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High-Risk Pregnancy - Risk Factors, Prevention and Management

High-Risk Pregnancy is a pregnancy are at greater risk than usual (for both mother and baby), the occurrence of disease or disability or death before and after childbirth.


Risk Factors of High-Risk Pregnancy

1. Characteristics of pregnant women
  • Age: less than 20 years old or over 35 years.
  • Parity: primiparous (first pregnancy) or multiparous pregnancies of more than 4 times.
  • Distance delivery last less than 2 years.
  • A woman who was not pregnant at the time, had a body weight less than 50 kg or a woman who is obese.
  • Height less than 142 cm.
  • Upper arm circumference less than 23.5 cm in the third trimester.
2. History last pregnancy.
  • A woman whose 3 times in a row had a miscarriage in the first trimester.
  • A woman who had delivered premature babies, have a higher risk for premature delivery in subsequent pregnancies.
  • A woman who has experienced pregnancy as much as 6 times or more, are more likely to experience: a weak contractions during labor (due to weak uterine muscles), bleeding after delivery (due to weak uterine muscles), rapid delivery, which may cause an increased risk of vaginal bleeding weight, placenta previa (low-lying placenta).
  • If a woman ever gave birth to babies with hemolytic disease, then the next baby at risk of suffering from the same disease.

3. Disorders structure
  • Structural abnormalities of the female reproductive organs (eg double uterus or cervix is weak) can increase the risk of miscarriage. (To determine the structural abnormalities, surgery can be done diagnostic, ultrasound or x-ray).
  • Fibroids (benign tumors) in the uterus can increase the risk of: premature birth, during labor disturbances, abnormal fetal position, placental location disorders, recurrent miscarriage.

4. Drugs or infection
  • Drugs that are known to cause birth defects if taken during pregnancy.
  • Drugs that work against folic acid.

5. Infection that can cause birth defects are:
  • Herpes simplex.
  • Hepatitis viruses.
  • Influenza.
  • Mumps.
  • Rubella.
  • Chicken pox (varicella).
  • Syphilis.
  • Listeriosis.
  • Toxoplasmosis.
  • Infection by coxsackie virus or cytomegalovirus.


Prevention of High-Risk Pregnancy
  • Regular prenatal care.
  • Obtained services by pregnant women during checkups.
  • Measurement of body weight.
  • Blood pressure checks.
  • Measurement of uterine fundus.
  • Immunization Tetanus Toxoid (TT).
  • Iron tablet.
  • Health education.
  • Self-care during pregnancy: nutrition, breast care, personal hygiene, activity, pregnancy exercise.

Considering most of the maternal deaths could have been avoided, then attempted to prevent late 4 that led to the death of the mother, namely:
  • Prevent delayed recognition of danger signs of high risk.
  • Preventing late making decisions in the family.
  • Preventing late in reference obtaining transportation.
  • Preventing late obtain adequate emergency care.

Management of High-Risk Pregnancy
  • Management of patients with high-risk pregnancies varies depending on what disease had previously suffered illness and the side effects are encountered later during pregnancy. The test is expected to help support improvement of the treatment or of the additional examination.
  • High-risk pregnancy should be treated by a gynecologist who need intensive supervision, for example by:
  • Set the frequency of prenatal examination.
  • Required consultation with other medical experts, especially experts in internal medicine and child health experts.
  • Management of cases is the result of teamwork between the various experts.

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