High-risk Pregnancy Overview

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A high-risk pregnancy is one in which the mother or baby has a higher risk of complications. A pregnancy may be designated high-risk for a variety of reasons. A high-risk pregnancy requires special attention and monitoring during the pregnancy and in some circumstances may require medical intervention before the birth.

Causes of high-risk pregnancy

A number of factors may contribute to a high-risk pregnancy. These include:

  • Advanced age. Risk is higher for women younger than 17 or older than 35.
  • Medical history. Previous miscarriages, a family or fetal genetic condition, or a prior C-section can all cause a pregnancy to be considered high-risk.
  • Pre-existing medical conditions such as diabetes, hypertension, epilepsy, anemia, infection or an underlying mental health issue can increase risk during pregnancy.
  • Complications, including problems with the uterus, cervix or placenta; severe morning sickness; too much or too little amniotic fluid; slow fetal growth; or Rh sensitization may be factors in a high-risk pregnancy.
  • Multiple pregnancy. Having twins, triplets or higher multiples creates more risk for the mother and babies.

Care for a high-risk pregnancy at BWH

Women with a high-risk pregnancy can find expert and compassionate care at the Division of Maternal-Fetal Medicine, also known as High-risk Obstetrics at Brigham and Women's Hospital (BWH) in Boston. Our staff of specialists provides multidisciplinary care for women whose pregnancies have been identified as high-risk. Our services include:

  • Collaborative care for mothers: Our multidisciplinary Collaborative Maternal Care Clinics provide coordinated care for women with a high-risk pregnancy due to complex medical conditions that include diabetes, cancer, cardiovascular disease, cardio-metabolic conditions, neurologic conditions, rheumatologic conditions, pulmonary conditions, autoimmune disorders and psychiatric illness during their pregnancy.
  • Medical treatment for fetuses: The Division collaborates with physicians at Children's Hospital to provide care for fetuses requiring intervention before birth, including laser or fetal surgeries.
  • Fetal cardiac intervention: Treating fetal cardiac disease through in-utero valve dilation has proven successful at stopping the progression of hypoplastic left heart disease.
  • Genetic counseling and pre-implantation genetic diagnosis: Our Center for Fetal Medicine and Prenatal Genetics provides genetic testing and screening for women who are considering pregnancy as well as those who are already expecting. Women of advanced maternal age can receive screenings for chromosome abnormalities before getting pregnant.
  • "First Look" Program: Women who are at increased risk of birth defects, chromosomal abnormalities and certain inherited diseases can receive early diagnosis and potential treatment, based on ultrasound exam and a maternal blood sample.

In addition to treatment and care for high-risk pregnancy, Brigham and Women's Hospital offers treatment for a wide range of medical conditions and specialties, including a laminectomy for spinal stenosis, lap band surgery for weight loss, a laparoscopic hysterectomy to treat uterine cysts and tumors and much more. Patients in need of a specific specialist, such as a rheumatologist or physician with expertise in women and depression, can use our physician directory to find physicians in their area.

Learn more about High-risk Pregnancy causes and prenatal care at Brigham and Women’s Hospital.

Maternal-Fetal Medicine Research: Advancing High-risk Pregnancy Care Video

Louise Wilkins-Haug, MD, PhD, Director, Maternal-Fetal Medicine (High-Risk Obstetrics) at Brigham and Women's Hospital, describes research to improve our understanding and care of patients with high-risk pregnancies. Transcript available.

Louise Wilkins-Haug, MD, PhD, Director of Maternal-Fetal Medicine (High-Risk Obstetrics) at Brigham and Women's Hospital (BWH), explains who will need high-risk pregnancy care. Transcript available.

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