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High-Risk Pregnancies

The term "high-risk pregnancy" is used to describe a pregnant woman who has one or more factors that may put her or her fetus at risk. It is important to recognize that the term "high-risk" is not meant to cause a woman and her partner to worry; rather it is a way to identify her situation so the gynecologist ensures she gets more specialized attention during her pregnancy.

If a pregnancy is high-risk, a gynecologist may also make special preparations for the birth itself. For instance, the gynecologist may schedule a Caesarean section early. Regardless of the reason why a pregnancy is high-risk, a woman can expect to have more exams and visits to the gynecologist than a woman with a non-high risk pregnancy. For example, a woman with a high-risk pregnancy will likely have more diagnostic ultrasounds as well as blood pressure checks and exams to check for urinary tract infections.

Existing Health Issues That Can Cause a High-Risk Pregnancy

  • Seizures
  • High blood pressure
  • Asthma
  • Thyroid issues
  • Heart disease
  • Diabetes
  • Lupus

You can stay actively involved by following your gynecologists instructions to manage a long-standing medical issue such as diabetes, as well as contacting your gynecologist as soon as possible if you have a concern or something does not feel right.

Being overweight can also cause you to have a high-risk pregnancy. If you are overweight or obese, you are more likely to have these issues during pregnancy:

  • Blood clots, high blood pressure, infections, sleep apnea, preeclampsia and gestational diabetes
  • Miscarriage or stillbirth
  • Remaining pregnant past your due date and needing to have labor induced
  • Needing to go to the hospital earlier in labor and having a longer labor
  • Problems during labor and birth, such as issues with pain medications
  • More likely to have a Cesarean birth (C-section)
  • Complications from a C-section, like an infection or losing too much blood
  • Longer hospital stay after having your baby

Obesity can also cause problems for the baby, such as: 

  • Premature birth
  • Birth defects
  • Greater difficulty performing fetal tests, such as diagnostic ultrasound
  • Delivering a baby over 9 lbs., 15 oz. , which can causing labor and delivery issues and possible injury to the baby
  • Having a baby that is more likely to develop heart disease, diabetes, and obesity later in life

Being pregnant and underweight can also be a concern. If you're underweight at the start of your pregnancy, you have a greater risk of having a preterm birth or a small for gestational age (SGA) baby. Preterm babies are at high risk for many short-term and long-term problems. Examples of short-term, yet serious, problems that can occur in infants born prematurely include:

  • Breathing problems due to immature lung development; long-term, this can lead to chronic lung disease issues
  • Heart problems and low blood pressure
  • Brain hemorrhages (bleeding)
  • Inability to generate adequate body heat
  • Digestive issues

However, gaining weight consistently throughout your pregnancy by eating healthy foods reduces risk. If you are underweight, your gynecologist will talk to you about ways to improve your diet to help make you and your baby as healthy as possible. You should also make sure you are consuming at least 400 micrograms (mcg) of folic acid per day.

Conditions That Can Cause a High-Risk Pregnancy

  • If she is pregnant with more than one fetus
  • If she is 35 years old or older or 17 years old or younger
  • If she has had a premature baby before or a prior baby with a birth defect, especially heart or genetic problems

These are factors that relate to your health that are simply beyond your control—such as your age. For example, if you are over age 35, your pregnancy will automatically be considered high-risk, and you will receive more specialized exams and care. For example, your gynecologist may recommend certain genetic tests. The best thing you can do to regarding existing conditions that you cannot change is to keep your gynecologist well informed about any issues you have early on, and do everything you can to maintain a healthy lifestyle and diet.

It is important to note that while a pregnancy may begin as normal, a woman can develop new issues after pregnancy such as gestational diabetes, preterm labor, pre-eclampsia or placenta previa. 

  • Preterm Labor: Most normal pregnancies last 40 weeks. If you go into labor before your 37th week of pregnancy, it is called preterm labor. Women who are most at risk for preterm labor are women carrying multiple fetuses, have a history of premature labor or have a weak cervix or certain vaginal infections. A gynecologist may recommend bed rest as a way to reduce pressure on the cervix, so it is less likely to dilate.
  • Preeclampsia: Preeclampsia is a condition that causes blood clotting and/or impaired kidney and liver function. At highest risk are women who are carrying more than one fetus, women over 40, or women who have a family member who has had preeclampsia. Symptoms include high blood pressure, nausea, swelling, severe headaches and blood in the urine. If your symptoms are mild, your gynecologist may suggest bed rest. Once you give birth, preeclampsia will likely end.
  • Gestational Diabetes: When a pregnant woman develops high blood sugar, it is known as gestational diabetes. It occurs when the pancreas cannot produce sufficient insulin to counteract the pregnancy hormones that increase blood sugar. The primary concern with gestational diabetes is that it puts the baby at risk of being too big. Symptoms include increased urination and thirst, as well as blurred vision. If you have gestational diabetes, your gynecologist may recommend a high-fiber, low-sugar diet or insulin injections.
  • Placenta Previa: When the placenta abnormally covers the cervix, it is known as placenta previa. When this happens, portions of the placenta may tear and bleed during labor and delivery, causing the mother to hemorrhage. Women most at risk include those who are over 40, carrying multiple fetuses or have had C-sections or abortions. A common symptom is bleeding during the second or third trimester. In most cases, the placenta will move away from the cervix on its own, however, if it doesn’t your gynecologist may recommend bed rest. If bleeding persists, you may have to be hospitalized.