High-Risk Pregnancy: Causes, Symptoms, and When to See a Doctor

Finding out you're pregnant comes with a rush of excitement, along with hopes and plans for the little one you're about to bring into the world. More than anything, you just want the pregnancy to go smoothly for both you and your baby. But sometimes, things don't go quite as expected. There are certain health conditions or complications that can impact the health of the mother or baby, in which case the pregnancy may be classified as high risk. Whether you're seeing concerning signs, or have already been diagnosed as having a high-risk pregnancy, understanding what it means can help. 

What Can Make a Pregnancy High Risk?

A pregnancy may be considered high risk when certain factors increase the chances of health complications for the mother, baby or both. Some of these factors may be present before pregnancy, while others can develop as the pregnancy progresses. These include:

Existing Health Conditions

Certain medical conditions present before pregnancy can affect the health of the mother or baby during pregnancy. These may include diabetes, high blood pressure, heart disease, kidney disease, thyroid disorders, autoimmune conditions and certain blood disorders.

Such conditions may require closer monitoring throughout pregnancy. Medicines may also need to be reviewed or adjusted to ensure that the underlying condition remains controlled while keeping pregnancy safety in mind.

Pregnancy Complications

Some complications develop only after pregnancy begins and may increase the need for monitoring. These can include gestational diabetes, high blood pressure, pre-eclampsia, problems involving the placenta, abnormal amounts of amniotic fluid and concerns about the baby's growth or development.

Some of these conditions may not cause noticeable symptoms in the early stages, making routine antenatal check-ups particularly important.

Complications in Previous Pregnancy

A previous pregnancy does not necessarily determine how a future pregnancy will progress. However, a history of certain complications can influence the level of monitoring recommended during a subsequent pregnancy.

Previous preterm birth, pregnancy loss, stillbirth, pre-eclampsia, gestational diabetes or other significant complications may prompt an obstetrician to assess the current pregnancy more closely.

Multiple Pregnancy

Pregnancies involving twins, triplets or more babies generally require closer monitoring than singleton pregnancies. Multiple pregnancies have a greater likelihood of complications such as premature birth and differences in fetal growth.

Additional scans and more frequent appointments may therefore be recommended to monitor the health and development of both the mother and babies.

Age 

Age is one of the several factors considered when assessing pregnancy risk. Pregnancy during adolescence and pregnancy at an advanced maternal age can be associated with certain increased risks.

However, age alone does not determine whether a pregnancy will be high risk. Overall health, medical history and the progress of the pregnancy are also taken into account.

Weight and Lifestyle

A higher body weight before or during pregnancy can increase the likelihood of conditions such as gestational diabetes, high blood pressure and pre-eclampsia. Smoking, alcohol consumption and recreational drug use can also affect pregnancy and fetal health.

Medical advice can help address these factors safely during pregnancy. Sudden dietary changes, restrictive diets or changes to prescribed treatment should not be undertaken without professional guidance.

Infections

Certain infections can affect pregnancy depending on the type of infection, when it occurs and whether treatment is provided. Some may increase the risk of complications for the mother or baby and may require additional tests, treatment or monitoring.

Routine screening and antenatal care can help identify some infections early, including those that may not initially cause noticeable symptoms.

Medicines

Some medicines are not recommended during pregnancy, while others may require dose adjustments or additional monitoring. Certain supplements and substances can also affect pregnancy.

Medication use should therefore be discussed with an obstetrician, including prescription medicines, over-the-counter products and supplements. Prescribed treatment should not be stopped or changed without medical advice.

Screening Findings

A pregnancy may also be considered higher risk following a finding during an ultrasound or prenatal screening test. This may relate to fetal growth, development, the placenta, amniotic fluid or another aspect of the pregnancy.

An unusual screening result does not automatically mean that a problem is present. Additional testing may be recommended to understand the finding more clearly and determine whether further monitoring is needed.

Symptoms of a High-Risk Pregnancy

A high-risk pregnancy does not always have noticeable symptoms. However, certain symptoms during pregnancy can indicate a possible complication and should be assessed by a healthcare professional. Some of the important high-risk pregnancy symptoms you should watch out for  include:

• Vaginal Bleeding: Bleeding during pregnancy can have different causes. Heavy bleeding, particularly when accompanied by pain or other symptoms, requires prompt medical assessment.

• Severe Abdominal Pain: Persistent or intense abdominal or pelvic pain may indicate a complication and should not be ignored.

