High-risk pregnancies

Overview

Every woman wishes for a smooth pregnancy and uncomplicated delivery, whether she is planning or expecting the birth of her child. This is exactly what most people experience. Women, on the other hand, may encounter unforeseen obstacles and complications.

What are High-risk pregnancies?

A high-risk pregnancy is one that endangers the mother's or her fetus's health or life. It frequently needs specialist treatment from properly trained physicians.

Some pregnancies become high risk as they develop, while some women are predisposed to difficulties for a number of reasons even before they get pregnant. Early and consistent prenatal care enables many women to have safe pregnancies and births free of problems.

A high-risk pregnancy implies that you or your baby require extra monitoring during your pregnancy, as well as during labor and delivery, for whatever reason. Some women have risk factors that make their pregnancies high-risk from the outset, while others experience an unanticipated problem that turns a normal pregnancy into a high-risk pregnancy.

Whatever the cause, a high-risk pregnancy implies that you or your baby are more likely to face special medical issues before, during, or after birth. These difficulties can range in severity from modest to life-threatening, necessitating further care and monitoring from your OB/GYN.

What factors can make a pregnancy high-risk?

Many circumstances, including those affecting the mother, the fetus, and difficulties that occur during pregnancy, might raise the chance of a pregnancy.

Maternal risk factors include:

Pre-existing diabetes: Pregnancy can be challenging for women who already have diabetes. (This is distinct from gestational diabetes, which occurs during pregnancy and usually resolves after childbirth.) Through our diabetic nurse educators, who are specially trained and experienced in the treatment of diabetes, we offer tailored glucose control programs, home glucose meter loans, and one-on-one counseling and support. Patients can also consult with our dietitians and obstetricians.
Organ transplant: They are more likely to have preeclampsia (a problem caused by high blood pressure), hypertension, and fetal growth restriction during pregnancy (when the fetus grows more slowly than normal).
Chronic high blood pressure: If a woman has severe, persistent high blood pressure, or hypertension, she is more likely to have heart failure, brain hemorrhage, renal failure, and placental abruption (when the placenta prematurely separates from the wall of the uterus). Another concern is preeclampsia, which can potentially limit fetal growth and result in early birth or pregnancy loss.
Blood clots: Thrombophilia, or a proclivity to form blood clots, may raise pregnancy risks.
Rheumatalogic diseases: Lupus, for example, can raise a mother's risk of preeclampsia. Furthermore, if the lupus is not under control before to pregnancy, pregnancy might aggravate a lupus flare up.
Heart disease (congenital or acquired)
Infectious diseases (HIV, viral hepatitis, pyelonephritis (a potentially serious kidney infection)
Cancer in pregnancy
Psychiatric disease

Fetal risk factors include:

Birth defects, such as congenital heart defects
Chromosome problems, such as Down syndrome
Genetic syndromes, such as Fragile X syndrome
Inherited diseases, such as cystic fibrosis
Fetal growth restriction: The fetus develops more slowly than usual. High blood pressure, renal illness, severe diabetes, heart or respiratory disease, anemia, infection, drug misuse, or smoking may all contribute to this. Often, no cause for prenatal growth limitation is discovered. Fetal growth restriction is also known as intrauterine growth restriction.
Fetal anemia, or an inadequate number or quality of red blood cells to carry oxygen to the cells and organs within the body.

Pregnancy-related risk factors include:

A history of multiple miscarriages or pregnancy losses: A woman's chance of losing a pregnancy increases to 20% after two miscarriages. After three miscarriages, it increases to 30%, and after four, it increases to 40%. However, even if a woman has had four miscarriages, she still has a 60% chance of bringing a baby to term.
Stillbirth
Preeclampsia and HELLP syndrome: HELLP is linked to preeclampsia, a pregnancy condition caused by high blood pressure. It may result in low platelet counts, red blood cell disintegration, and liver damage.
Placental abruption: Prior to birth, the placental lining separates from the mother's uterus. It is the most prevalent pathogenic cause of postpartum hemorrhage.
Abnormal placentation: This condition, also known as placenta accreta, develops when blood vessels and other placental components grow too far into the uterine wall.
Preterm premature rupture of membranes: This happens when the amniotic sac ruptures before 37 weeks of pregnancy and before the commencement of labor.
Too much or too little amniotic fluid. When amniotic fluid levels are irregular, it can lead to troubles for the mother as well as problems for the infant.
Infections: Cytomegalovirus, is a common herpes virus; Zika; and chorioamnionitis (infection of the membranes containing amniotic fluid). Toxoplasmosis; Listeria (a disease caused by a parasitic infection)
Multi-fetal gestation (twins, triplets)
Twin-to-twin transfusion syndrome: This happens when identical twins share a placenta, causing unequal blood flow between the newborns.

This is merely a short list of illnesses and events that may result in a "high-risk" pregnancy. The pregnancy may be deemed high-risk if the woman is beyond the age of 35. The likelihood of having a baby with Down syndrome increases as women age, and older women are more prone to hypertension, diabetes, and heart disease. The age of 35 is a landmark, but the main problem is women above the age of 40 or 45.

Women should not fear if they are classified as "high risk," as pregnancy is already stressful. The Obstetrician's responsibility is to ensure that she understands the dangers, treatments, and what she can do to obtain a healthy baby and mother.

What age is high risk to have a baby?

Most doctors consider pregnancy after the age of 35 to be high risk. First-time moms over the age of 35 are more likely to have specific complications throughout their pregnancy. These are some examples:

Having problems during labor, like heavy bleeding,
Having a cesarean section or C-section
Being in labor longer than 20 hours,
Having labor that stops on its own, and
Giving birth to a baby with a genetic disorder like Down syndrome.

