High-risk pregnancy: causes and how to manage it

By (embryologist) and (embryologist).
Last Update: 02/22/2024

A high-risk pregnancy is one in which the mother, the fetus or both are likely to suffer some type of complication both during the gestational period and during delivery, even endangering the lives of both.

The causes of high-risk pregnancies are diverse, but it is certain that the woman's age plays an important role in this regard.

In these cases, it is essential to attend medical check-ups and follow all the guidelines established by the specialist to avoid possible dangers during pregnancy.

What does risky pregnancy mean?

A risky pregnancy is a pregnancy that poses a certain risk to the life of the mother, the fetus or both. This type of pregnancy requires more medical attention.

Currently, the probability of a risky pregnancy occurring in Spain is around 15%. In some cases, pregnancy becomes risky as the weeks progress.

However, at other times, a woman is at risk even before she becomes pregnant due to certain personal circumstances. For example, if the woman has diabetes, high blood pressure or any other pathology, her pregnancy may be considered at risk.

What are the causes of risky pregnancy?

High-risk pregnancy usually occurs in women who have some type of disease prior to pregnancy or that they develop during pregnancy itself (e.g., gestational diabetes). These diseases are usually:

  • Diabetes
  • Cancer.
  • Hypertension
  • Renal problems.
  • Epilepsy.
  • Infections (cytomegalovirus, rubella, varicella, toxoplasma...).
  • Malformations in the uterus.
  • Placenta previa.

Hence, the importance of visiting a specialist before becoming pregnant if you suffer from any type of disease. He will control the medication (if necessary) during the gestation period and will give us guidelines to follow during the gestation period.

In addition, a family history of genetic diseases, miscarriages or premature deaths may also interfere with pregnancy.

Risk Factors

Some of the risk factors that lead to a possible high-risk pregnancy may include the following:

  • The mother's age: the probability of suffering a risky pregnancy is higher in mothers over 35 years of age.
  • Addictions: smoking, drinking alcohol and drug use can lead to a risky pregnancy.
  • Medical history: having had a cesarean section or premature delivery may increase the chances of having a risky pregnancy.
  • Underlying diseases: certain diseases such as diabetes, high blood pressure or epilepsy increase the risks in pregnancy, as does anemia. Suffering from an infection or mental illness may increase these risks.
  • Complications during pregnancy: there are several pathologies that may arise during pregnancy that pose health risks to mother and baby, such as problems in the cervix, placenta or severe nausea (hyperemesis gravidarum) that continue beyond the first three months. Other problems may be related to the amniotic fluid.

In addition to all these risk factors, women with an elevated body mass index or who have a multiple pregnancy are also likely to have their pregnancy classified as high risk.

Recommendations

Some of the points to consider in a high-risk pregnancy are pregnancy monitoring and birth planning.

Here are some tips on how to deal with a risky pregnancy so that the baby's birth goes well. It is important that the woman should be relaxed, but follow all the recommendations of specialists.

Exhaustive medical control

Women who have a high-risk pregnancy require exhaustive and continuous medical monitoring. These patients will have to undergo prenatal check-ups, more ultrasounds than in a conventional pregnancy, blood and urine tests, etc. In addition, the woman should inform her physician of any discomfort she may have throughout the weeks of pregnancy.

Today, technology makes it much easier to monitor the condition of the fetus and the mother, thanks to 4D ultrasound scans, for example, or Doppler studies that allow in-depth monitoring of the baby's condition.

Living a healthy lifestyle

The pregnant woman should follow a healthy and balanced diet throughout her pregnancy, especially if it is considered high risk. Eating whole grains, fish, white meats, etc. and avoiding the consumption of sweets and coffee, for example, are some of the recommendations to follow during pregnancy.

In addition, women should not drink alcohol during pregnancy as it increases the likelihood of fetal malformations and premature delivery.

Smoking and other drugs should not be taken during pregnancy either, as they can seriously complicate the pregnancy to the point of making it a high-risk pregnancy.

Birth planning

The timing of delivery should be planned, although this does not mean that it will necessarily be by cesarean section.

However, in high-risk pregnancies, labor is usually induced and monitored at all times to avoid endangering the health of the woman and/or her baby.

Psychological support

Parents who find themselves in this situation often require psychological support, since what was supposed to be a sweet moment in their lives has become a source of worry and uncertainty that can create a state of nervousness and anxiety.

The woman will require a greater degree of attention and support from both her partner and the physician with whom it is preferable to establish a relationship of trust.

