High-Risk Pregnancy
About 1 in 4 pregnancies is classified as high-risk
The term “high-risk pregnancy” sounds serious, but in reality it simply describes a pregnancy that requires more attention—more frequent monitoring and a personalized care plan.
With the right management, the vast majority of these pregnancies have an excellent outcome.
What is a high-risk pregnancy?
A pregnancy is classified as high-risk when the likelihood of complications for the mother or the fetus is higher than in the general population. This may be due to factors that existed before pregnancy, as well as conditions that develop during pregnancy.
A high-risk pregnancy does not necessarily start out that way—it can also develop into one during the course of the pregnancy. For this reason, monitoring is dynamic and is continuously adapted to the course of each pregnancy.
What factors characterize a pregnancy as high-risk?
Risk factors are divided into three categories:
Maternal factors
- Age under 18 or over 35
- Chronic conditions: hypertension, diabetes, autoimmune diseases, heart disease, kidney disease, thyroid disorders
- Obesity (BMI > 30) or very low body weight (BMI < 18)
- Thrombophilia
- Smoking, alcohol, or other addictions
- Psychiatric disorders, including depression
Obstetric factors
- Previous miscarriages or preterm births
- Preeclampsia or complications in a previous pregnancy
- Multiple pregnancy
- Pregnancy following in vitro fertilization (IVF)
- Placental complications (placenta previa, placental abruption)
- History of genetic disorders
- Abnormalities of the reproductive system (bicornuate uterus, large fibroids)
- Multiple pregnancies (more than 5 pregnancies)
Fetal factors
- Fetal abnormalities
- Intrauterine growth restriction (IUGR)
- Amniotic fluid disorders
- Blood incompatibilities (e.g., Rh incompatibility)
- Viral infections (herpes, rubella, chickenpox, cytomegalovirus)
- Bacterial or parasitic infections (syphilis, toxoplasmosis)
- Medications harmful to the fetus — any medication taken during pregnancy should always be discussed with your doctor
- Exposure to addictive substances (smoking, alcohol, drugs)
High-risk pregnancy following IVF
Pregnancies resulting from in vitro fertilization or other assisted reproductive technologies are often classified as high-risk, particularly in cases of multiple pregnancies, when the mother is over 35 years of age, or when there is a history of repeated failures or miscarriages.
Dr. Ioannis Doulotis, with deep expertise in both assisted reproduction and obstetrics, has unique experience in managing these pregnancies. He is familiar with the history, concerns, and specific circumstances of every couple who has reached pregnancy after a difficult journey.
A thorough understanding of the medical history—even before conception—close monitoring, and the timely diagnosis and management of potential problems ensure the best possible conditions for a healthy pregnancy and a safe delivery.
How is a high-risk pregnancy monitored?
A high-risk pregnancy requires a personalized monitoring plan—not a standardized program, but one tailored to the specific risk factors of each pregnancy. This may include:
- More frequent visits and ultrasound scans
- Regular growth ultrasounds and Doppler flow studies
- Specialized blood and urine tests
- Monitoring of blood pressure and blood sugar
- Cardiotocography (CTG) in the third trimester
- Collaboration with other specialists when necessary (cardiologist, endocrinologist, hematologist, rheumatologist, etc.)
- Specialized nutritional guidance or medication when deemed necessary
Psychological support
Symptoms that require immediate evaluation
In a high-risk pregnancy, there are symptoms that should not be ignored. Contact your doctor immediately if you notice:
- Bleeding or fluid leakage from the vagina
- Severe or persistent abdominal pain or cramps/contractions
- Severe headache or vision problems
- Severe swelling in the hands, feet, or face
- Decreased fetal movement
- Fever over 38°C
- Shortness of breath or chest pain
- Feeling of a racing heartbeat
- Vomiting and severe nausea that does not subside
- Severe exhaustion or dizziness
- Thoughts of self-harm, intense sadness, etc.
How is the method of delivery chosen?
A high-risk pregnancy does not automatically mean a cesarean section, but it does mean that the method and timing of delivery are planned with special care and tailored to the individual.
Factors such as hypertension, gestational diabetes, fetal position, placental condition, or previous complications determine whether vaginal delivery or a cesarean section will be chosen. In many high-risk cases, vaginal delivery is entirely possible with appropriate monitoring and preparation.
In high-risk pregnancies, delivery always takes place in a well-equipped maternity hospital with the necessary infrastructure to immediately address any emergency that may arise.
Frequently Asked Questions (FAQ)
It depends on the nature of the risk factors. In many cases, mild exercise is beneficial, but the type, frequency, and intensity should be discussed with your doctor. There are cases where complete rest is recommended, and this is always determined on an individual basis.
In most cases, yes, with possible adjustments depending on the nature of the work and risk factors. In some cases, the doctor may recommend reduced working hours or sick leave. The decision is always made in consultation with the patient.
Yes, prolonged, intense stress can contribute to complications such as preterm birth or low birth weight. It is perfectly understandable to feel stressed, and managing that stress is part of the holistic care we provide.
In some high-risk pregnancies, the risk of preterm birth is increased, but it is not a foregone conclusion. It depends on the type and severity of the risk factors. Close monitoring is specifically designed to identify any signs of preterm labor early on and take the appropriate measures.
Often, yes, as in vitro fertilization is associated with other factors that increase the likelihood of complications: the mother’s age, multiple pregnancies, and pre-existing health conditions.
It is important to emphasize, however, that classifying a pregnancy as “high-risk” does not mean that something will go wrong—it means that closer and more specialized monitoring is needed. With proper care, the vast majority of these pregnancies progress normally and result in a healthy birth.
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