Caution! Baby on the Way: How To Prevent & Deal With a High-Risk Pregnancy

Risky pregnancies imply that more caution is needed for the mother and child through the pregnancy, delivery, and early postpartum period. Pre-existing conditions and emergencies can both turn a seemingly normal pregnancy journey into a high-risk case. This requires periodic checkups and extra care for the childbearing mother by obstetricians, who play a crucial role in identifying, tracking, and managing these pregnancies until childbirth. 

A high-risk pregnancy cannot be precisely defined because the mother and her healthcare provider may have different perspectives on what constitutes risk. To put it simply, a high-risk pregnancy may be described as an unplanned or unforeseen medical or obstetric issue during pregnancy that presents an actual or possible danger to the health of the mother or foetus.

A 2023 study reported that high-risk pregnancies are prevalent among Indian women at 49.4%, with 33% having a single high-risk pregnancy and 16.4% having multiple high-risk pregnancies. With such high numbers, women should understand the causes and treatment for high-risk pregnancy. At the same time, primary healthcare providers/obstetricians must educate couples about it.

High-risk pregnancy causes can be related to the mother’s general health, certain risk factors, or an emergency during the 9-month pregnancy.

Some of the common existing medical conditions that heighten the chances of high-risk pregnancy are:

• Diabetes
• Anaemia
• Fibroids
• High blood pressure/ hypertension
• Depression is one example of a mental health disorder
• Obesity
• Polycystic ovarian syndrome (PCOS)
• Thyroid illness
• Blood clotting diseases
• Cardiac disease
• Rh incompatibility

Apart from these, HIV/AIDS, chronic kidney diseases, low body weight in females, autoimmune illnesses including lupus and multiple sclerosis, and COVID-19 can also contribute to a potentially risky pregnancy.

Factors that contribute to a high-risk pregnancy:

• Extremes of age: When the expectant mother’s age is above 35 years or below the age of 17, it is termed a high-risk pregnancy.
• Bad lifestyle: Smoking, alcoholism, drug addictions, and poor mental health can negatively impact the pregnancy.
• Health history: A history of miscarriage, preeclampsia, or preterm birth

High-risk pregnancy factors that may arise after conceiving:

• Multiple gestations; for example, twins, triplets, and higher-order pregnancies
• Defects in development or genetic illnesses found during pregnancy examinations
• Poor growth of the foetus

The fast-paced lifestyle, competitive work environment, and career graphs of the modern world have made one or more of these factors usual and common for most women.

Assisted reproduction techniques have made pregnancies possible for women of higher age groups who are more prone to medical disorders and thus high-risk pregnancies. So, it is vital to understand high-risk pregnancy symptoms and follow the necessary precautions thereafter.

High-risk pregnancy symptoms are easy to identify. Always inform your gynaecologist/obstetrician if you observe the following symptoms during your pregnancy journey. One may consider the following sequence as it covers symptoms of each disease in a systematic manner:

• Headaches that won’t go away but worsen with time
• Blurring of vision
• Abdominal pain
• Dizziness/fainting
• High fever - 100.4 F or more
• Chest discomfort, breathing difficulty
• Intractable nausea and vomiting
• Mild to moderate swelling of hands and legs
• Zero movements of the baby
• Vaginal leaks or bleeding

Severe vaginal bleeding postpartum is also considered an emergency. All these signs and symptoms, in unison or solo, are causes for concern.

While it is good to know your options for high-risk pregnancy treatment, it is better to understand how to avoid it in the first place. A mix of therapies, lifestyle changes, and routine monitoring are essential elements of care for high-risk pregnancies:

• Prioritise regular prenatal consultations: Selecting and adhering to a gynaecologist/obstetrician with expertise in high-risk pregnancies is vital. Sometimes, a skilled maternal-foetal medicine (MFM) expert may be required. Routine prenatal checkups are essential for the steady monitoring of the pregnancy, foetal growth, scans and tests, and early identification of complications.
• Get a hold on your stress levels: It is normal to be stressed about pregnancy, related seemingly endless imposed restrictions, body changes, and so on. But remember that every time you stress, the baby is stressed too. Stress can further worsen pre-existing conditions like hypertension. Stress management involves relaxation techniques such as yoga, meditation, or deep breathing. You can speak to siblings, cousins, friends, parents, or a mental health expert to de-stress yourself.
• Periodic blood pressure monitoring at home can be a game-changer. Remember to take medicines for any pre-existing medical conditions but only upon the physician's advice.
• Track the foetal movements. Your doctor will teach you techniques for following foetal movements and reporting changes immediately. 
• A healthy lifestyle comes first; eat a balanced diet, exercise daily, and say no to alcohol, smoking, and drugs for a while (better if you quit these for good). 
• Prepare yourself for any emergencies to avoid unnecessary panic. That’s why it is good to know about high-risk pregnancy symptoms and the available suitable treatments beforehand.
• Preconception counselling for effectively managing pre-existing medical disorders and their medications before planning a pregnancy helps one have better control of their pregnancy journey with fewer complications for both the mother and the baby .

Sometimes, the tension and worry surrounding a high-risk pregnancy may overshadow the excitement of the pregnancy journey. That is where family, friends, your gynaecologist/obstetrician, and psychologist come in. It is best to get yourself checked and adhere to prescribed medications and lifestyle changes early on if you have a pre-existing condition or risk factor for a high-risk pregnancy. This takes away half the stress over the next nine months. Apart from this, being disciplined with prenatal checkups is a wonderful way to stay updated with the current status of your child and the mother’s health. Pregnancy is a unique phase of adulthood that’s best enjoyed with zero fear.

A high-risk pregnancy is an unanticipated or unplanned obstetrical or medical condition during pregnancy that presents a risk to the health or well-being of the foetus and/or the mother.

High-risk pregnancy causes include pre-existing health issues like diabetes, uterine fibroids, PCOS, hypertension, and autoimmune issues or risk factors like late pregnancies, teen pregnancies, alcoholism, and smoking and other foetal complications during gestation such as birth defects, multiple pregnancies, and a history of recurrent pregnancy losses.

Ageing affects fertility and the body's ability to repair and regenerate. Moreover, with age, women also contract health issues like hypertension, diabetes, PCOS, and fibroids. Thus, pregnancies above the age of 35 have a higher chance of miscarriages, stillbirths, etc.

Pre-existing medical conditions that contribute to a high-risk pregnancy include diabetes, uterine fibroids, PCOS, hypertension, autoimmune issues, HIV/AIDS, anaemia, and obesity.

Genetic factors that could lead to a high-risk pregnancy are a predilection for diabetes, chronic blood pressure, rheumatologic diseases, heart diseases, among other conditions.

Lifestyle changes that can slash the chances of a high-risk pregnancy include healthy eating habits, regular exercise, yoga, breathing techniques, and avoiding smoking, alcohol, and drugs.