Angela Weinman sailed through two pregnancies free of common discomforts.

"I never had a day of morning sickness," says Angela, 46, an information technology executive who lives in Belmont with her husband Greg and their two sons. "I never felt better in my life."

Last year, during her second pregnancy, however, Angela developed gestational diabetes. The condition combined with her age, put her in a category doctors call a high risk pregnancy. About 6 to 8 percent of all pregnancies are considered high risk and require special care.

Angela’s obstetrician, Sandra Beretta, M.D., cares for many women with high risk pregnancies. Conditions that contribute to a high risk pregnancy include: diabetes, hypertension (high blood pressure), obesity, being pregnant with multiples and being over age 35.

"In our practice, the average age is probably 35 for someone who is newly pregnant," Dr. Beretta says. "In this area, women tend to have careers and wait a little longer to get pregnant."

Having a baby later can put the health of the mother or fetus at a higher than average risk during pregnancy. But at Mills-Peninsula, expert training, advances in testing and medication and careful monitoring throughout pregnancy most often result in an excellent outcome, Dr. Beretta says. Genetic counseling also is available for women with a family history of diseases such as cystic fibrosis or Tay-Sachs.

"We have a lot of testing we can do to reassure women," Dr. Beretta says. "The newer tests are very safe, accurate and non-invasive."

Before getting pregnant, Dr. Beretta advises women with a potential for high risk pregnancy to stay healthy and fit. Once pregnant, she encourages them to seek early prenatal care.

"Today, we offer more options for testing for genetic diseases and better surveillance for twins," she says. "For diabetes, we have excellent coordinated care among many specialties, and for hypertension, we have newer medications found to be safe for pregnancy. We’re able to achieve things that years ago we wouldn’t have felt comfortable trying."

About 11 weeks into her pregnancy, Angela underwent nuchal translucency, a special ultrasound in which a doctor or sonographer measures a small pocket of fluid at the back of the fetus’ neck.

"That’s a good test where they look for Down’s syndrome, because that’s what you really worry about as an older mom," Angela says. Her test results indicated her baby was developing normally.

About half way through her pregnancy, Angela also took a standard glucose test and the results revealed she had gestational diabetes. Dr. Beretta promptly referred her to Mills-Peninsula’s Sweet Success program, which helps women control blood glucose levels to increase the likelihood of a healthy pregnancy.

"They were great," Angela says. "They talk you through the nutrition side and show you how to test your blood. If your blood sugar level gets too high, too much goes to the baby and your baby gets too big."

A small bedtime dose of insulin and simple changes to her diet, kept Angela’s health and pregnancy on track.

Dr. Beretta also referred her for regular ultrasound testing during her third trimester.

"They checked the baby’s heartbeat and measured the amniotic fluid," Angela says. "The extra monitoring was really great."

Her son, Elliott, was born a healthy 9 pounds, 10 ounces.

"I had complete confidence Dr. Beretta knew what I needed," Angela says. "It never felt like I had a high risk pregnancy, because she makes you feel like she’s looking after you."