Pregnancy is undoubtedly the most fascinating and beautiful biological event that occurs in humans. Every couple dream of the moment of becoming pregnant and the sublime moment of birth, after an uncomplicated pregnancy.
However, in some cases, the course of pregnancy may not be as expected due to the appearance of complications that can result in adverse perinatal outcomes. The conditions that can lead to these circumstances define High-Risk Pregnancy (HRP).
HRP is considered when there are one or more conditions in the mother or the baby (called risk factors) that increase the chances of complications during pregnancy and childbirth.
A high-risk factor is defined as a characteristic or condition of the mother (before or during pregnancy) or the baby that affects the health of both the mother and the newborn. Some risk factors can be treated, reducing their adverse effects on pregnancy, while others cannot be modified but their management allows for a more rigorous monitoring plan, leading to a better-controlled pregnancy that results in favorable outcomes for both the mother and the baby.
How can I know if my pregnancy is high-risk?
The assessment of pregnancy risk should ideally be done before conception, or even better, before attempting to conceive there are preconceptional risk factors whose identification allows the couple to establish treatment with the aim of achieving the best possible health conditions when conception is achieved. Therefore, “Every couple trying to conceive requires a gynecological consultation before conception.” The evaluation of pregnancy risks begins with a detailed medical history, followed by routine tests, and finally, according to each case, special studies (laboratory tests, level II ultrasounds). At the end of these procedures, the specialist in gynecology and obstetrics can determine if a pregnancy is high-risk.
What are the most common risk factors?
Risk factors can be classified into:
1. Sociodemographic Factors
- Age: younger than 19 or older than 35
- Poor prenatal care
- More than 5 previous births
- Weight less than 50 kg
- Habits and lifestyle
2. Medical or Surgical Conditions
- Diabetes
- Hypertension
- Epilepsy
- Thyroid gland diseases
- Kidney diseases
- Asthma or other lung diseases
- Immunological diseases (Lupus, Arthritis)
- Hematological and coagulation disorders
- Psychiatric disorders
3. Obstetric Factors (Previous Pregnancies)
- Rh-negative blood type
- History of miscarriages
- History of stillbirth
- History of low-birth-weight newborns (less than 2.5 kg)
- History of premature birth (less than 34 weeks)
- History of fetal malformations
- Uterine malformations
- History of venous or arterial thrombosis
4. Pregnancy Complications (Current)
- Fetal growth restriction (low weight for gestational age)
- Threatened preterm labor
- Rupture of membranes
- Hemorrhage at any trimester of pregnancy
- Gestational diabetes
- Recurrent vaginal or urinary infections
- Anemia
5. History of Complicated Deliveries
- Emergency cesarean section
- Instrumental delivery (forceps)
- Vaginal tears
- Urinary or fecal incontinence after childbirth
- Newborn with signs of asphyxia
What are the measures or surveillance plan if my pregnancy is high-risk?
After the risk assessment of your pregnancy, the specialist will explain in detail the surveillance plan according to your specific case, as well as the measures and recommendations you will need to follow to achieve a pregnancy with the lowest probability of complications. The identification of risk factors in a pregnancy can only be done by a specialist physician.
