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.

High-Risk Obstetric Team

We recognize that childbirth is a major event in the lives of mothers and their families. The maternal fetal medicine staff at Summa Health is prepared to guide you through your pregnancy. We provide a multidisciplinary team, including maternal fetal medicine specialists, critical care specialist, cardiologist, pulmonary medicine, neurology and anesthesia to provide care and consultation 24 hours a day, seven days a week.

Summa offers outstanding care for women from preconception through pregnancy and delivery to ensure best possible outcomes. We provide preconception consultation for women planning pregnancy who may have high-risk concerns. During pregnancy, we see women during consultations and share care with their primary obstetric provider. We strongly encourage all pregnant women to regularly consult with their primary obstetric provider throughout their pregnancy for optimal prenatal care.

Maternal fetal medicine care and consultation is available 24 hours a day, seven days a week. Many times, pregnant women require urgent care, but may not be in Akron when an emergency happens.  For these women, we can arrange hospital-to-hospital transport to Summa Health.

Treatment  

Treatment of high-risk pregnancy will vary, dependent on the underlying condition and the stage of the pregnancy. 

Summa offers the Obstetrical Ultrasound Unit, where routine and high-risk pregnancies are evaluated with special emphasis on suspected fetal abnormalities. The unit performs Level II ultrasound-guided procedures including amniocentesis, chorionic villus sampling (CVS) and percutaneous umbilical blood sampling (PUBS), as well as fetal therapy such as in utero fetal transfusion.

Critical illness in pregnancy is uncommon but may arise from conditions unique to pregnancy, conditions exacerbated by pregnancy and coincidental conditions. The obstetric population has changed over the past decade and we are caring for older mothers with pre-existing disorders and advanced chronic medical conditions. It is therefore essential to adopt an early multidisciplinary approach for the care of these women.