Symptoms you may be searching for
If any of these brought you here, you are in the right place.
- sugar in pregnancy
- BP in pregnancy
- previous miscarriage now pregnant
- age 35 pregnancy risk
- twin pregnancy
- thyroid in pregnancy
- low haemoglobin in pregnancy
- previous caesarean now pregnant
- low-lying placenta
- pre-eclampsia symptoms
Warning signs of pre-eclampsia: same day
After 20 weeks, these can mean dangerously high blood pressure (pre-eclampsia). Call the clinic at once, or go straight to Unittas Multispeciality Hospital or the nearest hospital emergency, if you have:
- A severe headache that painkillers do not settle
- Blurred vision or spots before the eyes
- Pain in the upper belly, just under the ribs
- Sudden swelling of the face, hands or feet
- A fit (seizure): call an ambulance
What makes a pregnancy high risk?
A pregnancy is called high risk when something about you, the baby or the pregnancy raises the chance of a problem, so that monthly visits are not enough. It does not mean something will go wrong. It means more frequent visits, more specific tests and a carefully planned delivery.
The common reasons are:
- Sugar in pregnancy (gestational diabetes), or diabetes from before
- High blood pressure, or pre-eclampsia developing after 20 weeks
- A previous miscarriage, especially two or more, or a stillbirth
- Age 35 or above, or twins
- Thyroid disease, or anaemia that does not improve with iron
- Autoimmune conditions such as lupus (SLE) or antiphospholipid antibody syndrome (APLA)
- A previous caesarean, or a baby born early or very small before
- A placenta lying low or covering the cervix (placenta praevia)
- Obesity, kidney disease, heart disease or epilepsy
Dr. Ragavi treats these herself, including the autoimmune conditions, and brings in a physician only where it adds something.
When you should see a doctor
Book early, before you conceive if you can, or as soon as the test is positive, if:
- You have had a miscarriage, a stillbirth or a very early delivery
- You have diabetes, thyroid disease, high BP, epilepsy, kidney or heart disease
- You are 35 or older, or conceived through fertility treatment
- A scan has shown twins or a low placenta
- Your last delivery was a caesarean, or you have an autoimmune condition
Something come up mid-way, such as a high sugar reading, rising BP or a small baby on scan? Come in that week. If you are still trying after a loss, see infertility treatment in Chennai.
How risk is assessed at RV Clinic
The first visit is longer. Dr. Ragavi goes through your history, every previous pregnancy and how it ended, family history of diabetes and BP, and your current medicines; some must be changed in pregnancy.
Tests, by condition. Sugar: fasting sugar and HbA1c at the first visit, then the glucose tolerance test (GTT) at 24 to 28 weeks, earlier if you had gestational diabetes before. BP: checked at every visit, with urine protein and kidney and liver tests if it rises. Thyroid: TSH at the first visit, then every six to eight weeks. Anaemia: haemoglobin and iron studies. Previous miscarriage: antiphospholipid antibodies, thyroid, sugar and a scan of the uterus.
Scans. Beyond the dating, NT and anomaly scans, growth scans with Doppler (cord blood flow) are repeated every two to four weeks in the last trimester. A low-lying placenta seen at 20 weeks is rechecked at 32 weeks, because most move up as the uterus grows.
A note on scans
Sex determination of the foetus is not done at RV Clinic, and no scan report here will state it. It is a punishable offence under the PCPNDT Act, 1994.
Treatment options
Sugar in pregnancy. Diet first: smaller, more frequent meals, less rice and sugar, and a walk after meals. If diet is not enough, metformin tablets or insulin are started. Well-controlled sugars mean a normal-sized baby and a normal delivery for most women.
Blood pressure. Tablets that are safe in pregnancy (labetalol, nifedipine), and low-dose aspirin from 12 weeks for women at higher risk of pre-eclampsia. Visits become weekly if BP rises.
Previous miscarriage. Progesterone support in early pregnancy, low-dose aspirin or heparin injections if antiphospholipid antibodies are found, and thyroid correction.
Thyroid and anaemia. Thyroxine, with the dose adjusted through pregnancy. Iron tablets, or iron injections when tablets are not enough or delivery is close.
Twins, low placenta, previous caesarean. Growth scans more often and a delivery plan made by 34 to 36 weeks. Twins are usually delivered a little early. A placenta covering the cervix means a planned caesarean. After one caesarean, a normal delivery may be possible.
Autoimmune conditions. Dr. Ragavi manages lupus and APLA in pregnancy herself, switching to medicines that are safe for the baby and watching for flares, BP and growth.
Where treatment happens
Consultation, scans, blood test requests and follow-up happen at RV Clinic Madipakkam or RV Clinic Thalambur, whichever is closer. Routine pregnancy care in Chennai and high-risk care run at both branches.
Admission during the pregnancy, and the delivery itself, are at Unittas Multispeciality Hospital, 21 km from the Madipakkam clinic and 5 km from the Thalambur clinic. Dr. Ragavi admits, manages and delivers you there herself. RV Clinic is an outpatient clinic. No delivery or operation is done at either clinic address. An ectopic pregnancy (pregnancy in the tube) is also treated there; see laparoscopic gynaecological surgery in Chennai.
What to expect at your appointment
- Call or WhatsApp and say what makes your pregnancy high risk, so a longer first slot is kept for you.
- Bring every old report, previous pregnancy records and your current medicines.
- History, examination, and a BP and weight check. A lady attender is present, in a separate examination room.
- A scan the same day if one is due, and a test list written by condition, marking which are urgent.
- You leave with a written plan: medicines, home monitoring of BP or sugar, the visit schedule, and the warning signs to act on.
Frequently asked questions
Is pregnancy at 35 or 38 really risky?
The chance of sugar, BP and chromosomal problems rises with age, but most women over 35 have healthy pregnancies. What changes is closer screening. Age alone is not a reason for a caesarean.
What sugar level is normal in pregnancy?
The usual test is a 75 g glucose drink with a blood sugar reading two hours later. In India a value of 140 mg/dL or more is treated as gestational diabetes; it needs a diet plan and follow-up, not panic.
Sugar irundha normal delivery mudiyuma?
Mudiyum. Sugar control-la irundhu, baby size normal-a irundha, normal delivery-kku try pannalam. Sugar romba high-a irundhu baby periya size-a valarndha, appo caesarean dhaan safe. Adhu 36 weeks-la scan paathu decide pannuvom.
Munnadi miscarriage aachu, ippo pregnant. Bed rest venuma?
Full bed rest avasiyam illa; adhu miscarriage-a thadukkaadhu. Heavy weight thookkuradhu, neenda travel, idhu mattum avoid pannunga. Progesterone tablet, early scan, adhu dhaan mukkiyam. Bleeding illa pain vandha udane clinic-ku vaanga.
My placenta is low. Is that dangerous?
A low placenta at the 20-week scan usually moves up by 32 weeks. Until it is rechecked, avoid intercourse and heavy lifting, and come in at once for any bleeding. If it still covers the cervix near term, a planned caesarean is the safe route.
Do I need a separate physician for my thyroid or sugar?
Usually not. Dr. Ragavi manages thyroid, gestational diabetes, BP and autoimmune conditions in pregnancy herself, and brings in a physician only if insulin doses get complicated.
Book a consultation
Say on the call or WhatsApp that your pregnancy is high risk. To fix a time, book an appointment with Dr. Ragavi Vikram.