Clinical guidelines - THE CLINICAL IMPORTANCE AND SURVEILLANCE OF HIGH-RISK PREGNANCIES

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.