High‑Risk Pregnancy: What It Means and How It's Managed

What is a high-risk pregnancy?

A high‑risk pregnancy means there is a higher chance of health problems for you, your baby, or both. It does not mean something will go wrong. However, it may mean you need extra appointments, tests, and support.¹

Many people with high‑risk pregnancies go on to have healthy babies, especially if they get early and regular care.

Your care team may include an obstetrician (OB or OBGYN), a maternal‑fetal medicine (MFM) specialist, nurses, and other experts. Your care team will work together to watch your health and your baby’s growth.

Common Symptoms and Warning Signs of High-Risk Pregnancies

Call your provider right away if you notice any of the following symptoms:²

• Severe headache that won't go away
• Vision changes
• Extreme swelling of the face or hands.
• Chest pain or fast-beating heart
• Shortness of breath or trouble breathing
• Sudden heavy bleeding.
• Regular contractions before 37 weeks
• Dizziness or fainting
• Pelvic pressure
• Water breaking early.
• Severe belly pain that doesn't go away
• Severe nausea/vomiting
• Fast weight gain over a few days.

These signs may point to serious pregnancy problems. Acting early can help protect you and your baby.

Download or order conversation guide and palm card which are designed to help women who are pregnant or postpartum share their concerns with their health care providers. These resources are available in multiple languages.

What makes a pregnancy high-risk?

A pregnancy can be high risk from the start or become high risk later. Some of the most serious pregnancy complications are linked to high blood pressure and heavy bleeding. Be sure to discuss your own risk factors with your doctor to determine if they want to treat you as high-risk. 

Common factors include:

• Health conditions before pregnancy: High blood pressure, diabetes, obesity, kidney or heart problems, autoimmune disease.³
• Age: 35 or older.⁴
• Conditions that begin in pregnancy: Preeclampsia, fetal growth problems, or placenta issues.³
• Pregnancy history: Preterm birth, stillbirth, or past complications.³
• Pregnant with multiples: Twins, triplets, or more.³
• Lifestyle factors: Tobacco, alcohol, or substance use³

Testing and Monitoring High-Risk Pregnancies

Your provider will take a history, do physical exams, and order tests to check you and your baby. Common tests include:

Lab Tests³

• Blood pressure checks
• Urine protein tests
• Blood sugar tests (Oral Glucose Tolerance Test or OGTT) to detect gestational diabetes.

Fetal Monitoring⁵

• Nonstress test (NST): Tracks your baby’s heart rate when the baby moves.
• Biophysical profile (BPP): Combines ultrasound with NST to check breathing, movement, muscle tone, and amniotic fluid.
• Doppler ultrasound: Checks blood flow, often in the umbilical artery.

Imaging and Prenatal Screening⁵

• Ultrasound exams: Standard anatomy scan at 18–22 weeks; specialized scans if concerns arise. Both 3D and 4D ultrasounds may be used.
• Genetic screening and diagnostic tests: Cell‑free DNA screening, chorionic villus sampling (CVS), or amniocentesis are offered to pregnant patients after counseling.

Related High-Risk Pregnancy Conditions

There are many reasons for a pregnancy to be labeled as "high risk." They may be related to the following common pregnancy-related conditions.⁶

General Hypertension and Preeclampsia

• What It Is: A pregnancy‑related high blood pressure disorder that can appear after 20 weeks or postpartum; serious but manageable with prompt care.
• Possible Treatment: Close monitoring, blood pressure medicines, and sometimes early delivery if severe. Low‑dose aspirin may be recommended in high‑risk cases.

Gestational Diabetes

• What It is: High blood sugar that starts in pregnancy; often has no symptoms and needs screening and blood sugar control.
• Possible Treatment: Diet changes, activity, glucose checks, and sometimes insulin or other medicines.

Hyperemesis Gravidarum

• What It Is: Morning sickness (nausea and vomiting) so severe it leads to significant weight loss or hospitalization. 
• Possible Treatment: Ensuring adequate nutrients in diet; medication in some cases; nutrients and fluids via IV in severe cases.

Placenta Previa

• What It Is: Placenta partially or totally covers the cervix
• Possible Treatment: More frequent visits, ultrasounds, NSTs/BPPs, and planned C-section 2-4 weeks before due date.

Treatment for High-Risk Pregnancies

Treatment depends on the cause and how far along you are. Your team can make a high‑risk pregnancy care plan tailored to you. In complex cases, MFM specialists coordinate care and may involve cardiology, endocrinology, neonatology, or other experts to keep you and your baby as safe as possible.

Steps You Can Take to Stay Healthy

Simple steps can lower risk and support a healthy pregnancy:

• Know urgent warning signs. Learn the CDC’s “HEAR HER” symptoms and call if they appear.¹
• Go to all prenatal visits. Early and regular care helps catch problems fast.¹
• Eat a balanced diet. Focus on fruits, vegetables, whole grains, lean protein, and take prenatal vitamins (folic acid and iron).⁷
• Stay active (unless otherwise directed by your provider). Gentle exercise (like walking) supports mood, sleep, and blood sugar.¹
• Avoid tobacco, alcohol, and drugs. These raise risks for you and your baby.³

High Risk Means More Care, Not Less Hope.

It can be stressful having a high-risk pregnancy, but with the right care plan, many people have healthy pregnancies and deliveries. Stay engaged with your care team, ask questions, and take small steps each day to support your health.

¹ Pregnancy Complications, CDC, May 15, 2024, https://www.cdc.gov/maternal-infant-health/pregnancy-complications/index.html

² Urgent Maternal Warning Signs and Symptoms, CDC, May 15, 2024, https://www.cdc.gov/hearher/maternal-warning-signs/index.html

³ High-risk Pregnancy: Know What to Expect, Mayo Clinic, Jan. 25, 2024, https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/high-risk-pregnancy/art-20047012

⁴ Pregnancy at Age 35 Years or Older, ACOG, Reaffirmed 2025, https://www.acog.org/clinical/clinical-guidance/obstetric-care-consensus/articles/2022/08/pregnancy-at-age-35-years-or-older

⁵ Special Tests for Monitoring Fetal Well-Being, ACOG, January 2026,
https://www.acog.org/womens-health/faqs/special-tests-for-monitoring-fetal-well-being 

⁶ 4 Common Pregnancy Complications, Johns Hopkins Medicine, accessed Feb. 20, 2026.  https://www.hopkinsmedicine.org/health/conditions-and-diseases/staying-healthy-during-pregnancy/4-common-pregnancy-complications

⁷ Pregnancy Diet: Focus On These Essential Nutrients, Mayo Clinic, Jan. 31, 2025, https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-nutrition/art-20045082

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