High Risk Pregnancy

If you experience complications during your pregnancy or have a medical condition that is likely to cause complications, your doctor may categorize your pregnancy as “high risk.” A high risk pregnancy requires regular medical monitoring and management by a perinatologist, a doctor who focuses on complex or complicated pregnancies to ensure the best outcome for both you and your baby.

Although not every high risk pregnancy can be avoided, a highly trained specialist is in the best position to properly treat an expectant mother during the remainder of her pregnancy. If a doctor fails to identify issues that lead to complications in your pregnancy and you or your baby suffered injury as a result, you might be able to pursue a birth injury lawsuit. Please call Stern Law, PLLC (800) 462-5772 for more information about how our firm can help.

What are the risk factors associated with a high-risk pregnancy?

There are a variety of reasons why a pregnancy may be categorized as high-risk, including:

• Maternal age – One of the most common risk factors associated with a high risk pregnancy is the age of the expectant mother. Women who are under the age of 17 or more than 35 years old at the time their child is due may be at a greater risk of complications than those in their late teens and early 30s. The risk of genetic conditions, mental retardation and other problems greatly increase for pregnant women over the age of 40;
• Poor lifestyle choices – Women who use alcohol, drugs or smoked before or during pregnancy are at a greater risk of having serious and sometimes fatal complications;
• Prescription drug use – Certain prescription medications can place a woman at higher risk for pregnancy-related complications. These medications include, but are not limited to lithium, phenytoin, SSRIs, and valproic acid;
• Pre-existing medical conditions – There are a number of pre-pregnancy conditions that can present serious risks for an expectant woman and her unborn child, including diabetes, hypertension, HIV/AIDS, autoimmune diseases such as lupus and rheumatoid arthritis, epilepsy, diabetes, cancer, and heart, lung and kidney disorders. A history of previous miscarriages or complications that arose in past pregnancies, as well as a family history of genetic disorders may also characterize a pregnancy as high risk;
• Medical conditions that manifest during pregnancy – Sometimes women who are otherwise healthy before their pregnancy can develop certain problems that could adversely affect both them and their unborn child. The most common high-risk related complications are:
  • Preeclampsia – Also known as toxemia, preeclampsia is a serious condition that develops during pregnancy that is marked by sustained periods of high blood pressure – typically readings exceeding 140/90 mm Hg and high urine protein levels, or proteinuria. The reason why protein shows up in a pregnant woman’s urine is because the condition causes blood vessels to leak protein to various parts of the body, including the bladder;
  • Gestational diabetes – During pregnancy, hormonal fluctuations may make a woman’s body less responsive to insulin, which does not always present a serious problem. Oftentimes, a woman’s body is able to self-regulate during pregnancy to restore normal blood sugar levels within the healthy target range. A woman may have gestational diabetes if she received a fasting blood glucose test that exceeds the normal range of 7 and 100 mg/dL. For some expectant mothers, complications may arise if her body is unable to compensate for the inhibited insulin levels caused by her pregnancy. Gestational diabetes requires regular monitoring, diet and exercise to keep her blood sugar levels within the normal range. Generally, a woman’s blood sugar levels return to normal after she gives birth.
• Pregnancy-related complications – Oftentimes, a pregnancy is deemed high risk due to issues that manifest as a result of the pregnancy itself, which have little to nothing to do with a woman’s health. These are as follows:
  • Pre-term labor – This refers to a situation where a woman goes into labor before her 37th week of pregnancy. Despite the fact that there is no specific way to predict whether a woman will experience pre-term labor, there are a number of factors that increase the likelihood of this happening such as maternal infections including chicken pox, rubella, measles, hepatitis, encephalitis, meningitis, or cytomegalovirus; an incompetent cervix, polyhydramnios, macrosomia, or a history of previous premature births;
  • Multiple births – The more children that a woman is carrying, the greater the chance that certain complications will arise;
  • Placenta previa – This is a condition where the placenta either partially or fully covers the cervix; a doctor may decide to perform a cesarean section to avoid vaginal birth-related complications if the woman is close to her due date.

What are the signs and symptoms of a high risk pregnancy?

There are a number of different factors that give rise to a high-risk pregnancy, certain signs and symptoms may be indicative of a serious underlying problem, such as:

• Loss of consciousness;
• A burning sensation while urinating;
• Difficulty passing stool;
• Moderate to severe headaches;
• Moderate to severe vaginal bleeding;
• Uterine cramping;
• Moderate to severe back pain;
• Leaking amniotic fluid;
• Moderate to severe pain in the abdomen or pelvis;

• Moderate to severe edema, or swelling, in the extremities, especially the ankles and feet;
• Vision problems, including blurriness or dimness;
• High fever;
• Swelling in the face;
• Persistent and ongoing contractions that last for more than an hour;
• A feeling of pressure in the pelvis that will not subside.

How is a high-risk pregnancy diagnosed?

