Facing a high-risk pregnancy? Learn how maternal medicine provides expert support every step of the way

Written in association with: Ms Kenga Sivarajah
Published: | Updated: 13/12/2024
Edited by: Jessica Wise

High-risk pregnancies are not uncommon – around 10 per cent of pregnancies are classified as ‘high risk’. While the term may seem scary, the wonders of modern obstetric medicine mean that mother and baby have better chances of making it through the issues safely. In this article, expert consultant obstetrician Ms Kenga Sivarajah highlights how maternal medicine can be utilised in every stage of a high-risk pregnancy.

 

 

A high-risk pregnancy is one where doctors have discovered a complication or risk to the health of the mother and/or the foetus. These can be discovered at any stage of the pregnancy. People with high-risk pregnancies may need special medical care before, during, and after they give birth. Factors that contribute to a high-risk pregnancy are:

  • Preexisting health conditions
  • Health conditions that develop during the pregnancy
  • Lifestyle factors, such as substance use
  • Complications that occurred during a prior pregnancy

 

What is maternal medicine?

Maternal medicine is specialised prenatal care for those with high-risk pregnancies, often made of multidisciplinary teams that may consist of specialists in foetal medicine and nurses, haematologists, physicians, midwives, and genetic counsellors. They will have expertise which allows them to perform prenatal diagnosis techniques like ultrasound, genetic testing, and management of medical complications. They work together to ensure and maintain the health, comfort, and safety of both mother and baby, from the first few weeks of pregnancy all the way to postpartum.  


Depending on the specific condition of the mother or baby, those who receive maternal medical care will be scheduled for more frequent appointments for close monitoring and treatment for check-ups, early interventional treatment, screening and testing.

 

What does a high-risk pregnancy mean?

Some of the many conditions that are likely to cause a pregnancy to be high risk:

  • High blood pressure
  • Diabetes
  • Epilepsy
  • Thyroid disease
  • Cardiovascular disorders
  • Asthma without treatment
  • Sickle cell disease
  • HIV
  • Autoimmune diseases like lupus
  • Uterine and ovarian issues and obstruction like fibroids, PCOS, or endometriosis.

If you are pregnant and do not have, or do not know if you have, the conditions described above, signs that something is wrong during your pregnancy and you will need to seek medical attention include high fever, continuous vomiting, pain whilst urinating and blood in urine, frequent or bloody diarrhoea, swelling of the feet, hands, or face (which are signs of preeclampsia), intense headaches and distorted vision, abdominal pain particularly on one side of the belly and from the beginning of the pregnancy – this could be a sign of an ectopic pregnancy – and heavy vaginal bleeding, which may indicate a miscarriage.

 

A high-risk pregnancy that isn’t monitored and managed can have consequences for both the mother and the baby that are life-long debilitating or even deadly, such as:

  • A pre-term delivery
  • An emergency Caesarean delivery
  • Preeclampsia disorders
  • Low birth weight
  • Congenital conditions like a cleft palate, atypical limbs, neural tube defects, or heart or brain dysfunction

 

How does maternal medicine help in cases of high-risk pregnancies?

It is important to receive thorough prenatal care early in the pregnancy. Complications can be avoided or managed thanks to diagnoses from urine and blood testing, and ultrasound scans which can be used to compile a biophysical profile that looks at the baby’s heart rate, muscle tone, body movement, breathing, and the amount of amniotic fluid around them.

Maternal medicine encompasses mental health services, blood testing, close monitoring from the obstetrician, consultations with specialists, and exploration of birth options if needed. The risk factors that can impact the pregnancy may be discovered and rectified or treated, such as making adjustments to the diet and physical activity, or the management of conditions with methods and medications that are suitable for the mother and baby.

 

If you have concerns regarding the status of your pregnancy, you can consult with Ms Sivarajah via her Top Doctors profile.

By Ms Kenga Sivarajah
Obstetrics & gynaecology

Ms Kenga Sivarajah is an expert consultant obstetrician who sees patients in several clinics across London. Her specialities include high-risk pregnanciescaesareans procedures, pre-conception carechildbirthantenatal care, and pregnancy counselling.

 

Upon graduating from Imperial College London in 2008, she undertook foundational training at Oxford before completing additional qualifications in perinatal mental health at Boehringer Ingelheim. She began specialising in obstetrics and gynaecology in North East Thames in 2010, doing advanced training in obstetric medicine, advanced antenatal practice, and advanced labour ward. Since 2018, she has overseen the labour ward, led perinatal mental health initiatives and intrapartum care, and managed the cardiology, respiratory and liver pregnancy service at King's College Hospital (KCH).

 

Ms Sivarajah prioritises joint obstetric and psychiatric services for her patients with severe mental health conditions, collaborating with perinatal healthcare professionals and multidisciplinary teams to make important decisions for complex cases. She encourages thorough counselling and planning at the preconception stage to ensure holistic mental care. 

 

Additionally, Ms Sivarajah has medicolegal insight, having completed the Capsticks diploma in risk and claims management and has offered her expert medical opinion in over 250 cases. She contributes to patient safety efforts for the Patient Safety Incident Response Framework (PSIRF) for maternity risk incidents at KCH, using her extensive experience to analyse safety incidents in the maternity unit. She is passionate about enabling women to make informed decisions about their care – and for those who are not able to do so, she has an in-depth understanding of the legal framework applicable to them, having worked on 10 such cases for her involvement she was awarded a King’s Star award. Currently, she is part of a working group that is formulating a framework for assessing mental capacity in patients.

View Profile

Overall assessment of their patients


  • Related procedures
  • Platelet-rich plasma
    Sexually transmitted infections (STIs)
    Cosmetic Consulting
    Labiaplasty
    Vaginoplasty
    Breast reconstruction
    Congenital malformations
    Sexual dysfunction
    Laparoscopy
    Erectile dysfunction
    This website uses our own and third-party Cookies to compile information with the aim of improving our services, to show you advertising related to your preferences as well analysing your browsing habits. You can change your settings HERE.