What makes a pregnancy high risk?

A high-risk pregnancy involves increased health risks for a mother and her baby before, during, or after the pregnancy. Patients with high-risk pregnancies require specialised maternal-fetal care.

Here, Dr Srividhya Sankaran, renowned consultant in maternal-fetal medicine and obstetrics based in London, provides a comprehensive insight into high-risk pregnancies.

What classifies a pregnancy as high risk?

A pregnancy becomes high risk:

• If a patient has an existing medical condition during the pregnancy, such as diabetes, hypertension, epilepsy, or antiphospholipid syndrome.
• If a patient had complications in a previous pregnancy.

Some patients also develop high-risk medical conditions as they go through the pregnancy, such as gestational diabetes, pre-eclampsia, and intrahepatic cholestasis (itching during pregnancy). The pregnancy then becomes high risk.

Are there more appointments with a high-risk pregnancy?

Yes, but it depends on the underlying medical condition.

Patients who have diabetes and hypertension during their pregnancy, for example, need to be closely monitored. As a result, more appointments will be needed.

Patients who have thyroid disorders during their pregnancy may only need an extra two or three appointments.

What happens at a high-risk pregnancy appointment?

During a general pregnancy appointment, the patient’s blood pressure and urine will be checked. A consultant in maternal-fetal medicine and obstetrics like myself will perform an abdominal measurement of the tummy and also listen to the baby’s heartbeat. These are regular pregnancy checks.

During a high-risk pregnancy appointment, additional parameters will be checked alongside the regular checks. This might involve, for example, checking blood sugar (glucose) levels in patients who have diabetes.

A computerised cardiotocography (recording of the baby’s heartbeat) will be done twice a week. In some cases, extra blood tests may also be ordered.

Is there a difference between a high-risk ultrasound and a normal ultrasound?

A routine ultrasound can be performed by sonographers. Within the NHS, this is done at 12 weeks pregnant, at 20 weeks pregnant and, in some hospitals, at 36 weeks pregnant.

Patients who have a high-risk pregnancy will require an expert scan, during which a consultant in maternal-fetal medicine and obstetrics will perform extra checks on the routine scan. A test to check the blood flow in the baby, as well as additional tests, will also be carried out depending on the patient’s underlying condition.

How can patients who have high-risk pregnancies take care of their health?

If a patient has a high-risk medical condition, then it is absolutely important that they plan their pregnancy well in advance. It is also good practice to see a high-risk consultant in maternal-fetal medicine and obstetrics before becoming pregnant to make sure that blood sugar (glucose) levels, for example, are under control.

Some medications, or their doses, may need to be changed if they are not safe to take during the pregnancy. This will be done by a consultant in maternal-fetal medicine and obstetrics, a consultant haematologist, or a consultant endocrinologist.

Folic acid, regular physical exercise, and a healthy lifestyle will all go a long way in building a strong foundation for a healthy pregnancy.

Dr Srividhya Sankaran is a consultant in maternal-fetal medicine and obstetrics with over 15 years’ experience.

Don’t hesitate to book an appointment with Dr Sankaran via her Top Doctors profile today to receive expert maternal-fetal care and advice.