All Woman

Your pregnancy: high risk

Wednesday, May 28, 2014    

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A high-risk pregnancy might pose challenges before, during or after delivery. If you have a high-risk pregnancy, you and your baby might need special monitoring or care throughout your pregnancy.

What are the risk factors for a high-risk pregnancy?

Sometimes a high-risk pregnancy is the result of a medical condition present before pregnancy. In other cases, a medical condition that develops during pregnancy for either mom or baby causes a pregnancy to become high risk.

Specific factors that might contribute to a high-risk pregnancy include:

* Advanced maternal age. Pregnancy risks are higher for mothers age 35 and older.

* Lifestyle choices. Smoking cigarettes, drinking alcohol and using illegal drugs can put a pregnancy at risk.

* Medical history. A prior C-section, low birthweight baby or preterm birth — birth before 37 weeks of pregnancy — might increase the risks for subsequent pregnancies. Other risk factors include a foetal genetic condition, a family history of genetic conditions, a history of pregnancy loss or the death of a baby shortly after birth.

* Underlying conditions. Chronic conditions — such as diabetes, high blood pressure and epilepsy — increase pregnancy risks. A blood condition, such as anaemia, an infection or an underlying mental health condition also can increase pregnancy risks.

* Pregnancy complications. Various complications that develop during pregnancy pose risks, such as problems with the uterus, cervix or placenta, or severe morning sickness (hyperemesis gravidarum) that continues past the first trimester. Other concerns might include too much amniotic fluid (polyhydramnios) or too little amniotic fluid (oligohydramnios), restricted foetal growth or Rh (rhesus) sensitisation — a potentially serious condition that can occur when your blood group is Rh negative and your baby's blood group is Rh positive.

* Multiple pregnancy. Pregnancy risks are higher for women carrying twins or higher-order multiples.

* Overdue pregnancy. You might face additional risks if your pregnancy continues too long beyond the due date.

What steps can I take to promote a healthy pregnancy?

Whether you know ahead of time that you'll have a high-risk pregnancy or you simply want to do whatever you can to prevent a high-risk pregnancy, stick to the basics. For example:

* Schedule a preconception appointment. If you're thinking about becoming pregnant, consult your health care provider. He or she might counsel you to start taking a daily prenatal vitamin and reach a healthy weight before you become pregnant. If you have a medical condition, your treatment might need to be adjusted to prepare for pregnancy. Your health care provider might also discuss your risk of having a baby who has a genetic condition.

* Seek regular prenatal care. Prenatal visits can help your health care provider monitor your health and your baby's health. Depending on the circumstances, you might be referred to a specialist in maternal-foetal medicine, genetics, paediatrics or other areas.

* Eat a healthy diet. During pregnancy, you'll need more folic acid, calcium, iron and other essential nutrients. A daily prenatal vitamin can help fill any gaps. Consult your health care provider if you have special nutrition needs due to a health condition, such as diabetes.

* Gain weight wisely. Gaining the right amount of weight can support your baby's health — and make it easier to shed the extra pounds after delivery. A weight gain of 25 to 35 pounds (about 11 to 16 kilograms) is often recommended for women who have a healthy weight before pregnancy. If you're overweight before you conceive, you might need to gain less weight. If you're carrying twins or triplets, you might need to gain more weight. Work with your health care provider to determine what's right for you.

* Avoid risky substances. If you smoke, quit. Alcohol and illegal drugs are off-limits, too. Get your health care provider's OK before you start — or stop — taking any medications or supplements.

— Mayo Clinic

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