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High Risk Obstetrics

According to the National Institute of Child Health and Human Development, a high-risk pregnancy is one in which the mother, the fetus, or both are at an increased risk for complications during pregnancy or delivery than in a typical pregnancy. A pregnancy may be considered high-risk due to pre-existing health factors or conditions that develop during pregnancy.

Pre-existing Risk Factors

Certain pre-existing conditions or other factors can make a pregnancy qualify as high-risk. These include lifestyle factors and chronic health conditions. Risk factors may include:

  • Complications in past pregnancies
  • Diabetes
  • High blood pressure
  • Heart disease
  • Obesity
  • Being underweight
  • Kidney problems
  • Blood disorders
  • Cancer
  • Autoimmune disease
  • A history of uterine surgery
  • Advanced maternal age (35 or older)
  • Low maternal age (18 or younger)

Issues that Develop During Pregnancy

Women who do not have the above risk factors can sometimes experience complications that develop as the pregnancy progresses. These conditions may pose a risk to the mother, baby, or both.

  • Gestational diabetes: Diabetes that develops during pregnancy in a woman with no prior history of diabetes. Gestational diabetes increases the risk of the baby being too large, which makes delivery more difficult. Women with gestational diabetes are more likely to need a C-section.
  • Preeclampsia: High blood pressure that develops during pregnancy and can affect the liver, kidneys, and brain. Risks of preterm delivery and placental issues are also more common in women with preeclampsia.
  • Twins: The risks of preeclampsia, gestational diabetes, placental issues, and premature birth are higher for women carrying two or more babies.
  • Placental abruption: The placenta separates from the uterine wall early.
  • Placenta accreta: The placenta attaches to the uterine wall too strongly. This can cause bleeding and possibly lead to hemorrhaging during labor and delivery. 
  • Placenta previa: If the placenta is low in the uterus it may cover the cervix. This can lead to bleeding and early delivery.
  • Prenatal infections: Zika virus infection spread by mosquitos has been linked to increased rates of a birth defect called microcephaly. Other infections like listeriosis and toxoplasmosis do not always cause complications but have been linked to miscarriage, preterm labor, and birth defects.
  • Preterm labor: Labor that starts before 37 weeks of pregnancy. Babies born prematurely are more likely to have health and developmental issues and will likely need to stay in the NICU. 
  • Preterm premature rupture of membranes (PPROM): A membrane of the amniotic sac ruptures and leaks amniotic fluid before 37 weeks of pregnancy. 
  • HELLP Syndrome: A rare liver and blood-clotting disorder that most often develops in the third trimester. It is usually linked to high blood pressure or preeclampsia.

Managing High-Risk Pregnancy

How a high-risk pregnancy is managed depends on the factors that make it high-risk. If an underlying medical condition is present, then your healthcare team will work together to safely treat that condition throughout your pregnancy. If you develop complications during the pregnancy, then you should be treated and monitored based on those factors.

If you have a high-risk pregnancy, you may require more monitoring than the average pregnancy. Attending your regular prenatal appointments is critical. You will also need to keep any additional appointments your OB/GYN suggests. Your doctor may also recommend additional tests or procedures.

Women who have pre-existing risk factors or develop complications during pregnancy should consider seeing an OB/GYN experienced in managing high-risk pregnancies. The team at Kamm McKenzie OB/GYN has the experience and expertise required to manage these cases. Call us at 919-781-6200 to make an appointment. 

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3805 Computer Drive
Raleigh, NC 27609
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Durant Medical Center
10880 Durant Road, Suite 224
Raleigh, NC 27614
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