In a risk (risk) pregnancy is for the mother, the fetus or the newborn before or after birth increased morbidity or mortality risk.
2013, the maternal mortality rate overall was 28 / 100,000 births; in non-white women, the incidence is 3- to 4-fold increased. Maternal mortality is significantly higher in the US than in other Western countries (eg. As Germany, Netherlands, Poland, Spain, Sweden, Switzerland, United Kingdom).
In a risk (risk) pregnancy is for the mother, the fetus or the newborn before or after birth increased morbidity or mortality risk. 2013, the maternal mortality rate overall was 28 / 100,000 births; in non-white women, the incidence is 3- to 4-fold increased. Maternal mortality is significantly higher in the US than in other Western countries (eg. As Germany, Netherlands, Poland, Spain, Sweden, Switzerland, United Kingdom). Maternal mortality in selected countries Maternal mortality refers to the number of women who die due to pregnancy-related causes during pregnancy or within 42 days after the end of pregnancy per 100,000 live births. In 2013, the proportions ranged from 1 (Belarus) to 980 (Chad) per 100,000 live births (countries not shown). Maternal mortality is significantly higher in the US than in other Western countries. The data from the WHO, UNICEF, UNFPA, the World Bank and the United Nations Population Division. Trends in maternal mortality: 1990 to 2013. Geneva, World Health Organization (WHO), 2014 The most common causes of maternal death: bleeding preeclampsia pulmonary embolism infection complications of cardiovascular or other preexisting diseases Nearly half of maternal deaths are preventable. The perinatal mortality in the offspring in the United States is about 6 to 7/1000 births; Deaths are divided into roughly equal between them during the late fetal period (gestational age> 28 weeks) and those during the early neonatal period (<7 days after birth). The most common causes of perinatal death are: Obstetric complications infection placental abnormalities Congenital malformations preterm birth risk assessment during pregnancy A risk assessment is part of routine prenatal care. The risk must also during or shortly after birth and at any time when special events could change the risk status, be reassessed. The risk factors (see Table: Risk factors for pregnancy complications) are systematically assessed, as each given factor increases the overall risk. Several pregnancy monitoring and risk assessment systems are available. The most widely used system is the gestational judging Control System (PRAMS Pregnancy Assessment Monitoring System), which is a project of the Centers for Disease Control and Prevention (CDC) and state health authorities. PRAMS provides information for use to the state Department of Health to improve the health of mothers and children. PRAMS also allows the CDC and states, changes in health indicators (eg. As unwanted pregnancy, prenatal care, breastfeeding, smoking, drinking, health of young children) to monitor. Risk pregnancies require close monitoring and in some cases the transfer to a perinatal center. If a referral is necessary, the training is more likely before and after giving birth to decreased morbidity and mortality. The most common reasons for a briefing before birth are prematurity efforts (often caused by premature rupture of membranes) preeclampsia bleeding assessment of pregnancy risk category Risk factors Score * pre-existing cardiovascular and kidney disease have moderate to severe pre-eclampsia 10 Chronic Hype rtonie 10 moderate to severe renal disease 10 Severe heart failure (class II-IV, NYHA classification) 10 eclampsia history of 5 pyelitis (infection of the renal pelvis) in the past 5 mild heart failure (Class I, NYHA classification) 5 Light preeclampsia 5 Acute pyelonephritis 5 cystitis a history of pre-eclampsia 1 1 Acute cystitis history of 1 metabolic disorders obesity class III 10 Insulin dependent Diabetes 10 Back endocrine ablation 10 thyroid dysfunction 5 obesity Class II 5 5 gestational diabetes Obstetric family history of 1 anamnesis Fetal exchange transfusion with Rh incompatibility stillbirth 10 10 Later Abort (16th-20th SSW) 10 Transferred pregnancy (> 42 weeks) 10 preterm infants (<37 weeks and <2500 g) 10 Intrauterine growth retardation (weight <10th percentile of the estimated gestational age) 10 Irregular fetal position 10 Polyhydramnios (hydramnios) 10 Multiple pregnancy 10 Preceding brachial plexus injury 10 neonatal death 5 caesarean section 5 Habitual (? 3) Abort 5 Newborn> 4,5 kg 5 shoulder dystocia 5 Multi parity> 5 5 seizure disorders or cerebral palsy 5 Fetal malformations 1 Other diseases: Pathological findings of cervical cytology 10 sickle cell anemia 10 thrombophilia 10 Positive serological findings for STDs 5 Severe anemia (Hb <9 g / dl) 5 TBC history of, or induration ? 10 mm to the Mantoux test 5 Pulmonary disorders 5 Light anemia (Hb 9.0 to 10.9 g / dl ) 1 Anatomical anomalies Uterine malformation 10 10 Narrow cervical incompetence pool 5 Maternal characteristics Age ? 35 or ? 15 years 5 weight <45.5 or> 91 kg 5 Psychiatric disorder or intellectual deficit 1 Prenatal exposure to teratogens infections with group B streptococci 10 Certain viral infections (eg. As rubella, cytomegalovirus infections) 5 flu syndrome (severe) 5 Excessive drug use 5 Smoking ? 1 pack / day 1 alcohol consumption (moderate to severe) 1 pregnancy complications Preterm labor at <37 weeks 10 Premature rupture of membranes before the date of 10 Exclusive Rh sensitization (exchange transfusion needed) 5 Light vaginal bleeding 5 lower birth Maternal Moderately strong to severe preeclampsia 10 Polyhydramnios (hydramnios) or oligohydramnios 10 10 uterine transmission (> 42 weeks) 10 Light preeclampsia 5 Premature rupture> 12 hours, 5 ? Premature labor at 37 weeks 5 primary disorders of uterine contractions 5 Secondary birth arrest five labor> 20 hours 5 second stage of labor> 2,5 h 5 Pharmacological induction of labor 5 Rascher calving (<3 h) 5 Primary Cesarean section 5 Repeated cesarean section cae Sarea 5 Elective induction of labor 1 Longer latency Phase 1 increase in the oxytocin dose 1 Placental placenta previa 10 placental abruption 10 chorioamnionitis 10 Fetal Foul setting (breech, transverse or face presentation) or transverse position 10 multiple pregnancy 10 Fetal bradycardia for> 30 minutes 10 prolapsed cord 10 Fetal Weight <2.5 kg 10 Fetal Weight > 4 kg 10 Fetal acidosis, pH ?7 10 Fetal tachycardia for> 30 minutes 10 operative delivery by forceps or suction cup 5-breech delivery, spontaneous or assisted 5 * A score of 10 or more is a high risk. classes of BMI based on National Institutes of Health Obesity: Class I: 30 to 34.9 Class II: 35 to 39.9 Class III:> 40 NYHA = New York Heart Association.