Your pregnancy has been labeled ‘high risk’ – now what?

While pregnancy is a time of joy and excitement for most mommies-to-be, you have heard what no pregnant woman wants to hear; ‘your pregnancy is a high risk pregnancy.’ This can cause you to feel stressed, nervous and a number of other uncertain emotions. If this is of any comfort, for a vast majority of high risk cases, although this diagnosis sounds extremely scary, it just means you require extra care. Thankfully, most of the time everything turns out just fine.

Doctor Thewin Dejthevaporn sheds some light on the diagnosis: “There can be many reasons why you are given the label high risk, none of which are intended to stress you out. As doctors, when we categorize your pregnancy to be of high risk, in most cases it just means extra monitoring or care before or/and during your pregnancy and after delivery. If you have been diagnosed as high risk, everything should turn out completely fine, as long as you make sure to keep all your obstetrician appointments and discuss any unfamiliar changes you feel with your doctor immediately.”

Dr. Dejthevaporn is an obstetrician and gynecologist at Samitivej Sukhumvit hospital. He specializes in maternal fetal medicine with expertise in antenatal care, delivery and high risk pregnancy management including ultrasound for diagnosis of fetal abnormality and prenatal diagnostic procedures.

Your pregnancy could be labeled high risk for a number of reasons. Sometimes a pregnancy is riskier due to a medical condition present before the pregnancy, such as the mother’s advanced maternal age, lifestyle choices, the family’s medical history or if the mother has had problems in her previous pregnancies. The average global age for having a child is between the ages of 19 and 34. Anything outside of this range automatically puts a woman into the high risk category. If a mother-to-be is under weight or over weight, has an underlying of medical illness or a family history of a serious illness such as high blood pressure, kidney disease, heart disease, lupus, diabetes, fibroids, asthma, seizure disorders and mental or emotional disorders then they fall into this category.

“While most women are concerned about what happens after they conceive, I suggest more attention be given to the parental health before the couple even tries. If we can screen for risks prior to conception, there are a number of precautions and medications that can be given beforehand to ensure the safety of the pregnancy,” suggests Dr. Dejthevaporn.

Sometimes the risk could be from complications that develop during pregnancy. There could be problems with the uterus, cervix or placenta. The mother-to-be may have severe morning sickness that continues past the first trimester. Other concerns could be a result of too much or too little amniotic fluid or restricted fetal growth. Twin or multiple pregnancies also puts the current pregnancy at risk.

“Although less commonly known here, multiple pregnancies can often be high risk. Close to 60 percent of all twins and more than 90 percent of triplets are born prematurely. If babies are born before time, their organs may not be fully developed, which increases risks. Identical twins face even more risks, if there’s blood transfusion in which blood flows from one baby to another. This can result in one having a heart attack from receiving too much blood and the other not growing due to too little blood.” explains Dr. Dejthevaporn. “However, under special attention, this case is usually detected early, and can be fixed in time to maintain the safety of the mother and child.”

If you have been diagnosed as high risk, be regular with your appointments. Make sure you eat a healthy diet by including fruits, vegetables, and protein (unless you are advised differently by your doctor).

Dr. Dejthevaporn suggests “Eat a combination of everything. Don’t eat too much seafood; about twice a week should be fine. Even though seafood has a lot of omega 3, too much of it may lead to the accumulation of mercury which can harm the fetus’s brain. Neither do we recommend too much milk for moms who have a history of an allergy themselves or in their previous child, as the new born may also develop the allergy towards the protein from cow’s milk. Take care of your hygiene during pregnancy. Even a cavity can create a risk of infection for the baby and can lead to premature delivery.”

Take a good prenatal vitamin containing both iron and at least 400 milligrams of folic acid. Don’t drink alcohol or smoke cigarettes, as is a general advice with any pregnancy.

If your obstetrician thinks that you need more attention, then you may be recommended various tests or procedures, in addition to routine prenatal screening tests depending on the circumstances.

“Expect to have more visits to the doctor than a woman who does not have a high-risk pregnancy. You may need a specialized or targeted ultrasound to screen for a suspected problem such as abnormal fetal growth or an Amniocentesis, which is taking a sample of the fluid that surrounds the baby test for any genetic conditions and infections or other lab tests if needed” continues Dr. Dejthevaporn. “These lab tests are all done to detect possible problems in advance, to prevent it ahead of time and ensure the safety of you and your baby. I repeat again that being labeled ‘high risk’ only means extra care is needed.”

Don’t get stressed about it or let anxiety affect your health and your baby’s health. Consult your health care provider about healthy ways to relax and stay calm.

“You could use imagining pleasant objects or experiences to calm you down. Watch positive television, listen to music, read light books or whatever works for you to help reduce anxiety during pregnancy. Staying happy is the best way to minimize any risk involved” emphasizes Dr. Dejthavaporn.