High-risk Pregnancy
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High-risk Pregnancy
A high-risk pregnancy is one where the mother or the fetus has an increased risk of adverse outcomes compared to uncomplicated pregnancies. No concrete guidelines currently exist for distinguishing “high-risk” pregnancies from “low-risk” pregnancies, however there are certain studied conditions that have been shown to put the mother or fetus at a higher risk of poor outcomes. These conditions can be classified into three main categories: health problems in the mother that occur before she becomes pregnant, health problems in the mother that occur during pregnancy, and certain health conditions with the fetus. In 2012, the CDC estimated that there were approximately 65,000 pregnancies deemed "high-risk" in the United States. Causes Mother-related factors Pregnancies could be considered high risk if the mother has certain pre-existing health conditions. These include: * Age ** Older age - Pregnancies in women over the age of 35 are considered " advanced age". First-time p ...
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Advanced Maternal Age
Advanced maternal age, in a broad sense, is the instance of a woman being of an older age at a stage of reproduction, although there are various definitions of specific age and stage of reproduction.Effect of advanced age on fertility and pregnancy in women
at . Author: Ruth C Fretts. Section Editor: Louise Wilkins-Haug. Deputy Editor: Vanessa A Barss. This topic last updated: 3 December 2012.
The variability in definitions is in part explained by the effects of increasing age occurring as a

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Multiple Birth
A multiple birth is the culmination of one multiple pregnancy, wherein the mother gives birth to two or more babies. A term most applicable to vertebrate species, multiple births occur in most kinds of mammals, with varying frequencies. Such births are often named according to the number of offspring, as in ''twins'' and ''triplets''. In non-humans, the whole group may also be referred to as a ''litter'', and multiple births may be more common than single births. Multiple births in humans are the exception and can be exceptionally rare in the largest mammals. A multiple pregnancy may be the result of the fertilization of a single egg that then splits to create identical fetuses, or it may be the result of the fertilization of multiple eggs that create fraternal ("non-identical") fetuses, or it may be a combination of these factors. A multiple pregnancy from a single zygote is called ''monozygotic'', from two zygotes is called ''dizygotic'', or from three or more zygotes is calle ...
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Bacterial Vaginosis
Bacterial vaginosis (BV) is a disease of the vagina caused by excessive growth of bacteria. Common symptoms include increased vaginal discharge that often smells like fish. The discharge is usually white or gray in color. Burning with urination may occur. Itching is uncommon. Occasionally, there may be no symptoms. Having BV approximately doubles the risk of infection by a number of sexually transmitted infections, including HIV/AIDS. It also increases the risk of early delivery among pregnant women. BV is caused by an imbalance of the naturally occurring bacteria in the vagina. There is a change in the most common type of bacteria and a hundred to thousand fold increase in total numbers of bacteria present. Typically, bacteria other than ''Lactobacilli'' become more common. Risk factors include douching, new or multiple sex partners, antibiotics, and using an intrauterine device, among others. However, it is not considered a sexually transmitted infection and, unlike gonorrh ...
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Group B Streptococcal Infection
Group B streptococcal infection, also known as Group B streptococcal disease or just Group B strep, is the infection caused by the bacterium ''Streptococcus agalactiae'' (''S. agalactiae'') (also known as group B streptococcus or GBS). GBS infection can cause serious illness and sometimes death, especially in newborns, the elderly, and people with compromised immune systems. As other virulent bacteria, GBS harbours an important number of virulence factors, The most important are the capsular polysaccharide (rich in sialic acid), and a pore-forming toxin, β-haemolysin. The GBS capsule is probably the key virulence factor because it helps GBS escape from the host defence mechanisms interfering with phagocytic killing of GBS by human phagocytes. The GBS β-haemolysin is considered almost identical to the GBS pigment (granadaene). GBS was recognized as a pathogen in cattle by Edmond Nocard and Mollereau in the late 1880s. It can cause bovine mastitis (inflammation of the udder) in d ...
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Vertically Transmitted Infection
A vertically transmitted infection is an infection caused by pathogenic bacteria or Pathogenic virus, viruses that use mother-to-child transmission, that is, Transmission (medicine), transmission directly from the mother to an embryo, fetus, or baby during pregnancy or childbirth. It can occur when the mother has a pre-existing disease in pregnancy, pre-existing disease or becomes infected during pregnancy. Nutritional deficiencies may exacerbate the risks of perinatal infections. Types of infections Bacteria, viruses, and other organisms are able to be passed from mother to child. Several vertically transmitted infections are included in the TORCH complex: # T – toxoplasmosis from ''Toxoplasma gondii'' # O – other infections (see below) # R – rubella # C – cytomegalovirus # H – herpes simplex virus-2 or neonatal herpes simplex Other infections include: * Parvovirus B19 * Coxsackievirus * Chickenpox (caused by varicella zoster virus) * ''Chlamydia infection, Chlamydi ...
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Placenta Accreta Spectrum
Placenta accreta occurs when all or part of the placenta attaches abnormally to the ''myometrium'' (the muscular layer of the uterine wall). Three grades of abnormal placental attachment are defined according to the depth of attachment and invasion into the muscular layers of the uterus: # ''Accreta – chorionic villi'' attached to the myometrium, rather than being restricted within the ''decidua basalis''. # ''Increta – chorionic villi'' invaded into the ''myometrium''. # ''Percreta – chorionic villi'' invaded through the '' perimetrium'' (uterine serosa). Because of abnormal attachment to the myometrium, placenta accreta is associated with an increased risk of heavy bleeding at the time of attempted vaginal delivery. The need for transfusion of blood products is frequent, and surgical removal of the uterus ( hysterectomy) is sometimes required to control life-threatening bleeding. Rates of placenta accreta are increasing. As of 2016, placenta accreta affects an estimated 1 ...
