Common Complications in High-Risk Pregnancies
Introduction
A high-risk pregnancy means there are increased health dangers for the pregnant woman, the unborn child, or both. However, having a high-risk pregnancy does not necessarily mean issues will occur. Many women with additional medical needs still have healthy pregnancies and normal deliveries. Let’s take a look at some common complications in high-risk pregnancies.
What Causes High-Risk Pregnancies?
Several factors can cause high-risk pregnancies. Some of these include:
- Existing health issues in the mother before pregnancy
- Health problems that develop during pregnancy
- Lifestyle factors like smoking, drug use, alcohol abuse, or exposure to toxins
- The mother’s age (over 35 or under 17 at conception)
First pregnancies after age 35 are considered high-risk. Older mothers face increased risks like early pregnancy loss and gestational diabetes. Pregnancies under age 17 are also high-risk due to:
- Higher rates of anaemia
- Less consistent prenatal care
- Greater likelihood of preterm birth
- Potential undiagnosed sexually transmitted infections
Pre-existing Medical Conditions
Certain medical conditions can also cause high risks in pregnancies. These conditions include:
- Autoimmune diseases like multiple sclerosis or lupus
- COVID-19 infection
- Diabetes
- Uterine fibroids
- High blood pressure
- HIV/AIDS
- Kidney disease
- Being underweight (BMI under 18.5)
- Mental health disorders like depression
- Obesity
- Polycystic ovary syndrome (PCOS)
- Thyroid problems
- Blood clotting disorders
Pregnancy-Related Health Issues
Some complications can develop during the pregnancy itself that can make the pregnancy high-risk. These may include:
- Genetic disorder or birth defects in the baby
- Poor growth of the baby
- Gestational diabetes (diabetes during pregnancy)
- Multiple foetuses (twins, triplets, etc.)
- Preeclampsia (pregnancy-induced high blood pressure) and eclampsia (seizures)
- History of preterm labour/delivery or other problems in prior pregnancies
Signs and Symptoms of High-Risk Pregnancies
Contact your doctor immediately if you experience any of these symptoms in pregnancy, whether considered high-risk or not:
- Persistent abdominal pain
- Chest pains
- Dizziness or fainting
- Extreme fatigue
- Decreased foetal movement
- Fever over 100.4°F
- Rapid heartbeat
- Severe nausea and vomiting beyond morning sickness
- Severe headache that doesn’t go away
- Swelling, redness, or pain in the face or limbs
- Thoughts of harming yourself or the baby
- Trouble breathing
- Vaginal bleeding or discharge
Potential Complications in High-Risk Pregnancies
High-risk pregnancies can be life-threatening for mother or baby. Serious complications include:
- Preeclampsia (pregnancy-induced high blood pressure)
- Eclampsia (pregnancy-related seizures)
- Preterm (premature) delivery
- Caesarean delivery (C-section)
- Severe bleeding during labour, delivery, or postpartum
- Low or high baby birth weight
- Birth defects in the baby
- Problems with the baby’s brain development
- Admitting baby to a neonatal care unit
- Admission of mother to intensive care unit
- Miscarriage
- Stillbirth
Diagnosis and Testing During High Risk Pregnancies
Because of the increased risks involved, the diagnostic process is crucial in high-risk pregnancy situations to catch any potential issues early.
- Getting started with prenatal care as early as possible in the pregnancy is absolutely critical for detecting any high-risk conditions in time to treat them properly.
- It’s very important for expecting mothers to inform the doctors about their complete medical history, including details on any past pregnancies and complications.
- If a pregnancy is diagnosed as being high-risk, the mother will likely need to undergo extra monitoring and additional testing throughout the course of the pregnancy.
The specific testing will depend on the risk factors involved, but some common tests include blood tests and urine tests designed to screen for genetic issues, birth defects, and other abnormalities.
- Ultrasound imaging using sound waves is frequently used to visually examine the foetus for any potential problems or congenital conditions.
