High-Risk Pregnancy

A high-risk pregnancy is when the mother and/or fetus are at higher risk for problems during pregnancy or labor than in a typical pregnancy. However, with proper medical care and controlling the risks, many women deliver a healthy baby.

At Newton-Wellesley OB/GYN, our team of physicians has extensive experience in providing support and treatment for high-risk pregnancies.

Several risk factors can make a pregnancy high-risk. These include:

• Maternal Age. Pregnancies at a young age (younger than age 17) or first-time pregnancies after age 35 are at a greater risk of complications than those between their late teens and early 30s.
• Lifestyle factors. Alcohol use, tobacco use, and drug use can put a pregnancy at risk.
• Conditions of pregnancy. Certain conditions can develop during pregnancy, such as multiple gestations (pregnancy with twins, triplets, or more); gestational diabetes; preeclampsia and eclampsia; previous preterm birth; congenital disabilities or genetic conditions in the fetus. Preeclampsia and eclampsia are serious conditions that can be fatal for both the mother and the fetus or cause long-term health problems.Preeclampsia is a sudden increase of the mother’s blood pressure, urinary protein, and swelling after the 20th week of pregnancy. Eclampsia is more severe and can cause seizures and coma.
• Existing health conditions. Health conditions, such as high blood pressure, diabetes, PCOS, kidney disease, autoimmune disease, thyroid disease, obesity, HIV/AIDs, and Zika infection, put a pregnancy at risk.

According to the Centers for Disease Prevention and Control (CDC), pregnant women with COVID-19 are at increased risk for severe illness and might be at risk for preterm birth. The full impact of infection with SARS-CoV-2, the virus that causes COVID-19, in pregnancy is unknown. The Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET) will continue to follow pregnancies affected by COVID-19 to term and infants until age 6 months to guide clinical and public health practice.

If you suspect you have a higher risk for problems during pregnancy, you should consult with one of our OB/GYN physicians before getting pregnant. Your doctor will work with you to develop a preconception plan to get healthy and have a healthy pregnancy. During your appointment, your doctor will ask you questions about your medical history, including pregnancy history (if any), your lifestyle and behaviors, your medications, and your vaccinations. Your doctor may also run tests (e.g., ultrasound, lab tests), adjust medications, or advise you of precautions to take before you become pregnant, including:

• Taking 400 micrograms of folic acid every day (helps prevent significant congenital disabilities of the baby’s brain and spine).
• Avoiding drinking alcohol, smoking, and using certain drugs.
• Reaching and maintaining a healthy weight.
• Ensuring existing medical conditions are under control.
• Learning your family history.
• Getting mentally healthy.

If you have a high-risk pregnancy, your OB/GYN physician will closely monitor you and your baby, which may require more prenatal appointments and testing (e.g., blood work or ultrasounds) than a traditional pregnancy. Be sure to go to all your doctor appointments and scheduled tests and closely follow your doctor’s advice and instructions.

Depending on any medical conditions that may come up or existing conditions that may flare-up, your doctor may have you see specialists to help monitor and manage your care. For example, if you have a preexisting kidney condition and your lab tests show an increase of protein in your urine, your OB/GYN may refer you to a nephrologist to help monitor your condition.

You need to be especially vigilant for a high-risk pregnancy and watch out for any of these signs and symptoms.

• Bleeding
• Cramps
• Contractions
• Faintness or Dizziness
• A Gush of Fluid
• A Change In Type or Odor of Vaginal Discharge
• A UTI
• A Headache
• Blurry Vision
• A Fever
• A Change in the Baby’s Movement

If you experience any of these symptoms, seek out immediate medical care. They may not amount to anything, but it is best to know for sure and see your doctor or go to the hospital to get checked out.

A high-risk pregnancy can be uneventful, especially when you receive proper monitoring and treatment throughout your pregnancy. Follow your doctor’s advice and take good care of yourself and your baby.

Newton-Wellesley OB/GYN offers high-risk pregnancy care in Newton and Walpole, Massachusetts. To schedule an appointment, call us in Newton at (617) 332-2345 or in Walpole at (508) 668-5555. For your convenience, you may also request an appointment online.