Pregnancy is a beautiful experience, cherished by many at some point in life. However, the nine-month journey isn't always smooth for every woman. For some, it involves multiple health challenges, making their pregnancy high-risk. A high-risk pregnancy refers to one with increased health risks for the mother, the baby, or both. Factors such as pre-existing medical conditions or age (over 35 or under 17) can contribute to this. These pregnancies require careful monitoring to minimise the risk of complications and ensure a healthy outcome for both mother and child. Let us understand from Dr. N Sarada Vani, Senior Consultant Obstetrics & Gynaecology, Minimal Access Surgeon (Laparoscopy), High-Risk Pregnancy Specialist, Yashoda Hospitals, how to manage a high-risk pregnancy.
What is a High Risk Pregnancy?
All pregnancies carry some risks, but a high-risk pregnancy involves increased health risks for the mother, foetus, or both. Extra medical care may be needed before, during, and after birth to reduce complications. However, being high-risk doesn't mean you or the baby will necessarily face health problems. Many high-risk pregnancies result in healthy outcomes. If your pregnancy is labelled as high-risk, trust your healthcare team's advice and remember that most high-risk pregnancies end in the safe delivery of healthy babies with proper prenatal care.
A high-risk pregnancy indicates a higher-than-average chance of developing complications. Some pregnancies start as high risk, while others become high risk later on. Factors contributing to a high-risk pregnancy include:
- Preexisting health conditions you had before pregnancy.
- Health conditions that arise during pregnancy.
- Lifestyle factors, such as smoking, substance use, alcohol use, or exposure to harmful toxins.
Seek medical attention immediately from your gynaecologist if you experience any of the following symptoms during pregnancy, whether it’s high-risk or low-risk:
- Persistent abdominal pain
- Chest pain
- Dizziness or fainting
- Extreme fatigue
- Decreased or stopped foetal movement
- Heart palpitations
- Severe nausea and vomiting beyond typical morning sickness during pregnancy
- Persistent or worsening severe headache
- Swelling, redness, or pain in your face or limbs
- Thoughts of self-harm
- Difficulty breathing
- Vaginal bleeding or increased discharge
Common Conditions That Make a Pregnancy High Risk
Pre Existing conditions can increase health risks during pregnancy. These include autoimmune diseases, diabetes, high blood pressure, fibroids, HIV/AIDS, kidney disease, obesity, mental health disorders, polycystic ovary syndrome (PCOS), thyroid disease, and blood clotting disorders.
Pregnancy-related conditions that may cause complications include gestational diabetes, low birth weight, multiple gestations, gestational hypertension, preeclampsia, placental issues, history of preterm birth or pregnancy complications, and abnormal amniotic fluid levels.
These factors contribute to a "high-risk" label, not to alarm you but to ensure careful monitoring and care for the safety of you and your baby throughout pregnancy and delivery.
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A high-risk pregnancy can pose serious risks to both the mother and foetus, including complications like preeclampsia, preterm delivery, caesarean delivery, excessive bleeding, low birth weight, birth defects, and potential NICU or ICU admissions. Miscarriage and stillbirth are also possible risks. It's crucial to discuss these potential complications with your care provider and ask questions to understand your risks. With careful monitoring and management, many of these risks can be reduced.
Monitoring and Diagnosis: Importance of Frequent Prenatal Check-Ups
In order to detect and treat a high-risk pregnancy, early and comprehensive prenatal care is necessary. Your health history and any previous pregnancies must be disclosed to the healthcare professional. Extra monitoring is necessary during the pregnancy if it is high-risk.
Some of the tests to monitor the fetus’s health may include:
- Blood and urine tests to assess your health and screen for genetic conditions.
- Ultrasounds to track fetal development, with more frequent scans for high-risk pregnancies.
- Additional tests like biophysical profiles and nonstress tests to evaluate the fetus and placenta.
Treatment and Management
While a high-risk pregnancy may be concerning, it can be well-managed with proper care and monitoring, helping to ensure a smooth pregnancy. The management plan will depend on your specific risk factors and may include more frequent check-ups with your obstetrician, consultations with a maternal-fetal medicine specialist or other medical experts, additional ultrasounds, closer fetal evaluations, and home blood pressure monitoring. Medications used for preexisting conditions will also be carefully monitored. If complications arise, your healthcare provider may suggest early labor induction or a cesarean delivery.
Some of the preventive tips for high-risk pregnancy can be:
- Avoid alcohol, nonprescription drugs, and unsafe medications.
- Identify potential health risks by discussing your family and personal medical history with your provider before pregnancy.
- Maintain a healthy body weight, manage preexisting health conditions, and ensure that long-term medications are safe during pregnancy.
- Quit smoking and practise safe sex to reduce the risk of sexually transmitted infections (STIs).
Many individuals with high-risk pregnancies go on to deliver healthy babies, and a high-risk diagnosis doesn't necessarily mean you or your baby will face long-term medical issues. It's important to discuss your specific risks with your gynaecologist for a clearer understanding.
Learning that your pregnancy is considered high-risk can bring about feelings of anxiety and worry, which is natural. While it may seem overwhelming, trust in your healthcare team—they are focused on ensuring the best outcome for both you and your baby. Attending all your prenatal appointments and undergoing recommended imaging tests are crucial steps in managing a high-risk pregnancy, increasing the likelihood of a successful delivery and a healthy baby. Stay informed and rely on your care team for support and guidance throughout the process.