HIGH RISK PREGNANCY

- PHC LEVEL

WHAT IS HIGH RISK PREGNANCY ?

WHY IS IT IMPORTANT ?

MATERNAL DEATH.

PERINATAL MORTALITY.

NEONATAL MORTALITY RATE.

 SCREENING

HISTORY:
1. MATERNAL AGE : SAFE, UNSAFE .

REPRODUCTIVE HISTORY:
“ HIGH RISK FACTORS ”

MEDICAL DISEASES :

FAMILY HISTORY:
 PHYSICAL EXAMINATION

HEIGHT.

BMI.

ANEAMIA.

BLOOD PRESSURE.

CARDIAC DISEASE.

ORTHOPEDIC PROBLEMS.
 PELVIC EXAMINATION

UTERINE SIZE.

PELVIC INADEQUACY.

ASSOCIATED TUMOURS.
 SUBSEQUENT VISITS

REASSESSMENT DURING SUBSEQUENT

VISITS IS A MUST.

DETECTS ABNORMALITIES THAT OCCUR

LATER.

REASSESS DURING LATE PREGNANCY AND

LABOUR.
 REASONS FOR NONUSE

MCH CENTRES ARE SEEN AS PLACES TO WHICH

ONE GOES ONLY IF PROBLEM ARISES.

LONG DISTANCE.

LACK OF COMPANY.

WAITING TIME.

LOSS OF WAGES.
INADEQUATE SUPPLY / INFERIOR QUALITY OF
MEDICINES.

DEMANDING MONEY FOR SERVICES.

UNCONCERNED / RUDE BEHAVIOUR OF CLINICAL

PERSONNES.
 MANAGEMENT
IDENTIFICATION.

PROPER ANTENATAL , INTRANATAL,

NEONATAL CARE.

FOLATE SUPPLEMENTATION IN THE

PREPREGNANT STATE.

IRON SUPPLEMENTATION TO BE STARTED

AS EARLY AS POSSIBLE.

TREATMENT OF STD’S.
ADVICE REGARDING DIET, ACTIVITIES,
REST AND MEDICINE.

ROUTINE AND SPECIAL LAB

INVESTIGATIONS TO BE DONE IF NEEDED.

SEXUAL INTERCOURSE DURING LAST

MONTH.

CERVICAL TEARS AND CERVICAL

INCOMPETENCE TO BE DETECTED IN THE
PREPREGNANT STATE.
POST DELIVERY PERIOD – CARE OF
FUTURE INFANT, BREAST FEEDING, BIRTH
SPACING .

HEALTH SERVICES TO AIM AT

BETTER NUTRITION TO GIRLS.

PROPER IMMUNISATION.

REPRODUCTIVE HEALTH TOPICS INCLUDING

CONTRACEPTION – A PART OF CURRICULUM IN
SCHOOLS.
 REFERRAL SYSTEM

BASED ON RISK FACTORS.

HOW STRONG IS THE LINK BETWEEN RISK

FACTOR AND BAD OUTCOME.

HOW SERIOUS IS THE OUTCOME?

‘ ALL TIME AVAILABLE ’ TRANSPORTATION

SYSTEM.
 MANAGEMENT DURING LABOUR

MAINTANENCEOF PARTOGRAM.

PROMPT REFERRAL OF HIGH RISK

PREGNANCIES.

MONITORING DURING LABOUR.

 NEONATAL RESUSCITATION

ANTENATAL : FHR, LIQOR COLOUR.

(ANTICIPATION)
ASSESSMENT BY APGAR SCORE.

WIPE THE NEWBORN.

REMOVAL OF SECRETIONS.

CPR.

PROMPT REFERRAL.
 HOW ARE WE GOING TO MAKE THIS
POSSIBLE ?

PROPER TRAINING OF NURSING

PERSONNAL , COMMUNITY HEALTH
WORKERS.

PROPER UTILISATION OF HEALTH CARE,

MANPOWER AND FINANCIAL RESOURCES
WHERE IT IS MOSTLY NEEDED.
SPECIAL TRAINING PROGRAMMES ON HOW
TO IDENTIFY HIGH RISK PREGNANCIES.

AVAILABILITY OF PERINATAL
LABORATORY FOR NECESSARY
INVESTIGATIONS.

IMPROVE THE STANDARD OF HEALTH OF

OBSTETRIC POPULATION.

GOOD PAEDIATRIC SERVICE FOR

NEONATES.
FAMILY PLANNING POLICY.

HEALTH EDUCATION TO THE COMMUNITY.

POLITICAL SUPPORT AND PUBLIC

COMMITMENT.