From the December 2017 issue

High-Risk Pregnancy: What Expectant Parents Should Know

What makes a pregnancy 'high risk'? Should you receive extra monitoring? A Beaumont obstetrician offers guidance.

Brought to you by Beaumont
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When you’re expecting a baby, a little bit of worry comes with the territory.
You analyze your symptoms, read up on pregnancy dos and don’ts, and research just about everything. But many women find that they’re predisposed to problems from the start because their pregnancy is considered “high risk,” adding another layer of worry.

“‘High risk’ sounds really scary,” says Dr. Samuel T. Bauer, an OB-GYN and maternal-fetal medicine (MFM) specialist at Beaumont in Royal Oak.

It means that the mother or baby is at greater risk for complications due to health problems that the woman had before the pregnancy or that were discovered during it. For pregnant women with chronic health problems, MFM specialists work to keep the woman as healthy as possible while her body changes and her baby grows. This could include diabetes, high blood pressure, obesity, lupus or cancer.

“Those medical conditions can affect how a pregnancy progresses. MFM specialists also care for women who face unexpected problems that develop during pregnancy, such as early labor, bleeding, or high blood pressure,” Dr. Bauer explains.

A pregnancy is also considered high risk in cases of multiples or when concerns are found with the baby, such as a chromosomal abnormality or birth defect.

“High risk can either be a maternal problem, a fetal problem or both. In some cases, it’s the baby who faces the un-routine. If we find birth defects or growth problems, we can plan or often start treatment before birth,” he says.

But having a high-risk pregnancy doesn’t mean you’ll necessarily experience problems. Managing this type of pregnancy is all about proper care and monitoring.

“Everybody has some element of risk,” Dr. Bauer points out. “Learning about your health and reducing those risks is what will optimize your pregnancy.”

For starters, women should discuss their risk factors with their obstetrician – ideally, before even getting pregnant. If you’re high risk, it’s likely that your doctor will require either a consultation or ongoing care with a maternal-fetal medicine specialist.

“When you have these conditions, whether they’re preexisting or maybe they develop it during the pregnancy like hypertension or gestational diabetes, those would be conditions that need some extra attention,” he says. “That’s where maternal-fetal medicine fits in, to work with you and your primary obstetrical provider.”

A maternal-fetal medicine specialist is an OB-GYN who has completed an additional two to three years of special fellowship training in caring for high-risk pregnancies.

Depending on the situation, various interventions or additional monitoring techniques are used to keep a close eye on the mother and baby. In the case of gestational diabetes, for example, proper screening is key to catching the condition and followed by close monitoring of blood sugar levels, nutrition counseling, medication in some cases and extra planning for labor and delivery.

“We can really help to plan the expectations after the delivery,” Dr. Bauer says, such as monitoring baby’s blood sugar. “There’s more to it than, ‘I have this high-risk condition.’ You want to have a plan set up and in place for after the baby is born. Pre-delivery planning helps to set expectations and provide a smooth transition, which in turn can decrease potential complications.”

Caring for a high-risk pregnancy is often a collaborative effort with other doctors and specialists.

“One of the benefits of maternal-fetal medicine is to know what all the risks are in the pregnancy and know what you can do,” he says. “The team approach really looks at the patient and her baby as a whole. It’s important to work in a multidisciplinary fashion when you have a high-risk pregnancy with the patient’s general OB-GYN, other medical subspecialties, and our pediatric colleagues.”

Going through a high-risk pregnancy can be anxiety-inducing and it’s best to talk with your doctor about your concerns rather than seeking out internet advice.

“Make sure you’re getting information from reliable sources,” Dr. Bauer emphasizes, and keep in mind that maternal-fetal medicine specialists work with high-risk situations on a daily basis and specialize in the un-routine. “Beaumont has the ability to care for patients throughout the spectrum of possible pregnancy complications. From the Karmanos Center for Natural Birth that cares for low-risk patients to maternal-fetal medicine specialists, obstetricians, obstetric anesthesiologists and neonatologists 24/7/365. We’re here all the time to care for the most complicated patients and really to provide the whole spectrum of comprehensive obstetrical care for patients.”

For more information or to find a Beaumont doctor, visit beaumont.org.

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