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High-Risk Pregnancy: Know What to Expect

Posted Date: 12/15/2014
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High-Risk Pregnancy:
Know What to Expect

Michael Moretti, M.D.


In these situations, your doctor may recommend beginning care with a high-risk obstetrician called a perinatologist.

A perinatologist’s work is focused on keeping the baby inside for the duration of gestation, if possible. Babies have a better chance of survival if they are born at full term, rather than when they are born prematurely.

Which factors can make pregnancy high-risk?

Pregnant women with heart disease, high blood pressure, diabetes, kidney disease, cancer, seizure disorders or autoimmune disorders are potentially at risk.

Other areas of concern include:

• An advanced maternal age of 35 or older

• Lifestyle choices like smoking cigarettes, drinking alcohol and using illegal drugs

• A medical history of cesarean, low baby birth weight, preterm birth (before 37 weeks of pregnancy), miscarriage or death of a baby shortly after birth

• Underlying conditions such as diabetes, high blood pressure and epilepsy, or a blood condition, such as anemia or an infection, along with any underlying mental health issue

• Pregnancy complications with the uterus, cervix or placenta; severe morning sickness that continues past the first trimester; or situations like abnormal amniotic fluid volumes, restricted fetal growth or Rh (rhesus) sensitization, which occurs when your blood group is different from your baby’s

• Multiple pregnancy for twins or higher-order multiples

• Overdue pregnancy beyond the anticipated date


What steps can I take to promote a healthy pregnancy?

• Schedule a preconception appointment. You’ll learn about prenatal vitamins and your ideal pregnancy weight and can discuss any medical conditions

• Be cautious when using assisted reproductive technology (ART). Consider how many embryos will be implanted: Multiple pregnancies carry a higher risk of preterm labor

• Seek regular prenatal care. Prenatal visits can help your healthcare provider monitor your and your baby’s health

• Eat healthy. You’ll need more folic acid, calcium, iron and other essential nutrients. A daily prenatal vitamin can help fill in any gaps

• Gain weight wisely. A weight gain of 25 to 35 pounds is often recommended for women who have a healthy weight before pregnancy. If you’re overweight before you conceive, you might need to gain less weight

• Avoid risky substances. Tobacco, alcohol and illegal drugs are off-limits — and get your physician’s OK before you stop taking any medications or supplements

What else do I need to know about high-risk pregnancy?

Ask your healthcare provider to discuss specific signs or symptoms to look out for, such as:

• Vaginal bleeding

• Persistent headaches

• Pain or cramping in the lower abdomen

• Watery vaginal discharge — in a gush or a trickle

• Regular or frequent contractions — a tightening sensation in the abdomen

• Decreased fetal activity

• Pain or burning with urination

• Changes in vision, including blurred vision

Also, find out which signs or symptoms should prompt you to contact your healthcare provider and when to seek emergency care.

Michael Moretti, M.D., is Chairman of Obstetrics and Gynecology at Richmond University Medical Center. For more information or to make an appointment, please call 718-818-1234.