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High-Risk Pregnancy - Symptoms, Diagnostic Tests, Management, and Prevention

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A high-risk pregnancy means increased health issues for both the mother and the baby. During high-risk pregnancy, extra care is required.

Written byDr. P. V. Anoohya

Medically reviewed byDr. Priyadarshini Tripathy

Published At January 4, 2023
Reviewed AtSeptember 16, 2024

Introduction:

High-risk pregnancy is very tough to identify and should be done beforehand to avoid any complications to the mother during delivery and to the baby. Generally, pregnancies will have some risk factors, however, in the case of high-risk pregnancy, both the mother and the fetus's health will have complications. So the mother should be cared for during the pregnancy, delivery, and post-pregnancy period.

What Is Meant by High-Risk Pregnancy?

Every pregnancy has its own risk. However, high-risk pregnancy is its own, which has enhanced health risks for the pregnant woman, the fetus, or both. Those women who have high-risk pregnancies should be given extra care during and after pregnancy. This helps to reduce the risk of complications. High-risk pregnancy does not mean that the woman and the fetus may have health complications; many high-risk pregnant women have experienced normal delivery and a healthy pregnancy.

What Are the Causative Factors of High-Risk Pregnancy?

The causative factors of high-risk pregnancy are:

  1. Prior history of miscarriages.

  2. Prior history of delivery before the full term.

  3. Medical history of heart disease.

  4. Increased blood pressure during pregnancy.

  5. If the pregnant woman is diabetic.

  6. Presence of twins or more fetuses in the womb.

  7. Increased blood loss at the time of gestation.

  8. Detachment of the placenta before the delivery of the baby.

  9. Prior-term labor pain.

  10. Hemolytic anemia is the destruction of the RBCs (red blood cells).

  11. Reduced platelets, which are required for blood clotting.

  12. Medical history of bleeding disorders.

  13. Thalassemia-inherited blood disorder where hemoglobin (an oxygen-carrying protein) and red blood cells are reduced.

  14. Blood clots and blocked arteries and veins.

  15. Seizures.

  16. Ruptured blood vessels can result in bleeding within the brain and can cause hemorrhage.

  17. Cervical, ovarian, and breast cancers.

  18. Presence of fibroids in the uterus.

  19. Congenital disabilities to the fetus.

  20. Antiphospholipid syndrome is a condition where the immune system act of the normal proteins present in the body.

  21. Prior Cesarean delivery.

  22. Cephalopelvic disproportion (CPD) is a condition where the baby cannot pass through the birth canal.

  23. Prolonged labor pain.

  24. Shoulder dystocia is a condition where one or both the shoulders of the baby get stuck in the pelvis region.

  25. Retained placenta..

  26. Misplaced position of the uterus.

  27. Disruption of the uterus.

  28. If the blood group of the mother is Rh-negative.

  29. Presence of low-lying placenta.

  30. Smoking and consumption of alcohol.

  31. The mother's younger age, below seventeen, is also a high-risk pregnancy.

What Are the Symptoms of a High-Risk Pregnancy?

  • Severe abdominal pain.

  • Loss of consciousness.

  • Weakness.

  • Fetal movement is decreased.

  • High-grade fever.

  • Palpitations of the heart.

  • Shortness of breath.

  • Severe nausea and vomiting.

  • Headache.

  • Increased bleeding from the vagina.

What Are the Problems Associated with High-Risk Pregnancy?

The high-risk symptoms in pregnant women are:

In the First Trimester:

  • Ectopic pregnancy is where the fertilized egg fails to develop within the uterus and grows outside and damages the other organs.

  • Increased chances of abortion.

  • A non-cancerous tumor can develop within the uterus and result in a non-viable pregnancy.

  • Rupture of the uterus.

In the Second Trimester:

  • When the cervical tissue is weak it can result in premature birth.

In the Third Trimester:

  • The opening of the uterus and the cervix is covered by the placenta either entirely or partially.

  • The growth of the placenta extends deep into the uterine wall..

  • Increased bleeding after the delivery of the baby.

  • There may be uterine abruption.

  • There is a collapse of the uterine fundus into endometrial activity.

  • There is increased blood pressure.

What Are the Diagnostic Tests for a High-Risk Pregnancy?

The Non-invasive Diagnostic Tests Are:

  • Fetal Ultrasound: This produces sound waves to produce a picture of the fetus.

  • First Trimester: In the first trimester, a fetal ultrasound is done to determine how the pregnancy progresses and whether there is more than one fetus, to enumerate the duration of gestation of the fetus, and to estimate the chromosomal and congenital disabilities that affect the brain and spinal cord.

  • Second Trimester: In the second trimester, observe the size and position of the fetus, placenta, and amniotic fluid. It also detects neural tube defects and heart problems.

  • Third Trimester: In the third trimester, for the movement of the fetus.

  • Cardiotocography: Cardiotocography records the heartbeat of the fetus and uterine contractions during gestation, and the machine is a cardiotocograph.

  • Nonstress Test: A nonstress test is advised for women at increased risk of fetal death. Usually done at 26 weeks of gestation, it monitors fetal heart rate.

The Invasive Diagnostic Tests Are:

  • Chorionic Villi Sampling: These are tiny structures in the placenta. They contain cells that are removed through a needle. This is done before 15 weeks to determine genetic disorders in the fetus.

  • Amniocentesis: This test looks for congenital disabilities and genetic problems.

  • Embryoscopy: Direct visualization of the fetus.

  • Fetoscopy: Allow surgical access to the fetus.

  • Contraction Stress Test: This is performed near the end of delivery to observe how the fetus will tolerate the contractions during childbirth.

What Is the Management for High-Risk Pregnancy?

  • Check up with the gynecologist frequently.

