As per the UN, roughly 385,000 babies are born daily – this equates to around 140 million a year. For the majority of women, getting pregnant and delivering a healthy baby is just like any other natural phenomenon – they go into labour near or on their due date, give birth, and leave home with their little one after a short span of time.

However, not every pregnancy sails smoothly. For certain women and fetuses, ongoing monitoring by an obstetrics and gynae expert is critical to ensuring the well-being of both the mother and the baby, ensuring a safe and healthy delivery. Such pregnancies are what experts refer to as ‘high-risk pregnancies.

What could Lead to a High-Risk Pregnancy?

If you go back four to five decades, it was normal for women to bear multiple children in their early to mid-40s. These days, however, things have changed. As a consequence of poor diet, a sedentary lifestyle, and widespread pollution, women who are above the age of 40 pose a substantial risk to themselves and their unborn child. 

Similarly, an early pregnancy could be just as unsafe. We have data confirming that expectant moms under the age of 17 are at a greater risk of developing complications than those between the ages of 18 -35.  So, it is essential to speak with your gynae and obstetrics specialist to manage the developmental milestones for the fetus and your own health. If you experience unusual symptoms or are unable to feel movements of the baby in your tummy, waste no time to rush to the nearest hospital.

Medical Conditions Associated with a High-Risk Pregnancy

Preeclampsia 

The most common type of risk associated with a high-risk pregnancy include Preeclampsia, which is characterized by elevated blood pressure and protein in the urine during pregnancy, and could result in a premature birth.

Gestational Diabetes

Gestational Diabetes is marked by high blood sugar levels during pregnancy. This condition, if not treated, could lead to complications such as low or excessively high birth weight and a premature delivery.

Placenta Previa

Another concern is the heightened likelihood of Placenta Previa, a condition where the placenta partially or fully obstructs the cervix. While occurring in approximately one in 200 pregnancies overall, women aged 35 or older are more susceptible to it. It’s a serious condition that can increase the chances of premature labor and stillbirth, underscoring the importance of careful monitoring and medical intervention. 

Depression

As a clinical illness and acute condition, depression is the least talked about in expecting females. It develops among approximately 15-23% of women – and – is more likely if the mother has had depression episodes before. The onset of depression during pregnancy may be attributed to hormonal fluctuations, fatigue, domestic stressors, and inadequate support. This condition, in turn, can lead to potential complications during pregnancy and childbirth.

Even after childbirth, depression can significantly impede self-care and parenting responsibilities. Consulting with your healthcare provider about therapeutic interventions such as counseling or medication is highly advisable. It is also important to thoroughly discuss the potential risks and benefits of medication use during pregnancy or breastfeeding. 

The incidence of premature labour is almost twice as much during high-risk pregnancies than normal ones. It is classified as labour that begins before the start of week 37. While there is a fair chance that your premature baby or ‘preemie’ grows up to become a perfectly healthy individual, a small percentage of preemies can develop health problems or development delays later on in their lives. 

Despite not having sufficient data to indicate which women will go through preterm labour, experts point to factors such as certain infections from bacteria, chronic hypertension, a shortened cervix or previous preterm birth.

How is a High-Risk Pregnancy Managed?

For women with high-risk pregnancies, a biophysical profile (BPP) is performed to assess fetal well-being. This test, typically conducted after the 28th week of pregnancy, combines a nonstress test (NST) with an ultrasound examination.

The NST evaluates fetal health by monitoring the fetal heart rate in response to movements. It entails placing a fetal monitor on the mother’s abdomen – lasting between 20 and 30 minutes. Generally, Hospitalization is not required for this procedure.

Combined with an ultrasound exam, the BPP produces results based on the following factors:

• Fetal tone
• Fetal movements & response to stimuli
• Fetal breathing
• Volume of amniotic fluid

Each component, including the nonstress test, receives a score ranging from 0 to 2, with a total score of 10. The interpretation of the BPP score varies depending on the specific clinical circumstances. Typically, a score of 8 or 10 is deemed normal, while a score below 8 typically warrants additional assessment or the emergency delivery of the baby.

To further manage a high-risk pregnancy, your healthcare provider will recommend you do the following:

• Daily intake of at least 400 grams of folic acid till birth
• Maintain a healthy weight
• Avoid cigarettes, alcohol and any types of carcinogens
• Get the necessary immunizations
• Seek support of friends and family

Remember, don’t hesitate to have an open talk with your healthcare provider, because essentially, your physical and mental wellbeing will dictate how well you’re able to take care of yourself and your tiny munchkin!