Being pregnant means for most women a mixture of joy and curiosity, but also concern and fear. Every expectant mother hopes that the pregnancy will proceed without complications and that the child will be born healthy. There is therefore a great deal of trepidation when the doctor speaks of a high-risk pregnancy. When an expectant mother hears the term “high-risk pregnancy“, she may initially be frightened by the news. A high-risk pregnancy is defined as an expectant mother who is at risk of complications during pregnancy or delivery, or who is at increased risk of developing a fetal disorder.
Diagnosis of “high-risk pregnancy” is common
The good news is that most of the risks can be minimized with intensive screening and monitoring. However, it is also important to remember that the list of possible risks has expanded to 52 items in recent years. Which means that the diagnosis of high-risk pregnancy is very often made today. For example, even when the mother is “only” over 35 years old and expecting her first child.
Criteria risk pregnancy
Important criteria for deciding whether a woman needs care as a high-risk pregnant woman are, for example:
- The woman has already had a miscarriage, premature birth or stillbirth
- The pregnant woman is diabetic
- There is a disease of the heart, circulation or kidneys
- The woman is ill with pregnancy poisoning
- A multiple birth is expected
- There is a rhesus incompatibility present
- The child is lying incorrectly (transverse or breech presentation)
- The expectant mother has already been delivered once by cesarean section surgery
- The expectant mother is expecting her first child and is under 18 or over 35 years old
Although these criteria are for the good of the pregnant woman, but they have also led to the fact that the high-risk pregnancy has become the rule and a normal pregnancy is the exception. A study confirms that today three out of four pregnant women are defined as “high-risk pregnancy“. The result of such “overuse” could be that pregnant women no longer perceive their condition as natural and can enjoy it accordingly, but spend the period of pregnancy in constant concern for the well-being of their child and their own health.
What are the risks?
The range of possible risks is wide, but many of the causes are rare. A distinction can be made between maternal pre-existing conditions, problems that have occurred in previous pregnancies and complications caused by the course of pregnancy.
Maternal diseases
The most important chronic diseases that can lead to pregnancy complications are diabetes, cardiovascular diseases such as heart defects and hypertension, kidney as well as thyroid diseases. Affected women who wish to have children must talk in detail with their gynecologist and internist before planning a pregnancy. Individual risks must be carefully weighed and the therapy concept for the time before and during pregnancy must be determined. During the course of pregnancy, close monitoring of the mother and unborn child is necessary, and the gynecologist and internist should coordinate their efforts. Drug addiction or chronic infections of the mother (for example, HIV, hepatitis) also require an individually tailored treatment concept.
Problems associated with previous pregnancies
Women who have had a miscarriage, premature birth or stillbirth in the past are naturally afraid that this will happen again. But only in a few cases is this fear justified – most women subsequently have completely normal pregnancies. The risk depends on which week of pregnancy and how often these problems occurred and what the cause was. Therefore, it is important to have a detailed and clarifying discussion with the gynecologist. If the pregnant woman has given birth by cesarean section in the past, the risk of complications may be increased. As a result, a normal birth is often difficult or no longer possible. A woman who has already given birth to more than one child is also classified as a high-risk pregnant woman.If a rhesus-negative mother has already had a birth, miscarriage or abortion with a rhesus-positive child and has not then been vaccinated with a serum that prevents the formation of antibodies, rhesus incompatibility can become a problem in the next pregnancy. However, this complication usually no longer plays a role in our practice.
Pregnancy-related complications
The age of the mother can also cause problems. Young girls under 18 are more likely to have complications during pregnancy, and the risk of chromosomal damage to the baby increases in older women (35 and older). Fetal malformations diagnosed with ultrasound or amniocentesis can lead to complications during pregnancy and birth. Multiple births or a deficiency development of the child are also burdened with a higher complication rate. Complications can also occur in pregnancies that are initially normal.
EPH gestosis as a complication
One of the most common and dangerous is EPH gestosis. About five to eight percent of all expectant mothers are affected. The letter E stands for edema or edema (water retention in the tissues), P refers to proteinuria (protein excretion in the urine), and H stands for hypertension (elevated blood pressure above 140/90). Recurrent vaginal bleeding is also a reason for close monitoring, as is an amniotic fluid infection. Towards the end of pregnancy, the fetal heart tones are determined by means of CTG. Cardiac arrhythmias of the unborn child, such as the heart beating too slowly, too fast or irregularly, may be indications of fetal stress situations such as oxygen deficiency and may require medical action.
Conclusion High-risk pregnancy
What is known is a whole range of risks for possible pregnancy complications. However, through detailed discussions, preventive measures and close checks, these can usually be detected early and avoided or treated accordingly. A trusting relationship with the gynecologist can not only guarantee medical care, but also help reduce anxiety.
