High-risk pregnancy – what is it?

High-risk pregnancy - what is it?

For most women, being pregnant is a mixture of joy, curiosity, worry, and fear. Every expectant mother hopes that the pregnancy will proceed without complications and that the child will be born healthy. The anxiety is, therefore, great when the doctor speaks of a high-risk pregnancy. When a mother-to-be hears the term high-risk pregnancy, she may be frightened at first. A pregnant woman who is at risk is a mother who is at risk of complications during pregnancy or childbirth or who has an increased risk of developing a child disorder.

Diagnosis of “risk pregnancy” is frequently made.

The good news is that most risks can be minimized with careful prevention and monitoring. However, it should also be noted that the list of possible risks has expanded to 52 items in recent years, which means that the diagnosis of high-risk pregnancy is made very often today. For example, even if the mother is “only” over 35 years old and expecting her first child.


Criteria risk pregnancy

Essential criteria for deciding whether a woman needs to be cared for as a pregnant woman at risk 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, circulatory system or kidneys
  • The woman is ill with pregnancy poisoning
  • A multiple birth is to be expected
  • Rhesus intolerance is present
  • The child is in the wrong position (lateral or breech)
  • The mother-to-be has already given birth through a caesarean operation
  • The expectant mother is expecting her first child and is under 18 or over 35 years old

Although these criteria serve the well-being of the pregnant woman, they have also resulted in high-risk pregnancies becoming the norm and normal pregnancies being the exception. A study confirms that today, three out of four pregnant women are defined as “pregnant at risk”.

The result of such “oversupply” could be that pregnant women no longer perceive their condition as natural and can enjoy it accordingly but spend the time of pregnancy in constant concern for the well-being of their child and their health.

What are the risks?

The range of possible risks is extensive, but many causes are rare. A distinction can be made between maternal pre-existing conditions, problems that have occurred in previous pregnancies and complications that are caused by the course of the pregnancy.


maternal diseases

The most important chronic diseases that can lead to pregnancy complications are diabetes, cardiovascular diseases such as heart defects and high blood pressure, and kidney and thyroid diseases. Affected women who wish to have children must speak to their gynaecologist and internist in detail before planning a pregnancy. Individual risks must be weighed up precisely, and the therapy concept for the time before and during pregnancy must be determined.

During pregnancy, close monitoring of the mother and unborn child is necessary, which should be coordinated between a gynaecologist and an internal medicine specialist. Drug addiction or chronic infections in the mother (e.g. HIV, hepatitis ) also require an individually tailored treatment concept.

Problems with previous pregnancies

Of course, women who have had a miscarriage, premature birth or stillbirth in the past are afraid that this will happen again. But this fear is only justified in a few cases – most women have a completely ordinary course of pregnancy. The risk depends on the week of pregnancy, how often these problems occur and what the cause was found to be. It is, therefore, essential to have a detailed and clarifying discussion with the gynaecologist.

If the pregnant woman has given birth by caesarean section in the past, the risk of complications may be higher. As a result, a normal birth is often tricky or no longer possible. A woman who has already given birth to more than one child is also classified as a high-risk pregnancy.

Suppose a Rhesus-negative mother has already had a birth, miscarriage or abortion with a Rhesus-positive child and has not been vaccinated with a serum that prevents the formation of antibodies. In that case, Rhesus intolerance can become a problem in the subsequent pregnancy. However, this complication is usually no longer an issue for us.

Pregnancy-Related Complications

The age of the mother can also cause problems. Young girls under the age of 18 are more likely to have complications during pregnancy, while older women (35 and over) have an increased risk of chromosomal damage in the child. Malformations in children diagnosed with ultrasound or amniocentesis can lead to complications during pregnancy and childbirth. Multiple births or poor development of the child are also associated with a higher complication rate. Complications can also occur in initially normal pregnancies.


EPH gestosis as a complication

One of the most common and dangerous is EPH gestosis. About five to eight per cent of all expectant mothers are affected. The letter E stands for oedema or oedema (water retention in the tissue), P denotes proteinuria (protein excretion in the urine), and H stands for hypertension (elevated blood pressure over 140/90). Recurring vaginal bleeding is just as much a reason for close monitoring as amniotic fluid infection.

The child’s heart sounds are determined at the end of pregnancy using CTG. Cardiac arrhythmias in the unborn child, such as the heart beating too slowly, too quickly or irregularly, can be an indication of stressful situations in the child, such as a lack of oxygen, and may require medical attention.

Conclusion high-risk pregnancy

A whole range of risks for possible pregnancy complications is known. However, through detailed discussions, preventive measures and close controls, these can usually be identified early and avoided or treated accordingly. A trusting relationship with the gynaecologist can not only guarantee medical care but also help to reduce fears.


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