HIgh Risk Pregnancy

All pregnancies carry risks. The definition of a “high-risk” pregnancy is any pregnancy that carries increased health risks for the pregnant person, fetus (unborn baby) or both. People with high-risk pregnancies may need extra care before, during and after they give birth. This helps to reduce the possibility of complications.

• Factors that make a pregnancy high risk include:
• Preexisting health conditions.
• Pregnancy-related health conditions.
• Lifestyle factors (including smoking, drug addiction, alcohol abuse and exposure to certain toxins).
• Age (being over 35 or under 17 when pregnant).

People with many preexisting conditions have increased health risks during pregnancy. Some of these conditions include:

• Autoimmune diseases, such as lupus or multiple sclerosis (MS).
• COVID-19.
• Diabetes.
• Fibroids.
• High blood pressure.
• HIV/AIDS.
• Kidney disease.
• Low body weight (BMI of less than 18.5).
• Mental health disorders, such as depression.
• Obesity.
• Polycystic ovary syndrome (PCOS).
• Thyroid disease.
• Blood clotting disorders.

Pregnancy-related health conditions that can pose risks to the pregnant person and unborn baby include:

• Birth defects or genetic conditions in the unborn baby.
• Poor growth in the unborn baby.
• Gestational diabetes.
• Multiple gestation (pregnancy with more than one baby, such as twins or triplets).
• Preeclampsia and eclampsia.
• Previous preterm labor or birth, or other complications with previous pregnancies.

Talk to your doctor right away if you experience any of the following symptoms during pregnancy, whether or not your pregnancy is considered high-risk:

• Abdominal pain that doesn’t go away.
• Chest pain.
• Dizziness or fainting.
• Extreme fatigue.
• Your unborn baby’s movement stopping or slowing.
• Fever over 100.4°F.
• Heart palpitations.
• Nausea and vomiting that’s worse than normal morning sickness.
• Severe headache that won’t go away or gets worse.
• Swelling, redness or pain in your face or limbs.
• Thoughts about harming yourself or your unborn baby.
• Trouble breathing.

Vaginal bleeding or discharge.

People who get pregnant for the first time after age 35 have high-risk pregnancies. Research suggests they’re more likely to have complications than younger people. These may include early pregnancy loss and pregnancy-related health conditions such as gestational diabetes.

Young people under 17 also have high-risk pregnancies because they may be:

• Anaemic.
• Less likely to get thorough prenatal care.
• More likely to have premature labor or birth.

Unaware they have sexually transmitted diseases and infections (STDs and STIs).

A high-risk pregnancy can be life-threatening for the pregnant person or unborn baby. Serious complications can include:

• Preeclampsia (high blood pressure from pregnancy).
• Eclampsia (seizure from pregnancy).
• Preterm delivery.
• Excessive bleeding during labor and delivery, or after birth.
• Low or high birth weight.
• Birth defects.
• Problems with your baby’s brain development.
• Neonatal intensive care unit admission for your baby.
• Intensive care unit admission for you.
• Miscarriage.
• Stillbirth.

How is high-risk pregnancy diagnosed?

Getting early and thorough prenatal care is critical. It’s the best way to detect and diagnose a high-risk pregnancy. Be sure to tell your healthcare provider about your health history and any past pregnancies. If you do have a high-risk pregnancy, you may need special monitoring throughout your pregnancy.

Tests to monitor your health and the health of your unborn baby may include:

• Blood and urine testing to check for genetic conditions or certain birth defects in your baby.
• Ultrasonography, which uses sound waves to create images of your baby in the womb to screen for birth defects.

Monitoring to ensure your unborn baby is getting enough oxygen, such as a biophysical profile, which monitors their breathing, movements and amniotic fluid using ultrasound, and a non-stress test, which monitors their heartrate.

How is high-risk pregnancy managed?

Management for a high-risk pregnancy will depend on your specific risk factors. Your care plan may include:

• Closer follow-up with your obstetrician.
• Consultation with other medical specialists.
• More ultrasounds and closer fetal evaluation.
• Home blood pressure monitoring.
• Careful monitoring of medications used to manage preexisting conditions.

If your health or the health of your baby is in danger, your healthcare provider may recommend labor induction or a C-section.

How can I prevent a high-risk pregnancy?

You can reduce your risk of pregnancy complications by:

• Identifying potential health risks before getting pregnant. Tell your doctor about your familial and personal medical history.
• Maintaining a healthy body weight before pregnancy.
• Managing any preexisting health conditions you may have.
• Making sure any long-term medications are safe to take during pregnancy.
• Planning pregnancies between the ages of 18 and 34.
• Practicing safe sex.

What’s the prognosis (outlook) for people with high-risk pregnancy?
Many people who have high-risk pregnancies don’t experience any problems and deliver healthy babies. But they may be at a higher risk for health problems in the future, including:

• Complications during future pregnancies.
• Postpartum depression.
• High blood pressure.
• Cardiovascular disease.
• Type 2 diabetes.
• Stroke.

Some high-risk pregnancies can increase a child’s risk of:

• Behavioural problems.
• Breathing disorders.
• Gastrointestinal diseases.
• Growth and developmental delays.
• Mental health conditions.
• Neurological disorders.
• Obesity and diabetes.
• Vision, hearing or dental problems.

It’s possible for pregnancy-related complications to occur up to six weeks after a pregnancy ends. Pay close attention to your health. Alert your healthcare provider right away if you notice anything abnormal.