What does it mean when a pregnancy is deemed “high-risk”? In medical terms, a high-risk pregnancy is one involving any underlying potential complication that could harm the mother and/or baby. Having a high-risk pregnancy does not necessarily mean that the mother or baby will be harmed; rather, it implies that certain precautions must be taken in order to avoid poor outcomes. If you have a high-risk pregnancy, your doctor should closely communicate with you about how it should be managed and what your options are. In some cases, you may want to seek second opinions in order to ensure that your pregnancy and delivery go as smoothly as possible.
When Is a Pregnancy Considered High-Risk?
From genetic disorders to maternal age, there are a variety of things that can result in a pregnancy being classified as “high-risk.” Conditions that may cause a pregnancy to be flagged as high-risk include:
- Medical History – A history of high blood pressure (hypertension) and preeclampsia, diabetes, blood-clotting disorders, infections, asthma, and certain other health conditions, or prior surgical procedures affecting the abdomen or uterus.
- Prior Pregnancy Complications – Having complications during a prior pregnancy, such as having multiple miscarriages, entering into premature labor, preeclampsia or eclampsia, or giving birth to a child with a genetic disorder or birth injury.
- Maternal Age – Getting pregnant before age 18 or after age 34.
- Maternal Weight – Being underweight or obese at the time of conception or during gestation.
- Multiples – Being pregnant with twins, triplets, or more than three children.
- Gestational Complications – Abnormal fetal position, fetal growth restriction, Rh incompatibility, and other complications relating to the fetus’s development during gestation.
- Health Problems – Current material health problems including cancer, diabetes, epilepsy, hepatitis C, HIV, kidney disease, high blood pressure, syphilis, thyroid disease, and toxoplasmosis.
- Medications – Maternal use of carbamazepine (Tegretol), lithium, phenytoin (Dilantin), valproic acid (Depakene), and certain other prescription medications.
- Alcohol and Drug Use – Drinking, smoking cigarettes, smoking marijuana, using illegal drugs, or abusing prescription medications prior to or during pregnancy.
- Genetic Disorders – A family history of cystic fibrosis, diabetes, Down syndrome, high blood pressure, Huntington’s disease, or other genetic disorders.
How Are High-Risk Pregnancies Managed?
In any pregnancy, medical professionals should conduct regular tests to evaluate the health of the mother and baby. In high-risk pregnancies, physicians often require more frequent and extensive testing. Prenatal assessments may include non-stress tests (NSTs), ultrasounds for AFI (amniotic fluid index), biophysical profiles (BPPs), and Doppler flow studies. Routine testing is critical because careful surveillance can allow sufficient time for medical intervention if the need arises. Physicians may also suggest a planned early delivery for high-risk women. Furthermore, your doctor can counsel you on prenatal nutrition, substance use, exercise, and healthy lifestyle habits.
My Pregnancy is High-Risk: What Are My Treatment Options?
The best way to protect your health and the health of your child is to attend routine prenatal care appointments. Remember, you’re allowed to contact and interview multiple OBs to find the one that’s right for you. If you don’t feel like you’re receiving proper care, you’re welcome to seek a second opinion. Furthermore, women with high-risk pregnancies will be referred to a maternal-fetal medicine (MFM) specialist; these doctors focus specifically on treating moms with risk factors and can help you make smart decisions to welcome a healthy baby into your family.