High Risk Pregnancy

If you have a chronic health problem, such as hypertension (high blood pressure) or diabetes, your pregnancy is not routine. Consequently, women with a preexisting condition can benefit from preconception counseling before getting pregnant.

If you had a complication in a prior pregnancy, such as a pre-term birth or preeclampsia, you will need special care. That’s also the case if you had a child with a serious medical condition that could also affect future children.

Women over 35 or with a history of infertility or miscarriage need further evaluation and closer surveillance, as do women who are under-weight or over-weight. The use of certain prescription medications, alcohol, cigarettes, marijuana and illicit substances can place a woman at risk for health issues during her pregnancy.

The presence of multiple babies — twins or triplets —can increase the risk of complications to both the mother and fetuses.

Preeclampsia, a syndrome specific to pregnant mothers, involves high blood pressure, protein in the urine and other complications. If the syndrome is not identified and properly managed, it can be life-threatening — or even fatal — for mom and baby.

Call your doctor immediately if you begin experiencing:

• Persistent, severe headaches
• Abdominal pain
• Visual disturbances
• Decreased fetal movement

Like preeclampsia, gestational diabetes develops during pregnancy and requires a specialized treatment plan and careful surveillance.

Genetic testing or an ultrasound might indicate that the child has a condition requiring input from pediatric specialists. Some babies can be treated with medications or through surgery while still in your uterus.

ChristianaCare offers a list of common tests during pregnancy. If your baby needs special care after birth, Christiana Hospital is the only high-risk delivering hospital in Delaware offering Level III neonatal intensive care.

MFM physicians have training in medical, surgical, obstetrical, fetal and genetic complications of pregnancy and their effects on the mother and fetus. These subspecialists work with all obstetric providers and providers in other areas of medicine, such as endocrinology, cardiology, gastroenterology, pulmonology or intensivists.

If you require care from other non-obstetric subspecialty providers, the MFM can coordinate the care and take recommendations from these physicians to produce an individualized care plan for your primary obstetrician to follow.

MFM physicians see patients both in the outpatient and inpatient setting. If you are admitted to the hospital for a prolonged period and are concurrently pregnant, it’s not unusual for your obstetrical provider to consult an MFM.

Because of their specialized training, MFM providers consult on pregnant women who arrive at the hospital for any reason — including car accidents or kidney infections — to ensure that the woman and fetus remain as healthy as possible. The MFM provider in conjunction with your primary obstetrics provider can advocate for the mother and baby, especially if other physicians are unaccustomed to managing two patients at once.

The Delaware Center for Maternal and Fetal Medicine of ChristianaCare provides services to patients with high-risk pregnancies. The center’s technically advanced equipment and facilities can help diagnose your baby’s risks for genetic, growth and structural differences.

The center also integrates comprehensive genetics counseling to identify risks and help you and your family make decisions about medical care for your baby.

It’s essential that you take care of yourself, follow your health care provider’s instructions and keep your regular appointments. Build a support system of family and friends. Online support groups, such as Sidelines, can help you realize that you’re not alone and that you can successfully navigate a high-risk pregnancy.

For more information, visit:

ChristianaCare Maternity

National Institutes of Health

Society for Maternal-Fetal Medicine