How do I know if my pregnancy is “high risk”?

High risk pregnancy is a term used with certain conditions that can affect the health of the mother during pregnancy and/or the outcome of the pregnancy. Indications for a high risk pregnancy are:

• You have a health problem such as diabetes, high blood pressure, a blood disorder (i.e. sickle cell anemia, thalassemia hrombocytopenia), a seizure disorder, an isoimmune disease, heart disease, lung disease, HIV or other infectious disease or autoimmune disorder (lupus, thyroid), h/o blood clot when you needed to be on blood thinners, physical or sensory disability, organ transplant or chronic kidney disease or dialysis, or rheumatic arthritis
• You require specific medications to control a condition or disease such as a heart condition, a bleeding problem, psychological problems or a seizure disorder
• You developed high blood pressure during your pregnancy
• You have a history of preterm delivery for any reason
• You had a previous high-risk pregnancy for any reason
• You are currently pregnant with multiple fetuses
• You are carrying a fetus with a known birth defect that requires special testing or monitoring and/or delivery of the pregnancy
• You have experienced previous pregnancy loss (miscarriage or stillbirth) two or more in the1st trimester or one or more in the 2nd trimester, or poor previous pregnancy outcomes.

We provide diagnostic consultations with our maternal fetal medicine specialists (perinatologists) for patients with any one or combination of the above conditions. For certain indications, we offer genetic counseling and prenatal testing and diagnosis to help the patient make an informed choice about her pregnancy management options. Our specialists either manage the entire pregnancy through delivery of the baby or co-manage the pregnancy with the patient’s current obstetrician. If you have any one or combination of the above conditions or if you have questions about high risk pregnancy, please contact us. Preconceptional counseling is also available with our perinatologists.

Some of the conditions listed above as well as several others fall under the area known as reproductive genetics. Reproductive genetics focuses on fetuses at risk for having a wide range of birth defects specifically due to a problem with their genes or chromosomes. Pregnant women in this category can benefit from a genetic consultation.

You should consider genetic counseling for any one or a combination of the following:

• You will be 35 years or older at the time of delivery
• You had a previous pregnancy or child diagnosed with a birth defect (such as chromosome abnormality or spina bifida) or mental retardation
• You have an abnormal maternal serum screening test result indicating your pregnancy is at an increased risk for a chromosome abnormality or spina bifida (an opening in the spine)
• You have a family history of a chromosome abnormality
• You have a family history of a known or suspected inherited genetic disorder
• You have a family history of birth defects and/or mental retardation
• You have experienced previous pregnancy loss (miscarriage or stillbirth)
• Your physician suspects a fetal abnormality
• You are currently pregnant with multiple fetuses
• You have been exposed to certain medications, street drugs, alcohol, chemicals, x-rays, specific infections or other potentially harmful agents
• You or your ancestors are of an ethnic origin which has a higher occurrence of a specific genetic disorder (For example, Tay Sachs disease in the Eastern European Jewish population, sickle cell anemia in the African-American population or Beta thalassemia in the Mediterranean [Italian, Greek, Middle Eastern, Northern African] populations)
• You and your partner are blood relatives

If you and/or your obstetrician suspect that you are at risk for having a baby with a birth defect, we encourage you to contact us to discuss genetic counseling and prenatal testing and diagnosis. Preconceptional counseling is also available with our reproductive geneticists and genetic counselors.