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High-Risk Pregnancy

A pregnancy is referred to as high-risk if the mother or baby is at an increased risk for a health problem either during the pregnancy, during delivery, or following the birth. The diagnosis of high-risk pregnancy may be determined when reviewing medical history or during the ultrasound at 16–19 weeks gestation.

There are many things that can place an expectant mother at high risk, and though the term may sound scary, it is actually just a way for your pregnancy to be classified to make sure special attention is given to you throughout your pregnancy, during delivery and after the birth of your baby. Your obstetrician will be watching for any health problems that may surface in the early stages to ensure you have a successful delivery. With a high-risk pregnancy, closer monitoring will be needed, which may include more frequent visits with your primary caregiver, tests to monitor the medical problem, and/or blood tests.

Conditions that may contribute to a high-risk pregnancy


There are some conditions that may place you and your baby at a higher risk for such problems as slowed growth of the baby; preterm labor; preeclampsia; and problems with the placenta. These conditions might include

  • Obesity or pre-pregnancy weight under 100 lbs.
  • Height under 5 ft.
  • Anatomical challenges; height under 5 ft., gynecological challenges
  • Alcohol or illegal drug use
  • Smoking
  • Age -- Younger than 17 or older than 35.
  • Multiple pregnancy
  • History of three or more miscarriages.
  • Your baby has been found to have a genetic condition, such as Down syndrome, or a heart, lung, or kidney problem.
  • Problem in a past pregnancy, such as:
    • Preterm labor.
    • Preeclampsia or seizures (eclampsia).
    • Baby with a genetic problem
  • Infections such as: HIV, hepatitis C, cytomegalovirus (CMV), chickenpox, rubella, toxoplasmosis, and syphilis.
  • Certain medications, such as lithium, phenytoin (such as Dilantin), valproic acid (Depakene), or carbamazepine (such as Tegretol).
  • Pre-mature labor
  • Fetal problems
  • Infertility treatment
  • Maternal cardiac disease
  • Family history of birth defects
  • History of delivery complications or bleeding

In addition, some health problems can place you at high risk, such as:

  • Diabetes
  • Cancer
  • High blood pressure
  • Kidney disease
  • Epilepsy
  • Heart valve problems
  • Sickle cell disease
  • Asthma
  • Lupus
  • Rheumatoid arthritis

If you have a medical condition, it's important to talk with your doctor before you decide to become pregnant. Your doctor can run tests, adjust medications, or discuss precautions you may need to take in order to ensure the health of you and your baby.

Most patients will see only one healthcare provider during pregnancy, either an obstetrician, a midwife, or a nurse practitioner. However, those patients who have a medical condition may need to also see a specialist in high-risk obstetrics, called a perinatologist who practices maternal-fetal medicine.

Treatment  

Treatment of high-risk pregnancy will vary, dependent on the underlying condition and the stage of the pregnancy. If it is the fetus, additional ultrasounds, fetal heart rate monitoring or amniocentesis may be required.

High-risk obstetric team. Summa has maternal fetal medicine specialists on staff that focus on the medical and surgical management of high-risk pregnancies. A referral is required to see a maternal fetal medicine specialist. If you wish to schedule an appointment or referral, contact us online or call (330) 535-1143.

Dr. Angela Silber  Angela C. Silber, M.D., FACOG
Chief of Maternal Fetal Medicine
Summa Akron City Hospital

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