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TOPIC: CARE OF MOTHER AND CHILD AT RISK OR WITH PROBEMS
HIGH RISK PREGNANCY
HIGH RISK PREGNANCY
Is one which is a concurrent disorder, pregnancy –related complication or external factor jeopardizes the health of the woman , fetus or both.
Majority of the high-risk pregnancies are identified during the first prenatal visit through careful history taking, complete physical examination, and laboratory studies.
Two Groups of High-Risk Prenatal Clients
1. Women with pre-existing or newly acquired illness such as:
-CVD
-HIV/AIDS
-DM
-RH Incompatibility
-Substance Abuse
-Anemia
2. Women who developed complications of pregnancy such as:
-Hyperemesis Gravidarum
-Ectopic Pregnancy
-Multiple Pregnancies
-Premature Cervical Dilatation
-PIH
-Abortion
-DIC
-Placenta Previa
-HELLP Syndrome
-Abruptio Placenta
-PROM
-APAS
-HELLP Syndrome
Areas to be assessed for high-risk factors include obstetrical history, medical history, current obstetric status and social-personal characteristics.
FACTORS THAT CATEGORIZES A PREGNANCY AS HIGH RISK
Psychological
Social
Physical
OBSTETRICAL HISTORY
Infertility
Cervical insufficiency or incompetent cervix
Uterine or cervical anomaly
Previous preterm labor/birth
Previous cesarean birth
Previous gestational hypertension
Previous infant over 4000g
2 or more spontaneous or elective abortions
Previous ectopic pregnancy
Previous stillbirth/neonatal death
Previous multiple gestation
Pregnancy spaced less than one year apart does not give the woman’s body time to recover.
MEDICAL HISTORY
Pre-existing medical conditions can predispose a pregnant woman to have complications.
There is an increased risk of gestational hypertension associated with chronic hypertension, diabetes mellitus and renal or vascular disease.
Sexually transmitted infections
Infection during pregnancy can increase the risk of congenital anomalies, may require a cesarean delivery and can increase the risk for preterm labor.
A history of depression or bipolar disorder is a risk factor for postpartum depression.
Previous surgery of the reproductive organs can affect fertility, the ability to carry a pregnancy to term and method of delivery.
VULNERABLE GROUPS OF PREGNANT WOMEN:
Adolescent
Mentally ill
18 y/o and below
Women over 40 y/o
Physically and cognitively challenge
Woman who is a substance dependent
Several ways before and during pregnancy to ensure maternal and fetal safety and well-being:
Prevention Before Pregnancy- Taking the time to treat or manage them before conceiving is the best way to significantly reduce the risk of complications.
During Pregnancy- Some of the best ways to stay healthy during pregnancy can include the following:
Taking prenatal vitamins as soon as confirmed pregnancy.
Undergoing regular doctor's check-ups and recommended prenatal testing
Maintaining a balanced and nutritious pregnancy diet
Keeping up with moderate-level pregnancy exercise (Doctor's approval needed)
Ensuring a safe and healthy pregnancy weight gain
Practicing various techniques for stress reduction during pregnant.
Quitting addictions to alcohol, tobacco, and illicit drugs
Management of High-Risk Pregnancy
More frequent prenatal visits and specialist consultations are a must in high-risk pregnancies in order to closely monitor maternal health and fetal development.
Additional or specialized prenatal testing might include laboratory work and diagnostic tests, like amniocentesis, biophysical profile, and others.
Bed rest or hospitalization might be necessary to help a woman safely carry her baby to term.
Medications or surgery can be used to treat the underlying problem and stop its progression.
A premature delivery might sometimes be the safest way to manage a high-risk pregnancy and prevent further life-threatening complications.
REFERENCES/SUPPLEMENTAL MATERIALS
REFERENCES/SUPPLEMENTAL MATERIALS
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