What is a High Risk Pregnancy?

A high risk pregnancy is the one in which some conditions puts the mother or the developing fetus or both at higher than normal risk of developing complications during or after the pregnancy and birth. Such women and their babies need close monitoring and care throughout the pregnancy. It is essential to understand what causes a high risk pregnancy and to manage it properly at the right time. 

What are the factors that increase the chances of a High Risk Pregnancy?

Pre-existing conditions/factors that can increase the chances of a High Risk Pregnancy include:

    1. Heart disease
    2. High blood pressure
    3. Kidney problems 
    4. Diabetes
    5. Thyroid disorders
    6. Epilepsy
    7. Respiratory disorders like asthma
    8. Autoimmune diseases (like SLE, Rheumatoid arthritis, APLA)
    9. Blood disorders (anemia, thalassemia, sickle cell disease, ITP, etc.)
    9. Underlying mental health conditions 
    10. Family history of high risk pregnancies, or genetic conditions
    11. Problematic past pregnancies
    12. Including previous adverse pregnancy outcome, repeated pregnancy losses, preterm labor
    13. Habits like – smoking, drinking alcohol, using illegal drugs
    14. Being overweight or underweight
    15. Maternal age over 35 years

Pregnancy complications - Various complications that develop during pregnancy pose risks, such as problems with the uterus, cervix or placenta. 

Other concerns might include too much amniotic fluid (polyhydramnios) or low amniotic fluid (oligohydramnios), restricted fetal growth, or Rh (rhesus) sensitization — a potentially serious condition that can occur when the mother’s blood group is Rh negative and the baby's blood group is Rh positive.

Other conditions/factors that can develop during pregnancy include:

    1. Preeclampsia (high blood pressure during pregnancy that can affect the mom-to-be’s liver, kidneys and brain)
    2. Gestational diabetes (diabetes that develops during pregnancy)
    3. Preterm labor (labor that starts before 37 weeks)
    4. Placenta praevia (placenta lying unusually low in the uterus so that it may be covering the cervix, which can cause excessive bleeding during delivery)
    5. Pregnancy with more than one baby (multiple pregnancies)

What else you must know about high-risk pregnancy?

Consult your health care provider about how to manage any medical conditions you might have during your pregnancy and how your health might affect labor and delivery. Ask your health care provider to discuss specific signs or symptoms to look out for, such as:

    1. Vaginal bleeding
    2. Persistent headaches
    3. Pain or cramping in the lower abdomen
    4. Watery vaginal discharge — in a gush or a trickle
    5. Regular or frequent contractions — a tightening sensation in the abdomen
    6. Decreased fetal activity
    7. Pain or burning with urination
    8. Changes in vision, including blurred vision

Also, find out which signs or symptoms should prompt you to contact your health care provider and when to seek emergency care.

A high-risk pregnancy might have ups and downs. Do your best to stay positive as you take steps to promote a healthy pregnancy.

How is a High risk pregnancy diagnosed?

A high risk pregnancy can be detected at an early stage in the pregnancy with a complete medical history of the mother, a thorough medical examination supported by certain investigations. Continuous monitoring of physical health and personal habits help a health care provider in identifying any risks/problems that develop during pregnancy. 

Once a diagnosis has been made, the woman with a high-risk pregnancy should receive specialized care from a team of health care providers adept in managing high risk pregnancies throughout the pregnancy to ensure that she carries the fetus or fetuses to term.