High Risk Pregnancy Care
The term “high-risk pregnancy” refers to a pregnancy that has an increased potential for complications that could affect the mother and/or baby. A normal, healthy delivery is entirely possible despite a high-risk pregnancy, but it requires special monitoring and attention.
Common High-Risk Pregnancy Conditions
Preterm labor occurs when a woman goes into labor before the 37th week. Babies who are born prematurely may not have developed fully and could be at risk for health problems. While there isn’t one main cause of premature labor, doctors will look for any abnormalities of the cervix and certain vaginal bacterial infections.
Preeclampsia is a dangerous condition for mother and baby. It causes the blood vessels to constrict, increasing blood pressure and potentially reducing blood flow to vital organs such as the liver, kidneys and brain. Instances of preeclampsia are reduced in women who are a healthy weight, eat a nutritious diet and get regular exercise.
Pregnant women who have never had diabetes before can develop gestational diabetes. The increased blood sugar levels can lead to the baby being born too big. Although gestational diabetes may disappear after delivery, it is important that symptoms are managed.
High-Risk Pregnancy Factors
If a woman exhibits one or a combination of several of the following factors, their pregnancy may be considered high-risk:
- Maternal Age. Women who are under 17 or over 34 years of age have a greater risk of complications than those between 17 and 34. Those risks increase even more once a woman is 40 or older.
- Medical History. If a previous pregnancy was delivered preterm, resulted in a low birth weight or required a c-section, future pregnancies will be considered high-risk. Women with diabetes, blood pressure disorders, anemia or various infections are also at risk for complications.
- Lifestyle. Smoking cigarettes, drinking alcohol, taking drugs, poor nutrition and un-managed weight (overweight or underweight) can all cause complications for the mother and her baby.
Important Appointments & Tests
In order to give mother and baby the best possible chance at a healthy delivery, it is recommended that women attend:
- Preconception counseling. Before trying to get pregnant, a preconception counseling appointment will help the mother and father be better prepared for pregnancy. The doctor will explain any potential risks and recommend lifestyle changes in order to increase chances of a healthy pregnancy.
- Routine Checkups. Most pregnant women have around ten prenatal appointments during their pregnancy. Women with a high-risk pregnancy may visit more, especially during the second and third trimester.
In addition to routine prenatal tests, additional screenings are recommended. Depending on circumstances, your obstetrician may choose to perform the following:
- Targeted Ultrasound. A fetal ultrasound can provide the doctor with images of the baby in the uterus. The doctor will be able to determine if certain abnormalities or defects are present.
- Cervical Ultrasound. Ultrasound images of the cervix may be taken to help the doctor determine if its length could be a factor that causes preterm labor.
- Chorionic Villus Sampling (done at 10-13 weeks). A sample of chorionic villus cells from the placenta where it attaches to the uterine wall.
- Amniotic Fluid Test (done at 14-16 weeks). A sample of the fluid that surrounds the baby in the uterus will be taken and tested in order to identify various genetic defects.
- Umbilical Cord Sample. A blood sample will be taken from the umbilical cord after the 18th week of pregnancy in order to identify certain chromosomal conditions and blood disorders.
- Fetal Fibronectin Test. Vaginal swabs will be tested for fetal fibronectin, which could be an indication of preterm labor. Fetal fibronectin is a protein produced by the fetal cells. It acts like a glue binding the fetal sac and uterine wall. This protein “leaks” into the vagina if a pre-term delivery is likely.