High-risk Pregnancy and Perinatal Outcome: An Observational Study

Abstract

Background: High-risk pregnancies are associated with adverse perinatal and maternal outcomes. Aim: To know the overall perinatal outcome in high-risk pregnancies. Methods: Present observational study was conducted in Obstetrics and Gynecology department of rural tertiary center of Northern India over eight months (February-October 2018) on 3 085 antenatal women at gestation ≥ 28 weeks with 1 309 high-risk cases and 1 776 normal pregnancy cases after Institutional ethical committee approval and informed written consent from the participants. The demographic features including age, gravidity, parity, gestation, high risk factors, onset of labor, mode of delivery of all the selected antenatal women at gestation ≥ 28 weeks was recorded on a preformed data sheet by a trained staff. All the participants were observed till delivery and perinatal outcome was recorded. Statistical analysis was done using software SPSS 22.0 version and a p value <0.05 was considered statistically significant. Results: Of total 1,309 high-risk pregnancies, 365(27.9%) were preterm, 936(71.5%) term and eight (0.6%) post-term cases. Of 1,309 neonates delivered, 66(5.04%) were intra-uterine dead fetuses, 1,243 live fetuses, of which nine (0.7%) had intrapartum still birth, 278(22.4%) required neonatal intensive care unit admission, 70(5.6%) intubated, 238(19.1%) needed oxygen support, 343(27.6%) developed complications, 11(0.9%) had early neonatal deaths. The average birth weight of neonates delivered to highrisk mothers was 2.47±0.571 Kg with 271(20.7%) neonates having low birth weight (<2.5 Kg). Of all high-risk factor Hypertensive disorders of pregnancy, Antepartum hemorrhage, Anemia, Gestational diabetes mellitus, Intra-uterine growth restriction, oligohydramnios was significantly associated with adverse perinatal outcomes (p<0.05). High-risk pregnancy was associated with preterm births, low birth weight, NICU admission, intubation, complications, neonatal deaths, still births as compared to normal pregnancy. Most common neonatal complication was low birth weight (20.7%) followed by Respiratory distress syndrome (17.6%), prematurity (13.1%). Conclusion: High-risk pregnancy was associated with adverse overall perinatal outcome with increased risk of perinatal morbidities and mortalities

A case control study to elicit fetal outcome in high-risk pregnancies and to study the various maternal parameters associated with fetal outcomes

“…The prevalence of HRP is 5-40%. 7 A HRP is any condition associated with a pregnancy where there is an actual or potential risk to mother/fetus. 8 Women with risk factors for HRP have 1/4 th chance of developing one-tenth.…”