The Role of an OBGYN in Monitoring and Managing High-Risk Pregnancies

Without the vigilant watch of an OBGYN, high-risk pregnancies can threaten your and your baby’s safety. While many of these pregnancies can see through to term, the slew of complications can spell the worst results if not managed promptly and/or effectively.

In these situations, there is no underestimating the role of an OBGYN in monitoring and managing it. Unlike normal pregnancies, high-risk ones often require a multi-disciplinary and vigilant approach to care, as complications can arise from various factors.

Risk Factors for High-Risk Pregnancies

Since each body is unique, your pregnancy experience can differ vastly from that of others. That said, it can be hard to determine whether or not a pregnancy will be high-risk without further assessment.

You see, high-risk pregnancies can stem from more than just pre-existing conditions like hypertension or diabetes. There are multiple contributing factors, such as:

Maternal age. Women under 18 or over 35 have a higher likelihood of pregnancy complications.
Pre-existing health conditions. Hypertension, diabetes, kidney disease, autoimmune disorders, or heart conditions can increase pregnancy risks.
Multiple gestations. Carrying twins, triplets, or more increases the risk of preterm labor, gestational diabetes, and other complications.
History of pregnancy complications. Previous preterm labor, miscarriage, or stillbirth can indicate a higher risk for complications in subsequent pregnancies.
Placental abnormalities. Placenta previa, placental abruption, or insufficient blood flow to the placenta can impact fetal health.
Obesity or underweight status. Extreme body weight variations can contribute to gestational diabetes, hypertension, or fetal growth restrictions.
Lifestyle factors. Smoking, alcohol consumption, and substance use can significantly affect pregnancy outcomes.

If you have or are exposed to one or more of these factors, your pregnancy may immediately be categorized as high-risk. Should this be the case, you must communicate and work with your OBGYN honestly and openly so they can best support you through this journey.

The OBGYN’s Role in Monitoring High-Risk Pregnancies

OBGYNs are specifically trained to give care and support for normal and high-risk pregnancies alike. Their targeted expertise can help address your most worrying concerns and provide effective management strategies for safe and successful deliveries.

These management strategies will span everything from monitoring to therapeutic interventions and other important forms of support. The guide below details these specific roles.

Vigilant Monitoring of Pregnancy Progress.

Because various factors contribute to high-risk pregnancies, monitoring may involve more advanced and frequent ultrasounds and other monitoring techniques. On the same thread, watchful observation allows doctors to address undesirable developments promptly.

To do so, an OBGYN will develop a care plan that achieves the optimal mix of advanced screening procedures and arrange frequent visits for you.

1. Conducts prenatal screenings and diagnostic tests.

For women with high-risk pregnancies, early and frequent screenings are essential to detect potential complications. OBGYNs utilize various diagnostic tools to assess fetal development and maternal health, including:

Nuchal translucency screening. This ultrasound is performed in the first trimester to determine the risk of chromosomal abnormalities.
Non-Invasive Prenatal Testing (NIPT). NIPT is a blood test that screens for genetic conditions such as Down syndrome.
Amniocentesis. A diagnostic test that collects amniotic fluid to detect genetic disorders or fetal infections.
Glucose tolerance test. Used to identify gestational diabetes, a condition that can lead to complications if left untreated.

2. Conduct frequent monitoring and specialized ultrasounds.

High-risk pregnancies require more frequent ultrasounds and fetal monitoring to track development, identify potential concerns, and ensure appropriate interventions are in place. In-office ultrasounds help monitor:

Fetal growth and development. Identifying intrauterine growth restrictions or macrosomia (excessive fetal growth).
Amniotic fluid levels. Low or excessive fluid levels can indicate potential complications.
Placental health. Ensuring the placenta is functioning correctly to support fetal needs.
Fetal movement and heart rate. Non-stress tests and biophysical profiles assess fetal well-being.

