What is a high-risk pregnancy?
A high-risk pregnancy simply means that you or your baby may need extra medical attention and monitoring to help prevent or manage potential complications. While the term "high-risk" can sound alarming, many women with high-risk pregnancies go on to have healthy babies and successful deliveries with proper medical care.
You may be considered high-risk due to factors present before pregnancy, such as diabetes, heart conditions, kidney disease, anaemia or being over 35 years old. Alternatively, complications that develop during pregnancy, like high blood pressure or problems with your baby's growth, can also classify your pregnancy as high-risk. The key is that with appropriate medical supervision and care, most high-risk pregnancies result in positive outcomes for both mother and baby.
What makes a pregnancy high-risk?
Advanced maternal age:
Pregnancies in women over 35 are considered high risk due to an increased likelihood of complications such as gestational diabetes and chromosomal abnormalities.
Multiple gestation:
Twins, triplets, or higher-order multiples pose higher risks, including premature birth and low birth weight.
Pre-existing medical conditions:
Conditions such as diabetes, hypertension, autoimmune disorders, and heart disease can elevate the risk during pregnancy.
Gestational diabetes:
The onset of diabetes during pregnancy can lead to complications for both the mother and the baby.
Hypertensive disorders in pregnancy:
Hypertensive disorders in pregnancy can compromise both the mother and the foetus.
Placenta previa:
Placenta previa, where the placenta partially or completely covers the cervix, can result in bleeding and complications during delivery.
Use of Assisted Reproductive Technologies (ART):
Pregnancies resulting from fertility treatments, such as in vitro fertilisation (IVF), may be at a higher risk of certain complications.
Lifestyle factors:
Smoking, substance abuse, or excessive alcohol consumption increases the risk of preterm birth, low birth weight, developmental issues, and other complications.
What high-risk pregnancy services are provided to women and families?
If you're experiencing a high-risk pregnancy, you'll receive significantly more intensive medical care designed to monitor and protect both your health and your baby's well-being throughout your pregnancy. This typically includes increased appointment frequency—sometimes as often as weekly visits—allowing your healthcare providers to closely track your vital signs, weight gain, blood pressure, and other important health indicators.
You'll also receive additional screening and monitoring beyond what's provided in typical pregnancies. This may include more detailed ultrasounds to check your baby's development, specialised blood tests to watch for pregnancy complications, and regular monitoring of your baby's heart rate and movement. Your care team may also include specialists such as maternal-foetal medicine doctors who work together to address your specific needs. The specific tests you receive will depend on your individual risk factors and medical history.
When should you see an obstetrician for high-risk pregnancy services?
You should seek care from a high-risk pregnancy specialist as soon as you know you're pregnant if you have pre-existing conditions that could complicate your pregnancy. These include chronic conditions like diabetes, high blood pressure, heart disease, kidney problems, or autoimmune disease.
If you develop complications during pregnancy, your regular obstetrician may refer you to a high-risk pregnancy specialist at any point during your pregnancy. Common reasons for referral include gestational diabetes, preeclampsia, placental problems, concerns about your baby's growth or development, or if you're carrying multiples (twins, triplets, or more).
Additionally, you should consider seeking specialised care if you're over 35 years old, have a history of pregnancy complications or recurrent miscarriages, or if genetic testing reveals potential issues with your baby's development. Early consultation allows for proper planning and monitoring throughout your pregnancy.
High-risk Pregnancy Doctors
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How to manage a high-risk pregnancy?
Management of high-risk pregnancy depends on the underlying condition of the mother and the risk factors. It involves a multidisciplinary approach.
Consultation with specialists:
Collaboration with specialists such as maternal fetal medicine specialists, endocrinologists, and other relevant healthcare providers.
Specialised prenatal care:
High-risk pregnancies require more frequent and specialised prenatal visits to monitor both maternal and foetal health.
Medical interventions:
Medications may be prescribed to manage conditions such as gestational diabetes or hypertension.
Bed rest and activity restriction:
In some cases, bed rest or activity restriction may be recommended to prevent complications.
