High Risk Pregnancy Management

While any pregnancy can be challenging, high risk pregnancies may potentially threaten the health of both the mother and the fetus. High risk pregnancies need a greater level of attention and monitoring since they carry an elevated risk of complications, and increase a baby’s chances for health and developmental problems at birth and beyond.

A pregnancy may be deemed high risk due to a variety of factors, such as pre-existing medical conditions, multiple births, previously abnormal pregnancies or health issues that develop during pregnancy. Routine screening tests, such as blood tests or ultrasound exams, along with diagnostic tests, such as amniocentesis or chorionic villus sampling (CVS), will help identify whether a pregnancy is high risk. These screenings are used to determine the presence of a number of health problems as well as test for certain genetic conditions. Women dealing with high risk pregnancy must schedule more frequent visits with their doctor and manage their lifestyle to ensure proper prenatal care.

Symptoms of High Risk Pregnancy

Symptoms of high risk pregnancy are often difficult to distinguish from symptoms of a typical pregnancy. However, the symptoms may last longer and be far more severe than in a normal pregnancy. The patient should report any painful or worrisome symptoms to her doctor right away. During a high risk pregnancy a woman may experience:

  • Severe pain or cramping in the lower abdomen

  • Noticeable changes in vision, including blurred vision

  • Decreased fetal movement

  • Persistent headaches

  • Painful burning sensations while urinating

  • Vaginal bleeding

  • Clear, watery vaginal discharge, similar to a yeast infection

  • Frequent contractions

Risk Factors of High Risk Pregnancy

A patient's personal habits, as well as a variety of existing health issues and developments, can contribute to a pregnancy being considered high risk. Some common risk factors that may increase the chance of having a high risk pregnancy include:

  • Smoking cigarettes, drinking alcohol or using certain drugs

  • Being significantly underweight or overweight during pregnancy

  • Age, especially if the mother is younger than 20 or older than 35

  • Problems with the uterus, such as an abnormal shape

  • Previously having a child with a genetic condition such as Down syndrome

  • Being pregnant with multiple fetuses

  • Weakness in the cervix or a short cervix

  • High blood pressure

  • Poor prenatal nutrition

  • Epilepsy

  • Anemia

  • Infection

  • Diabetes

  • Cancer

  • Kidney disease

  • Liver disease

  • Lung condition

  • Heart problems

  • Asthma

  • Urinary tract problems

  • Lupus

  • History of premature labor

  • History of miscarriages

  • Rheumatoid arthritis

  • Preeclampsia

  • Sickle cell disease

High risk pregnancies usually require a woman to schedule a greater number of prenatal office visits with an obstetrician, in order to closely monitor the progression of the pregnancy. Women with high risk pregnancies are counseled to be especially attentive to their health, eat a nutritious diet, gain a proper amount of weight and avoid any risky substances or medications. Doctors will often prescribe vitamins, iron supplements or medicines to enhance the health of the mother and baby.

In addition to regular screening exams, additional tests may be recommended to further assess the health and development of the baby. These may include a biophysical profile or targeted ultrasound, which can provide doctors with more detailed information than standard testing. Delivery of a high risk pregnancy is recommended to take place in a hospital setting, since giving birth at home is considering too risky for women with serious health conditions or complications. Depending on the individual case, the baby may be delivered vaginally or through a C-section.

Management of a High Risk Pregnancy

Consultation for a High Risk Pregnancy

After evaluating the circumstances of a high risk pregnancy, the patient may be referred to a specialist in maternal-fetal medicine or genetics in addition to visits with their regular obstetrician. We offer consultative services for such patients. During these visits, the doctor will conduct necessary testing to gather additional information. The goal is to improve the outcome of the patient’s current pregnancy, as well as lower her risks for complications in future pregnancies.