What Is a High-Risk Pregnancy? (video)

Brad Dolinsky, MD, is an obstetrician and gynecologist who specializes in maternal and fetal medicine at Scripps Clinic. Dr. Dolinsky explains the factors that make a pregnancy high risk, including age, and the role perinatologists like himself play in treating high-pregnancies.

A high-risk pregnancy is essentially a patient who has either a complex medical problem like diabetes or high blood pressure or some sort of autoimmune condition that potentially could affect them in the pregnancy or affect their child. From a baby standpoint, a high-risk pregnancy sometimes involves ultrasound findings that we’re not really quite sure what they are, and it is a reason for us to see patients.

Advanced maternal age is considered a patient who is 35 years and older. There is also a subset or category for a patient who is over 45 that we call very advanced maternal age. But I always like to think of age as sort of a spectrum. Nobody is young or old, and risks for the pregnancy really depend on a lot of other factors.

Moms who are older have a higher risk for complications, sometimes problems with the placenta, problems with the baby’s growth and other medical complications, such as high blood pressure, which can complicate the pregnancy.

A perinatologist, or a maternal fetal medicine doctor, is a high-risk pregnancy doctor. We take care of patients. We take care of their medical problems. We perform ultrasounds. We provide counseling. We give them information as well as help the general obstetrician help manage these conditions to get the best outcome for the mother and the baby.

Genetic counselors provide counseling to patients who have a high risk for having a child with a birth defect or a genetic syndrome. They provide information regarding interpretation of abnormal tests or options for specific tests in pregnancy that can help diagnose their baby with specific syndromes.

Patients get offered genetic testing or screening and it’s their option if they want to do this. It’s definitely elective. It’s not something mandatory. In certain patients we recommend it, but it’s definitely individualized and up to the patient if they want to do this.