 Hello everyone, I am Dr. Mukthapal. I am a senior consultant obstetrician and gynecologist at Manipal Hospital, Skharadi Pune. Today we are going to talk about high risk pregnancy. High risk pregnancy is a pregnancy, any pregnancy wherein there are conditions or complications which affects the outcome of the pregnancy adversely. It can be any condition which is pre-pregnancy like if you have high blood pressure, if you have diabetes, if you have ulcerative epilepsy or hypothyroidism to name just a few. It can be other factors which develop during pregnancy. So any pregnancy can turn into a high risk pregnancy from a low risk pregnancy. Like if you develop BP in pregnancy or you develop diabetes in pregnancy which is called gestational diabetes or you develop other conditions related which are specific to pregnancy like placenta previa wherein the placenta lies in the lower segment. If you have twins, if you have preterm delivery, risk of preterm delivery, these all make the pregnancy a high risk condition. It can also sometimes be factors related to fetus or the baby itself. Now how to best optimize your health is by doing pre-conception counseling especially for women who have already some medical conditions. In pre-conceptional counseling what we do is do a risk assessment pre-pregnancy like if you have a high BMI. Normal BMI should be between 19 to 25. If you have a high BMI it affects the pregnancy in all different ways. It will increase the risk of you developing high blood pressure, diabetes, the chances of operative delivery and even if the baby can have more weight during birth which increases the risk of baby developing adult diseases like diabetes. Later on once the baby is old. So we help optimize your weight by doing dietitian referral by giving you a healthy exercise regime and following a balanced diet. We do a medication detail history as well because there are many medications which are not safe during pregnancy. When you start planning a baby you should visit your physician, neurophysician, physician and the anatologist so that you can change the medications after detailed discussion with the pros and cons and taking the, noting the benefits and the risks to change medication pre-pregnancy. Like if you are on anti-apileptic drugs there are few like sodium valproate which can cause many genetic congenital problems in the baby. Hence should be changed to safer ones but only after a detailed discussion with your neurologist. If you are on anti-hypertensives there are few which are again should be changed to other medications to maintain your BP as well as be safe during a repregnancy period. These are just to say if you name a few of the changes that can be done pre-pregnancy to optimize the outcome. We at Manipal hospitals being a multi-speciality hospital have onboard physicians, senior physicians, cardiologists, ICU specialists, neurologists and other physicians who may be required time to time or not at all as well but if we have them onboard which helps to have a better outcome. Whenever you plan a pregnancy or a delivery you should be planning it at a tertiary care center where in all facilities are there in case you need it. Thanking you.