However, just because you are over the age of 35 does not mean you cannot or should not become pregnant. Instead, understand your risks and learn how to make lifestyle adjustments to improve your baby's health. Maternal-fetal medicine professionals assist women over the age of 35 in increasing their chances of having a healthy baby. Certain drugs, such as steroid hormones, may be prescribed by specialists.

What Can I Do to Have a Healthy Baby After Age 35?

Pregnant women over the age of 35 are more likely to have specific health issues throughout their pregnancy. If you're a first-time parent over the age of 35, work with a maternal-fetal medicine expert to address several lifestyle habits that might jeopardize your pregnancy. This might include:

Controlling your diet and limiting sugar so you don’t develop gestational diabetes,
Monitoring your blood pressure so you don’t develop preeclampsia, and
Quitting marijuana, cigarettes, and alcohol. First-time mothers over 35 are already more likely to deliver a kid with a low birth weight. However, these medications may raise your baby's risks of being born prematurely.

High-Risk Teen Pregnancy

Most of us think of women beyond the age of 35 when we think about dangerous ages to give birth. However, many pregnant teenagers have high-risk pregnancies. Pregnant adolescents, for example, have a larger likelihood of having a preemie (preterm delivery) than older mothers. Teenagers are also more likely to acquire excessive blood pressure and anemia. Many adolescent mothers do not receive the prenatal care they require to ensure their baby's wellbeing in the womb.

Some teenagers are also unaware of which medications are safe to use and that drugs can damage a growing fetus.

What medical tests and care can I expect from my OB/GYN?

If a pregnancy is classed as high-risk, the doctor will closely monitor the pregnancy. A perinatologist, an obstetrician who specializes in high-risk pregnancy care, may also be referred to expectant mothers. The doctor may order the following tests depending on the kind of high-risk pregnancy:

Biophysical profile

This is done via ultrasound to evaluate the baby’s well-being.

Detailed foetal ultrasound screening

Your doctor will perform this screening to check for possible birth defects.

Foetal echocardiography

This test evaluates to evaluate your baby’s heart for any abnormalities.

Genetic screening

Amniocentesis or chorionic villus sample are used for genetic screening. A sample of the fluid around the fetus is collected during amniocentesis (called the amniotic fluid). A sample of the placenta is collected during chorionic villus sampling. These samples will be tested for genetic disorders. The doctor will describe the modest risk of pregnancy loss associated with amniocentesis and chorionic villus sampling. Before deciding whether or not to proceed with these tests, the couple and the doctor should consult.

Routine laboratory tests

Urinalysis, total blood count, oral glucose tolerance test, and testing for infectious disorders including syphilis and human immunodeficiency virus are among them (HIV (

Even though a pregnancy is deemed high-risk, it is still possible to deliver a healthy baby without difficulties. Regular prenatal care and appropriate self-care routines will help you have a safe and healthy pregnancy. If you have any reservations or worries about pregnancy, see a doctor.

How to manage High-risk pregnancies?

How one can reduce the risk of pregnancy complications?

Some easy precautions can help lower the danger of your pregnancy. Stopping smoking (which is linked to growth restriction, bleeding in pregnancy, premature birth, SIDS, and childhood asthma in children of smoker mothers), not using illicit drugs (which can cause growth restriction, fetal abnormalities, bleeding in pregnancy, and premature delivery), and quitting alcohol are obvious things to do (which is associated with fetal developmental problems). Keeping up with your vaccinations (rubella, chicken pox, whooping cough, influenza) and practicing sanitary hand washing and food preparation helps lower your risk of illness during pregnancy. Being severely overweight is widely acknowledged to be one of the most major risk factors for pregnancy. A BMI in the 'obesity' range (more than 30) increases a woman's risk of hypertension, diabetes, preterm birth, difficulty in labor and caesarean section for delivery, bleeding after delivery, infection, thrombosis, and mortality. It also raises the baby's chance of growth limitation. Anyone planning pregnancy who believes she is severely overweight should visit their doctor and maybe a dietician to help them lose weight and learn and maintain appropriate eating habits during pregnancy.

Various than lifestyle modifications, other adjustments can be performed to reduce a woman's risk during pregnancy. The majority of these will be related to the underlying reason of her risk. For example, if a woman has hypertension previous to pregnancy, maintaining adequate blood pressure control prior to pregnancy is critical for lowering her risk of pre-eclampsia during pregnancy. As part of her treatment, medicines may need to be changed or added. Women who have pre-existing medical issues or had complications with a prior pregnancy would benefit from a "pre-pregnancy consultation" with an obstetrician or maternal fetal medicine expert in developing a well-thought-out strategy for a safe pregnancy.

If you have a high-risk pregnancy, changes to "normal" prenatal care may be required. This might imply extra medical appointments for you and your kid throughout pregnancy, as well as more scans or blood tests. It is sometimes required to adjust or add new medications. For a few women, this may imply intending to have their baby a little sooner than their due date, and sometimes (though rarely) it may entail having their baby prematurely. A high-risk pregnancy may not necessarily necessitate a caesarean section; this depends on the related issue and the timing of birth. Individual evaluation and conversation with your obstetrician are required.

Conclusion

If you or your baby are at a higher risk of developing a health concern, your pregnancy is considered high-risk. Many things can put you in danger. The term "high-risk" might be frightening. However, it is simply a technique for doctors to ensure that you receive extra care during your pregnancy. Some pregnancies become high risk as they develop, while some women are predisposed to difficulties for a number of reasons even before they get pregnant. During your pregnancy, your doctor will regularly monitor you to detect any concerns early. Women with difficult pregnancies may require lifestyle modifications, pharmaceutical regimens, technical assistance, and possibly hospitalization.