1 High Risk Pregnancy Assessment and Management
1 High Risk Pregnancy Assessment and Management
1 High Risk Pregnancy Assessment and Management
Some risk factors may later appear and are detected at subsequent visit.
The cases are also reassessed near term and again in labour for any new
risk factors.
The neonate are also assessed very soon after delivery for any high risk
factors.
SCREENING AND ASSESSMENT
B. NON-INVASIVE SCREENING
C. INVASIVE SCREENING
A. INITIAL SCREENING - HISTORY
4.Grand multi
6. Anaemia
parity
2. Previous still
8.Previous infant
birth, neonatal
with Rh- iso
death or birth of
immunisation or
babies with
also
congenital
incompatibility
abnormalities. 1. Two or more
previous
abortions or
previous induced
abortion
1.
Pulmonary
disease
6. Viral 2. Thyroid
hepatitis disorder
Medical
Surgical
Disorders
5. Cardiac
3. Epilepsy
disease
4. Renal
disease
1.
Myomectomy
3. Repair of
complete
perineal tear
Family History
safety grounds.
6. Transvaginal Ultrasonography
The total counts multiplied by four is given daily (12 hours) fetal
movement count.
7. Kick Chart
II. Daily Fetal Movement Count (DFMC)
4. Capnometry
1. CVP and Pulmonary Artery Monitoring
Risk approach for MCH is to identify the high risk cases from a
large group of antenatal mothers.
Short statured primi (< 140 cm) Previous still birth, IUD
Rh incompatibility
Ectopic pregnancy
ABO incompatibility
Gestational DM
Abruptio placenta
Categories Of High Risk Pregnancy
◦ Syphilis in pregnancy
PHC caters low risk maternity and neonatal service in labour room,
maternity beds and refers high risk cases to CHC and higher centre hospitals.
Family Welfare program in all PHCs and MTP in some centres are
available.
Level II or Secondary Care
It is provided by rural hospitals, sub divisional district hospital at
towns with obstetrician, anaesthetist, paediatrician, blood
transfusion, laboratory, family welfare and MTP centres.
There are 2500 CHC and over 500 district hospitals and around
3000 sub divisional hospitals.
Level II or Secondary Care
Municipal, ESI, Central GOVT. and private maternity hospitals are
included at level II.
Level II hospitals cater 20% of all births both low and high risk
cases.
Level III or Tertiary Care
They cater high risk cases which are referred from periphery.