High-Risk Pregnancies

The term "high-risk pregnancy" is used to describe a situation in which the mother, her fetus, or both are at higher risk for problems during pregnancy or childbirth than a woman with a normall pregnancy.

Medical History Factors

1. High Blood Pressure (Hypertension)

• Women with well-managed mild hypertension can still have a normal pregnancy and delivery.
• Uncontrolled hypertension, however, can lead to kidney damage, low birth weight, or preeclampsia.
• Regular blood pressure monitoring is crucial for early detection and treatment.

2. Polycystic Ovary Syndrome (PCOS)

• Women with PCOS have a higher risk of:
  • Miscarriage before 20 weeks
  • Gestational diabetes
  • Preeclampsia
  • Cesarean section delivery

3. Diabetes

• Poorly controlled blood sugar levels can:
  • Increase the risk of birth defects
  • Cause the baby to be larger than normal (macrosomia)
  • Lead to low blood sugar in the newborn
• Women with diabetes should closely monitor blood sugar levels before and during pregnancy.

4. Kidney Disease

• Mild kidney disease does not always affect pregnancy.
• Severe kidney disease can cause:
  • Infertility
  • Preterm birth, low birth weight, and preeclampsia
• Regular monitoring and medication adjustments may be needed.

5. Autoimmune Diseases (Lupus, Multiple Sclerosis, etc.)

• Lupus increases the risk of preterm birth and stillbirth.
• Some women experience symptom relief during pregnancy, while others have flare-ups.
• Medications for autoimmune diseases may need adjustment to prevent fetal harm.

6. Thyroid Disorders

• Uncontrolled thyroid disease can lead to:
  • Heart problems in the fetus
  • Poor fetal growth
  • Brain development issues
• Frequent blood tests and medication adjustments are necessary.

7. Obesity

• Pre-pregnancy obesity increases the risk of:
  • Gestational diabetes
  • High birth weight (macrosomia), making delivery more difficult
  • Sleep apnea
  • Structural heart defects in the baby
• Managing weight gain during pregnancy is crucial.

8. HIV/AIDS

• HIV can be transmitted to the baby during pregnancy, delivery, or breastfeeding.
• Proper antiretroviral treatment (ART) can reduce transmission risk to less than 1%.
• Planned C-section and formula feeding may be recommended.

Age-Related Risk Factors

Teen Pregnancy (Under 18 years old)

• Higher risk of:
  • Anemia
  • High blood pressure
  • Preterm birth
• Regular prenatal visits are crucial for monitoring maternal and fetal health.

First Pregnancy After 35

• Increased risks of:
  • Gestational hypertension & diabetes
  • Miscarriage & stillbirth
  • Ectopic pregnancy
  • Cesarean delivery
  • Excessive bleeding during labor
  • Genetic disorders (e.g., Down syndrome)

Lifestyle-Related Risk Factors

1. Alcohol Consumption

• Fetal Alcohol Spectrum Disorders (FASD) can cause:
  • Developmental disabilities
  • Behavioral issues
  • Heart, kidney, and bone defects
• Alcohol use also increases the risk of miscarriage and stillbirth.

2. Smoking

• Doubles or triples the risk of stillbirth or fetal death.
• Leads to immune system changes in the baby.
• Increases the risk of sudden infant death syndrome (SIDS).

3. Drug Use (Including Marijuana)

• Doubles the risk of stillbirth and affects brain development.
• Can cause long-term cognitive issues for the baby.

Pregnancy-Related Risk Factors

1. Multiple Pregnancies (Twins, Triplets, etc.)

• Increased risk of preterm birth.
• Higher chances of C-section delivery.
• More likely to require neonatal intensive care (NICU).

2. Gestational Diabetes

• Increases risk of:
  • Preterm birth
  • High birth weight
  • Future Type 2 diabetes for both mother and baby

3. Preeclampsia & Eclampsia

• Preeclampsia: High blood pressure that can damage the kidneys, liver, and brain.
• Eclampsia: A severe form that causes seizures or coma.
• Can be life-threatening for both mother and baby.

4. Previous Preterm Birth

• Women who delivered before 37 weeks in a previous pregnancy are at higher risk of preterm labor again.
• Close monitoring and preventive treatments may be necessary.

5. Birth Defects or Genetic Disorders in the Fetus

• Some conditions can be treated before birth (e.g., spina bifida surgery).
• Early diagnosis helps parents and doctors prepare for specialized neonatal care.

Can High-Risk Pregnancies Be Prevented?

While some risk factors cannot be prevented, others can be managed through:
✔ Preconception health check-ups
✔ Controlling chronic conditions before pregnancy
✔ Healthy lifestyle choices (diet, exercise, avoiding smoking & alcohol)

How Are High-Risk Pregnancies Managed?

Management depends on individual risk factors:

• Thyroid disorders → Medication adjustments
• Smoking → Cessation programs
• HIV → Antiretroviral therapy (ART) and C-section delivery

Women with high-risk pregnancies require frequent monitoring to detect complications early. This is particularly important for conditions like preeclampsia and preterm labor.

Specialized Care at Thely-Clinic

The doctors at Thely-Clinic have advanced training in managing high-risk pregnancies, with postgraduate education and extensive experience from leading UK medical centers.

Our goal is to provide personalized care that ensures the safest possible pregnancy outcome for both mother and baby.