High Risk Pregnancies

Question 1

What are the risk factors for high risk pregnancies?

Answer 1

• Age <15yo or >35yo
• Pre-pregnancy weight under 45kg or Obese
• Height under 5 ft (1.5m)
• Any previous pregnancy complications
• Incompetent cervix
• Uterine malformations
• Small pelvis
• Being single
• Smoker or alcohol
• Illicit drugs
• No access to early prenatal care
• Low socioeconomic status
• Previous history of recurrent miscarriages
• Hypothyroid
• Hyperthyroid
• Any previous complicated pregnancies

Question 2

What is the management of high risk pregnancies?

Answer 2

• Obstetrician-led care
  
  • Continued surveillance for high risk patients – more frequent scans
• Offer high dose folate 5mg – also give to:
  
  • Previous child with NTD
  • Diabetes mellitus
  • Woman on an anti-epileptic
  • Obesity
  • HIV positive taking co-trimoxazole
  • Sickle cell disease
• Offer low dose aspirin (75mg, OD) as prophylaxis for pre-eclampsia