Special delivery: A guide to high-risk pregnancies

Every pregnancy is special, but we’re here to tell you why some might require a little extra TLC.

Many moms-to-be spend their nine months prepping for the arrival of their new addition, and while most fret about remembering to take their prenatal vitamins, some have a little something extra to worry about. A number of expectant mothers’ pregnancies are complicated due to existing factors or other conditions that have the potential to develop. A pregnancy that has a greater likelihood for complications than others is known as “high risk”.

Since many mothers go into their pregnancies knowing they have a chronic illness, their pregnancy will fall into the high-risk category from the beginning—but that doesn’t mean it’s doomed for failure.

“Many conditions may lead to a high-risk pregnancy,” says Courtney Sinclair, OB/GYN. “These would include preventable things such as smoking and the consumption of alcohol, as well as chronic preexisting conditions like asthma, hypertension and diabetes. Other things may develop during the pregnancy such as premature rupture of membranes, preterm labor, gestational diabetes and preeclampsia.”

Numerous medical conditions can cause a pregnancy to be termed high risk, but the mother’s health issues are not the only reason such a pregnancy may occur; it can also be due in part to the baby’s condition.

“An ultrasound may identify findings in the baby that can cause the pregnancy to be viewed as high risk, such as if the baby has too much (polyhydramnious) or too little (oligohydramnious) amniotic fluid, or if there are anatomical changes such as fluid around the brain or heart defects,” says Dr. Sinclair. If an abnormality is detected during an ultrasound, your doctor might suggest further testing to better pinpoint possible developing conditions that could affect you and your baby.

Each chronic condition has its own course of treatment during a pregnancy, and that’s why it is imperative that you see your doctor regularly. One fairly common condition is asthma. If you have asthma and you suffer from frequent attacks, treat them promptly to avoid depriving your growing baby of oxygen, and work out a care plan with your physician in case an attack does not subside with normal treatment. Asthma can also affect the labor process. “Asthmatics may not be able to tolerate labor if [their asthma] is not well controlled, and they may need an epidural or a C-section,” notes Dr. Sinclair.

Diabetes is another condition that needs to be monitored closely during pregnancy. Dr. Sinclair explains, “With diabetes, whether chronic or gestational, keeping your blood sugar tightly controlled (not too high or too low) is extremely important to the [health] of the baby.

Complications can include anatomical problems, as well as macrosomia and low blood sugar for the baby after birth.” If you need insulin, you will likely need more as your pregnancy progresses, so be sure to make the necessary adjustments in your routine to facilitate the proper care of your diabetes.

If you have a history of complications or prior failed pregnancies, you may also be at an elevated risk level. An earlier pregnancy that resulted in a miscarriage or stillbirth could put you at a higher risk for problems, but it doesn’t mean that your current pregnancy will result in a similar outcome. Countless moms who miscarry go on to have normal pregnancies with healthy, happy babies.

Some physicians will recommend bed rest for a mom who is at risk for premature labor to ensure the mother will be under the least amount of physical stress possible. “Bed rest is often recommended for conditions like premature rupture of membranes, elevated blood pressure, placenta previa and premature contractions,” says Dr. Sinclair. “Bed rest may help you to deliver a full-term baby.” Remember that even if you’re not required to be on bed rest, allowing yourself some extra R&R is beneficial, since it can help you de-stress and feel better overall.

If your chronic illness requires daily medication, inform your physicians of all medicines you are taking to make sure they’re safe for your developing child, and remember not to ignore any sudden illnesses you experience during your pregnancy.

A simple urinary tract infection, if left untreated, can cause your kidneys to become inflamed and could actually lead to premature labor. Even something that seems like a common cold may need to be treated to avoid a worsening respiratory condition. Try your best not to expose yourself to illnesses by adopting good hand-washing practices.

A high-risk pregnancy is certainly something to treat with caution, but most are manageable when monitored carefully. Due to recent advances in medical technology, women who would have otherwise been discouraged from having children are being given the go-ahead by their physicians to add to their family.

Sadly, the most devastating effects of a high-risk pregnancy are often psychological in nature. If you’re worried all the time about every little thing that could go wrong during your pregnancy, you’ll miss the wonderful excitement and anticipation of becoming a mom. With good health practices and regular visits to your doctor, a high-risk pregnancy can be successfully managed, resulting in a good outcome for both you and your baby.