Sunday, July 14, 2024

An Introduction to High-Risk Pregnancies

Pregnancy usually goes smoothly for many women, but a small number of women experience serious complications that can impact the health of the mother, baby, or both. Medical professionals refer to these as high-risk pregnancies because specialist care is needed to ensure optimal health for both mother and baby.

Is a high-risk pregnancy preventable?

Many high-risk pregnancies are due to pre-existing medical conditions but some risk factors can be managed with regular prenatal care and living a healthy lifestyle. Your doctors will assess your risk factors at your first “booking” antenatal appointment so you will have an early opportunity to discuss any concerns with your doctor. For those in Cayman looking for an OBGYN, see our article on choosing an OBGYN in the Cayman Islands.

Some complications of pregnancy arise as the pregnancy progresses, so each antenatal visit is in effect a repeat assessment of risk factors… No matter the reasons behind your concerns, your doctor is the best person to advise you.

What are some risk factors for a high-risk pregnancy?

Here is a list of possible reasons that might lead to a high-risk pregnancy:

  • The age of the mother. Women who are younger than the age of 17 and older than the age of 35 are more likely to experience pregnancy complications than women between the ages of 17 and 35. Women who are over 40 years of age also have a higher risk of experiencing miscarriage and delivering a baby with genetic disorders.
  • Pre-existing medical conditions. Women living with health problems like high blood pressure, epilepsy, diabetes, heart or blood disorders, obesity, autoimmune disease, kidney disease, thyroid disease, or chronic infections like HIV are at higher risk. Some sexually transmitted infections and mental health concerns like depression can also pose a risk to pregnancy.
  • Pregnancy complications. These medical conditions take place during pregnancy, even when a woman is healthy before becoming pregnant. Pre-eclampsia is a serious condition causing high blood pressure, swelling, and increased levels of protein in urine. Gestational diabetes is another complication that develops during pregnancy, usually resolving after the delivery of the baby.
  • Placental complications. Placenta previa is a condition in which the placenta covers the cervix. The condition can cause bleeding, especially if a woman has contractions. If the placenta still covers the cervix close to delivery, your doctor will schedule a cesarean section to reduce bleeding risks to the mother and baby.
  • Fetal problems.  These can be seen on ultrasound. Approximately 2% to 3% of all babies have a minor or major structural problem in development. Sometimes there may be a family history of fetal problems, but other times these problems are completely unexpected.
  • Pregnancy history. Previous issues with miscarriage and/or a complicated genetic family history are also risk factors for a high-risk pregnancy. If a woman has had pre-eclampsia in the past or pregnancy-related hypertension, her pregnancy might also be considered high-risk. Past pre-term births may also predict future early deliveries.
  • Multiple pregnancy. Women carrying twins or triplets or higher order multiples are at higher risk for pregnancy complications like pre-eclampsia and gestational diabetes.
  • Lifestyle. Certain lifestyle choices are dangerous for pregnancy. For example, women who smoke, drink alcohol, and use illegal drugs are putting their pregnancies at risk.

Having a high-risk pregnancy can be a challenging or overwhelming experience. Talking with your doctor about how you’re feeling is important because complications of pregnancy can lead to depression.

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