Being told your pregnancy is 'high-risk' is frightening. But the term is often misunderstood it does not mean your pregnancy is doomed or your baby is definitely in danger. It means your pregnancy requires closer monitoring and specialist care. And with that care, the vast majority of high-risk pregnancies result in healthy mothers and healthy babies.
What Makes a Pregnancy High-Risk?
A pregnancy is classified as high-risk when maternal or fetal factors increase the probability of complications. These factors can exist before pregnancy, develop during it, or relate to the pregnancy itself. Common categories include: maternal age under 17 or over 35, pre-existing medical conditions such as diabetes, hypertension, heart disease, kidney disease, lupus, thyroid disorders, or epilepsy, pregnancy-related conditions such as gestational diabetes, preeclampsia, placenta praevia, or cervical incompetence, and fetal factors including multiple pregnancy (twins or more), detected fetal anomalies, IUGR (intrauterine growth restriction), or Rh incompatibility.
Preeclampsia: The Silent Danger
Preeclampsia characterised by new-onset high blood pressure and organ dysfunction after 20 weeks of pregnancy is the most important pregnancy-specific complication to monitor for. It affects 5–8% of pregnancies and is a leading cause of maternal and fetal mortality in India.
Warning Signs of Preeclampsia
Severe headache that doesn't resolve · Visual disturbances (flashing lights, blurred vision) · Sudden swelling of face, hands, and feet · Pain below the ribs on the right side · Sudden weight gain of more than 1 kg in a week. Report any of these to your obstetrician immediately do not wait for the next scheduled visit.
Low-dose aspirin (75–150 mg daily from 12 weeks) reduces the risk of preeclampsia by up to 62% in high-risk women and is one of the most evidence-based interventions in modern obstetrics. Ask your doctor if you are eligible.
Gestational Diabetes: More Common Than You Think
Gestational diabetes mellitus (GDM) high blood sugar developing during pregnancy affects approximately 20–25% of pregnancies in India, one of the highest rates in the world. If uncontrolled, it significantly increases the risk of a large baby (macrosomia), difficult delivery, neonatal hypoglycaemia, and the mother's risk of developing Type 2 diabetes later in life.
All pregnant women should be screened for GDM between 24 and 28 weeks with a 75g oral glucose tolerance test. Most cases of GDM are manageable with dietary modification and blood sugar monitoring. Insulin or oral medication is added when lifestyle measures are insufficient, and dose requirements change rapidly as pregnancy progresses making frequent monitoring essential.
What Increased Monitoring Looks Like
Depending on the risk category, high-risk pregnancy monitoring may include more frequent antenatal visits (fortnightly or even weekly in the third trimester), additional ultrasounds for growth and Doppler blood flow assessment, biophysical profiles to assess fetal wellbeing, non-stress tests (CTG), specialist consultations (cardiologist, nephrologist, endocrinologist), and planned hospital delivery with a neonatal team on standby.
This level of care is not alarming it is precisely what modern obstetrics is designed to provide. The goal is to identify any deterioration early enough to intervene before it becomes dangerous. At MNR Hospital's Maternal-Fetal Medicine unit, all high-risk obstetric cases are managed with a dedicated multidisciplinary team including a fetal medicine specialist, neonatologist, and relevant medical subspecialists.
Dr. Kavitha Bhat
Dr. Kavitha Bhat is a Consultant Gynecologist and Fetal Medicine specialist at MNR Hospital with 13 years of experience. Trained at KMC Manipal with a Fellowship in Maternal-Fetal Medicine, she specialises in high-risk obstetrics, complex fetal anomaly management, and prenatal diagnosis.
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