High risk pregnancy Flashcards
Why do we need to think more about high risk pregnancies?
Want to prevent problems
Try to decide what extra care woman might need
What maternal conditions might make a pregnancy high risk?
Obesity (risk of: diabetes, clots, pre-eclampsia, difficult C-section)
Diabetes
Hypertension (high risk of pre-eclampsia)
Chronic disease (renal, autoimmune, respiratory..)
Infections
Previous surgery
VTE
Cardiac problems
What social factors might make a pregnancy high risk?
Teenage pregnancy (family support, education, partner etc. - may consider teenage midwives)
Maternal age >40 (chromosomal abnormality, miscarriage, pre-eclampsia, diabetes)
High parity and low inter pregnancy interval (para 4>= has increased risk of haemorrhage as uterus is more atonic after birth)
Poor socioeconomic conditions
Alcohol intake
Substance abuse
What are previous obstetric issues may make a pregnancy high risk?
Caesarean section
Preterm delivery
Recurrent miscarriage
Stillbirth
Pre-eclampsia
Gestational diabetes
Third degree tear
What are previous obstetric issues may make a pregnancy high risk?
Caesarean section (risk of uterine rupture in VBAC - women will need counselling)
Preterm delivery (delivery before 37 weeks. risk doubles if previous preterm delivery)
Recurrent miscarriage
Stillbirth
Pre-eclampsia
Gestational diabetes
Third degree tear
What are some problems in this pregnancy which make it high risk?
Multiple Pregnancy
Small for gestation age
Placenta praevia (low-lying placenta)
Gestational diabetes
Pre-eclampsia
what structure is involved in first degree tears?
vaginal wall
what structure is involved in second degree tears?
Perineal wall
what structure is involved in third degree tears?
involves anal sphincter
Who do women undergoing uncomplicated pregnancy get cared for by?
midwife/GP-led models
Who do women undergoing uncomplicated pregnancy get cared for by?
midwife/GP-led models
Who do women undergoing complicated pregnancy get cared for by?
consultant-led care
25 year old lady in her first pregnancy 11 weeks No personal medical/surgical history Allergic to Penicillin Her mother has had an MI at 68 years
High risk or low risk
Low risk
15 year old
First pregnancy
14 weeks
No medical or surgical history
High risk or low risk?
High risk
30 year old Second Pregnancy 12 weeks Previous Gestational Diabetes LSCS in last pregnancy due to foetal distress BMI 40 No medical or surgical history
what are the risk factors?
High BMI
previous gestational diabetes
LSCS