Some experts say that it helps to talk to other parents who have experienced the same situation when dealing with a high-risk pregnancy.

FAQs from users

Can high-risk pregnancy be prevented?

By Marta Barranquero Gómez B.Sc., M.Sc. (embryologist).

In some cases, it is possible to reduce the likelihood of it occurring before becoming pregnant.

For example, in women who suffer from illnesses, it is important that they inform their doctor of their decision to have a baby beforehand. The specialist will then indicate the best way to proceed so that the pregnancy does not pose any danger to either the woman or the baby.

Is absolute rest necessary in an at-risk pregnancy?

By Marta Barranquero Gómez B.Sc., M.Sc. (embryologist).

There are several situations in which the specialist will indicate that it is best to do absolute rest during pregnancy. For example, those women with a risky pregnancy and threatened miscarriage, it is advisable to perform absolute rest.

Similarly, if the cause of the risky pregnancy is placenta previa, the presence of intrauterine hematomas or preeclampsia, for example, it would also be advisable for the woman to remain lying in bed.

What are the risks I should expect during pregnancy if I have PCOS?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Some studies have shown that women with PCOS have a greater risk of miscarrying. Moreover, there are other obstetric complications to keep in mind, including:

  • Gestational diabetes
  • Preeclampsia
  • Low birth weight
  • Preterm birth
  • C-section

For these reasons, women with PCOS are more likely to go through a high-risk pregnancy.
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Suggested for you

The age of the woman is a very important factor in assessing risk in pregnancy. If you would like to learn more about the optimal age to have a baby and be safe, we recommend you visit the following article: What is the best biological age to become a mother?

If, on the other hand, you are interested in learning more about pregnancy control, we invite you to visit the following link: Prenatal pregnancy control: tests, analyses and ultrasound scans.

We make a great effort to provide you with the highest quality information.

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References

Hamilton, B. E., Martin, J. A., Osterman, M. J. K., Curtin, S. C., & Mathews, T. J. (2015). Births: Final data for 2014. National Vital Statistics Reports, 64(12).

L Coco, T T Giannone, G Zarbo. Management of high-risk pregnancy. Minerva Ginecol. 2014 Aug;66(4):383-9.

Marcela de Oliveira Demitto, Angela Andréia França Gravena, Cátia Millene Dell'Agnolo, Marcos Benatti Antunes, Sandra Marisa Pelloso. High risk pregnancies and factors associated with neonatal death. Rev Esc Enferm USP. 2017 Apr 3;51:e03208. doi: 10.1590/S1980-220X2016127103208 (View)

Nola Holness. High-Risk Pregnancy. Nurs Clin North Am. 2018 Jun;53(2):241-251. doi: 10.1016/j.cnur.2018.01.010 (View)

Selcan Sinaci, Eda Ozden Tokalioglu, Doga Ocal, Aysegul Atalay, Gamze Yilmaz, Huseyin Levent Keskin, Seval Ozgu Erdinc, Dilek Sahin, Ozlem Moraloglu Tekin. Does having a high-risk pregnancy influence anxiety level during the COVID-19 pandemic? Eur J Obstet Gynecol Reprod Biol. 2020 Dec;255:190-196. doi: 10.1016/j.ejogrb.2020.10.055 (View)

Zarko Alfirevic, Tamara Stampalija, Therese Dowswell. Fetal and umbilical Doppler ultrasound in high-risk pregnancies. Cochrane Database Syst Rev. 2017 Jun 13;6(6):CD007529 (View)

FAQs from users: 'Can high-risk pregnancy be prevented?', 'Is absolute rest necessary in an at-risk pregnancy?' and 'What are the risks I should expect during pregnancy if I have PCOS?'.

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Authors and contributors

 Marta Barranquero Gómez
Marta Barranquero Gómez
B.Sc., M.Sc.
Embryologist
Graduated in Biochemistry and Biomedical Sciences by the University of Valencia (UV) and specialized in Assisted Reproduction by the University of Alcalá de Henares (UAH) in collaboration with Ginefiv and in Clinical Genetics by the University of Alcalá de Henares (UAH). More information about Marta Barranquero Gómez
License: 3316-CV
 Zaira Salvador
Zaira Salvador
B.Sc., M.Sc.
Embryologist
Bachelor's Degree in Biotechnology from the Technical University of Valencia (UPV). Biotechnology Degree from the National University of Ireland en Galway (NUIG) and embryologist specializing in Assisted Reproduction, with a Master's Degree in Biotechnology of Human Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI) More information about Zaira Salvador
License: 3185-CV

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