High Risk Pregnancy Care
Perinatology is a subspecialty of obstetrics that is concerned with the care of the fetus during high-risk pregnancies. Women who are a higher risk of developing problems or complications during pregnancy are often sent to a perinatologist to ensure the pregnancy is as healthy as possible.
Common High-Risk Pregnancy Conditions
Preterm labor occurs when a woman goes into labor before the 37th week. Babies who are born prematurely may not have developed fully and could be at risk for health problems. While there isn’t one main cause of premature labor, doctors will look for any abnormalities of the cervix and certain vaginal bacterial infections.
Preeclampsia is a dangerous condition for mother and baby. It causes the blood vessels to constrict, increasing blood pressure and potentially reducing blood flow to vital organs such as the liver, kidneys and brain. Instances of preeclampsia are reduced in women who are a healthy weight, eat a nutritious diet and get regular exercise.
Pregnant women who have never had diabetes before can develop gestational diabetes. The increased blood sugar levels can lead to the baby being born too big. Although gestational diabetes may disappear after delivery, it is important that symptoms are managed.
Conditions that result in a pregnancy being considered high risk include:
- Preeclampsia – Preeclampsia is when a pregnant women has dangerously high blood pressure and large amounts of protein in her urine. The condition typically occurs around week 32 of pregnancy. A perinatologist will be able to help a woman suffering from preeclampsia stay healthy throughout the remaining weeks of her pregnancy.
- Preterm Labor – Preterm labor is when labor starts between weeks 20 – 37. The earlier the delivery, the greater the chance the baby€™s organs will be underdeveloped. Preterm labor is often stopped with medications and women are usually allowed limited mobility until after week 37.
- Slowed growth for the baby – Fetal growth restriction can be caused by placental abnormalities and hypertension during pregnancy.
- Maternal age – If a woman is under 17 or more than 35, they are at a higher risk of pregnancy complications and will be monitored throughout pregnancy.
- Weight – If a person is classified as underweight or obese, a pregnancy can be considered high-risk and dangerous. Please check with your physician prior to trying to conceive in order to ensure you’re at a healthy weight for pregnancy.
Important Appointments & Tests
In order to give mother and baby the best possible chance at a healthy delivery, it is recommended that women attend:
- Preconception counseling. Before trying to get pregnant, a preconception counseling appointment will help the mother and father be better prepared for pregnancy. The doctor will explain any potential risks and recommend lifestyle changes in order to increase chances of a healthy pregnancy.
- Routine Checkups. Most pregnant women have around ten prenatal appointments during their pregnancy. Women with a high-risk pregnancy may visit more, especially during the second and third trimester.
In addition to routine prenatal tests, additional screenings are recommended. Depending on circumstances, your obstetrician may choose to perform the following:
- Targeted Ultrasound. A fetal ultrasound can provide the doctor with images of the baby in the uterus. The doctor will be able to determine if certain abnormalities or defects are present.
- Cervical Ultrasound. Ultrasound images of the cervix may be taken to help the doctor determine if its length could be a factor that causes preterm labor.
- Amniotic Fluid Test. A sample of the fluid that surrounds the baby in the uterus will be taken and tested in order to identify various genetic defects.
- Umbilical Cord Sample. A blood sample will be take from the umbilical cord after the 18th week of pregnancy in order to identify certain chromosomal conditions and blood disorders.
- Fetal Fibronectin Test. Vaginal swabs will be tested for fetal fibronectin, which could be an indication of preterm labor.
The OBGYN physicians at Virginia Women’s Health provide high quality obstetrical care, including care for high risk pregnancies, for women in and around Reston, VA. Call our office at (703) 435-2555 to make an appointment! You can also request an appointment online.