14 Conditions That Lead To High-Risk Pregnancy Complications
A high-risk pregnancy can be defined simply as a pregnancy with a high potential for complications that can affect the mum or baby.
These pregnancies may have a problem in the 1st, 2nd or 3rd trimester – or during labour and after delivery.
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Why Read This?
Today we are going to look at conditions (or groups of conditions) that could render your pregnancy high risk.
In addition, what could your medical team do to reduce this risk leading to safe delivery for you and your baby?
Because the problem could develop at any stage of pregnancy, you must be familiar with some of them and why they may happen.
Age
Being too young is a risk as physical, mental or emotional maturity can affect the successful pregnancy outcome for both baby and the young mother.
Conversely, older mothers from age 35 years upwards run risks of developing conditions like high blood pressure in pregnancy and pre-eclampsia, which could affect the baby’s development; and cause birth complications.
The risk of having babies with some chromosome abnormalities increases as women grow older. One example is Trisomy 21, where babies are born with Down’s Syndrome.
Pre-existing Medical Problems
If you have certain pre-existing conditions, there is a chance you may become very ill when pregnant.
This can also affect your baby’s development leading to premature birth or caesarean section.
Examples are:
- High blood pressure- bp (pre-eclampsia – check out my detailed video on this with risks in pregnancy here)
- Diabetes Mellitus,
- Asthma
- Sickle cell dx, Thalassemia,
- Cystic fibrosis
- Lupus
- Anaemia
- Other heart conditions like IHD or cardiomyopathies etc
Previous Pregnancy Complications
Suppose you experienced any complications in a previous pregnancy. In that case, they could have affected your ability to have a normal pregnancy next time. Or those conditions may recur in a future pregnancy.
Examples are:
- Having 2 previous CS means any future pregnancy is also delivered by CS.
- gestational DM,
- PIH,
- Conditions that can affect the progress of labour – malposition, malpresentation,
- Recurrent miscarriage (cervical insufficiency – cervix dilates in the absence of womb contractions- leading to premature labour),
- Any conditions that increase the risk of preterm labour
Assisted Pregnancy
Assisted pregnancy – any pregnancy conceived via IVF, IUI or other measures outside of natural conception will require increased monitoring. (precious baby)
Infections
Infections can affect the successful progress of a pregnancy. In addition, some have the potential for severe complications if not carefully managed.
With effective antivirals, women with Hiv can have successful pregnancy outcomes while remaining well to care for their children.
Covid 19 infections can put a woman exposed or infected at higher risk of developing blood clots especially life-threatening PE.
Thus, they will need monitoring and anticoagulant treatment while battling the risk of developing pneumonia.
Vaccines reduce the risk of adverse outcomes in pregnant women with C19.
Remember, pregnancy is a relatively immunocompromised condition. The body does this to reduce the chance of the mum rejecting the baby.
While this is good for the baby, it renders mum at a higher risk of contracting Covid and pneumonia from that leading to death. Vaccines help prevent this outcome.
First-time Pregnancy
First-time pregnancy! Yes, this could be a risk for some ladies. However, the changes in pregnancy could affect women significantly enough to cause problems that can be managed better next time because we are already aware of them.
Multiple Pregnancy
Multiple pregnancy is a fantastic event, but it also brings several problems. Low birth weight, preterm labour, and high blood pressure – to name a few may be issues your medical team needs to deal with in your pregnancy.
Mental Health
We’ve been speaking a lot about physical health problems.
But let’s remember, mental disorders can also have a severe effect.
Conditions like severe depression, bipolar disorder, and severe anxiety are a few examples. As a result, the mum’s ability to bond with and care for her baby can be disrupted, which can cause emotional problems for the baby in the future.
Some Gynaecological conditions
#9. The presence of some gynaecological conditions could affect the pregnancy.
Examples in this group are fibroids (pain, bleeding or preterm labour) or endometriosis and others.
Foetal Abnormalities
Where there are foetal abnormalities: heart defects, and hydrocephalus can affect the development of the baby, preterm labour and surgical delivery may be required.
Blood Group Disorders
Blood group disorders – The most common of these is Rhesus incompatibility.
In this condition, a baby’s red blood cells are destroyed after his blood mixes with his mother’s.
But why or how?
We all belong to different blood groups and types.
If a woman with blood type Rh- carries a child with blood type Rh+, the mum’s blood becomes ‘sensitised’ to Rh+ blood. This is the case whether she has a miscarriage, termination or goes on to deliver her baby.
This first baby is perfectly fine, mum is doing well too, but her blood now contains Rh antibodies from her baby.
Now, if she becomes pregnant again, the danger appears if baby #2 is also Rh+. Mixing of mum’s and baby’s blood via the placenta means that Rh antibodies from mum enter the baby’s blood and attack its blood cells. This situation causes rhesus disease, initially with severe anaemia and jaundice.
If rhesus disease is left untreated, severe cases can lead to stillbirth. If that doesn’t happen, devastating problems like brain damage, learning difficulties, hearing loss and loss of eyesight.
Rh type is inherited from our parents. So in this instance, mum is Rh-, Dad is Rh +, and their children can inherit either blood type. This is one of the reasons a complete account of previous pregnancy is taken and blood tests at your antenatal booking.
Then when we identify women with Rh- blood, we give them an anti-D immunoglobulin treatment that mops up any antibodies in them. Her baby is safe. But, if we did not do this, we could have a pretty sick child.
Endocrine Conditions
Endocrine conditions like Thyroid dx. The thyroid gland is responsible for the normal performance of our cells and organs. If it fails to work correctly, both mum and baby may become very unwell.
Neurological Conditions
Neurological conditions such as Epilepsy. Keeping seizures under control with the right drugs and at the right dose is vital in any lady with this condition. Care is also required to avoid or manage seizure triggers.
Both mum and baby can potentially be harmed if her condition is not carefully controlled.
Abnormal Weight
Abnormal weight, including being obese and severely underweight, can affect a woman’s ability to carry a pregnancy safely.
Preterm birth complications, anaemia, electrolyte imbalance or developing blood clots are only a few challenges either of these conditions may cause.
Monitoring High-risk Pregnancy
High-risk pregnancy issues may develop as pregnancy develops, not just from the beginning.
Some treatments your medical team will undertake are:
- access to your detailed health information, i.e. booking to take a history including mum, partner, family hx
- Tests inc blood tests for blood group and genotype, Diabetes, Anaemia
- Regular scans, especially (20 weeks) anomaly scans
- Drug Treatments – with regular monitoring, medicines such as:
- Aspirin for pre-eclampsia to reduce the risk of developing problems like low foetal growth rate or preterm labour.
- Others are progesterone to support the growth of the pregnancy,
- anti-hypertensive for PIH and pre-eclampsia,
- and steroids to help development in babies at risk of premature birth.
- More frequent scans, blood tests, and appointments with specialists, in addition to the midwife and general practitioner.
After birth focus is on any persisting complication, women can still have, including blood pressure, DM, and her risk of infections or blood clots.
Care to issues around the baby’s birth like prematurity, infection risk, breastfeeding, etc., and areas mother and baby will need support.
More Reading
Editing by AskAwayHealth Team
Disclaimer
All AskAwayHealth articles are written by practising Medical Practitioners on a wide range of healthcare conditions to provide evidence-based guidance and to help promote quality healthcare. The advice in our material is not meant to replace a qualified healthcare practitioner’s management of your specific condition.
Please contact a health practitioner to discuss your condition or reach us directly here.
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