  • A complete history of the pregnant woman is prior pregnancy history if any, family history, and pre-existing disorders history.

  • Make a note of the blood pressure and other vital signs frequently.

  • Conduct ultrasounds and other diagnostic procedures and perform correct fetal evaluations to provide the proper treatment.

  • Monitor the medications used during the gestation period correctly.

  • A multi-treatment approach must be followed to treat complications during gestation appropriately.

  • Another medical physician consultation is also recommended.

  • In case of fetal distress, there is not enough oxygen for the baby, immediately provide oxygen support medications and fluids to pregnant women or change the position.

  • Opt for early delivery if there is a high risk for both the mother and the fetus.

  • Emergency C-sections are performed in critical cases to reduce health risks.

What Is the Prevention for High-Risk Pregnancy?

  • Complete avoidance of cigarettes and alcohol during gestation.

  • Opting for a healthy lifestyle and correct body mass index before pregnancy.

  • Prohibiting intake of high-dosage drugs.

  • Supervising drugs consumed during gestation is safe, and long-term drug usage is not recommended.

Some common complications are

  • Gestational hypertension.

  • Preterm delivery.

  • Low birth weight.

  • Cesarean delivery.

  • Extreme bleeding during labor or after birth.

  • Stillbirth.

  • Miscarriage.

  • Birth defect.

  • Intensive care unit admission for the mother and Neonatal intensive care unit for the child.

What Is the Prognosis of High-Risk Pregnancy?

Most of the women who are in high-risk pregnancy do not face any issues during delivery. However, they may have problems in the future, such as

  • Postpartum depression.

  • Increased blood pressure.

  • Stroke.

  • Type 2 diabetes.

  • Cardiovascular conditions.

Some complications that the baby faces are:

  • Respiratory issues.

  • Behavioral problems.

  • Vision, hearing, and dental issues.

  • Neurological issues.

  • Obesity.

  • Diabetes.

  • Delay in growth and development.

Conclusion:

Proper management of the risks and timely treatment modalities can ensure safe delivery. A high-risk pregnancy can cause severe side effects to the fetus and cause lifelong problems and brain disorders. Report to the doctor as soon as possible in cases of severe symptoms. Preliminary information regarding the risks to the pregnant woman is mandatory. Educating the mother regarding the dangers of consuming alcohol and other illicit substances during gestation. The ultimate goal is to maintain the health of the mother and fetus and the delivery of a baby without any potential threat. Motivating pregnant women to undergo specialized tests and scanning procedures to interpret the risks beforehand is also important.

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Frequently Asked Questions

 
A high-risk pregnancy is when the pregnant woman, fetus, or both face higher health risks. Certain health issues, such as age (being above 35 or under 17 while pregnant), might increase the likelihood of a pregnancy. To limit the possibility of problems, these pregnancies must be closely monitored.
Eating a nutritious diet, limiting exposure to chemicals and dangerous environmental variables, exercising, getting enough sleep, and avoiding stressful circumstances are all good ways to start.
 
Many women with high-risk pregnancies give birth to healthy kids without any issues. However, they may be more vulnerable to future health issues, such as Complications with subsequent pregnancies.
The following are the four types of high-risk pregnancy:
- Premature or Term Labor - Women are in preterm or premature labor if they start having consistent contractions before the 37th week of their pregnancy.
- Preeclampsia - A potentially harmful pregnancy condition marked by hypertension.
- Gestational Diabetes - A kind of elevated blood sugar that affects expectant mothers.
- Placenta Previa - Placenta previa is a condition that prevents a woman from giving birth vaginally because the placenta has been deposited at the base of the uterus, over the cervix, or nearby.
 
 
Stress during pregnancy may cause high-risk pregnancy and increase the risk of having a preterm baby (born before 37 weeks) or a kid with low birthweight (less than 5 pounds, 8 ounces).
 
The majority of miscarriages happen before the 12th week of pregnancy. Vaginal bleeding or spotting are two possible signs and symptoms of a miscarriage.
No evidence exists that stress causes miscarriage, even though it is bad for your general health.
In the early and middle stages of high-risk pregnancy, women will have at least two ultrasounds, and depending on their health requirements and circumstances, some may have ultrasounds as frequently as once per week in the latter stages.
Yes, pregnancy-related issues or difficulties are more likely to affect women with polycystic ovarian syndrome (PCOS). Additionally, newborns delivered to moms who have PCOS are more likely to require treatment in the neonatal critical care unit.
Yes, brisk walking, swimming, stationary cycling, low-impact aerobics, yoga or pilates, and jogging are all acceptable activities for pregnant women.
Certain doctors recommend bed rest for illnesses such as infant growth issues, high blood pressure or preeclampsia, vaginal bleeding from placenta previa or abruption, premature labor, cervical insufficiency, threatening miscarriage, and others.
Sleep should never be viewed as a luxury. It is especially important when women are pregnant. In reality, pregnant women require a few extra hours of sleep per night or should supplement their nocturnal sleep with naps throughout the day.
If a woman is 17 or younger, her pregnancy can be deemed high risk. 
The following are typical warning signs and symptoms of a high-risk pregnancy:
- Abdominal discomfort.
- Ache in the chest.
- No or little fetal movement.
- Extreme tiredness.
- Feeling dizzy or faint.
- A racing heart.
- Vomiting and nauseous.
Many women with high-risk pregnancies give birth to healthy kids without any issues. However, they may be more vulnerable to future health issues, such as Complications with subsequent pregnancies.
 
If a woman has any pre-existing medical issues, such as diabetes, high blood pressure, or HIV positivity, obesity and being overweight are more prone to high-risk pregnancy.
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Dr. Priyadarshini Tripathy from iCliniq
Dr. Priyadarshini Tripathy

Obstetrics and Gynecology

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