A pregnancy may be classified as high risk if the mother has a chronic medical condition or if there are signs of complications in the fetus or with the pregnancy.

Medical Conditions in the Mother

Medical conditions that warrant special care include diabetes, hypertension, asthma, seizure disorder, thyroid conditions, heart conditions, blood clotting abnormalities, HIV infection, sickle cell anemia, cancers, and systemic lupus erythematosus (SLE).

Fetal Problems

Problems in the fetus are usually detected after the pregnancy has progressed to a certain point or else they are suspected based on the outcome of a previous pregnancy. For example, a birth defect, such as spina bifida or heart malformation, may be detected in the fetus by means of screening tests during pregnancy or may be suggested because of the outcome of a previous pregnancy. Rh incompatibility (in which the mother is Rh-negative and the baby is Rh-positive), fetal infection, or fetal growth problems also designate the pregnancy as high risk.

Detection of multiple gestation, such as twins and triplets, will classify the pregnancy as high risk even though nothing is inherently wrong with the fetuses.

Obstetrical Problems

Obstetrical problems that may classify the pregnancy as high risk include placenta previa (a condition in which the placenta is covering the opening of the uterus to varying degrees), premature labor, premature rupture of membranes (bag of waters), fibroids, or an abnormally shaped uterus.

Some obstetricians and family practitioners may feel comfortable managing women with such conditions; others may choose to refer the woman to a maternal-fetal medicine specialist. Your provider may recommend consultation (an in-depth evaluation) by the specialist, co-management by your provider and the specialist throughout pregnancy, or transfer of care (the specialist will assume primary responsibility for your pregnancy care).