You are classified as a high risk pregnancy, that does not mean that the next nine months are going to be bad. What matters ? Monitor certain factors or pathologies to anticipate possible problems and choose a suitable maternity unit (level 3).
Late pregnancies, multiple pregnancies or pregnancies with a chronic disease are considered at risk. Explanations according to each profile.
You are pregnant after 38 years: your pregnancy is considered at risk
Pregnancy is considered late, when the mother-to-be is 38 years old and over. If at this age it is more difficult to get pregnant, pregnancy also carries more risks. Miscarriages in the first trimester are more numerous, compared to those of younger women.
This is why monitoring the mother-to-be is essential from the first months of pregnancy. Pregnancy toxemia, intrauterine growth delays or gestational diabetesare also more common after the age of 38-40 years. You should also know that the risks of premature childbirth and Down’s syndrome are a little more important.
What monitoring for a late pregnancy?
Be confident, late pregnancies are now very rigorously monitored and are going well. You will have close medical appointments with the realization of ultrasounds in particular. This monitoring allows the necessary measures to be implemented quickly and efficiently.
Screening for trisomy 21 is systematic in women over 35 years of age. In the first trimester, an ultrasound is performed to measure the clarity of the fetal neck and craniocaudal length. Maternal serum markers are also assayed.
In the event of abnormal results of these examinations, the risk of Down’s syndrome is assessed and, if this risk is high, an amniocentesis is performed. The practice of amniocentesis is limited because it is an invasive examination, with the risk of infection and miscarriage.
Previous difficult pregnancy or multiple pregnancy: your pregnancy is considered at risk
The establishment of medical monitoring of a pregnancy takes into account both the number of pregnancies experienced and the accidents that have occurred during previous pregnancies.
Know the medical history to anticipate the risks
You should know thatFrom the fourth child, delivery may be more difficult because the uterus has lost tone. Likewise, it is essential to know the antecedents of the mother-to-be to better anticipate possible risks. Indeed, she may have been the victim of several miscarriages, may have given birth to premature children or have suffered complications (toxemia of pregnancy, gestational diabetes, etc.).
In the latter cases, the pregnancy will be punctuated by more in-depth examinations. There can be no more ultrasounds coupled with a Doppler (measurement of blood flow in the vessels). The baby’s heart rate will also be recorded regularly to ensure that his activity is normal.
You are expecting twins
Again, you will benefit from enhanced monitoring of your pregnancy. Apart from the risk of abortion, more frequent in the first trimester, this is to prevent premature births, pregnancy toxemia or intrauterine growth retardation (especially low weight).
The medical follow-up takes place through very close sessions. They can be carried out at the home of the mother-to-be, if she is tired or bedridden. The latter is generally stopped several weeks before the start of her maternity leave. Sometimes hospitalization may be necessary in the event of a threat of premature delivery, in particular.
You are pregnant with a chronic disease: your pregnancy is considered at risk
Hypertension, diabetes, heart disease, obesity, AIDS, herpes, addictions (tobacco, drugs, alcohol)… If you have a disease even before you are pregnant, you will automatically be considered a risk pregnancy.
Indeed, in a sick woman, the onset of pregnancy can pose problems both for the health of the mother and for the development of the baby.
Careful monitoring is essential throughout pregnancy. Specialists generally work in pairs with the gynecologist in charge of monitoring (diabetologist, infectious disease specialist, etc.). There may be hospitalization. The delivery modalities will also be discussed in relation to your state of health.
Scientists can predict which women will have serious pregnancy complications
In a study published in June 2021 in the journal Nature Communications Biology, scientists say they have discovered that “hormonal biomarkers in the placenta could indicate which women may have pregnancy complications. These biomarkers are present from the first trimester. They stress the importance of their discovery because complications diagnosed too late during pregnancy can have a significant impact on the health of the mother and the fetus.
Using mice, the researchers examined the proteins produced by the placenta and compared them to blood samples from women who had had uneventful pregnancies or having developed gestational diabetes. The scientific team looked at the endocrine cells of the placenta of mice, responsible for the secretion of hormones during pregnancy, to identify all the hormones secreted. The results obtained were compared with several data from previous studies on the placenta human and pregnancy and researchers found that about a third of the proteins identified changed in women during pregnancies with disorders.
This was especially the case for one of them: gestational diabetes, a disorder of sugar tolerance with increased blood sugar. Specifically, they found “that abnormal hormone levels were present in the mother’s blood from the first trimester, week 12 of gestation, in women who developed gestational diabetes. A complication usually diagnosed at 24-28 weeks. The explanation would lie on the side of genetic biomarkers linked to the production of placental hormones. Ultimately, their method could lead to a more rapid diagnosis of complications, and therefore to the implementation of earlier treatment.