High-Risk Pregnancy: What It Means and How We Manage It

Being told your pregnancy is 'high risk' is frightening, but it does not mean something will go wrong. It means we need to watch more carefully and plan more thoroughly. Many high-risk pregnancies end with a healthy mother and baby when managed properly.

Common reasons a pregnancy is classified as high risk include: age over 35 or under 18, pre-existing diabetes or hypertension, previous caesarean section, recurrent miscarriage, multiple pregnancies (twins or more), autoimmune conditions, and significant obesity.

Extra monitoring typically means more frequent clinic visits — fortnightly rather than monthly in the second trimester, and weekly in the third. Additional ultrasound scans track growth velocity, amniotic fluid and placental function. Blood tests monitor kidney and liver function, blood sugar and blood counts at closer intervals.

Preeclampsia — high blood pressure with protein in the urine — is one of the most important conditions to detect early. Symptoms include persistent headache, visual disturbances, sudden swelling and upper abdominal pain. Low-dose aspirin started before 16 weeks reduces the risk in women with known risk factors.

Delivery planning is a conversation, not a unilateral decision. We discuss the safest mode and timing of delivery based on your specific situation. Some high-risk pregnancies benefit from planned early delivery at 37–38 weeks; others can safely go to term. The goal is always the safest outcome for both mother and baby.

If you have had a complicated pregnancy before, preconception counselling — ideally three to six months before trying to conceive — lets us optimise your health, adjust medications, and establish a monitoring plan from the very start.