High Risk Pregnancy Overview

High Risk Pregnancy

• A condition where a concurrent disorder, pregnancy-related complication, or external factor jeopardizes the health of the woman, fetus, or both.

Risk Factors for Pregnant Women

Psychological

• History of drug dependence
• History of partner abuse
• History of mental illness
• History of poor coping mechanisms
• Cognitive challenges
• Childhood sexual abuse
• Loss of support person
• Illness within the family
• Decrease in self-esteem
• Drug abuse (including alcohol and smoking)
• Poor acceptance of pregnancy
• Severe fear of labor and birth
• Inability to participate due to anesthesia
• Separation of infant at birth
• Lack of preparation for labor
• Disappointing infant

Social

• Occupation involving toxic substances
• Environmental contaminants in the home
• Isolation
• Low socioeconomic status (SES)
• Poor access to transportation
• High altitude
• Highly mobile lifestyle
• Poor housing
• Lack of support persons

Pregnancy

• Refusal or neglect of prenatal care
• Exposure to environmental teratogens
• Disruptive family incidents
• Decreased economic support
• Conception less than 1 year after the last pregnancy

Labor and Birth

• Lack of support persons
• Inadequate home care for infant
• Unplanned caesarean birth
• Lack of access to continued healthcare
• Lack of access to emergency personnel or equipment

Physical

• Visual or hearing challenges
• Pelvic inadequacy or malformation
• Uterine incompetency, position, or structural abnormalities
• Secondary major illnesses (diabetes, hypertension, tuberculosis, etc.)
• Poor gynecological and obstetric history
• History of poor pregnancy outcomes
• Obesity (BMI over 30)
• Underweight (BMI under 18.5)
• Pelvic inflammatory disease
• History of inherited disorders
• Short stature
• Blood incompatibility
• Younger than 18; older than 35
• Cigarette smoking
• Substance abuse
• Trauma
• Fluid and electrolyte imbalance
• Intake of teratogens (drugs)
• Multiple gestation
• Bleeding complications
• Poor placental formation/position
• Gestational diabetes
• Nutritional deficiencies (iron, folic acid, protein)
• Poor weight gain
• Pre-eclampsia (PIH)
• Infections
• Abnormal amniotic fluid
• Post-maturity
• Hemorrhage
• Dystocia
• Precipitous birth
• Cervical or vaginal lacerations
• Cesarean delivery required

Additional Information (Page 2)

• Age: Adolescent girls (under 15) and women over 35 have increased risks of complications like preeclampsia, anemia, and gestational diabetes.
• Weight: Significant weight gain or loss during pregnancy can indicate complications like toxemia, diabetes, or multiple pregnancies. Women with a low weight before pregnancy are more likely to have low birth weight babies. Obese women are more susceptible to larger babies and potential for difficult deliveries as well as gestational diabetes, hypertension, or preeclampsia.
• Height: Women shorter than 5 feet are more likely to encounter difficulties with labor due to a narrower pelvis.
• Reproductive Abnormalities: Issues with the uterus or cervix can increase the risk of difficulties during labor, miscarriage, or abnormal fetal positioning.
• Social Factors: Unmarried or low SES women tend to have higher risks of complications, likely due to factors like smoking, less access to healthcare, or poor nutrition. First pregnancies have higher risks than subsequent ones, and risks increase with the age of the expectant mother.

Additional Information (Page 3)

• Endocrine System:
  • Diabetes Mellitus: A chronic condition with hyperglycemia and abnormalities in carbohydrate, protein and fat metabolism; all pregnant women experience changes in their glucose-insulin regulatory system during pregnancy.
• Symptoms (Maternal): Dizziness with hypoglycemia, confusion if hyperglycemic, increased thirst, increased risk of PIH (pre-eclampsia), glycosuria, polyuria, or hyperglycemia
• Symptoms (Fetal): Congenital anomalies, macrosomia (large baby), poor fetal heart rate variability and rate, hydraminos.
• Diagnosis: Fasting blood sugar, one-hour, and two-hour glucose tolerance tests
• Risk Factors (Maternal): overweight/obese, family history of diabetes and gestational diabetes, a large baby, stillborn baby, or birth defects, age 25+, specific ethnicities (Mexican American, African-American).

Additional Information (Page 4)

• Management: Dietary changes, insulin management (if necessary) and careful monitoring.
• Infant of Diabetic Mother (IDM): Increased risk of complications such as hypoglycemia due to high insulin levels if the mother has diabetes.

Additional Information (Page 5)

• Cardiovascular System (Risk and Classification): Heart disease impacting pregnancy is classified from Class I (no limitations) to Class IV (inability to perform any activity without discomfort); class I and II are more likely to have a normal delivery.
• Left-sided heart failure: mitral valve issues, pulmonary edema, reduced cardiac output that decrease oxygen/nutrients to the body during labor.
• Right-sided heart failure: output from the right ventricle is decreased, back-pressure in the circulatory system results in edema, low blood pressure, enlarged liver and spleen, abdominal fluid buildup.

Additional Information (Page 6)

• Signs and symptoms: heart murmurs, reduced oxygen supply/nutrient, late decelerations.
• Congestive Heart Failure: increased blood volume causing pulmonary edema, edema, shortness of breath.
• Peripartal Cardiomyopathy: Heart failure during pregnancy or shortly after in women who did not have a history.
• Management: bedrest, diet, medications (like digitalis), management of anemia.

Additional Information (Page 7)

• Respiratory System: Asthma, characterized by reversible airflow obstruction, airway hyperactivity, and airway inflammation. Increased vulnerability due to susceptibility genes (such as for T-helper 1 and 2 cells, IgE, cytokines, granulocyte-monocyte colony-stimulating factor, and ADAM33 gene) and environmental factors.
• Allergens: Diet, perinatal factors (e.g., maternal nutrition, prematurity, low birth weight), exposure to allergens.

Additional Information (Page 8)

• Infections: Respiratory syncytial virus, rhinovirus, parainfluenza, exercise, environment, anxiety/excitement.
• Asthma Management (Pregnancy): Controlling triggers (allergens), medications (e.g., bronchodilators, corticosteroids), and education.

Additional Information (Page 9)

• Note: This page contains only the name "cheryll." Further details are absent.

This quiz covers the various risk factors associated with high-risk pregnancies, focusing on psychological, social, and pregnancy-related conditions. Understanding these factors is crucial for providing better care and support for pregnant women. Test your knowledge on the complexities of high-risk pregnancy management.