Prenatal Tests During a High-Risk Pregnancy: Care Instructions

Your Care Instructions

Your pregnancy is high-risk if you or your baby has a higher risk for health problems. Many things can put you at high risk. But that doesn't mean that you or your baby will have a problem.

Your doctor will watch you to make sure that your pregnancy is going well. Your doctor will do tests at different times. Many of the tests are routine. If your doctor thinks there might be a problem, you may have other tests. Sometimes babies are delivered early if needed.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Tests in the third trimester of a high-risk pregnancy

Routine tests

You will have blood pressure checks along with urine tests. You may have blood tests.
Your doctor may listen to your baby's heartbeat with a special stethoscope.
Your doctor may ask you to keep track of how much your baby moves every day. One way to do this is to note how much time it takes to feel 10 movements.
You will have tests to check for infections that could harm your newborn. These include group B streptococcus and sometimes hepatitis B.
Your doctor will do ultrasounds to check for problems and your baby's position. This test uses sound waves to produce a picture of an unborn baby (fetus).

Other tests

A nonstress test records your baby's heart rate while your baby is moving and then not moving. A heart monitor is placed on your belly to record your baby's heart rate.
A contraction stress test records your baby's heart rate during contractions. This will help you know how your baby will do during labor.
A biophysical profile includes a nonstress test with heart monitoring and an ultrasound. It measures your baby's heart rate, muscle tone, movements, and breathing. It also measures the amount of amniotic fluid around your baby. You may have this test weekly toward the end of your pregnancy.
A modified biophysical profile includes a nonstress test. It also measures your amniotic fluid. The level of this fluid is one of the signs of your baby's health.
You may have a test called amniocentesis. In this test, a needle is put into your uterus to pull out a small amount of fluid.
Your doctor may use a heart monitor throughout labor and delivery to know right away if your baby is in distress.
You may have other tests related to your high-risk condition.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You passed out (lost consciousness).
You have a seizure.
You have severe vaginal bleeding.
You have severe pain in your belly or pelvis.
You have had fluid gushing or leaking from your vagina and you know or think the umbilical cord is bulging into your vagina. If this happens, immediately get down on your knees so your rear end (buttocks) is higher than your head. This will decrease the pressure on the cord until help arrives.

Call your doctor now or seek immediate medical care if:

You have signs of preeclampsia, such as:
- Sudden swelling of your face, hands, or feet.
- New vision problems (such as dimness, blurring, or seeing spots).
- A severe headache.
You have any vaginal bleeding.
You have belly pain or cramping.
You have a fever.
You have had regular contractions (with or without pain) for an hour. This means that you have 8 or more within 1 hour or 4 or more in 20 minutes after you change your position and drink fluids.
You have a sudden release of fluid from the vagina.
You have low back pain or pelvic pressure that does not go away.
You notice that your baby has stopped moving or is moving much less than normal.

Watch closely for changes in your health, and be sure to contact your doctor if:

You have any new symptoms, such as a fever.
You have vaginal discharge that smells bad.

Where can you learn more?

Go to http://www.healthwise.net/patientEd

Enter S194 in the search box to learn more about "Prenatal Tests During a High-Risk Pregnancy: Care Instructions".

The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.

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