About 13 million high-risk pregnancies occur each year, requiring specialized care for mom and baby

Story by: Lynne Choate on September 28, 2018

High-risk pregnancies account for about six percent to eight percent of pregnancies. Though the reasons for a pregnancy to be high risk can vary, one constant is that you and your baby will need specialized care.

“Women considered high risk may be referred to a maternal and fetal medicine specialist or perinatalogist,” said W. Vance Cuthrell, M.D., with Norton Children’s Maternal-Fetal Medicine. “These specialists have advanced training in caring for obstetrical, medical and surgical complications of pregnancy. We work with obstetricians and family physicians even before conception and all the way through delivery.”

What is a high-risk pregnancy?

There are four categories of most high-risk pregnancies:

• The age of the mother — younger or older
• A pre-existing medical condition
• Medical conditions that develop during pregnancy
• Pregnancy-related issues

Women under age 17 and over age 35 at the time of delivery are at greater risk of complications than those between their late teens and early 30s. The risk of miscarriage and genetic defects increases after age 40.

An expectant mother’s pre-existing medical conditions can lead to complications during pregnancy and delivery, putting her at a high risk.

High blood pressure or lung, kidney and heart problems are common pre-existing conditions that can lead to complications during pregnancy and delivery.

Conditions that require mom to take medications regularly can affect the baby’s growth and development in the womb. Those include diabetes, autoimmune diseases, sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV).

Medical conditions that develop during a pregnancy are unusual but can happen. The two most common are pre-eclampsia and gestational diabetes.

• Pre-eclampsia is condition in which mom develops high blood pressure, has elevated levels of protein in her urine and swelling of her extremities. Pre-eclampsia can be dangerous, even fatal to mom or baby if not treated. If managed properly, most women who develop pre-eclampsia deliver healthy babies.

It is important to note that women who develop pre-eclampsia may be at risk for heart disease. Her primary provider and/or a cardiologist should monitor her.

• Gestational diabetes is specific to pregnancy. Pregnant women may experience episodes of high or low blood glucose (blood sugar) levels. In most cases nutritional counseling and daily monitoring of blood sugar levels under the guidance of a certified diabetes educator can result in a healthy delivery. It is important to note that women who develop gestational diabetes during pregnancy are at a greater risk of developing Type 2 diabetes. Her primary care provider should monitor the situation

High-risk pregnancy-related issues can range from carrying twins or more, premature labor (earlier than 37 weeks gestation), placenta previa (a condition in which the placenta covers the cervix) and fetal problems.