Are you pregnant at risk? What is a high risk pregnancy?

High risk pregnancy 

Pregnancy is a physiological event that is always a source of excitement for families. It includes different emotions and symptoms from daily life from its onset to birth. It may differ for each woman, and even for each woman’s different pregnancies.

There are many issues that pregnant women should pay attention to in order for the pregnancy process to be healthy and the baby to be born in a healthy way. Foods, diseases, treatments, diagnostic methods, working environment, living space can pose a risk for pregnant women. For thousands of years, pregnant women have always been considered as groups requiring special attention.

Pregnancy is an important process in which there are many biopsychosocial changes in the expectant mother. Many physical, emotional or social reasons may pose a risk to the pregnant woman. Some diseases or health conditions that existed before pregnancy may increase the risk level of the pregnant woman.



Risky pregnancy is possible in every pregnancy, even if it is small. However, some pregnancies may occur and contain high risk. It may be necessary to approach these pregnant women differently and to apply different practices to protect the health of the mother and the baby. Intervention methods should be developed according to the risk during delivery. The follow-up of the mother and the baby after the birth requires attention.

These are pregnancies that are not expected to occur in the expectant mother or baby under normal conditions, during pregnancy, at birth or after birth, but with increased probability as a result of pre-existing reasons or developments in the pregnancy process.

Depending on the level of this risk, the pregnancy process and birth can be difficult, the health status of the expectant mother may deteriorate, even life risks may occur, serious problems may occur due to bleeding etc. arising from the birth process, the risk of stillbirth and congenital anomaly may increase.

It has been shown that one third of pregnancies worldwide carry significant risks, and up to 15% of them can be life-threatening for the mother.

Risk levels in pregnancy: 

Pregnancy is evaluated in three groups according to risk level. These:

• • Low-risk pregnancies: Currently, there are no health problems. However, a health problem may develop and should be followed closely. These health problems are usually not very serious, they are fixable problems. There is no underlying cause. Laboratory and screening tests are normal. All pregnancies fit this definition. Therefore, all pregnancies are low-risk pregnancies.
  • Risky pregnancies: Laboratory tests are normal. However, the tests need to be repeated periodically and followed closely. They can be monitored on an outpatient basis, but hospitalization may be required when a problem is identified and necessary. Coordination with other specialties may be required if needed. Nausea, vomiting, risk of premature birth, urinary infection, high blood pressure, increase in blood sugar level, cardiovascular problems may occur.
  • High-risk pregnancies: It can be life-threatening for the mother or baby. Undesirable adverse events can seriously affect the expectant mother or baby.
  • Health problems that existed before pregnancy:
    • Maternal age (early age or advanced age),
    • Pre-pregnancy maternal weight
    • Blood group incompatibility,
    • Cardiovascular diseases,
    • Blood diseases,
    • Sexually transmitted infections,

• Complications related to pregnancy:
  • Gestational hypertension,
  • Pregnancy-related extreme nausea and vomiting (hyperemesis gravidarum),
  • Multiple pregnancies etc.

In high-risk pregnancies, the expectant mother may need to be hospitalized and followed up. Although not a common condition among pregnancies, they require careful follow-up because they can quickly become life-threatening.

Risk factors in high-risk pregnancies: 

• Maternal age below 18 years and above 35 years of age,
• The mother’s height is below 150 cm,
• The mother is extremely thin or obese,
• low educational level of the mother,
• Low socioeconomic level of the mother,
• poor working conditions of the mother,
• Unwanted pregnancy
• consanguineous marriages,
• Having a genetic disease in other children of the mother or father-to-be,
• Having a genetic disease in close relatives of the mother and father,
• Exposure of the mother-to-be to violence,
• Being in an immigrant, asylum seeker or minority group,
• Mother’s smoking,
• Mother’s alcohol or substance abuse
• The mother has nutritional problems
• Stressful living conditions of the mother,
• Not getting support for pregnancy from family, relatives or close circle,
• Conceiving through assisted reproductive methods
• If the mother has more than five children,
• Having a history of ectopic pregnancy
• Having a low history
• Having a history of preterm birth
• Having a low birth weight child
• To have given birth to a large baby,
• Intervention of previous births,
• Having given birth to a child with congenital anomaly,
• Having diseases such as cardiovascular diseases, diabetes, thyroid diseases, high blood pressure, kidney failure, respiratory problems, SLE in the mother,
• Inability to benefit from health services adequately during pregnancy,
• Preeclampsia, eclampsia,
• Having a bleeding disorder
• Having psychiatric problems in the mother,
• Inadequate personal care of the mother,
• Having blood group incompatibility (Rh incompatibility),
• multiple pregnancies,
• Fetal developmental delays,
• Too little or too much amniotic fluid
• Infections vs.

Risky pregnancy diagnosis methods: 

It is recommended that expectant mothers with suspected risky pregnancy should seek expert help.



A good anamnesis should be taken if a risky pregnancy is suspected. Previous pregnancy information of the expectant mother, genetic diseases in the family, congenital anomalies, nutritional status of the expectant mother, life habits, and existing health problems are investigated. In the physical examination, the mother and fetus are thoroughly evaluated.

The most ideal for risky pregnancies is to determine the risks before pregnancy, to have a planned pregnancy, if any, to be treated.

Tests required for risky pregnancy detection:

• Blood group,
• Rh factor,
• Complete blood count,
• Cervical, vaginal discharge samples,
• Tuberculin test, if necessary
• Urine tests,
• ELISA Test (HIV/AIDS),
• VDRL Test (Syphilis),
• Hepatitis tests,
• Ultrasonography,
• If necessary, amniocentesis etc.

There are different risk assessment forms for high-risk pregnancies. The risk is determined for the pregnant by using the appropriate one. Some symptoms require the follow-up of the pregnant woman in hospital conditions, under the control of more than one specialist. Some of these are those:

• Having a hemoglobin level below 7gr/dl,
• Having bleeding,
• Preeclampsia symptoms (high blood pressure, proteinuria, etc.),
• The uterus is not suitable for the gestational week (in ultrasound),
• Fetal movements and heartbeat are not suitable for the gestational week,
• Having signs of infection in the pregnant
• The presence of an uncontrolled chronic disease of the pregnant woman,
• Presence of psychiatric illness of the pregnant
• Multiple pregnancy vs.