Neonatal outcome following multi-risk pregnancy

A high risk pregnancy is a condition that puts the mother, the developing fetus or both at higher - than - normal risk for complications during or after the pregnancy and birth. The adverse outcome could be due to inadequate prenatal care, previous obstetrical problems, preexisting maternal diseases or pregnancy - induced diseases, multiple gestation, etc. The aim of this paper was to present a case that has experienced multi risk pregnancy and to pose th e dilemma whether anything else could be done to prevent the adverse outcome of such newborns by providing better antenatal care and monitoring of the mother’s condition during pregnancy. Matherial and methods: the presented case is pregnant woman at the a ge of 38, G=2, P=1, Ab=1 (second pregnancy, first delivery and one spontaneous abortion). At the moment of the admission to the O&G Clinic (tertiary level of care), the fetus was at gestational age of 33 weeks, and during the previous period the woman had regular antenatal visits at her chosen gynecologist. On admission, obtained data showed unknown last menstrual period, obstetrical risk factors as diabetes, preeclampsia and obesity; as laboratory alterations were considered mild blood coagulation changes and proteinuria; soon after the admission, fetal distress was detected. Following the stabilization of the mother’s condition, cesarean section was performed. The newborn was large for gestation age, experiencing birth asphyxia, with slow response to primary resuscitation, severe Respiratory Distress Syndrome; cardiomyopathy and unilateral renal agenesis were confirmed by ultrasound examination. Seventy two hours after the birth, the newborn died. Conclusions: The goal of pregnancy management should be: understanding and early detection of the magnitude of high - risk pregnancy, mandatory intensive monitoring than the average pregnant woman before, during, and after pregnancy, emphasizing preventable and avoidable causes, recognizing and utilizing basic diagnostic tools, thus raising the awareness of maternal - fetal medicine.