Clinical guidelines - THE CLINICAL IMPORTANCE AND SURVEILLANCE OF HIGH-RISK PREGNANCIES|
Mirko Prodan, Alemka Brnčić-Fischer, Aleks Finderle, Oleg Petrović
Pregnancy and delivery as physiological processes are genetically and
biologically well determined.
About 20% of pregnancies and deliveries are accompanied with mild
or serious complications that mark them as low or high-risk pregnancies.
Due to a possible poor perinatal outcome, these pregnancies
require the need of a particular fetal surveillance.
The traditional methods of the antenatal assessment that are widely
implemented in the obstetric care (such as counting fetal movements,
cardiotocography, ultrasound, biophysical fetal profile, fetal Doppler)
have proven to have the beneficial effect on the perinatal outcome,
but, unfortunately, they are still low on sensitivity and specificity.
Unfavorable events during pregnancy such as transitory hypoxia
and/or infection starting even few weeks before the termination of
pregnancy, if unobserved might cause the impairment. The hypoxia
during the labor, as it was previously meant, is not the primary reason
of neonatal encephalopathy and later cerebral palsy.
The main pathological conditions during pregnancy with possible poor
impact on immediate as well as long-term neonatal outcome are discussed
in this article. The antenatal surveillance methods, possibilities,
doubts and limitations are analyzed. The improvement of the quality of
the antenatal fetal surveillance, the early screening of high-risk pregnancies,
especially with the mild disturbances, but with the possible
risk for the development of neurological impairments will probably
improve the immediate as well as the long-term neonatal outcome.
high-risk pregnancy, antenatal surveillance, perinatal outcome