McKinney High-Risk-Pregnancy Management
Although any pregnancy has the potential of complications, one defined as “high risk” is more likely to have complications that potentially threaten the health of both the mother and fetus, so requires a greater level of attention and monitoring. A high-risk pregnancy increases a baby’s chances for health and developmental problems at birth and beyond.
A pregnancy is considered high risk in a number of instances, including when there are preexisting, problematic medical conditions; health issues that develop during the pregnancy; multiple births involved; and a history of abnormal pregnancies. Routine screening tests, such as blood tests and ultrasound exams, in conjunction with diagnostic tests, such as amniocentesis or chorionic villus sampling (CVS), help identify whether a pregnancy is a high risk. These tests are used to determine the presence of a number of health problems, as well as tests for certain genetic conditions. A woman with a high-risk pregnancy must schedule more frequent visits with her doctor, and manage her lifestyle to ensure her and her baby’s health.
Symptoms Of High-Risk Pregnancy
Symptoms of high-risk pregnancy are often difficult to distinguish from symptoms of a typical pregnancy, although they may last longer and be far more severe. Symptoms of a high-risk pregnancy include the following:
- Noticeable changes in vision, including blurring
- Decreased fetal movement
- Persistent headaches
- Painful burning sensations while urinating
- Vaginal bleeding
- Clear, watery vaginal discharge
- Frequent contractions
Women with high-risk pregnancies may also experience severe pain or cramping in the lower abdomen. Pregnant women experiencing any of these symptoms should seek immediate medical attention.
Risk Factors For High-Risk Pregnancy
Smoking and abusing alcohol or drugs during pregnancy can make it a high-risk one. Other conditions, such as an abnormally shaped uterus, or a weakened or shortened cervix, can also be the cause of a high-risk pregnancy. Other risk factors include the following:
- Being significantly underweight/overweight
- Getting poor prenatal care
- History of premature labor
- Previously having a child with a genetic condition
- History of miscarriages
- Being pregnant with multiple fetuses
- Sickle cell disease
Preexisting health conditions such as epilepsy, high blood pressure, diabetes, cancer and lupus, and heart, kidney, or lung problems, can also contribute to a high-risk pregnancy. Age may also be a factor, especially if the mother is either younger than 16 or older than 35.
Management Of High-Risk Pregnancy
A high-risk pregnancy usually requires a greater number of prenatal obstetric office visits to closely monitor the progression of the pregnancy. A woman needs to be attentive to her health, eat a nutritious diet, gain a proper amount of weight, and avoid risky substances or medications. Vitamins, iron supplements, and medicines to enhance the health of the mother and fetus are often prescribed.
In some cases, a woman may be advised to stop working and rest at home during the remainder of her pregnancy.
In addition to regular screening exams, additional tests may be recommended to further assess the health and development of the fetus. These may include a biophysical profile or targeted ultrasound, which can provide doctors with more detailed information than standard testing. Delivery should take place in a hospital setting; giving birth at home is considering too risky for women with serious health conditions or complications. Depending on the individual case, a baby may be delivered vaginally or through a C-section.
"Today was our first day visiting our new OB- Dr. Christine Baidwan, and we were beyond satisfied! We loved the office staff, nurses & our sonographer! It was such a great visit, I love how informative their office is, and how at ease they made us feel! We HIGHLY recommend their office!"
What Can You Do To Prevent High-Risk Pregnancies?
Many high-risk pregnancies are due to preexisting medical conditions on the part of the mother. Some of these are within your control, such as being significantly overweight or underweight. Others, such as chronic kidney disease, are out of your control. Regardless, there are some steps you can take to help promote a healthy, successful pregnancy:
- Schedule a preconception appointment — If you’re considering becoming pregnant, call us at Craig Ranch. We’d like to get you on a daily prenatal vitamin with folic acid and we’d like to see you at a healthy weight prior to becoming pregnant. We also need to take into account any medical conditions that can affect your pregnancy.
- Receive regular prenatal care — Prenatal visits allow us to monitor your health and your baby’s. They help ensure everything is going well, and they give you peace of mind.
- Avoid risky substances — Alcohol and illegal drugs are off-limits during any pregnancy. If you’re a smoker, now is the time to quit, as smoking can affect pregnancy and fetal development. We also need to know any over-the-counter medications, prescription medications, and supplements you’re taking.
- Stay active during pregnancy — Walking and other forms of low-key exercise are great for both your body and your mind during pregnancy. Exercise also helps keep your weight in a healthy range.
- Take care of your emotional health — Pregnancy is difficult under all circumstances. Throw in some potential risks and it can be quite stressful. Look to your partner, friends, and family members for help and support along the way.
How Often you Should see a OB/GYN During A High-Risk Pregnancy
According to the Department of Health and Human Services, you should see your Craig Ranch OB/GYN at these intervals for high-risk pregnancies:
- Weeks 4 – 28 = Once each month
- Weeks 28 – 36 = Twice each month
- Weeks 36 to birth = Once each week
These ranges may be adjusted depending upon your unique circumstances.
Can I Work During A High-Risk Pregnancy?
