At Risk Pregnancy

It doesn’t matter if you are in your first pregnancy or your fifth; hearing the words “high-risk” can create a great deal of stress. The team at Grace Obstetrics and Gynecology is here to support you with comprehensive care and clear communication about the details of your pregnancy. As well as how you can manage optimal health for you and your baby.

What Is High-Risk Pregnancy?

There is a variety of conditions that may put a woman into the high-risk pregnancy category. Some of these conditions may be present prior to pregnancy, and some may develop sometime during the nine months leading to childbirth.

High-risk pregnancy does not translate into complications or a greater intensity of pregnancy conditions such as morning sickness. What it typically means is that there are aspects of the pregnancy that the obstetrics team will want to monitor more closely.

There may be the need for referral to the Maternal Fetal Medicine specialist for further evaluation or care.

What Causes High-Risk Pregnancy?

High-Risk Pregnancy can be caused by multiple reasons, some of which include but are not limited to:

• Multiples (twins or more)
• Abnormal bloodwork, such as alpha fetoprotein
• Previous miscarriages
• Lack of fetal development
• Previous pre-term labor
• Pre-eclampsia

Pre-Existing Conditions Related to High-Risk Pregnancy

• Seizure disorder
• Heart disease
• Diabetes
• Gastrointestinal or kidney disease
• Infectious disease such as herpes or sexually transmitted disease
• Conditions that affect blood-clotting
• Hypertension
• Obesity
• Advanced maternal age

If you have an existing health condition and want to become pregnant, schedule a consultation with your healthcare provider to discuss prenatal counseling and preconception care.

Can a High-Risk Pregnancy Affect Future Pregnancies?

Experiencing one high-risk pregnancy does not necessarily dictate that any future pregnancy will also carry higher risks. Since health conditions may change over time, every pregnancy itself is unique. Although, there seems to be one exception, pre-term labor. Women who have had one instance of pre-term delivery will most likely be monitored closely in subsequent pregnancies and may be managed with medication.

How Does Being High-Risk Affect My Labor?

Being High-Risk Pregnancy makes it difficult to anticipate how your labor experience will be. That is why it is advisable that you prepare yourself for the idea that birth may not go as you choose. You may not have the option of a home birth or attending a birthing center. Giving birth in a hospital may be necessary where you and your baby can be monitored closely and specialist care is available for assistance.

If you have a high-risk pregnancy preterm labor for many reasons, such as having too much amniotic fluid around the baby or other medical conditions. You may also need to have your labor induced to prevent or reduce health problems for you and your baby. Or there may be reasons why a vaginal birth isn’t possible and you need to have a c-section.

Talk to your provider about what you can expect during labor, so you can prepare yourself in the best way possible.

How Can I Reduce the Risk of Pregnancy Complications?

There are a few things you can do to reduce the risk of pregnancy complications when you’re high risk:

• Find out all you can about your condition and what you can do to stay healthy. Ask your provider for information.
• At your first prenatal visit, tell your provider about any current health problems you have, any medication you’re taking, and any difficulties you had in previous pregnancies.
• Go to all your prenatal appointments and follow your healthcare provider’s advice.
• Have a healthy lifestyle: Follow your provider’s nutritional guidance, gain the right amount of weight, and stay active if you’re able. Don’t smoke or drink alcohol.
• Look after your emotional well-being. Take time out for yourself and reduce your stress levels where you can.

What Are Chromosomal Problems?

One of the first-trimester screenings that are performed is an ultrasound to measure tissue at the back of the baby’s neck. This screening is usually performed between week 11 and week 14, and it serves as an early indicator for chromosomal abnormality such as Down syndrome. This screening also involves blood work to measure proteins in the mother’s blood.

Chromosomes are responsible for how our genes are organized. Every cell has 46 chromosomes that are paired off (one from the mother, one from the father); 23 pairs in all. In each chromosome are up to 5,000 genes. Due to this complex genetic structure, it is crucial that every chromosome is intact. Small discrepancies in numbers can create serious problems. The presence of too many chromosomes, or not enough, could lead to miscarriage. Although, some pregnancies with extra chromosomes, especially chromosome 21 (Trisomy 21, or Down syndrome), complete successfully.

What Is a Trisomy?

Trisomies are conditions in which there are three chromosomes rather than two. For example, Trisomy 21 describes the presence of three #21 chromosomes within cells. Two other trisomy conditions include Trisomy 13 and Trisomy 18, indicating a third chromosome of the given number.

What is the concern with Trisomy 13 and Trisomy 18?

Each of these trisomies is a genetic disorder that may cause birth defects. According to research, both Trisomy 13 (Patau syndrome) and Trisomy 18 (Edwards syndrome) typically result in death before 1 year of age. However, some babies do survive beyond this time; some reports indicate life expectancy into the teen years.

When Should I Contact My Healthcare Provider?

We support our patients in managing pregnancy in a way that increases the joy of the experience and decreases risks as much as possible. If you experience the following, contact your health care provider for prompt evaluation:

• Vaginal bleeding
• Abdominal pain or cramping
• Decreased fetal movement
• Painful urination
• Persistent headaches
• Vision changes, including blurriness
• Watery discharge