SCREENING OF PREGNANCIES FOR HIGH RISK CASES
- Obstetricians have to be vigilant to screen all high risk pregnancies from start of pregnancy to avoid any mishaps.
- Questionnaire
- Maternal age – Below 16 years or above 35 years particularly up the patient is a primigravide.
- Post obstetric history – Previous congenital malformation, macroscopic baby, repeated abortion, repeated preterm labour, small for date fetus, still birth or neonatal death. Operative delivery like cesarean or forceps or ventouse delivery.
- Grand multiparity – 5 or more previous delivery.
- Previous or current medical disorders : Anemia, hypertension, diabetes, cardiac, renal, pulmonary and hepatic disease, coagulation defects, hemoglobinopathies, serious infection such as HIV.
- Previous or current obstetric disorder: Ante partum hemorrhage, Rh isoimmunization, intrauterine growth restriction, premature rupture of membranes, polyhydramnios, oligohydramnios, post-term pregnancy.
- H/O surgery or trauma : myomectomy, metroplasty, repair of CPT, VVF repair, surgery for SUI.
- Family H/O medical disorders : Genetic disorders multiple pregnancies and poor socio-economic status.
Management
Preconception counselling is important to diagnose high risk factors from history investigate before pregnancy so that they conceive when their basic medical conditions are under control.