• Severe Headache: A severe or persistent headache, particularly later in pregnancy, can be associated with high blood pressure or pre-eclampsia.

• Vision Changes: Blurred vision, flashing lights or other sudden changes in eyesight can occur with conditions such as pre-eclampsia and require medical attention.

• Sudden Swelling: Mild swelling can occur during pregnancy, particularly in the feet and ankles. Sudden or marked swelling of the face, hands or feet can be more concerning, especially when accompanied by headache or vision changes.

• Reduced Baby Movement: Once regular fetal movements have been established, a noticeable reduction or change in movement should be reported to the maternity care team.

• Fluid Leakage: Fluid leaking from the vagina may indicate that the amniotic sac has ruptured and should be evaluated.

• Breathing Difficulty: Mild breathlessness can be common during pregnancy, but sudden or severe difficulty breathing can indicate a serious problem and requires urgent attention.

• High Fever: A high temperature during pregnancy may indicate an infection and should be assessed, particularly when accompanied by other symptoms.

• Severe Vomiting: Persistent or severe vomiting can lead to dehydration and may require medical treatment.

How is a High-Risk Pregnancy Managed?

There is no single treatment plan for every high-risk pregnancy. Management depends on the reason for the increased risk, the mother's health, the baby's wellbeing and how the pregnancy progresses.

Common approaches to managing a high-risk pregnancy include:

Monitoring

More frequent antenatal appointments may be recommended to monitor the mother's health and identify changes early. Blood pressure, weight, symptoms and other relevant health indicators may be assessed during these visits.

The frequency of appointments varies according to individual risk. Some pregnancies may need only occasional additional monitoring, while others may require more frequent follow-up.

Additional Testing

Additional blood tests, urine tests, blood pressure checks, blood sugar monitoring or other investigations may be recommended depending on the underlying risk factor.

These tests allow the healthcare team to monitor existing conditions and identify potential pregnancy complications as early as possible.

Ultrasound Scans

Additional ultrasound scans may be used to monitor fetal growth, development, the placenta, amniotic fluid and other aspects of pregnancy.

The timing and frequency of scans depend on the individual circumstances and the specific concern being monitored.

Fetal Monitoring

Depending on the stage of pregnancy and the associated risk, fetal monitoring may be used to assess the baby's wellbeing. This can include monitoring the baby's heart rate, movements and growth.

The type of monitoring recommended will depend on the pregnancy and the reason for increased risk.

Medicines and Treatment

Certain high-risk conditions can be managed with medicines, dietary changes, monitoring or other treatments. For example, blood pressure or blood sugar may need to be controlled during pregnancy to reduce the risk of complications.

Treatment is tailored to the specific condition and stage of pregnancy. Medicines should always be taken according to medical advice, with any changes discussed with the treating doctor.

When Should You See A Doctor?

Medical advice should be sought promptly in the following situations:

• Heavy Bleeding: Heavy vaginal bleeding or bleeding accompanied by severe pain requires urgent assessment.

• Severe Pain: Severe or persistent abdominal pain should be evaluated, particularly when it occurs suddenly or is accompanied by bleeding.

• Severe Headache: A severe headache that does not improve, especially when accompanied by swelling or vision changes, can require urgent assessment.

• Vision Changes: Sudden blurred vision, flashing lights or other significant changes in vision should be reported immediately.

• Reduced Movements: A noticeable reduction or change in the baby's usual movements warrants prompt contact with the maternity care team.

• Fluid Leakage: Suspected leakage of amniotic fluid should be assessed by a healthcare professional.

• Breathing Problems: Sudden difficulty breathing, particularly with chest pain, fainting or severe dizziness, requires immediate medical attention.

• High Fever: A high temperature or fever accompanied by chills, weakness or other signs of infection should be medically assessed.

• Feeling Seriously Unwell: A sudden or significant change in general health should not be ignored, even when the cause is unclear.

For women already receiving care for a high-risk pregnancy, the obstetrician may provide specific instructions about symptoms that require a call, hospital visit or emergency treatment

Consult an Obstetrician at Sterling Hospitals

A high-risk pregnancy can bring many questions, but the right medical support can make the journey easier to navigate. Obstetricians at Sterling Hospitals can assess individual risk factors, monitor the health of the mother and baby, and recommend appropriate investigations, treatment and follow-up when needed. For expert guidance during pregnancy or specialised care for a high-risk pregnancy, consult an obstetrician at Sterling Hospitals and discuss the best care approach for a healthy pregnancy and delivery.