What Is a High-Risk Pregnancy?
A high-risk pregnancy is one in which the mother or infant is at higher risk for health problems or complications than a healthy mother or infant. A pre-existing health condition can put a mother at high risk at conception. Or, she or her infant may develop a health problem during pregnancy that increases the risk.
Factors that can increase risk before or during a pregnancy include:
- Age — Pregnant teenagers and women over 35 have higher risk levels.
- Lifestyle — Alcohol and drug use, as well as smoking, put a woman’s pregnancy at risk.
- Medical history — Infections as well as conditions such as autoimmune diseases, blood-clotting disorders, breathing problems, cancer, diabetes and hypertension can jeopardize a pregnancy, as can a history of prior preterm births or delivering a low-birth-weight infant.
- Multiple gestation — Women carrying multiple babies, such as twins or triplets, are at greater risk than women carrying a single baby.
- Overweight and obesity — Excess weight raises risk of complications, such as stillbirth, gestational diabetes and high blood pressure.
- Surgeries — Women who have had surgical procedures involving the uterus are at higher risk.
Health conditions that occur during pregnancy and can lead to a high-risk pregnancy include:
- Cervical insufficiency — This condition causes the cervix to dilate prematurely during pregnancy, often without contractions and their related pain.
- Gestational diabetes — This type of diabetes occurs only during pregnancy.
- Maternal heart disease — Women who have a history of heart disease, with high blood pressure, or who are over 40 are at greater risk for this type of heart disease.
- Placenta previa — In this condition, the placenta rests low in the uterus and either partially or completely covers the woman’s cervix. It can also separate from the uterine wall when the cervix dilates.
- Thyroid disease in pregnancy — Graves’ disease can cause your thyroid to produce excess hormones.
Symptoms of a high-risk pregnancy will vary, particularly if a pre-existing condition factors in. Additional symptoms that require attention during a high-risk pregnancy include:
- Unexplained bleeding — This could result from placenta previa and often occurs during the third trimester.
- Serious headaches and/or blurred vision — These are signs of preeclampsia.
- Pain and/or cramping — Intense pain (as opposed to mild cramping) is a sign of preeclampsia, placental abruption (when the placenta detaches from the uterine wall prematurely) and miscarriages, among other serious pregnancy conditions.
- Rapid breathing or heart rate — This could signify maternal heart disease, an infection or Graves’ disease.
For mothers with pre-existing conditions, treating the specific condition can help ensure a healthy delivery. During pregnancy, the following treatments may mitigate complications:
- Bed rest — Many conditions, including high blood pressure, cervical insufficiency and carrying multiples, benefit from bed rest.
- Cervical cerclage — Used to treat cervical insufficiency and prevent miscarriage, a cerclage is a procedure involving stitching the cervix closed. Sutures are typically put in between weeks 14 and 16 and removed between weeks 36 and 38.
- Lifestyle changes — Avoiding alcohol and cigarettes and eating a diet rich in iron, folic acid, calcium and protein can help mothers avoid some complications.
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