High Risk
Pregnancy Care

The pregnancy journey is joyful, but for couples facing a high-risk pregnancy, it can also bring unexpected challenges and concerns. While daunting, a high-risk pregnancy can be managed effectively with proper care and guidance from an obstetrician.

A high-risk pregnancy is one that presents potential complications that could negatively impact the health of the mother, the baby, or both. Some common factors that can contribute to a pregnancy being classified as high risk include:

  • Maternal Age

    Women who are very young (under 17) or older (over 35) are at higher risk for complications such as gestational diabetes, high blood pressure, and chromosomal abnormalities.

  • Pre-existing Medical Conditions

    Chronic conditions such as diabetes, hypertension, autoimmune disorders, heart disease, kidney disease, and certain infections can increase the risk of complications during pregnancy.

  • Multiple Pregnancies

    Carrying twins, triplets, or higher-order multiples increases the risk of complications such as premature birth, low birth weight, and preeclampsia.

  • Previous Pregnancy Complications

    Women who have experienced complications in previous pregnancies, such as preterm birth, miscarriage, stillbirth, or gestational diabetes, may be at higher risk for recurrence in subsequent pregnancies.

  • Lifestyle Factors

    Factors such as smoking, drug use, excessive alcohol consumption, obesity, and inadequate prenatal care can increase the risk of complications during pregnancy.

  • Genetic Factors

    Certain genetic conditions or family histories of genetic disorders may increase the risk of birth defects or genetic abnormalities in the baby.

  • Prenatal Care

    Through regular check-ups, ultrasounds, and screenings, we aim to identify any potential risks or complications early on and take proactive measures to address them.

  • Placental Disorders

    Conditions such as placenta previa (where the placenta partially or completely covers the cervix) or placental abruption (where the placenta separates from the uterine wall prematurely) can lead to serious complications, including heavy bleeding and fetal distress. To ensure the health and well-being of both mother and child throughout this delicate time, we create personalised care plans that address the specific needs and concerns of each patient.

  • Specialised Testing

    We offer a variety of specialised tests and screenings to assess the health and development of the baby, including genetic testing, fetal monitoring, and advanced imaging techniques. These tools allow us to detect any abnormalities or concerns and provide appropriate management and treatment options.

  • High-Risk Pregnancy Management

    For mothers with pre-existing medical conditions or those who develop complications during pregnancy, we provide specialised management and monitoring to optimise outcomes for both mother and baby. This may include medical interventions, lifestyle modifications, and close surveillance to mitigate risks and ensure the best possible outcome.

  • Perinatal Counseling and Support

    We understand that navigating a high-risk pregnancy can be emotionally challenging for expectant mothers and their families. That’s why we offer perinatal counselling and support services to help address concerns, alleviate anxiety, and provide resources and guidance every step of the way.

What classifies a pregnancy as high-risk?

Advanced age

Advanced maternal age, typically considered to be 35 years or older, increases the risk of complications such as gestational diabetes, hypertension, and chromosomal abnormalities.

Multiple gestations

Pregnancies with twins, triplets, or higher-order multiples are inherently more complex and carry a higher risk of complications such as preterm birth and very low birth weight.

Pre-existing medical conditions

Women with pre-existing medical conditions such as diabetes, hypertension, autoimmune disorders, and obesity are at increased risk of pregnancy complications.

Previous pregnancy complications

A history of pregnancy complications such as preterm birth, miscarriage, stillbirth, or caesarean section can increase the risk of similar complications in subsequent pregnancies.

Lifestyle factors

Smoking, drinking, and using drugs can put a mother at risk for pregnancy complications and adverse outcomes for both her and the baby.

Genetic factors

Having genetic predispositions and a family history of certain conditions can heighten the likelihood of congenital abnormalities and disabilities in the newborn.

Assisted Reproductive Technologies (ART)

Pregnancies conceived through assisted reproductive technologies such as in vitro fertilisation (IVF) may have an increased risk of complications due to multiple pregnancies, maternal age, and underlying fertility issues.

How to manage a high-risk pregnancy?

Managing a high-risk pregnancy involves comprehensive care and close monitoring to ensure the best possible outcomes for both the mother and fetus. Our doctors recommend the following measures to address a high-risk pregnancy.

Regular prenatal check-ups and monitoring

Women with high-risk pregnancies require more frequent prenatal visits and specialised monitoring to assess the progress of the pregnancy, detect any complications early, and adjust the management plan accordingly.

Medical procedures & services

Depending on the specific risk factors involved, women with high-risk pregnancies may require additional medical procedures and services such as specialised ultrasound scans, genetic testing, fetal monitoring, and consultations with specialists.

Lifestyle modifications

Ensuring a healthy lifestyle is essential in the management of a high-risk pregnancy. We advise adhering to a balanced diet, engaging in guided exercises, abstaining from harmful substances like tobacco and alcohol, and effectively managing stress.

Medication management

Certain medications may need to be adjusted or discontinued during a high-risk pregnancy, depending on their safety profile and potential risks to the mother and the baby. For this reason, it is essential to consult with a doctor before changing medication regimens.

Emotional support

Coping with the challenges of a high-risk pregnancy can be emotionally taxing for couples. Finding support from your loved ones, joining support groups, or seeking professional counselling can help alleviate anxiety and stress.

