High-Risk Pregnancy
A high-risk pregnancy is one in which the health of the mother, the baby, or both is at increased risk of complications before, during, or after delivery. Being classified as high-risk does not mean that complications will occur — it means that closer monitoring and specialist involvement are warranted to optimise outcomes.
What makes a pregnancy high-risk?
Risk factors are varied and can be maternal, foetal, or related to the pregnancy itself. Pre-existing maternal conditions include type 1 or type 2 diabetes (which requires particularly careful blood glucose management in pregnancy), chronic hypertension, autoimmune disorders such as systemic lupus erythematosus, epilepsy, heart disease, kidney disease, and mental health conditions. Conditions that develop during pregnancy include gestational diabetes, gestational hypertension, and pre-eclampsia — a serious condition characterised by high blood pressure and organ involvement that requires careful surveillance and sometimes early delivery. Advanced maternal age (over 35) is associated with higher rates of chromosomal abnormalities in the foetus and increased maternal cardiovascular risk. Multiple pregnancy (twins or more) carries substantially increased risks of preterm birth and other complications. A history of previous pregnancy complications — including miscarriage, stillbirth, preterm birth, or a baby with a structural anomaly — also warrants enhanced monitoring.
Care in a high-risk pregnancy
Management involves more frequent antenatal appointments, additional ultrasound scans (including growth scans and Doppler studies of foetal blood flow), specialist obstetric or maternal-foetal medicine review, and in some cases input from other specialities such as cardiology or endocrinology. Women with pre-eclampsia or severe foetal growth restriction may require hospital admission.
Choosing where to be treated
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