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Understanding High-Risk Pregnancies

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If you think your pregnancy may be high risk, seeking medical care early on is the best way to make sure you are doing everything you can to have the healthiest baby possible. Once you have your first OB/GYN visit and learn that your pregnancy is considered high risk, you must follow the recommendations your OB/GYN provides. Keep in mind that the OB/GYN you choose must be experienced with high-risk pregnancies. In addition, he or she must be someone that you feel comfortable with.

What is a High-Risk Pregnancy?

A pregnancy is considered high risk when the mother has a health issue or uses products that are known to increase the likelihood of a complication. Complications can occur during pregnancy or, if the baby is negatively affected, become evident once the baby is born.

A pregnancy may be considered high risk if any of the following conditions apply:

  • Was overweight or underweight before conceiving.
  • Has structural problems associated with her cervix, uterus or placenta.
  • Is 17 years old or younger.
  • Is 35 years of age or older.
  • Has previously given birth to a child with some kind of genetic disorder (e.g., Down syndrome, cystic fibrosis) or a birth defect (e.g., cleft palate).
  • Has hypertension, polycystic ovary syndrome (PCOS), suffers with depression or has diabetes.
  • A preterm birth, which refers to a woman giving birth before she reaches her 37th week of pregnancy.
  • Previously had a miscarriage, cesarean section (C-section) or problematic pregnancy.
  • Has an autoimmune disease, kidney disease, heart disorder, epilepsy, blood disorder, asthma, Zika infection, HIV/AIDS or a thyroid disease.
  • Is carrying more than one baby.
  • Has some other health issue that could cause her to experience complications.
  • Smokes cigarettes, vapes, participates in recreational drug use or drinks alcoholic beverages regularly.
  • Has Rh-negative blood.

Maternal Rh Sensitization

When a pregnant woman has Rh-negative blood, and she is carrying a baby with Rh-positive blood, maternal Rh sensitization is possible. This can be a serious complication causing the baby to develop Rh disease. Rh disease can cause an increase in the baby’s bilirubin level, leading to jaundice and a decrease in red blood cells causing anemia. Nonetheless, with the prescription medication RhoGam, maternal Rh sensitization is preventable. This potential complication is one of the reasons that visiting your OB/GYN early on in pregnancy is so important.

If you have a high-risk pregnancy, it is vital that you and your OB/GYN work together to get any manageable health issues that could cause a complication under control (e.g., diabetes, hypertension).

Factors and health conditions that specifically relate to pregnancy can also cause it to be considered high risk.

Additional Pregnancy Risks:

Preeclampsia

A woman develops hypertension after she reaches her 20th week of pregnancy.

Eclampsia

A serious complication of preeclampsia. This can cause the mother to experience seizures. It could also cause her to lose consciousness and slip into a coma.

Gestational diabetes

Affects women who do not have diabetes before becoming pregnant, but develop it during their pregnancy. A short time after giving birth most mothers with gestational diabetes are no longer diabetic.

A Pregnancy Plan for a High-Risk Pregnancy: What to Expect

If your pregnancy is deemed high risk, you can expect your OB/GYN to follow you more closely than a woman who has a low-risk pregnancy. For example, you may visit your OB/GYN more frequently, have additional tests run and receive a referral to see a maternal-fetal medical specialist or a genetic counselor.

A high-risk pregnancy plan may include:

  • An exercise routine designed to ensure you and your baby remain safe while you are exercising. Conversely, your OB/GYN may recommend that you do not exercise at all during your pregnancy.
  • Your OB/GYN may provide you with diet recommendations to help you choose highly nutritious foods during your pregnancy.
  • You may also receive information about the signs that indicate you should call your OB/GYN (e.g., pain, bleeding, contractions).

When a pregnancy is extremely high risk, the mother may need to remain on bed rest or at the hospital throughout her pregnancy.

Reduce the Likelihood of a High-Risk Pregnancy by Making Changes Before Conception

Women who plan to become pregnant can make lifestyle changes to reduce the likelihood of experiencing a high-risk pregnancy. For example, women who smoke, participate in recreational drug use or drink alcoholic beverages regularly can discontinue these practices before becoming pregnant.

In addition, women with certain health conditions can address them before they conceive. For example, an overweight woman can lose some of the excess weight she is carrying or an underweight woman can work towards gaining weight. She can determine the amount of weight she needs to gain or lose by using the CDC’s body mass index (BMI) calculator.

If you are thinking about conceiving and have concerns about experiencing a high-risk pregnancy, ask your general practitioner for advice. He or she can help you address health issues that could put you and your baby at risk.

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