High-risk pregnancy
Overview
For the vast majority of women, pregnancy follows a routine course. Some women, however, have medical difficulties related to their health or the health of their baby. These women experience what is called a high-risk pregnancy.
High-risk complications occur in only 6 percent to 8 percent of all pregnancies. These complications can be serious and require special care to ensure the best possible outcome.
While some problems are unavoidable, UCSF perinatologists – obstetricians with special training and board certification in high-risk pregnancy care – work to minimize complications and help you achieve the healthiest pregnancy possible.
Our approach to high-risk pregnancy
UCSF provides world-class care for women who are pregnant or considering becoming pregnant. Each pregnancy is unique. When medical conditions affect the health of a pregnant woman or her baby, our team has the training and experience necessary to provide highly specialized, comprehensive care. Our doctors, nurses and support staff coordinate all aspects of your care, from consultation, testing and diagnosis through delivery and long-term follow-up. Each year, we deliver hundreds of babies from high-risk pregnancies in our state-of-the-art, family-oriented birth center.
UCSF is a world leader in diagnosing and treating birth defects before delivery. Many of the fetal surgeries and endoscopic fetal interventions in use today were pioneered here. We are also home to one of the nation's finest intensive care nurseries, as well as the only specialized clinic in California dedicated to long-term follow-up care for children with complex birth defects.
Causes
A pregnancy may be considered high-risk for a variety of reasons. Some of these include:
- The mother has medical conditions that began before pregnancy, such as diabetes
- The mother develops a medical condition during pregnancy, such as preeclampsia
- The mother experienced problems in a previous pregnancy, such as miscarriage
- Problems are detected in the developing baby
- Complications occur during pregnancy, such as premature labor
- The mother is pregnant with multiples (twins or more)
At UCSF, we treat the full range of conditions that may affect a woman's pregnancy. Our doctors have special training in treating diabetes in pregnancy, preterm labor, recurrent miscarriages, and fetal abnormalities.
Testing
Fortunately, advances in technology have helped improve the diagnosis and treatment of high-risk pregnant women. UCSF provides specialized fetal imaging techniques, such as MRI, to detect various conditions in the mother and baby. Our Prenatal Diagnosis Center offers the latest tests used to evaluate a developing baby. Some of these tests are available in only a few centers nationwide, and can be performed as early as 10 weeks of pregnancy.
Multiples
Being pregnant with multiples doesn't necessarily mean that your pregnancy will be problematic. However, women carrying multiples do have a higher chance of developing complications such as high blood pressure and preterm labor. For this reason, all multiple pregnancies are considered high-risk.
Prenatal care
Due to the higher risk of complications, women expecting multiples require special prenatal care. At UCSF, some of the differences in prenatal care include:
- More frequent visits. We schedule prenatal visits more frequently than for a singleton pregnancy, so we can watch for early signs of complications.
- Additional testing. Because multiples and their moms are more likely to develop complications, they need more tests to diagnose problems and monitor fetal development. Ultrasounds are performed every four to six weeks to ensure that your babies are growing normally. You also may decide to have additional genetic testing, although it can be more complicated to test multiples than singletons. Your provider or a genetic counselor at the Prenatal Diagnosis Center can answer any questions you have about which tests are best for you.
UCSF's Great Expectations prenatal education program offers special classes for families expecting multiples.
Premature birth
One of the reasons multiple pregnancies are considered higher risk is because 50 percent of them deliver prematurely. A premature delivery occurs prior to 37 weeks of gestation, while a normal full-term pregnancy lasts 38 to 42 weeks. Every effort is made to prolong your pregnancy as long as possible, to reduce some of the risks that may occur when babies are delivered prematurely. Premature infants may have problems with breathing and digesting.
Should your babies be born early or experience any other complications that require the care of a neonatologist – a pediatrician specializing in the care of sick newborns – access to renowned experts and services is available at UCSF Benioff Children's Hospital, one of the highest-ranked pediatric programs in California. The hospital has state-of-the-art facilities to care for premature newborns, including the Intensive Care Nursery.
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
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At 19 weeks, they did a laser procedure to separate the connections…At 35 weeks, I had two beautiful, healthy babies.
At 15 weeks pregnant with twin boys, Meghann Bauer was devastated to learn that the babies' lives were at risk. She was diagnosed with twin-to-twin transfusion syndrome, a circulation imbalance that can occur when twins share the same placenta, in which one twin receives too much blood and the other too little. Bauer's doctor reassured her that there were treatments available and that the best place to go was UCSF.
Read more about Meghann Bauer's storyElianna's story
Dr. Tippi MacKenzie is stopping disease before it starts – in the womb. In a first-of-its-kind clinical trial, she transplanted stem cells from expectant mothers to their own fetuses to treat alpha thalassemia major (ATM), a potentially lethal disorder that can lead to progressive anemia and heart failure before birth.
The first patient enrolled in the clinical trial was born in February 2018. Her name is Elianna.
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