High-Risk Pregnancy

Most babies are born healthy. However, about one out of 10 pregnancies has a problem that affects the mother, baby or both. Sometimes these problems are genetic disorders passed from one or both parents to their children. Sometimes a fetus has birth defects and does not develop “normally.” Perhaps the mother has a medical condition or develops one that makes the pregnancy risky. Unfortunately, some problems can cause babies to die before they are born or shortly after birth.

Advances in prenatal and newborn medical care for these problems has greatly improved chances that mothers will deliver babies who will survive and lead healthy, normal lives.

Close monitoring for high risk pregnancies by ultrasound and electronic fetal monitoring tests, more frequent prenatal care and improved patient education can help prevent many problems or make them not so severe. If you have a medical problem before becoming pregnant or develop one during pregnancy that affects you or your baby, you may be advised to consult or transfer your care to a UT Medical Center doctor who specializes in high-risk pregnancies. These doctors, called perinatologists, are experts in managing problems of mothers and unborn babies, and they will work closely with your own doctor to do everything possible to make sure you and your baby remain healthy.

Problems in pregnancy often can be managed from home with more frequent visits to the doctor. Sometimes, it is necessary to put mothers in the hospital where they can be watched more closely and get help quickly if it becomes necessary. Remember, your doctors are experienced with pregnancies of all types and want only the best for you and your baby. They know that it can be very stressful to have pregnancy complications that require more trips to the hospital or long periods of time on bed rest at home or in the hospital.

It is important to realize that providing care for high-risk pregnancies takes time. Many visits involve fetal testing such as electronic fetal monitoring and ultrasound. It is not unusual for high risk mothers to have NSTs and ultrasound weekly or twice a week. Lab work may need to be done more often, too. Your lab work can give us critical information, and we may ask that you stay at the hospital until we get lab results that tell us it is safe for you to go home. It is not unusual to be at the office for several hours at a time. By asking you to keep more frequent appointments, we often can keep you out of the hospital and successfully help you manage problems at home. Please keep in mind that we do not want to put you in the hospital if we can manage you safely at home.

At UT Medical Center, we have a team of care professionals that will support you and your family through these difficult times, should that become necessary. This team includes nurses, nurse practitioners, social workers and care managers in addition to prenatal doctors, OB/GYN residents and neonatal doctors who are specialists in taking care of very small babies.

Some prenatal problems that may require consultation or transfer to a high-risk prenatal doctor include the following.

• High Blood Pressure
• Toxemia (PIH, preeclampsia, eclampsia or HELLP
• syndrome)
• Diabetes and gestational diabetes
• Heart, thyroid, lung or kidney disease
• Epilepsy or other seizure disorders
• Blood clot history
• Premature Labor
• Early rupture of membranes (bag of waters)
• Vaginal bleeding especially in the 2nd or 3rd trimester
• Poor fetal growth
• Low or high amniotic fluid
• Infections
• Multiple pregnancy (twins, triplets)
• Previous pregnancy problems
• Mothers younger than age 15 or older than 35
• Mental health problems
• Drug use
• Severe obesity
• Abnormal fetal heartbeat
• Rh factor problems
• Placental problems