High-Risk-Pregnancy Management

Although any pregnancy has the potential of complications, one defined as "high risk" is more likely to have complications that potentially threaten the health of both the mother and fetus, so requires a greater level of attention and monitoring. A high-risk pregnancy increases a baby's chances for health and developmental problems at birth and beyond.

A pregnancy is considered high risk in a number of instances, including when there are preexisting, problematic medical conditions; health issues that develop during the pregnancy; multiple births involved; and a history of abnormal pregnancies. Routine screening tests, such as blood tests and ultrasound exams, in conjunction with diagnostic tests, such as amniocentesis or chorionic villus sampling (CVS), help identify whether a pregnancy is high risk. These tests are used to determine the presence of a number of health problems, as well as test for certain genetic conditions. A woman with a high-risk pregnancy must schedule more frequent visits with her doctor, and manage her lifestyle to ensure her and her baby's health.

Symptoms of High-Risk Pregnancy

Symptoms of high-risk pregnancy are often difficult to distinguish from symptoms of a typical pregnancy, although they may last longer and be far more severe. Symptoms of a high-risk pregnancy include the following:

  • Noticeable changes in vision, including blurring
  • Decreased fetal movement
  • Persistent headaches
  • Painful burning sensations while urinating
  • Vaginal bleeding
  • Clear, watery vaginal discharge
  • Frequent contractions

Women with high-risk pregnancies may also experience severe pain or cramping in the lower abdomen. Pregnant women experiencing any of these symptoms should seek immediate medical attention.

Risk Factors for High-Risk Pregnancy

Smoking and abusing alcohol or drugs during pregnancy can make it a high-risk one. Other conditions, such as an an abnormally shaped uterus, or a weakened or shortened cervix, can also be the cause of a high-risk pregnancy. Other risk factors include the following:

  • Being significantly underweight/overweight
  • Getting poor prenatal care
  • History of premature labor
  • Previously having a child with a genetic condition
  • History of miscarriages
  • Being pregnant with multiple fetuses
  • Preeclampsia
  • Sickle cell disease

Preexisting health conditions such as epilepsy, high blood pressure, diabetes, cancer and lupus, and heart, kidney or lung problems, can also contribute to a high-risk pregnancy. Age may also be a factor, especially if the mother is either younger than 16 or older than 35.

Management of High-Risk Pregnancy

A high-risk pregnancy usually requires a greater number of prenatal obstetric office visits to closely monitor the progression of the pregnancy. A woman needs to be attentive to her health, eat a nutritious diet, gain a proper amount of weight, and avoid risky substances or medications. Vitamins, iron supplements and medicines to enhance the health of the mother and fetus are often prescribed. In some cases, a woman may be advised to stop working and rest at home during the remainder of her pregnancy.

In addition to regular screening exams, additional tests may be recommended to further assess the health and development of the fetus. These may include a biophysical profile or targeted ultrasound, which can provide doctors with more detailed information than standard testing. Delivery should take place in a hospital setting; giving birth at home is considering too risky for women with serious health conditions or complications. Depending on the individual case, a baby may be delivered vaginally or through a C-section.

Additional Resources