High Risk Pregnancy NCM 109

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RISK FACTORS and VULNERABLE GROUPS ASSOCIATED WITH

NEGATIVE PREGNANCY OUTCOME

High Risk Pregnancy


 Condition where in a concurrent disorder, pregnancy-related complication, or external factor
jeopardizes the health of the woman, fetus, or both.

Psychological Social Physical

Pre-pregnancy

 History of drug dependence  Occupation involving toxic  Visual or hearing challenges


 History of partner abuse substances  Pelvic inadequacy or misshape
 History of mental illness  Environmental contaminants  Uterine incompetency,
 History of poor coping at home position, structure
mechanism  Low Socio-economic status  Secondary major illnesses
 Cognitively challenged  Poor access to transportation  Poor gynecologic and obstetric
 Childhood sexual abuse  High altitude history
 Highly mobile lifestyle  History of poor pregnancy
 Poor housing outcome
 Lack of support persons  Obesity (BMI >30)
 Underweight (BMI<18.5)
 Pelvic inflammatory disease
 History of inherited disorder
 Small stature
 Potential for blood
incompatibility
 Younger than 18; older than
35
 Cigarette smoker
 Substance abuse
Pregnancy

 Loss of support person  Refusal of or neglected  Subject to trauma


 Illness of a family member prenatal care  Fluid and Electrolyte
 Decrease in self esteem  Exposure to environmental imbalance
 Drug abuse (including alcohol teratogens  Intake of teratogen such as
and cigarette smoking)  Disruptive family incident drugs
 Poor acceptance of  Decreased economic support  Multiple gestation
pregnancy  Conception <1 yr after last  Bleeding disruption
pregnancy  Poor placental
formation/position
 Gestational diabetes
 Nutritional deficiency of iron,
folic acid, CHON
 Poor weight gain
 Pregnancy Induced
Hypertension
 Infection
 Amniotic fluid abnormality
 Post maturity

Labor and Birth

 Severely frightened by labor  Lack of support person  Hemorrhage


and birth experience  Inadequate home for infant  Infection
 Inability to participate care  F and E imbalance
because of anesthesia  Unplanned caesarean birth  Dystocia
 Separation of infant at birth  Lack of access to continued  Precipitous birth
 Lack of preparation for labor health care  Laceration of cervix and vagina
 Birth of infant who is  Lack of access to emergency  Cephalic-pelvic disproportion
disappointing in some way personnel or equipment  Internal fetal monitoring
 Illness in NB  Retained placenta

INSTRUCTIONS:

1. Divide clinical group into 4 subgroups


2. Each subgroup will choose one factor that is considered to contribute to high risk
pregnancy and come up with evidence base synthesis of journals (2-3 journals)
discussing how this factor can produce negative outcomes for the mother ,and
fetus or child.
3. Group 1 ( Subgrp. 1 – alcohol dependence, Subgrp 2- partner abuse/domestic
violence, subgrp. 3 maternal depression, subgrp.4- cigarette smoking)
Group 2 ( subgrp 1- maternal malnutrition, subgrp. 2- poverty, subgrp 3-poor
access to transportation, subgrp 4- poor housing)
Group 3 (subgrp.1- physical disabilities, subgrp 2- maternal hypertension, subgrp
3- maternal heart disease, Subgrp 4- cepahalic –pelvic disproportion)
Group 4 (subgrp.1 taking over the counter drugs, subgrp. 2 exposure to
environmental toxic waste, subgrp. 3 multiple gestation, subgrp 4 birth of an
infant with defects unexpected by parents
4. The synthesis should not be more than 2 pages, single space, arial font 11 and
submit synthesis with journals on Monday.
5. Indicate members of the group and come up with peer evaluation.

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