A high risk pregnancy is one in which some condition puts the mother, the developing fetus, or both at higher-than-normal risk for complications during or after the pregnancy and birth.
For the vast majority of women, pregnancy follows a routine course. Some women, however, have medical difficulties related to their health or the health of their baby. These women experience what is called a high-risk pregnancy.
High-risk complications occur in only 6 % to 8 % of all pregnancies. These complications can be serious and require special care to ensure the best possible outcome.
While some problems are unavoidable, – obstetricians with special training and board certification in high-risk pregnancy care — work to minimize complications and help you achieve the healthiest pregnancy possible. Each year, we deliver hundreds of high-risk pregnancies.
Your health plan may have its own list of what makes a pregnancy high-risk. In general, your pregnancy may be high-risk if:
You have a health problem, such as:
A pregnancy may be considered high-risk for a variety of reasons. Some of these include:
- The mother has medical conditions that began before pregnancy, such as diabetes
- The mother develops a medical condition during pregnancy, such as preeclampsia
- The mother experienced problems in a previous pregnancy, such as miscarriage
- Problems are detected in the developing baby
- Complications occur during pregnancy, such as premature labor
- The mother is pregnant with multiples (twins or more)
- You use alcohol or illegal drugs, or you smoke.
- You are younger than 17 or older than 35.
- You are pregnant with more than one baby (multiple pregnancy).
- You have had three or more miscarriages.
Your baby has been found to have a genetic condition, such as Down syndrome, or a heart, lung, or kidney problem.
You had a problem in a past pregnancy, such as:
- Preterm labor.
- Preeclampsia or seizures (eclampsia).
- Having a baby with a genetic problem, such as Down syndrome.
- You have an infection, such as HIV or hepatitis C. Other infections that can cause a problem include cytomegalovirus (CMV), chickenpox, rubella, toxoplasmosis, and syphilis.
- You are taking certain medicines, such as lithium, phenytoin (such as Dilantin), valproic acid (Depakene), or carbamazepine (such as Tegretol).
Other health problems can make your pregnancy high-risk. These include heart valve problems, sickle cell disease, asthma, lupus, and rheumatoid arthritis. Talk to your doctor about any health problems you have.
How will your doctor care for you during your pregnancy?
You will have more visits to the doctor than a woman who does not have a high-risk pregnancy. You may have more ultrasound tests to make sure that your baby is growing well. You will have regular blood pressure checks. And your urine will be tested to look for protein and urinary tract infections.
Fortunately, advances in technology have helped improve the diagnosis and treatment of high-risk pregnant women. Doctors provide specialized fetal imaging techniques, such as MRI, to detect various conditions in the mother and baby. Or Prenatal Diagnosis Center provides you the latest tests used to evaluate a developing baby. Some of these tests are available in only a few centers nationwide, and can be performed as early as 10 weeks of pregnancy.
Being pregnant with multiples doesn’t necessarily mean that your pregnancy will be problematic. However, women carrying multiples do have a higher chance of developing complications such as high blood pressure and preterm labor. For this reason, all multiple pregnancies are considered high-risk.
Due to the higher risk of complications, women expecting multiples require special prenatal care. some of the differences in prenatal care include:
More Frequent Visits — We schedule prenatal visits more frequently than for a singleton pregnancy, so we can watch for early signs of complications.
Additional Testing– Because multiples and their moms are more likely to develop complications, they need more tests to diagnose problems and monitor fetal development.
Ultrasounds are performed every four to six weeks to ensure that your babies are growing normally. You also may decide to have additional genetic testing, although it can be more complicated to test multiples than singletons. Your provider or a genetic counselor at the Prenatal Diagnosis Center can answer any questions you have about which tests are best for you.
One of the reasons multiple pregnancies are considered higher risk is because 50 percent of them deliver prematurely. A premature delivery occurs prior to 37 weeks of gestation, while a normal full-term pregnancy lasts 38 to 42 weeks. Every effort is made to prolong your pregnancy as long as possible, to reduce some of the risks that may occur when babies are delivered prematurely. Premature infants may have problems with breathing and digesting.
Should your babies be born early or experience any other complications that require the care of a neonatologist -a paediatrician specializing in the care of sick newborns-access to renowned experts and services.
High Risk Pregnancy – what’s the Difference between a High-Risk vs. Normal-Risk Pregnancy?
Pregnancy and birth are natural processes, right? So when you hear “high risk,” you have to wonder why, and what’s the difference between a high-risk vs. low-risk pregnancy?
Knowing your own status means you can mention it in your birth plan and anticipate how your needs can be met, even under high-risk circumstances.
Most pregnancies are normal risk – healthy mom, few or no complications – and frequently allow for your birth preferences to be followed by your team. When your weight, overall health, and age are within safe range – and if you are having just one baby – then both you and babe are pretty much assured of a safe pregnancy and birth.
High risk means that you or your baby’s life could be threatened by complications.
Certain medical issues that already exist, or develop, can change your status from normal to high-risk. The usual suspects for a high-risk pregnancy are:
Existing health conditions – including high blood pressure, diabetes, or HIV+ status
High maternal weight (overweight or obese) – more than half of U.S. pregnant women are in this category and need special attention during pregnancy.
Mom’s weight can cause high blood pressure that may lead to heart attacks, strokes, chronic heart disease, or kidney disease. During pregnancy, this can slide into preeclampsia, gestational diabetes, stillbirth, neural tube defects (brain, spine, or spinal cord), and caesarean section delivery.
It can also raise baby’s risk of heart problems at birth.
Multiple births – having more than one bun in the oven (twins, triplets, etc) is higher risk because premature labour is common with multiples. Prematurity can lead to complications for babies at birth. Mom could also develop preeclampsia, which comes with its own set of issues.
Multiple births are usually manageable and have even been born at home. You just have to have the right circumstances and the right care provider.
Maternal age – either very young (teens) or older (35 years+) increases a tendency toward preeclampsia and gestational high blood pressure.
Lifestyle – smoking, alcohol, or drug addiction all affect you, but mostly affect your developing baby.
Depending on your circumstances and your care provider, with a high risk pregnancy you may still have a range of options for your health care. If your birth preference is to have a midwife, there are those who accept certain high-risk women.
Usually, with a high-risk pregnancy you’ll be referred to a perinatologist- an obstetrician who specializes in high-risk pregnancies and can use advanced testing to monitor yours.
Even with a high risk status, your birth plan can promote collaboration between you and your care providers. Your birth plan can help your preferences be considered, as far as health and safety allow. Moms with high-risk pregnancies have stated in their birth plan that they want to give birth in the birthing centre, at home, without medical interventions, with a midwife, or without medications. Many of these moms got their wishes because their prenatal care was thorough and they did what was necessary during pregnancy.
When the big day arrives, bring the final version of your birth plan in your hospital bag, work with your care provider to include as much from it as you can, and look forward to gazing into your new baby’s eyes.