- Biophysical monitoring of the foetus checks vitals like breathing, movement, heart rate, and oxygen levels to ensure the baby is developing properly and getting adequate oxygen supply.
Managing and Treating High Risk Pregnancies
The management and treatment plan for a high-risk pregnancy will depend on what the specific risk factors are in each case. However, there are some common aspects of treatment.
- Expecting mothers will need to follow up with their obstetricians, the doctors providing prenatal care, much more frequently than in normal pregnancy cases.
- They may also be referred to consult with maternal-foetal medicine specialists who are experts in dealing with high-risk and complicated pregnancies.
- If other specific medical conditions are present, the mother may need to see other specialists as well, such as cardiologists for heart issues, endocrinologists for diabetes, etc.
- More frequent ultrasounds and closer monitoring of the foetus will be required compared to a normal pregnancy.
- The mother may need to use a home blood pressure cuff to check her blood pressure routinely.
- Any medications the mother was already taking will need to be carefully evaluated to ensure they are safe to continue during the pregnancy course.
Suppose the health of the mother or baby deteriorates and is in grave danger. In that case, the doctor may recommend inducing labour early or scheduling an urgent caesarean delivery as a lifesaving measure.
Prevention and Reducing High Risk Factors
While some high-risk factors for pregnancy may be unavoidable, there are some proactive steps women can take which may reduce their overall risks and complications.
- Avoiding recreational drugs, alcohol abuse, and smoking cigarettes during the pregnancy (and ideally, before conception as well) is wise.
- Before even trying to become pregnant, women should discuss any existing health issues or potential risk factors with their doctors.
- Following the advice to achieve and maintain a healthy body weight or body mass index (BMI) before getting pregnant is recommended.
- For women already dealing with chronic health conditions, ensuring those conditions are properly managed and under control is important.
- Making sure any long-term prescription medications have been approved as safe for use in pregnancy is crucial, too.
- Practising safe sex to prevent potential sexually transmitted infections that could affect the baby is a must.
In general, women who are able to plan their pregnancies between the ideal age window of 18 and 34 are at the lowest overall risks from an age perspective.
Prognosis and Long Term Outlook
The good news is that many women who experience high-risk pregnancies still manage to deliver healthy babies and get through the pregnancy with no significant complications in the end. However, high-risk pregnancies do increase the chances of other health problems arising later on, both for the mothers and the children.
Risks for the mothers after a high-risk pregnancy include:
- Increased chances of complications in any future pregnancies.
- A higher susceptibility to postpartum depression after delivery.
- Developing chronic conditions such as type 2 diabetes, heart disease, or even high blood pressure.
- Having an increased future stroke risk.
Babies born from high-risk pregnancies may face various long-term effects, even if they appeared healthy initially. They are more prone to:
- Behavioural problems
- Breathing or respiratory issues
- Gastrointestinal conditions like reflux
- Delays in achieving normal growth and development milestones
- Increased risks of mental health disorders
- Neurological problems impacting the brain and nervous system function
- Obesity and diabetes later in life
- Vision, hearing, or dental abnormalities.
Living and Coping with High Risk Pregnancies
Even though the birth itself marks the end of the pregnancy, the period immediately afterwards is still a sensitive time. Serious complications related to the pregnancy can develop up to six weeks after the delivery.
- Women who go through high-risk pregnancies need to pay very close attention to any potential symptoms and overall health status during the entire postpartum period.
- Any abnormal issues or “red flag” symptoms like bleeding, severe headaches, vision problems, etc., need to be reported to the doctor immediately and could require emergency medical care.
- Frequent follow-up visits are recommended.
Conclusion
While high-risk pregnancies require extra care and monitoring, many result in positive outcomes with healthy moms and babies. Various factors like age, pre-existing conditions, or pregnancy complications can increase the risks. Work closely with your medical team, follow prevention tips, and observe for any warning signs. With proper management, high-risk pregnancies can have an excellent prognosis. If you have any other questions, let your doctor know.