Overview
A high-risk pregnancy is one in which the pregnant person or fetus has a greater chance of complications before, during, or after birth. The reason may be present before pregnancy, develop during pregnancy, or relate to the pregnancy itself. Care often includes more frequent visits, extra tests, and input from specialists.
Key Symptoms
High-risk pregnancy is not a single symptom, but some warning signs can signal a serious problem. These include vaginal bleeding, severe abdominal pain, severe headache, swelling that appears suddenly, vision changes, fever, trouble breathing, chest pain, leaking fluid, contractions too early, or reduced fetal movement later in pregnancy. Any of these symptoms should be reported promptly to a healthcare professional.
Causes and Risk Factors
Risk factors include long-term conditions such as high blood pressure, diabetes, heart disease, kidney disease, autoimmune conditions, or infections. Pregnancy-related problems such as preeclampsia, gestational diabetes, placenta problems, preterm labor, or carrying twins or more can also make a pregnancy high risk. Age may play a role, including very young pregnancy or pregnancy at an older maternal age. Smoking, alcohol, substance use, poor nutrition, and limited access to prenatal care can also increase risk.
Who Is Affected
Anyone who is pregnant can develop a high-risk pregnancy, even without earlier health problems. Some people are identified as higher risk before conception or at the first prenatal visit, while others become high risk later because of complications that develop during pregnancy. This term applies across all countries and care settings, though the risks may be greater where access to prenatal and emergency obstetric care is limited.
Prevention
Not all high-risk pregnancies can be prevented, but planning and early care can lower some risks. Steps may include managing chronic health conditions before and during pregnancy, avoiding tobacco, alcohol, and non-medical drug use, taking recommended prenatal supplements, getting advised vaccines, and attending prenatal appointments. Seeking care early in pregnancy is especially important.
Diagnosis and Tests
Healthcare professionals identify high-risk pregnancy by reviewing medical history, checking blood pressure, weight, and symptoms, and ordering tests as needed. Common tests include blood and urine tests, ultrasound scans, fetal growth checks, glucose testing, and monitoring of the baby's heart rate and movement. Some pregnancies also need genetic screening, infection testing, or referral to a maternal-fetal medicine specialist.
Treatment Categories
Treatment depends on the reason the pregnancy is high risk. Care may include closer monitoring, treatment of underlying health conditions, activity advice, management of blood pressure or blood sugar, specialist care, and planning the timing and place of birth. In some cases, hospital care is needed if there are signs of serious complications.
Living With It
Living with a high-risk pregnancy can be stressful and may involve more appointments, tests, and uncertainty. It can help to keep a list of symptoms, medications, and questions for each visit, and to have a plan for transport and emergency care. Emotional support from family, community, or a counselor may also be helpful.
When to Seek Medical Care
Contact a healthcare professional promptly if you have new swelling, severe nausea and vomiting, pain or burning with urination, fever, persistent headache, vision changes, contractions, leaking fluid, or if the baby seems to be moving less than usual later in pregnancy. Also seek advice if you miss appointments, cannot get medicines, or have trouble managing a chronic condition such as diabetes or high blood pressure.
When It May Be an Emergency
Get emergency medical help right away for heavy vaginal bleeding, severe shortness of breath, chest pain, seizures, fainting, severe abdominal pain, severe headache with vision changes, signs of stroke, or if you think labor is happening too early. Emergency care is also needed for severe trauma, thoughts of self-harm, or if the baby stops moving after you have noticed a clear change.