The High Risk Pregnancy 

Since more than 3,000 congenital disorders can be passed to baby through parents, initial evaluations are vital to establishing guidelines for managing any pregnancy. Past medical history (including genetic and infection history) establishes pre-existing conditions. Pregnancy risk factors are most often detected during this basic review, resulting in the physician offering additional diagnostic tests to further define potential problems.

Entering the second trimester can be both exciting and frightening as more tests can establish the healthy progression of pregnancy. At 28 weeks a Glucose Tolerance Test is administered to detect gestational diabetes. Ultrasound gives the first picture of the developing baby, while amniocentesis can either reassure parents everything is normal or detect fetal conditions not always visible. At this time the physician may offer The Triple Screen or Rapid Prenatal Aneuploid Screen (RPAS).

RPAS becomes most appropriate with abnormal ultrasound, high risk of chromosome abnormality detected by maternal hormone screen, strong family history of aneuploidy (chromosome abnormalities), and high maternal anxiety. Amniotic fluid is collected during amniocentesis, with results usually reported within two working days. Results are confirmed through additional culture testing prior to any pregnancy management decisions.

As pregnancy nears full-term, the monitoring of maternal and fetal health intensifies. The best route to a healthy pregnancy is not to be afraid of high risk, but rather to detect risk for informed management of the pregnancy.

Date last updated:  January 27, 2003