HIGH RISK PREGNANCY

Most of the time having a baby is a natural process, but a few may experience certain conditions which put them under high risk pregnancy category. High risk pregnancy is defined as pregnancy in which the mother, fetus or newborn are at increase risk of morbidity or mortality during pregnancy. Labour or pueperium due to some complicating factors. Our team identify these factors to determine the degree of risk for a particular woman or baby and thus helps to provide a better medical care. About 20% of all pregnancies are at high risk.

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 counseling is important to diagnose high risk factors from history investigate before pregnancy so that they conceive when their basic medical conditions are under control.