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The significance of broadened approach to risk pregnancy
The appropriateness of widened indications for special surveillance during pregnancy was studied prospectively in a series of 2460 randomly selected mothers. Factors necessitating special care were classified as anamnestic (gr A), those appearing during pregnancy (gr B) or just during labour (gr C). The cumulative contribution of different groups of risk factors to the final risk group of 1811 patients was as follows: gr A 37.0%, gr B 58.4% and gr C 4.6%. Offsprings of mothers with no risk factors had the most favourable prognosis followed by those belonging to groups C, A and B. Maternal risk was clearly highest in the presence of group C factors. Group B factors were recognized by maternal health centre personnel far better than group A factors. The performance of hospital personnel in the observation of different types of risk factors was assessed on the basis of intrapartum monitoring frequencies. The highest monitoring frequency was observed in group O followed by group B, A and C. The results suggest that clearly definable complications of pregnancy and those occurring during labour are easily observed and their management is adequate. Anamnestic risk factors which are more obscure by definition and especially by mechanism of action tend to escape the attention of medical personal. Fortunately these factors alone contributed only an insignificant proportion of adverse outcomes in the mother and child.
The appropriateness of widened indications for special surveillance during pregnancy was studied prospectively in a series of 2460 randomly selected mothers. Factors necessitating special care were classified as anamnestic (gr A), those appearing during pregnancy (gr B) or just during labour (gr C). The cumulative contribution of different groups of risk factors to the final risk group of 1811 patients was as follows: gr A 37.0%, gr B 58.4% and gr C 4.6%. Offsprings of mothers with no risk factors had the most favourable prognosis followed by those belonging to groups C, A and B. Maternal risk was clearly highest in the presence of group C factors. Group B factors were recognized by maternal health centre personnel far better than group A factors. The performance of hospital personnel in the observation of different types of risk factors was assessed on the basis of intrapartum monitoring frequencies. The highest monitoring frequency was observed in group O followed by group B, A and C. The results suggest that clearly definable complications of pregnancy and those occurring during labour are easily observed and their management is adequate. Anamnestic risk factors which are more obscure by definition and especially by mechanism of action tend to escape the attention of medical personal. Fortunately these factors alone contributed only an insignificant proportion of adverse outcomes in the mother and child.