Medical procedures & services needed in high-risk pregnancy management

In high-risk pregnancies, various medical procedures and obstetrics services may be necessary to monitor maternal and foetal health closely, identify potential complications early, and mitigate risks to ensure a safe and successful birth.

  1. Specialised prenatal monitoring: Prenatal visits and specialised monitoring may include regular blood pressure measurements, urine tests to check for protein (a sign of preeclampsia), and fetal growth and development monitoring.
  2. Ultrasound scans: Ultrasound scans assess fetal growth, development, and well-being in high-risk pregnancies.
  3. Fetal Non-Stress Test (NST): A fetal non-stress test measures the baby’s heart rate to monitor for signs of fetal distress or compromise.
  4. Biophysical Profile (BPP): A biophysical profile evaluates fetal movements, muscle tone, breathing movements, amniotic fluid volume, and fetal heart rate patterns to determine the baby’s overall health and readiness for delivery.
  5. Amniocentesis: An amniotic fluid sample is collected to diagnose genetic abnormalities, assess lung maturity in cases of preterm labour, or detect infections such as intra-amniotic infection (chorioamnionitis).
  6. Chorionic Villus Sampling (CVS): Chorionic villus sampling may be recommended in high-risk pregnancies to diagnose the baby’s chromosomal abnormalities or genetic disorders.
  7. Maternal-fetal medicine consultation: A specialist with expertise in managing complex pregnancies can provide additional support and guidance.
  8. Genetic counselling and testing: Genetic counselling and testing may involve discussing family history, genetic screening tests, and prenatal diagnosis and intervention options.
  9. Preterm birth prevention: Measures to prevent preterm birth may include medications such as progesterone supplementation, cervical cerclage (a procedure to reinforce the cervix), or bed rest.
  10. Specialised neonatal care: If there is a risk of complications or preterm birth, arrangements may be made to access a neonatal intensive care unit (NICU) equipped to provide care for premature or critically ill newborns.

When should you see a high-risk pregnancy gynaecologist in Singapore?

Recognising when to seek care from a high-risk pregnancy gynaecologist is essential to ensure the safety of mother and baby. While every pregnancy is unique, there are signs and circumstances which warrant prompt evaluation by a specialist. Here are some indicators.

  1. Vaginal bleeding: Vaginal bleeding during pregnancy can indicate a miscarriage, ectopic pregnancy, placental abruption, or placenta previa.
  2. Abdominal pain or cramping: Persistent or severe abdominal pain during pregnancy may signal a serious complication.
  3. Severe headaches: Severe headaches accompanied by dizziness, nausea, or swelling require immediate medical attention
  4. Changes in vision: Blurred, double, or other vision changes can be warning signs of high-risk pregnancy conditions.
  5. Reduced fetal movement: A noticeable decrease in fetal movement or kicks should be reported to a healthcare provider.
  6. High blood pressure: Elevated blood pressure, especially if it is persistent, requires close monitoring and management.
  7. Preterm labour signs: Seek immediate assistance if you observe pelvic pressure, lower back pain, abdominal cramping, and vaginal discharge or bleeding occurring before 37 weeks of gestation.

Pregnant patients must be aware of these symptoms and promptly report any changes in their condition to their doctor for early intervention.

If you are facing a high-risk pregnancy or have concerns about your pregnancy health, we are here to help. Your health and the health of your baby are our top priorities, and we are dedicated to providing quality care every step of the way.

Specialist for high-risk pregnancy in Singapore

While a high-risk pregnancy may present unique challenges, it can be managed with proper care, monitoring, and support. Couples can have peace of mind by working closely with experienced gynaecologists and following personalised management plans.

Dr Chang TC is a respected obstetrician specialising in high-risk pregnancies in Singapore. With years of experience and a compassionate approach to care, Dr Chang works closely with couples to navigate the challenges of high-risk pregnancies and achieve successful childbirths.

Frequently Asked Questions

How often should women with high-risk pregnancies have prenatal check-ups and monitoring?

Women with high-risk pregnancies typically require more frequent prenatal check-ups, often every 2-4 weeks or even more frequently as deemed necessary by their specialist.

The safety of medications during pregnancy varies depending on the specific medication and the underlying condition being treated. Consulting a doctor to assess the risks and benefits of continuing or adjusting medicines during pregnancy is essential.

Common complications associated with high-risk pregnancies include preeclampsia, gestational diabetes, preterm labour, placental abnormalities, fetal growth restriction, and congenital anomalies.

Depending on the specific risk factors involved, women with high-risk pregnancies may require additional prenatal tests such as specialised ultrasound scans, genetic testing, and fetal monitoring to assess the health and development of the baby.

Preeclampsia is a pregnancy complication presented by high blood pressure and damage to other organs, most commonly the liver and kidneys. Left untreated, preeclampsia can cause severe complications, including eclampsia, placental abruption, and fetal growth restriction.

Preterm labour in high-risk pregnancies can lead to complications such as respiratory distress syndrome, intraventricular haemorrhage, necrotising enterocolitis, and long-term developmental disabilities for the baby.

Symptoms that should prompt immediate medical attention during a high-risk pregnancy include:

  • Vaginal bleeding
  • Severe abdominal pain
  • Persistent headaches
  • Visual disturbances
  • Sudden swelling of the face or hands
  • Reduced fetal movement
  • Signs of preterm labour

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