High-Risk Pregnancy
Approximately 1 in 4 pregnancies is considered high risk
The term “high-risk pregnancy” sounds serious, but in reality it simply describes a pregnancy that needs closer attention—more frequent monitoring and an individualized 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 it.
A high-risk pregnancy does not necessarily start out that way from the beginning—it may become high risk during the course of pregnancy. That is why monitoring is dynamic and continuously adapted to the progress of each pregnancy.
Which factors make a pregnancy high risk?
Risk factors fall into three categories:
Maternal factors
- Age under 18 or over 35
- Chronic conditions: hypertension, diabetes mellitus, autoimmune diseases, heart disease, kidney disease, thyroid disorders
- Obesity (BMI > 30) or very low body weight (BMI < 18)
- Thrombophilias
- 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 after in vitro fertilization (IVF)
- Placental complications (placenta previa, placental abruption)
- History of genetic disorders
- Reproductive tract abnormalities (bicornuate uterus, large fibroid)
- Grand multiparity (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 during pregnancy should always be taken in consultation with your doctor
- Exposure to addictive substances (smoking, alcohol, narcotic substances)
High-risk pregnancy after IVF
Pregnancies resulting from in vitro fertilization or other assisted reproductive methods are often classified as high risk, especially in cases of multiple pregnancy, when the mother is over 35, or when there is a history of repeated failures or miscarriages.
Dr. Ioannis Douliotis, with deep expertise in both assisted reproduction and obstetrics, has unique experience in monitoring these pregnancies. He understands the history, concerns, and particularities of every couple who reached pregnancy after a difficult journey.
His thorough knowledge of the medical history—even before pregnancy—combined with close follow-up and the early diagnosis and management of potential problems, ensures 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 checks
- Regular growth scans 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 required (cardiologist, endocrinologist, hematologist, rheumatologist, etc.)
- Special dietary guidance or medication when considered necessary
- Psychological support
Symptoms that require immediate assessment
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 visual disturbances
- Marked swelling in the hands, feet, or face
- Reduced fetal movements
- Fever above 38°C
- Shortness of breath or chest pain
- A sensation of rapid heartbeat
- Vomiting and severe nausea that does not subside
- Severe exhaustion or dizziness
- Thoughts of self-harm, intense sadness, etc.
How is the mode of delivery chosen?
A high-risk pregnancy does not automatically mean a cesarean section, but it does mean that the mode and timing of delivery are planned with particular care and on an individualized basis.
Factors such as hypertension, gestational diabetes, the baby’s position, placental status, or previous complications determine whether vaginal delivery or cesarean section is chosen. In many high-risk cases, vaginal delivery is absolutely possible, with appropriate monitoring and preparation.
In a high-risk pregnancy, delivery always takes place in a well-organized maternity unit with the necessary facilities, so that any emergency situation can be managed immediately.
A high-risk pregnancy requires an individualized monitoring plan—not a standardized schedule, but one designed around the specific risk factors of each pregnancy. This may include:
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 situations 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 the risk factors. In some cases, the doctor may recommend reduced hours or sick leave. The decision is always made in consultation.
Yes, prolonged and intense stress may contribute to complications such as preterm birth or low birth weight. It is completely understandable to feel anxious, 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 given. It depends on the type and severity of the risk factors. Close monitoring aims precisely to detect any signs of preterm labor early and to take the appropriate measures.
Often yes, as in vitro fertilization is associated with other factors that increase the likelihood of complications: maternal age, multiple pregnancy, pre-existing health problems.
What is important to emphasize, however, is that classifying a pregnancy as “high risk” does not mean that something will go wrong—it means that it requires closer and more specialized monitoring. With the right care, the vast majority of these pregnancies progress normally and lead to a healthy delivery.
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