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Women's Health


Managing High Risk Pregnancies


Prevention and Precaution



November 01, 2009
Pregnancy is often the most exciting time in a woman's life. Yet if you're a woman with a high-risk pregnancy, then nine months can seem very long and possibly stressful. But, with the knowledge and advanced technology available today, physician specialists are able to manage high risk pregnancies with greater ease than in past years.

What makes a pregnancy high risk

Generally, a high-risk pregnancy is anything outside a normal pregnancy. Factors that may increase your chances for a high-risk pregnancy include age; if you're overweight or underweight; or if you've had problems in previous pregnancies.

A mother's pre-existing health condition – such as diabetes, heart disease, kidney problems or autoimmune disorders – also increases likelihood of high-risk pregnancies. A mother having multiples amplifies the risk.

Health problems can also develop during a pregnancy that can make it high-risk. "Sometimes problems arise that are unique to being pregnant, such as pre-term labor, pre-eclampsia or gestational diabetes," says A.K. Hiett, MD, a maternal fetal medicine specialist at the St.Vincent Maternal Fetal Medicine and Genetics Center. "These conditions can occur even in a woman who was previously healthy, making it risky while she is pregnant."

Dr. Hiett says high-risk pregnancies don't always involve issues with the mom. Sometimes, a baby develops problems in the womb, such as heart or lung complications.

When you should seek specialized care

Exactly when a woman should seek specialized care depends on the condition and situation. If you have a pre-existing condition or have had difficulty with previous pregnancies, it's important to seek counsel early—even pre-conception, if possible.

"Many times, seeking care from a specialist pre-conception can greatly affect the outcome of pregnancy," says Dr. Hiett. For example, a woman with diabetes who is able to conceive while her diabetes is under control, provides a better chance for a successful pregnancy for both herself and her baby.

Dr. Hiett says other women who would benefit from pre-conception consultation include those with seizure disorders, high blood pressure or a known family history of genetic complications.

But, any woman – high-risk or not – should talk with her healthcare provider about maintaining proper health prior to getting pregnant.

What a specialist provides

As a maternal fetal medicine specialist, Dr. Hiett makes it a point to work with a woman's obstetrician or primary care physician to develop a plan of care tailored to her personal needs and medical history.

"We realize the majority of our patients already have established relationships with their healthcare providers," said Dr. Hiett. "We simply become part of that team and help facilitate care for the best possible outcome for mother and baby. Our skills are designed to complement those of obstetricians."

Maternal fetal medicine physicians provide maternal and fetal medical care, monitoring, ultrasound examinations, genetic counseling, diabetes education, state-of-the-art diagnostic tests, tests of fetal well being and other specialized services. Dr. Hiett provides services to both pregnant women and those who have other gynecologic issues, such as uterine abnormalities, ovarian masses and uterine bleeding, all of which may make becoming pregnant and carrying a baby to term difficult.

How technology helps

A specialist's ability to care for you and your baby during a high-risk pregnancy is aided in large part by innovations in technology. 3D and 4D ultrasound, for example, have become a critical tool to help physicians determine the gestational age and identify cardiac or other fetal complications a baby may have by providing more complete views of fetal development.

"3-D ultrasound is like looking at a still picture from a 3-D movie. It is a static picture, but it has depth," Dr. Hiett explains. "4-D ultrasound takes that one step further. It's like actually seeing the movie. You have a 3-D image that's in motion, so physicians – and parents – can see the baby moving in real time."

(Sidebar)

Seeing a maternal fetal medicine specialist

If your pregnancy is considered high-risk, a visit to a maternal fetal medicine physician may help put your mind at ease. You can learn what you can do to best protect the health of you and your baby.

At the St.Vincent Maternal Fetal Medicine and Genetics Center (offices at St.Vincent Women's Hospital, St.Vincent Carmel and St.Vincent Medical Center Northeast), you can receive high-risk pregnancy management and consultation, routine and targeted obstetrical and gynecological ultrasound examinations, genetic counseling, prenatal screening and fetal diagnostic testing.

"Our goal is to provide families with information and resources that will help them best cope and bond with their babies," said Dr. Hiett. "We want to help them understand what to expect and what can be done – either before or after the baby is born."

To contact Dr. Hiett or another physician with the St.Vincent Maternal Fetal and Genetics Center (317) 415-8100.

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