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Placental Abruption
Placental abruption is when the placenta separates early from the uterus, in other words separates before childbirth. It occurs most commonly around 25 weeks of pregnancy. Symptoms may include vaginal bleeding, lower abdominal pain, and dangerously low blood pressure. Complications for the mother can include disseminated intravascular coagulopathy and kidney failure. Complications for the baby can include fetal distress, low birthweight, preterm delivery, and stillbirth. The cause of placental abruption is not entirely clear. Risk factors include smoking, pre-eclampsia, prior abruption (most important and predictive risk factor), trauma during pregnancy, cocaine use, and previous cesarean section. Diagnosis is based on symptoms and supported by ultrasound. It is classified as a complication of pregnancy. For small abruption, bed rest may be recommended, while for more significant abruptions or those that occur near term, delivery may be recommended. If everything is stable, ...
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Postterm Pregnancy
Postterm pregnancy is when a woman has not yet delivered her baby after 42 weeks of gestation, two weeks beyond the typical 40-week duration of pregnancy. Postmature births carry risks for both the mother and the baby, including fetal malnutrition, meconium aspiration syndrome, and stillbirths. After the 42nd week of gestation, the placenta, which supplies the baby with nutrients and oxygen from the mother, starts aging and will eventually fail. Postterm pregnancy is a reason to induce labor. Definitions The management of labor and delivery may vary depending on the gestational age. It is common to encounter the following terms when describing different time periods of pregnancy. * Postterm – ≥ 42 weeks + 0 days of gestation (> 293 days from the first day of last menstrual period, or > 13 days from the estimated due date) * Late term – 41 weeks + 0 days to 41 weeks + 6 days of gestation * Full term – 39 weeks + 0 days to 40 weeks + 6 days of gestation * Early term – 37 ...
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Prelabor Rupture Of Membranes
Prelabor rupture of membranes (PROM), previously known as premature rupture of membranes, is breakage of the amniotic sac before the onset of labor. Women usually experience a painless gush or a steady leakage of fluid from the vagina. Complications in the baby may include premature birth, cord compression, and infection. Complications in the mother may include placental abruption and postpartum endometritis. Risk factors include infection of the amniotic fluid, prior PROM, bleeding in the later parts of pregnancy, smoking, and a mother who is underweight. Diagnosis is suspected based on symptoms and speculum exam and may be supported by testing the vaginal fluid or by ultrasound. If it occurs before 37 weeks it is known as PPROM (preterm prelabor rupture of membranes) otherwise it is known as term PROM. Treatment is based on how far along a woman is in pregnancy and whether complications are present. In those at or near term without any complications, induction of labor is ...
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Preterm Birth
Preterm birth, also known as premature birth, is the Childbirth, birth of a baby at fewer than 37 weeks Gestational age (obstetrics), gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 weeks, very early preterm birth is between 28 and 32 weeks, early preterm birth occurs between 32 and 36 weeks, late preterm birth is between 34 and 36 weeks' gestation. These babies are also known as premature babies or colloquially preemies (American English) or premmies (Australian English). Symptoms of preterm labor include uterine contractions which occur more often than every ten minutes and/or the leaking of fluid from the vagina before 37 weeks. Premature infants are at greater risk for cerebral palsy, delays in development, hearing problems and problems with their Visual impairment, vision. The earlier a baby is born, the greater these risks will be. The cause of spontaneous preterm birth is often not known. Risk factors include dia ...
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Type 2 Diabetes
Type 2 diabetes, formerly known as adult-onset diabetes, is a form of diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Common symptoms include increased thirst, frequent urination, and unexplained weight loss. Symptoms may also include increased hunger, feeling tired, and sores that do not heal. Often symptoms come on slowly. Long-term complications from high blood sugar include heart disease, strokes, diabetic retinopathy which can result in blindness, kidney failure, and poor blood flow in the limbs which may lead to amputations. The sudden onset of hyperosmolar hyperglycemic state may occur; however, ketoacidosis is uncommon. Type 2 diabetes primarily occurs as a result of obesity and lack of exercise. Some people are genetically more at risk than others. Type 2 diabetes makes up about 90% of cases of diabetes, with the other 10% due primarily to type 1 diabetes and gestational diabetes. In type 1 diabete ...
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Gestational Diabetes
Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. Gestational diabetes generally results in few symptoms; however, it increases the risk of pre-eclampsia, depression, and of needing a Caesarean section. Babies born to mothers with poorly treated gestational diabetes are at increased risk of macrosomia, of having hypoglycemia after birth, and of jaundice. If untreated, diabetes can also result in stillbirth. Long term, children are at higher risk of being overweight and of developing type 2 diabetes. Gestational diabetes can occur during pregnancy because of insulin resistance or reduced production of insulin. Risk factors include being overweight, previously having gestational diabetes, a family history of type 2 diabetes, and having polycystic ovarian syndrome. Diagnosis is by blood tests. For those at normal risk, screening is recommended between 24 and 28 weeks' gestation. For those at high risk, testin ...
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