What is a High-Risk Pregnancy?
A pregnancy is considered high-risk when maternal
or fetal complications are present that could
affect the health or safety of either the mother
or baby. Depending on the condition of your health
or the baby’s health, you may be required
to see a high-risk obstetrician, also known as
a maternal
fetal medicine specialist or perinatologist,
for a portion of your prenatal care or for your
entire pregnancy.
Complications could be pre-existing or could
arise during pregnancy and include:
Prenatal Screening
Certain prenatal
screening tests are routine
and occur throughout your pregnancy to help you
and your doctor monitor your health and the health
of your baby. These tests can also signal when
a problem arises and can help determine the best
course of treatment.
Depending upon your level and type of risk
and your family medical history, your doctor
may offer a variety of genetic tests including:
Genetic Counseling
At times, high-risk pregnancies are associated
with genetic
disorders. High-risk specialists
work with reproductive geneticists to provide
the most advanced testing for a range of genetic
disorders including Down’s Syndrome, spina
bifida, hemophilia, sickle cell disease and more.
Preconception
The preconception period is
the best time to prepare for a healthy baby and to reduce your chances of having
a high-risk pregnancy. Prior to conception, you should stop drinking alcohol,
smoking and using illegal drugs. These habits can have adverse effects on a
fetus and are associated with miscarriage, low birth weight, birth defects
or stillbirth.
A balanced diet is always important. You should
try to make the appropriate changes to your diet
before you get pregnant. Balancing your diet
with foods high in protein, fruits and vegetables,
grains, and dairy products will make you healthier
before you get pregnant. The Food and Drug Administration
(FDA) advises women of childbearing age who may
become pregnant, pregnant women, nursing mothers,
and young children not to eat shark, swordfish,
king mackerel and tilefish. These fish may contain
high levels of a form of mercury called methyl
mercury that may harm an unborn baby's or small
child’s developing nervous system.
Most doctors recommend that women begin taking
a daily multi-vitamin supplement and at least
400 micrograms (mcg) of folic acid before getting
pregnant. Taking folic acid is thought to reduce
a baby's risk of developing birth defects of
the spine, such as spina bifida. Ideally, you
should start taking a multivitamin with 400-800
mcg of folic acid two months before you get pregnant.
Talk to your doctor about taking folic acid during
pregnancy.
Maternal Fetal Medicine (High-Risk) Services
at Penn
Penn’s team of obstetricians, in the Division
of Maternal
Fetal Medicine,
specializes in high-risk pregnancies. Our Level III Intensive Care Nurseries
are staffed by physicians from The Children’s Hospital of Philadelphia,
who are highly trained in infant intensive care.
Reviewed by Linda Dunn, MD
October 17, 2005
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