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Types of High-Risk Pregnancies and their Management

By Dr. Gayatri Deshpande in Gynaecology & Obstetrics

Apr 24 , 2023 | 5 min read

When the second line appears on the home pregnancy test kit, people's hearts skip a beat. However, a high-risk pregnancy can affect one's emotions and health. There are different types of high-risk pregnancies, and around 10 to 15% of women are likely to have high-risk pregnancies.

Calling a pregnancy high-risk is a way for doctors to specify pregnancies that need more attention and care. So, relax, be happy, and see a doctor for effective high-risk pregnancy management.

What is a high-risk pregnancy?

A high-risk pregnancy has higher chances of possible complications for the unborn baby, the expecting mother, or both. Therefore, women who experience high-risk pregnancy symptoms are likely to require more care and should exercise more precautions before and during their gestation and after giving birth.

Many mothers have healthy pregnancies even after having risks related to carrying a baby because of better high-risk pregnancy management.

What makes a pregnancy high-risk?

Many factors are considered causes of high-risk pregnancy. They are:

  • Pre-existing health conditions in the mother, such as high blood pressure, PCOS, diabetes, fibroids, renal problems, low or high thyroid levels, autoimmune diseases, HIV/AIDS, Zika virus infection, or obesity, are some of the most potent causes of high-risk pregnancy.
  • Alcoholism, smoking, exposure to harmful chemicals, etc., also contribute to developing high-risk pregnancy symptoms.
  • Pregnancy-induced health conditions, such as gestational diabetes, birth issues, multiple gestations, preeclampsia, preterm labor (in the previous pregnancy), and ectopic pregnancy, can pose risks.
  • The chances of complications rise if the first pregnancy happens when a woman is under 17 or over 35.

No matter the types of high-risk pregnancy, with proper care and management, one can enjoy a healthy pregnancy.

High-Risk Pregnancy: What are the signs and symptoms?

The common high-risk pregnancy symptoms include:

  • Persistent abdominal pain and cramping.
  • Chest pain.
  • Fainting.
  • Dizziness.
  • Extreme weakness and fatigue.
  • High body temperature (more than 100.4° F).
  • Slow or no movement of your fetus.
  • Palpitations.
  • Vaginal bleeding.
  • Persistent severe headache.
  • Unusual vomiting and nausea.
  • Swelling of limbs or face.
  • Breathing difficulties.

Knowing high-risk pregnancy symptoms leads to timely diagnosis of the causes of high-risk pregnancy and effective high-risk pregnancy management.

Types of high-risk pregnancies

The types of high-risk pregnancies include:

Premature labor

Experiencing frequent contractions before the onset of the 37th week of pregnancy may indicate premature or preterm labor. It is one of the most common types of high-risk pregnancy.

The possible causes of high-risk pregnancy may include medical history, multiple pregnancies, vaginal infections, and cervical abnormalities. Expecting mothers can avoid preterm labor by managing stress, exercising, taking enough rest, and seeking medical help whenever required.

Preeclampsia

It is a pregnancy-related condition in which the mother develops high blood pressure, and protein tends to accumulate in her urine. It may lead to blot clotting and reduced kidney and liver functions. It is a severe condition and can impact the health of both the mother and the fetus. This condition is characterized by persistent headaches, swelling in the feet and hands, nausea, and blood in the urine.

Gestational diabetes

Hormonal changes during pregnancy can lead to an increase in blood sugar levels. Gestational diabetes occurs when the pancreas fails to produce enough insulin to check blood sugar levels. Although, in most cases, it goes away after delivery, it is still a type of high-risk pregnancy. Expecting mothers who have gestational diabetes may end up developing type 2 diabetes. A low-sugar and high-fiber diet and low-impact exercises can help the best.

Placenta previa

It is a non-treatable pregnancy-related condition in which the placenta partially or completely covers the cervix. Although it affects less than 1% of women, it is a high-risk pregnancy because it can lead to heavy bleeding during labor. However, depending on the symptoms, the doctor may prescribe treatments and bed rest. In case of continuous heavy bleeding, the patient may need immediate hospitalization.

How can high-risk pregnancies be managed?

High-risk pregnancies can be managed by taking the following measures:

  • Regular follow-up with the doctor.
  • Keeping in touch with high-risk pregnancy experts.
  • Close evaluation of the fetus and the mother.
  • Regular ultrasounds.
  • Frequent blood pressure monitoring.
  • Taking medications on time.
  • Working with the doctor to check for pre-existing health conditions that may affect the pregnancy.

If the doctor suspects complications leading to risks to the mother and the unborn baby, they may perform a C-section to deliver the baby.

What to expect during a pre-pregnancy check-up?

A pre-pregnancy check-up is important to understand underlying health issues and ensure the pregnancy is safe and low-risk. Here is what to expect during a pre-pregnancy check-up:

  • The doctor will examine the expectant mother s overall health to diagnose whether they have any health issues.
  • The doctor will ask about the medical history of both the family's mother and father to determine issues that may arise during the pregnancy.
  • They will resolve queries related to conceiving and the precautions to be taken before getting pregnant.
  • The doctor will also suggest when the patient should stop taking contraceptives.
  • They may recommend taking a physical and pelvic exam before conception.
  • Doctors may prescribe taking pap tests and various blood examinations.
  • They may also ask the patient to visit a genetic counselor.

How will doctors care for you during high-risk pregnancy?

To take care of a high-risk pregnancy, the doctor will create a program based on the mother's physical and mental needs. The doctor may address the emotional and mental wellness concerns the expecting mother may be going through. Furthermore, the doctor will also carry out various diagnostic tests to monitor the pregnancy.

Frequently Asked Questions

1. When is the highest risk of pregnancy?

Women who get pregnant with their first child after 35 carry more high-risk pregnancies. The risks may include early loss of pregnancy, gestational diabetes, etc. Therefore, regularly visiting the doctor is imperative for high-risk pregnancy management.

2. Is IVF pregnancy considered high-risk?

IVF conceptions put the mother at the likelihood of multiple pregnancies, such as twins, triplets, or more. It comes with the risks of high blood pressure, preterm births, placental problems, and other health issues. The mother's age also increases the possibility of congenital conditions and miscarriage.

3. How many pregnancies are considered high-risk?

Out of all the pregnancies, the percentage of high-risk cases is around 10 to 15%. An untreated high-risk pregnancy can lead to life-threatening complications.

4. How can we identify high-risk patients?

The following symptoms characterize a high-risk pregnancy:

  • Watery vaginal discharge.
  • Vaginal bleeding.
  • Cramping or pain in the pelvic area.
  • Decrease in fetal movement.
  • Pain or a burning sensation while urinating.
  • Fever.
  • Chills.
  • Dizziness.
  • Vomiting.
  • Continuous episodes of nausea.
  • Blurred vision.
  • The tendency to harm oneself or the fetus.

5. What are the high-risk medications?

The medications that are considered high-risk and should be avoided during pregnancy include the following compositions:

  • Bismuth subsalicylate.
  • Phenylephrine.
  • Aspirin and ibuprofen.
  • Naproxen.
  • Clonazepam.
  • Sulfonamides.
  • Primaquine.
  • Ciprofloxacin.
  • Lorazepam.
  • Chloramphenicol.
  • Warfarin.
  • Codeine.
  • Trimethoprim.