3. Managing the complications of high-risk pregnancies.

As we’ve established, frequent monitoring enables prompt action to prevent high-risk pregnancy complications so that you can have a successful and healthy delivery. Depending on your health history, your OBGYN might recommend one or any combination of the following care approaches:

Lifestyle modifications. Nutritional counseling, physical activity recommendations, and avoiding harmful substances.
Medications. Prescribing blood pressure medications, insulin for diabetes management, or progesterone therapy to reduce the risk of preterm labor.
Bed rest or activity restrictions. Recommended for conditions like placenta previa or cervical insufficiency.
Hospital monitoring. Some high-risk pregnancies require hospitalization for continuous observation.

4. Coordinating multidisciplinary care.

Pregnancies categorized as high-risk also require a multidisciplinary care approach. Depending the specific pre-existing conditions that are making your pregnancy complex, your OBGYN might also enlist the help of and coordinate with other health professionals including:

Maternal-fetal medicine (MFM) specialists. Experts in managing complex pregnancies.
Endocrinologists. For managing gestational diabetes or thyroid conditions.
Neonatologists. Specialists in newborn care, especially for preterm or high-risk infants.

The involvement of a multidisciplinary team ensures that all aspects of maternal and fetal health are addressed comprehensively.

5. Providing emotional and psychological support.

High-risk pregnancies can be emotionally challenging experiences. You might feel more anxious or stressed, and if not managed correctly, these feelings can seep into relationships. Thus, part of the role of an OBGYN is providing emotional support for patients. Mental health support is an essential component of high-risk pregnancy care. OBGYNs may:

Provide reassurance and clear explanations about test results and medical recommendations.
Refer patients to mental health professionals for therapy or counseling.
Encourage stress-reducing techniques such as prenatal yoga, meditation, or support groups.

Open and transparent communication between OBGYNs and patients fosters trust and confidence. Regular check-ins allow patients to:

Express concerns and ask questions.
Stay informed about their pregnancy status and potential risks.
Feel empowered to make informed decisions regarding their care.

Compassionate and clear communication is a cornerstone of high-quality obstetric care.

Preparing for delivery and offering guidance.

Lastly, the most critical role an OBGYN plays in high-risk pregnancies is preparing you for and facilitating a safe delivery. This process will entail planning or pre- and post-partum care and monitoring.

As your delivery date draws near, your OBGYN will assess various factors to determine the safest delivery approach. This process includes:

Fetal position and development. This assessment checks if the baby is ideally positioned to be delivered easily. Ideally, the top of the baby’s head is rested just on top of the cervix a few weeks before delivery.
Risk of preterm labor. Assessing the risk of preterm labor entails monitoring the frequency and duration of your contractions. If your contractions start early or are becoming more frequent early on, your baby risks not developing fully in the womb. In this situation, your OBGYN will decide between early delivery or delaying it.
Maternal health conditions. Gestational diabetes, preeclampsia and other maternal health conditions need to be kept under control before delivery. For the former, your OBGYN will seek to keep your glucose levels down while, for the latter, blood pressure will need to be normalized before the baby comes.

For some high-risk pregnancies, Cesarean section (C-section) may be recommended to ensure a safer birth.

Provide postpartum care and monitoring.

Postpartum follow-ups are critical in high-risk pregnancy cases to ensure that mothers recover well after delivery. During this phase, your OBGYN will check for postpartum complications such as excessive bleeding and/or infections. Continued postpartum care supports both physical and emotional recovery for new mothers.

Similarly, your newborn’s health will also be monitored. In the case of preterm infants, OBGYNs will monitor for health complications vigilantly and communicate any and all progress in their development. Expect prompt and open communication of any changes to be provided so that you can collaborate with your doctor regarding the best care approaches.

The Importance of Expert OBGYN Care in High-Risk Pregnancies

High-risk pregnancies require specialized care, close monitoring, and a proactive approach to managing potential complications. OBGYNs play a critical role in guiding expectant mothers through these challenges, providing medical expertise, emotional support, and coordinated care.

Seeking expert OBGYN care ensures that both mother and baby receive the best possible outcomes. Women experiencing high-risk pregnancies should work closely with their healthcare providers to develop personalized plans that prioritize safety and well-being.

For additional information and guidance for high-risk pregnancies, we urge you to set an appointment at any Roswell Ob/Gyn clinic. Our specialists will be more than happy to accommodate your needs and concerns.