage. For support and information to achieve a healthy weight please visit: https://www.nhs.uk/conditions/pregnancy-and-baby/overweight-pregnant.
- Stopping smoking- Smoking cigarettes can cause problems with the growth and development of your baby as it can affect how well your placenta works. It can also cause miscarriage/ still birth and cot death. For help to stop smoking you can visit. https://www.nhs.uk/smokefree/why-quit/smoking-in-pregnancy or Smoking in pregnancy.
- Cutting out alcohol- Alcohol crosses the placenta and can affect the development and health of your baby. For more information visit: https://www.nhs.uk/conditions/pregnancy-and-baby/alcohol-medicines-drugs-pregnant.
- Folic acid- You should take 400 micrograms / day. It helps to reduce neural tube defects such as Spina Bifida. Some people would be recommended to take an increased dose of 5 mg / day of Folic acid. This includes people who have; diabetes, epilepsy or have a family history of spina bifida.
You may also be recommended to take aspirin (depending on your personal circumstances), this reduces this risk of developing complications in pregnancy.
It is also recommended that you are immunised against Rubella prior to pregnancy. (For most women this vaccination forms part of their childhood vaccinations).
If you require pre-conception counselling due to a complex medical condition, your GP can refer you to one of our maternal medicine consultant, Mr Sampat, via the ‘choose and book’ system.