High-Risk Pregnancy

 



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All pregnancies carry risks. The definition of a “high-risk” pregnancy is any pregnancy that carries increased health risks for the pregnant person, fetus or both. People with high-risk pregnancies may need extra care before, during and after they give birth. This helps to reduce the possibility of complications.

However, having a pregnancy that’s considered high-risk doesn’t mean you or your fetus will have problems. Many people experience healthy pregnancies and normal labor and delivery despite having special health needs.

 What Causes High-Risk Pregnancy?

Factors that make a pregnancy high risk include:

- Preexisting health conditions.

- Pregnancy-related health conditions.

- Lifestyle factors (including smoking, drug addiction, alcohol abuse and exposure to certain toxins).

- Age (being over 35 or under 17 when pregnant).

What are common medical risk factors for a high-risk pregnancy?

People with many preexisting conditions have increased health risks during pregnancy. Some of these conditions include:

- Autoimmune diseases, such as lupus or multiple sclerosis (MS).

- COVID-19.

- Diabetes.

Fibroids.

- High blood pressure.

- HIV/AIDS.

- Kidney disease.

- Low body weight (BMI of less than 18.5).

- Mental health disorders, such as depression.

- Obesity.

Polycystic ovary syndrome (PCOS).

- Thyroid disease.

- Blood clotting disorders.

Pregnancy-related health conditions that can pose risks to the pregnant person and fetus include:

- Birth defects or genetic conditions in the fetus.

- Poor growth in the fetus.

- Gestational diabetes.

- Multiple gestation (pregnancy with more than one fetus, such as twins or triplets).

- Preeclampsia and eclampsia.

- Previous preterm labor or birth, or other complications with previous pregnancies.

What are the signs and symptoms of a high-risk pregnancy?

Talk to your doctor right away if you experience any of the following symptoms during pregnancy, whether or not your pregnancy is considered high-risk:

- Abdominal pain that doesn’t go away.

- Chest pain.

- Dizziness or fainting.

- Extreme fatigue.

- The fetus's movement stops or slows.

- Fever over 100.4°F.

- Heart palpitations.

- Nausea and vomiting that’s worse than normal morning sickness.

- Severe headache that won’t go away or gets worse.

- Swelling, redness or pain in your face or limbs.

- Thoughts about harming yourself or the fetus.

- Trouble breathing.

- Vaginal bleeding or discharge.

At what age is pregnancy considered high-risk?

People who get pregnant for the first time after age 35 have high-risk pregnancies. Research suggests they’re more likely to have complications than younger people. These may include early pregnancy loss and pregnancy-related health conditions such as gestational diabetes.

Young people under 17 also have high-risk pregnancies because they may be:

- Anemic.

- Less likely to get thorough prenatal care.

- More likely to have premature labour or birth.

- Unaware they have sexually transmitted infections (STIs).

How is high-risk pregnancy diagnosed and monitored?

Getting early and thorough prenatal care is critical. It’s the best way to detect and diagnose a high-risk pregnancy. Be sure to tell your healthcare provider about your health history and any past pregnancies. If you do have a high-risk pregnancy, you may need special monitoring throughout your pregnancy.

Tests to monitor your health and the health of the fetus may include:

- Blood and urine testing to check for genetic conditions or certain congenital conditions (birth defects).

- Ultrasonography, which uses sound waves to create images of the fetus to screen for congenital conditions.

- Monitoring to ensure the fetus is getting enough oxygen, such as a biophysical profile, which monitors their breathing, movements and amniotic fluid using ultrasound, and a non-stress test, which monitors their heart rate.

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