This depends on your work. Work that requires long hours of standing: salesclerks, waiters, flight attendants, nurses, cooks, and others can be difficult for a pregnant woman, but they can be dangerous for an unborn baby. Studies have found that long hours of standing on the job might increase the risk of the mother developing high blood pressure, and it increases the risk of premature birth.
For this reason, women with high-risk pregnancies who work more than four hours a day on their feet should switch to a desk job or they should quit by their 24th week of pregnancy. Those who stand for 30 minutes out of each hour should change jobs or quit by the 32nd week.
Lifting, pushing, bending, and other aspects of jobs that require physical strength can also be a problem for high-risk pregnancies. Lifting 25 pounds or less is not a concern, but anything above that should be limited. If you have a physical job, it’s wise to ask for reassignment or to take leave by your 20th week. This is a must if you lift items weighing 50 pounds or more.
Exposure to hazardous substances is a no-no; they can harm your fetus. For instance, if you’re a painter or work in a dry-cleaning business, you’re exposed to solvents all day long. Others may be exposed to car exhaust fumes throughout the day. Ask for reassignment, wear a facemask, or try and have better ventilation in your work area. Talk with your Craig Ranch OB/GYN about any hazardous items you have to deal with at work.
The Best Position For Sleeping During A High-Risk Pregnancy
For all pregnancies, it’s best to sleep on your side. Why? Blood flow. Sleeping on your side allows for optimal blood flow from the inferior vena cava (IVC), which is a large vein that runs parallel to your spine on the right side. It carries blood to your heart and, in turn, to your baby.
Sleeping on your left takes the pressure off your liver and your kidneys, which can help with swelling issues in your hands, ankles, and feet.
There is some thought that the left side is better than the right for the reasons listed above, but research shows equal safety on either left or right sides.
Are There Any Medical Conditions That May Occur During A High-Risk Pregnancy?
Certain medical conditions can develop while a woman is pregnant. This can happen in high-risk and normal pregnancies. These are:
- Anemia — This is lower than a normal number of red blood cells.
- Gestational diabetes — This is diabetes that develops for the first time when a woman is pregnant
- High blood pressure
- Hyperemesis Gravidarum — This is severe persistent nausea and vomiting during pregnancy, far more extreme than normal morning sickness
- Infections — These can be urinary tract infections or other common infections
Can Too Many Ultrasounds Harm A Baby?
Ultrasounds are a necessary part of tracking any high-risk pregnancy. This will typically involve more frequent ultrasounds than for a normal pregnancy. This concerns some mothers, but there is nothing to worry about. The safety of ultrasounds has been well established. They do not contain any radiation, only using soundwaves to create the images of the fetus. A review of 50 medical studies found that ultrasounds did not pose any danger to mothers or their fetuses.
In high-risk pregnancies, ultrasounds are a valuable tool. Don’t let questionable sources on the Internet tell you otherwise.
What Tests Might I Need During High-Risk Pregnancy?
High-risk pregnancies are carefully monitored. Your doctor may schedule more frequent visits and a wider variety of tests. These enable us to continually assure you of your baby's development and health. Some of the tests that may be considered at some point, or multiple points, in your pregnancy include:
- Specialized ultrasound. You may have more ultrasounds than average during a high-risk pregnancy. This allows your doctor to visualize your fetus and confirm that all organs are developing normally.
- Cervical ultrasound. This screening can help your doctor determine your risk of preterm labor.
- Amniocentesis. This screening obtains a sample of the amniotic fluid that surrounds the fetus. The purpose of this test is to screen for genetic conditions as well as neural tube defects that may affect the brain or spinal cord.
- Chorionic villus sampling. This test removes a sampling of cells from the placenta. The purpose is to screen for certain genetic conditions.
- Cell-free DNA testing. This blood test samples DNA from the mother and baby to assess the risk of certain chromosomal conditions.
These tests are performed in addition to the routine screenings that occur during any pregnancy. Your doctor will also perform fetal heart monitoring and regular lab tests that evaluate your blood glucose and other vital health data.
I'm over 35. Is My Pregnancy Automatically Considered High Risk?
If you are over the age of 35 when you become pregnant, your doctor will conduct well-thought-out screenings to ensure that you and your baby are healthy and on track for a successful delivery. Although older maternal age does comes with its own unique risks, statistics tell us that the vast majority of "geriatric pregnancies" result in healthy, thriving babies. In fact, there are even a few benefits to be gained in this scenario!
Older maternal age is a risk factor for a few potential conditions. These include:
- High blood pressure (preeclampsia risk)
- Gestational diabetes
- Low birth weight
- Premature birth
- Chromosomal abnormalities such as Down syndrome
Keep in mind that all pregnancies carry some degree of risk. Your obstetrician will partner with you to manage the risks that you face on your way to motherhood! In addition to seeing your doctor regularly, your high-risk pregnancy may be optimally supported by taking the recommended prenatal vitamins. Folic acid is one of the vital nutrients that you need to reduce the risk of birth defects, specifically those that affect the baby's brain and spinal cord. Studies suggest that this risk can be reduced with 400+ micrograms of folic acid daily (most prenatal vitamins have between 400 and 1,000 mcg). If you're planning to become pregnant, your doctor may advise that you begin taking folic acid before conception.