Introduction
A pregnancy is classified as a high-risk pregnancy if the pregnant woman has risk factors that can lead to complications for the mother or child during the course of the pregnancy. These can result from the medical history (pre/illness history) or after the examination of the becoming mother or with complications during the pregnancy. A high-risk pregnancy means more intensive care for mother and child. For example, the intervals between visits to the gynaecologist are shorter, ultrasound examinations of the pregnancy are carried out more frequently or special examinations are performed.
Classification
Anamnestic (pre-existing) risk factors are the age of the mother (under 18 years, over 35 years), diseases of the mother or within the family (e.g. diabetes mellitus, high blood pressure, epilepsy, severe overweight, infections) and previous operations, malformations or fibroids of the uterus. A high-risk pregnancy also exists in the case of a previous Caesarean section, more than five births in the past, a rapid succession of pregnancies (less than one year) and complications in previous pregnancies or births (see below). The use of medicines, drugs and alcohol can also lead to a high-risk pregnancy.
and alcohol during pregnancy and epilepsy and pregnancy Smoking during pregnancy also involves many risks for the pregnancy and the unborn child. Various risks can arise during pregnancy, making more intensive care of mother and child necessary. These include the occurrence of anemia (anemia), the occurrence of bleeding, blood group incompatibility (rhesus factor incompatibility), a malposition of the placenta (placenta praevia) or other placental disease, cervical weakness and premature labor. Other factors of a risk pregnancy are the diagnosis of various infections during pregnancy, gestational diabetes, high blood pressure during pregnancy or pre-eclampsia (pregnancy poisoning).
Age of the mother
If women are younger than 18 years or older than 35 years (from the second child older than 40 years), the pregnancy is classified as a high-risk pregnancy. Among other things, very young women are more likely to experience premature labor and premature births. In women over 35 years of age, chromosomal changes such as trisomy 21 (Down syndrome) are more common and the risk of miscarriage is higher.
Older women are more likely to have pre-existing conditions that lead to classification as high-risk pregnancies. In addition, the development of gestational diabetes, high blood pressure or thrombosis is more frequent during pregnancy. In the case of a high-risk pregnancy, the pregnant woman and the growing child receive intensive care.
This includes more frequent visits and ultrasound examinations at the gynecologist and special examinations can be carried out as part of prenatal diagnostics. Additional examinations include: Chorionic villus sampling: from the 6th week of pregnancy, puncture of the placenta (invasive), detection of chromosomal changes and metabolic diseases First-trimester screening: about 11th-13th week of pregnancy, taking the mother’s blood sample and ultrasound examination, detection of trisomy 21 (Down’s syndrome) Amniocentesis: from the 13th week of pregnancy, amniocentesis (invasive), detection of a genetic disease Umbilical cord puncture: from the 18th week of pregnancy SSW, puncture of the umbilical cord (invasive) and examination of the child’s blood Fine ultrasound: 19-22 SSW, ultrasound examination of the child’s organs, exclusion of developmental changes The costs of some of these examinations are covered by the statutory health insurance in the case of a high-risk pregnancy.
- Chorionic villus sampling: from the 6th week of pregnancy, puncture of the placenta (invasive), detection of chromosomal changes and metabolic diseases
- First-trimester screening: about 11-13 SSW, maternal blood collection and ultrasound examination, detection of trisomy 21 (Down’s syndrome)
- Amniocentesis: from the 13th SSW, amniocentesis (invasive), detection of a genetic disease
- Measurement of neck wrinkles: 11th -14th SSW, ultrasound examination, detection of chromosomal changes or a heart defect
- Prenatal test: from the 11th week of pregnancy, blood sample of the mother, detection of chromosomal changes
- Triple or quadruple test: 15th -18th SSW, blood sample of the mother, detection of chromosomal changes or malformations such as neural tube defects
- Puncture of the umbilical cord: from the 18th SSW, puncture of the umbilical cord (invasive) and examination of the child’s blood
- Fine ultrasound: 19-22nd SSW, ultrasound examination of the child’s organs, exclusion of developmental changes
