High risk pregnancy

High risk pregnancy

1. SAKSHI RANA M.Sc. NURSING HIGH RISK PREGNANCY

2. DEFINITION High risk pregnancy is defined as one which is complicated by factors that adversely affects the pregnancy outcome—maternal or perinatal or both.  

3. SCREENING OF HIGH RISK CASES INITIAL SCREENING Maternal age Reproductive history

4. REPRODUCTIVE HISTORY Two or more previous miscarriage Previous stillbirth Neonatal death or birth of babies with congenital abnormalities Previous preterm labour or birth of a IUGR or macrosomic baby

5. CONTT.. Grand multiparity Previous caesarean section or hysterectomy PPH Rh- isoimmunisation or ABO compatibility

6. MEDICAL DISORDERS IN PREGNANCY Diseases— Pulmonary disease- tuberculosis  Renal disease ( Pylonephritis ) Thyroid disorders Psychiatric illness Cardiac disease

7. CONTT.. Epilepsy Viral hepatitis Pre-eclampsia, eclampsia Anaemia Infections in pregnancy (Malaria, HIV)

8. PREVIOUS SURGERY Myomectomy Repair of complete perineal tear Repair of vesico -vaginal fistula Repair of stress incontinence

9. CONTT.. In all the conditions, fetal or maternal outcome or both may be affected. Family history Socio-economic status

10. EXAMINATION 1 . GENERAL PHYSICAL EXAMINATION 2. PELVIC EXAMINATION Uterine size- disproportionally smaller or bigger Genital prolapsed Lacerations or dilatation of the cervix Associated tumors Pelvic inadequacy

11. SPECIAL TESTS

12. COMPLICATIONS OF LABOR

13. POSTPARTUM COMPLICATIONS

14. RETAINED PLACENTA

15. SHOCK

16. NEONATAL COMPLICATIONS APGAR score below 7 Birth weight less than 2500 g Birth weight more than 4 kg Convulsions Respiratory distress Hypoglycemia

17. CONTT.. Sepsis Persistant cyanosis Anemia Major congenital abnormalities Jaundice

18. MANAGEMENT Preconception counseling Antenatal management Management of labor

19. THANK YOU