Fetal monitoring:
Continuous monitoring of the foetus's growth and well-being through ultrasounds, non-stress tests, and other diagnostic tools.
FAQ
When should I go for antenatal booking if I have high-risk pregnancy?
It should be done as soon as you are confirmed pregnant. The recommended time is when you are less than 12 weeks pregnant.
What are the complications associated with high-risk pregnancy?
High-risk pregnancies are associated with an increased likelihood of complications that require careful monitoring and specialised medical attention. The specific complications can vary based on the underlying risk factors and health conditions. Here are some common complications associated with high-risk pregnancies:
Preterm birth:
One of the most significant complications is the risk of preterm birth. Babies born before 37 weeks of gestation may face developmental challenges and health issues.
Low birth weight:
Babies born from high-risk pregnancies are more likely to have low birth weight, which can lead to complications such as developmental delays, respiratory problems, and a higher risk of infections.
Hypertension and preeclampsia:
Hypertension (high blood pressure) during pregnancy can lead to preeclampsia, a serious condition characterised by high blood pressure and damage to organs such as the liver and kidneys. Preeclampsia can result in premature birth and affect the health of both the mother and the baby.
Foetal growth restriction:
In high-risk pregnancies, inadequate foetal growth may occur, leading to foetal growth restriction. This condition can result in low birth weight and other health problems for the baby.
Caesarean Section (C-Section):
High-risk pregnancies may have a higher likelihood of requiring a C-section, either as a planned intervention or due to complications during labour.
Neonatal Intensive Care Unit (NICU) admission:
Babies born from high-risk pregnancies may require admission to the NICU for specialised care and monitoring, especially if born prematurely or with health issues.
Chromosomal abnormalities:
High-risk pregnancies, especially in older mothers, may be associated with an increased risk of chromosomal abnormalities, such as Down syndrome.
Postpartum complications:
The risks associated with high-risk pregnancies can extend into the postpartum period, including an increased likelihood of maternal complications such as postpartum haemorrhage, infections, and challenges in breastfeeding.
Maternal health issues:
The mother's health is also at risk in high-risk pregnancies, and complications may include exacerbation of pre-existing conditions, gestational hypertension, and postpartum depression.
I'm currently taking medications for a chronic medical condition and just found out I'm pregnant. Should I stop taking my medication?
Do not stop taking or alter the dose of a prescribed medicine without the knowledge and consent of your doctor. It can be dangerous to make the decision to stop taking a medication without guidance from a doctor as some illnesses or pregnancy complications may risk the health of the mother or baby, or both if untreated. Discuss any concerns you may have about medicines with your doctor.
What can you do to prevent complications during a high-risk pregnancy?
Preconception planning:
Planning pregnancies and optimising health before conception can reduce the risk of complications.
Regular prenatal check-ups:
Regular and early prenatal care allows for the timely identification and management of potential risk factors.
Lifestyle modifications:
Adopting a healthy lifestyle, including a balanced diet, regular exercise, and avoiding harmful substances, can contribute to a lower risk of complications.
Management of pre-existing conditions:
Managing chronic conditions before and during pregnancy can minimize associated risks.
Early detection and intervention:
Early detection of risk factors and prompt medical intervention can prevent or mitigate complications.
For more information, contact us:
Thomson Specialists (Women's Health)
Thomson Women's Clinic (TWC)
- Novena:
6592 6686 (Call), 8611 8986 (WA) - Bukit Batok:
6569 0668 (Call), 8686 3525 (WA) - Choa Chu Kang: 6893 1227
- Jurong: 6262 8588
- Katong (female doctor):
6970 2272 (Call), 8611 9020 (WA) - Punggol: 6243 6843
- Sembawang: 6753 5228
- Sengkang: 6388 8125
- Serangoon (female doctor): 6382 3313
- Tampines: 6857 6266
- Tiong Bahru: 6276 1525
Dr Ryan Lee Wai Kheong
Obstetrics & Gynaecology (O&G)
Thomson Specialists Woodleigh (Women's Health)
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