High-risk pregnancy refers to a pregnancy complicated by medical or obstetric conditions that increase the likelihood of adverse outcomes for the mother, fetus, or both. Gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy are among the most common and significant high-risk conditions, requiring intensified monitoring and specialized management throughout pregnancy.

Gestational diabetes develops due to pregnancy-induced insulin resistance, leading to elevated blood glucose levels. If inadequately controlled, it can result in excessive fetal growth, birth trauma, neonatal hypoglycemia, and increased rates of operative delivery. Pregnancy-related hypertension, including gestational hypertension and preeclampsia, poses risks such as placental insufficiency, fetal growth restriction, preterm birth, and maternal organ dysfunction.

Management of high-risk pregnancy begins with early diagnosis through standardized screening protocols. Once identified, individualized care plans are established to control blood sugar or blood pressure while closely monitoring fetal well-being. Glycemic control in GDM involves structured glucose monitoring, nutritional management, physical activity modification, and pharmacologic therapy when required. Hypertensive disorders require careful blood pressure monitoring, medication selection appropriate for pregnancy, and assessment for progression to preeclampsia.

Fetal surveillance is intensified through serial ultrasounds, growth assessments, amniotic fluid evaluation, and Doppler studies to assess placental function. Non-stress testing and biophysical profiling may be used in later pregnancy to monitor fetal health. Delivery planning is individualized, balancing maternal stability with fetal maturity to determine optimal timing and mode of delivery.

High-risk pregnancy care also includes counseling regarding potential complications, signs of deterioration, and postpartum follow-up, as conditions such as GDM and hypertension may have long-term health implications. With structured monitoring and timely intervention, most high-risk pregnancies can achieve favorable outcomes while minimizing complications.