There are a number of ways in which a medical professional can determine whether you are at risk for pregnancy-related complications. The specific tests or procedures used often depends upon the nature of the suspected condition. Here are some of the possible tests or studies:

• Ultrasound – There are a variety of ultrasounds, including targeted ultrasounds, that are able to produce images of a child in utero and target a suspected issue, such as abnormal fetal development;
• Amniocentesis – This is a procedure where a syringe is inserted into the uterus in order to extract a sample of the amniotic fluid that surrounds and protects a growing fetus. This procedure, which is typically performed after the 15th week of pregnancy, is able to diagnose certain fetal genetic conditions, such as neural tube defects as well as brain and spinal cord abnormalities;
• Cordocentesis – This is a highly-specific procedure, also referred to as percutaneous umbilical blood sampling, that involves the extraction and testing of blood from the umbilical cord. This test is usually performed after the 18th week of pregnancy and is able to identify certain fetal chromosomal abnormalities, blood conditions and viral or bacterial infections;
• Laboratory tests – If you have a history of pre-term labor, your doctor may choose to take a sample of your vaginal fluid to test for fetal fibronectin – a glue-like substance that is responsible for connecting the fetal sac to the uterine lining. If fetal fibronectin is present, it may be sign of an impending early delivery;
• Chorionic villus sampling (CVS) – This is a procedure typically performed between the 10th and 12th week of gestation, in which placental cells are removed and subsequently tested for certain abnormalities in the event a doctor suspects a fetal genetic condition;
• Fundal height measurement – Fundal height is a measurement of the distance between the pubic bone and the top of the uterus. If the measurement is too large, it may indicate a macrosomic, or overly large fetus;
• Cervical length measurement – This is a measurement of the length of the cervix, which is typically determined through the use of an ultrasound. If you have a shortened cervix or other related issues, this could result in a premature birth if medical intervention is not sought immediately;
• Fetal monitoring – A health care provider may also conduct non-stress testing to monitor the well-being of an unborn child thought to be overly large; the test measures the baby’s heart rate in response to his or her movements, and may be repeated should a doctor believe the child has a condition that may cause fetal distress during delivery.
• Urinalysis – Certain conditions such as preeclampsia can be diagnosed through a urinalysis, which detects the excess protein in the urine that is indicative of preeclampsia;
• Blood testing – Routine blood testing can demonstrate that you may have an underlying condition, such as gestational hypertension, which could place you and your child at a greater risk for complications without regular prenatal monitoring and treatment.

Certain tests, including an amniocentesis or CVS, may present small, yet potentially dangerous risks to an unborn child. It is important that parents decide which tests they feel comfortable pursuing. Every expectant mother should review with her doctor the various risks and benefits associated with the tests that have been suggested.

How can mothers prevent complications associated with a high-risk pregnancy?

Just because you are diagnosed has a high-risk pregnancy that does not necessarily mean that complications will automatically occur. Whether you already know that you are having a high-risk pregnancy or wish to prevent one, there are a number of proactive measures you can take to reduce the likelihood of problems, such as:

• Schedule a preconception visit – Even if you are extremely healthy before pregnancy, you can schedule a preconception appointment to ensure that you understand all of the steps that must be taken to have a healthy pregnancy and carry your baby to full term without complications;
• Seek regular and consistent prenatal care – Prenatal visits are the best way in which a health care provider can monitor the progress of your pregnancy and catch certain problems early before further complications can occur. If you are already at risk due to problems that arose in previous pregnancies, your doctor may refer you to a geneticist, prenatal specialist or other medical practitioner to maximize you chances of giving birth to a healthy, injury-free child;
• Seek help to manage diabetes – Since diabetes is often a precursor to a number of pregnancy-related complications, it is vital that your condition be properly managed;
• Avoid alcohol, drugs and smoking – Women who are pregnant are advised to avoid exposing themselves and their unborn child to alcohol, drugs and cigarette smoke, as these teratogens or substances that are capable of interfering with the normal development of an unborn child, can cause serious and sometimes fatal complications;
• Keep track of your child’s movements – During the latter portion of your pregnancy, you should keep track of how many times you feel your child move. You should feel you baby move at least 10 times per hour. If not, it is best to speak with a doctor to determine if there is a more serious problem at hand;
• Consult a doctor regarding prescription and over-the-counter drug use – Although certain medications are safe to take before pregnancy, there are certain drugs that may cause harm to your unborn child. Consulting with a doctor to make sure medications will not negatively affect your unborn baby is advisable;
• Avoid sick people – While it is not always possible to avoid sick people – including spouses and children – it is highly recommended that you do what you can to prevent colds and infection during pregnancy. Washing hands as often as possible is one way you can prevent the spread of germs and illnesses. It is also important to avoid visiting places with a high concentration of illness and infection, such as hospitals, nursing homes and daycare centers.

If you did not receive the special attention your high-risk pregnancy warranted, and either you or your baby were injured as a result, you may have legal options. Please call (800) 462-5772 for a free consultation with a birth injury attorney at Stern Law, PLLC.