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High-Risk Obstetrics

In the Hospital, Close-up Shot of the Doctor Doing Ultrasound / Sonogram Scan to a Pregnant Woman. Obstetrician Moving Transducer on the Belly of the Future Mother; High-Risk ObstetricsRaleigh OB/GYN Centre is home to a dedicated team of healthcare providers qualified to provide comprehensive prenatal care to our patients. This includes experience with high-risk obstetrics and helping patients manage high-risk pregnancies.

According to the National Institute of Child Health and Human Development, a high-risk pregnancy is one in which the mother, the fetus, or both are at an increased risk for complications during pregnancy or delivery than in a typical pregnancy. A pregnancy may be considered high-risk due to chronic health problems, lifestyle factors, or conditions that develop during pregnancy.

Pre-existing Risk Factors

There are certain pre-existing conditions or factors that can make a pregnancy qualify as high-risk. These include lifestyle factors and chronic health conditions. If you have any of the following risk factors, consult your doctor:

  • Diabetes
  • High blood pressure
  • Heart disease
  • Kidney problems
  • Blood disorders
  • Obesity
  • Being underweight
  • Complications in past pregnancies
  • A history of uterine surgery
  • Cancer
  • Autoimmune disease
  • Advanced maternal age (35 or older)
  • Low maternal age (18 or younger)

Issues that Develop During Pregnancy

Sometimes complications develop as the pregnancy progresses, even in women who don’t have the above risk factors. These conditions can pose a risk to the baby and/or mother.

  • Multiples: The risks of preeclampsia, gestational diabetes, placental issues, and premature birth are higher for women carrying two or more babies.
  • Preeclampsia: High blood pressure that develops during pregnancy and can affect the liver, kidneys, and brain. Risks of preterm delivery and placental issues are also more common in women with preeclampsia.
  • Gestational diabetes: Diabetes that develops during pregnancy in a woman with no prior history of diabetes. Gestational diabetes increases the risk of the baby being too large, which makes delivery more difficult. Women with gestational diabetes are more likely to need a C-section.
  • Placental abruption: The placenta separates early from the uterine wall.
  • Placenta accreta: The placenta attaches too strongly to the uterine wall. This can cause bleeding and possibly lead to hemorrhaging during labor and delivery. 
  • Placenta previa: The placenta is low in the uterus and may cover the cervix. This can lead to bleeding and early delivery.
  • HELLP Syndrome: A rare liver and blood-clotting disorder that most often develops in the third trimester. It is usually linked to high blood pressure or preeclampsia.
  • Prenatal infections: Zika virus infection has been linked to increased rates of a birth defect called microcephaly. Other infections like listeriosis and toxoplasmosis do not always cause complications but have been linked to miscarriage, preterm labor, and birth defects.
  • Preterm labor: Labor that starts before 37 weeks of pregnancy. Babies born prematurely are more likely to have health and developmental issues and will need to stay in the NICU for at least a few days if not longer. 
  • Preterm premature rupture of membranes (PPROM): A membrane of the amniotic sac ruptures and leaks amniotic fluid before 37 weeks of pregnancy. 

Managing High-Risk Pregnancy

Management of high-risk pregnancy depends on the factors that make it high-risk. If there is an underlying medical condition, then your healthcare providers will work together to safely treat your condition during your pregnancy. If complications develop during the pregnancy, then you should be monitored and treated based on those factors.

High-risk pregnancies may require more monitoring than the average pregnancy. Going to your regular prenatal appointments is critical, as is keeping any additional appointments your OB/GYN suggests. Your doctor may also recommend additional tests or procedures to keep an eye on risk factors.

Women who have pre-existing risk factors or develop complications during pregnancy should consider seeing an OB/GYN experienced in managing high-risk pregnancies. Raleigh OB/GYN Centre’s physicians are experienced in managing pregnancy, including providing high-risk obstetric care.  We work with the Rex Hospital Women’s Center and the new Obstetric Emergency Department (OB ED). To learn more about our obstetric services, call our office at (919) 876-8225 to make an appointment.