Dr Rekha Prabhu

What is High-risk Pregnancy?

A pregnancy that carries increased health risks, for the mother, the fetus, or both is considered high-risk.

What makes a pregnancy High-risk?

Pregnancy can be high-risk for a woman due to the following:

  • Pre-existing health conditions: Health disorders and conditions in a woman makes her pregnancy high risk. Conditions such as diabetes, hypertension, kidney disease, HIV/AIDS, thyroid disorders, autoimmune disorders, and disease of the lung and the heart are some health conditions that can impose additional risk on the mother and child.
  • Pregnancy-induced health conditions: At times, a woman may be healthy when she gets pregnant but develops health disorders as induced by pregnancy. Gestational diabetes, preeclampsia, pregnancy-induced liver or thyroid disorders, etc makes a pregnancy high risk.
  • Lifestyle: Unhealthy lifestyles and habits, such as consumption of alcohol or smoking impose additional risks on the mother and child.
  • Age: Being over 35 or under 17 makes a pregnancy high risk.

Does High-risk pregnancy always lead to complications?

A high-risk pregnancy doesn’t necessarily mean that the mother or the child will always develop complications. It simply means that such pregnancy would require more careful and frequent monitoring for healthy pregnancy outcomes.

Monitoring fetal health in high-risk pregnancy

Monitoring the biophysical profile of the fetus helps assure the health of the fetus in a high-risk pregnancy. This combines, performing a non-stress test (NST) and an ultrasound examination and is usually done at regular intervals after the 28th week of pregnancy.

NST is a simple test, which places a belt and a sensor around the mother’s abdomen to monitor fetal heart rate. The sensor is connected to a monitor which records the fetal heart activity and prints the report for immediate assessment. The test takes no more than 20-30 minutes and requires the mother to lie down comfortably. At the end of the test, the report is assessed by the gynecologist.

Ultrasound is performed for assessment of the biophysical profile of the fetus and checks the fetal tone, amniotic fluid volume, fetal breathing, and fetal movements.

Monitoring maternal health in high-risk pregnancy

Pregnant mothers with a high-risk pregnancy, need more frequent health check-ups to assure good health. At times, your doctor may also prescribe you some medications to keep the underlying medical condition under control. Adjustment of the dosage of such medication may also be required depending on the health condition.

While most high-risk pregnancies can go on like normal pregnancies, some may require elective cesarean sections and early delivery. This is decided by your gynecologist after assessing your health condition.

Pregnant women with high-risk pregnancies should report to their doctor in case of:

  •       Vaginal bleeding discharge
  •       Pain or cramping in the lower abdomen
  •       Decreased fetal activity (not feeling enough baby movements)
  •       Pain or burning with urination
  •       Changes in vision
  •       Sudden or severe swelling in the face, hands, or fingers
  •       Fever
  •       Vomiting or persistent nausea
  •       Dizziness or headaches

What can I do for a healthy pregnancy?

To assure the best pregnancy outcomes, the following are recommended:

Ø  Schedule a pre-conception appointment: As soon as you start planning for pregnancy, schedule a visit with your gynecologist. Such a pre-conception appointment helps you monitor your baseline health and thus you can know whether your pregnancy can have any additional risks. Knowing about risks can help monitor and control them from the start. Additional to just monitoring your health, your doctor may also start you on some prenatal vitamins, which are beneficial for the health of the child and prevents unwanted complications.

Ø  Never miss your prenatal appointments: High-risk or normal, all pregnancies demand regular prenatal appointments to assure healthy pregnancy outcomes. Assure to seek regular care and never miss an appointment with your gynecologist to minimize any possible complications for the mother and the child.

Ø  Follow a good lifestyle: Quit abusive substances, such as alcohol or cigarettes and change your diet and lifestyle to minimize complications and assure the good health of your child.

Dr. Rekha Prabhu has vast experience of over two decades in handling normal and high-risk pregnancies. She is a senior obstetrician and gynecologist practicing in Vijayawada, India.