How are high-risk pregnancies managed?

Written in association with: Ms Laura Fulwell-Smith
Published: | Updated: 14/05/2024
Edited by: Conor Lynch

In this article, we discuss the main risk factors and causes associated with high-risk pregnancies, whilst also telling you about the general outlook for women with a high-risk pregnancy. Here to tell us more is esteemed consultant obstetrician, Ms Laura Fulwell-Smith

What is meant by high-risk pregnancy?

High-risk pregnancy refers to pregnancies that pose potential risks to the health and well-being of the mother and/or the baby. While many pregnancies proceed without complications, some women may experience medical conditions or factors that increase the likelihood of complications during pregnancy, labour, or delivery.

 

What are the main causes of high-risk pregnancies?

There are various factors that may contribute to a high-risk pregnancy, including maternal age, medical history, lifestyle factors, and pre-existing health conditions. Advanced maternal age, typically defined as age 35 or older, is one of the most common risk factors for pregnancy complications, including gestational diabetes, preeclampsia, and chromosomal abnormalities such as Down syndrome. Young maternal age, particularly in adolescents, may also increase the risk of complications due to inadequate prenatal care, socioeconomic factors, and lack of support.

 

What are the associated risk factors?

Women with pre-existing health conditions, such as diabetes, hypertension, heart disease, autoimmune disorders, or thyroid disorders may be at increased risk for pregnancy complications, as these conditions can impact the health of both the mother and the baby. Additionally, women with a history of previous pregnancy complications, such as premature birth, miscarriage, stillbirth, or caesarean delivery, may be considered at higher risk for recurrence of these complications in subsequent pregnancies.

 

Other factors that may contribute to a high-risk pregnancy include multiple gestation (twins, triplets, or higher-order multiples), placental abnormalities, foetal growth restriction, and certain lifestyle factors such as smoking, alcohol use, or substance abuse. 

 

How are high-risk pregnancies managed?

The management of a high-risk pregnancy typically involves close monitoring and coordination of care between the patient and a multidisciplinary team of healthcare providers, including obstetricians, maternal-foetal medicine specialists, perinatologists, genetic counsellors, neonatologists, and other specialists as needed.

 

Prenatal care for high-risk pregnancies may involve more frequent prenatal visits, specialised testing and screenings, foetal monitoring, and early intervention to prevent or manage potential complications.

 

What is the outlook for women with high-risk pregnancies?

Despite the increased risk of complications, many women with high-risk pregnancies go on to have successful outcomes with proper medical care and management. By receiving timely and appropriate prenatal care, adhering to medical recommendations, and making lifestyle modifications as needed, women can optimise their chances of a healthy pregnancy and delivery, even in the setting of high-risk factors. 

 

To book an appointment with Ms Laura Fulwell-Smith, visit her Top Doctors profile today. 

By Ms Laura Fulwell-Smith
Obstetrics & gynaecology

Ms Laura Fulwell-Smith is a highly regarded consultant obstetrician renowned for her compassion and expertise in obstetrics. Her main areas of expertise include high-risk pregnancy, ultrasound scanning, preconception care, childbirth, miscarriage, and early pregnancy.

Ms Fulwell-Smith successfully completed her undergraduate medical training at Imperial College, London, where she first developed an interest in women's health. Following medical school, she worked across London, Hampshire and Dorset, pursuing further specialisation in obstetrics and gynaecology, undergoing intense training which focussed on providing comprehensive care to women during pregnancy, childbirth, and beyond.

She has worked at Queen Alexandra Hospital in Portsmouth since 2016, and held the position of Consultant Obstetrician since 2019. She is currently the Clinical lead for the Labour Ward and for Fetal Monitoring, so is ideally positioned to counsel you through all aspects of pregnancy, birth and beyond. Miss Fulwell-Smith is also highly competent in the use of ultrasound and managing complex pregnancies, such as fetal growth restriction and multiple pregnancy.

Ms Fulwell-Smith is also an expert in Perinatal Mental Health, and instigated her Perinatal Mental Health Clinic in Portsmouth in 2020. In addition to her clinical practice, Ms Fulwell-Smith is actively involved in continuous service improvement, medical education and research. She has pioneered novel surgical techniques for complex Caesarean section, and regularly assists patients to have Maternal Assisted Caesarean sections. She is committed to improving safety and quality both locally and nationally through clinical governance, research, and teaching and training.

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