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Chapter: Medicine Study Notes : Reproductive and Obstetrics

'At Risk' Pregnancies

Adolescent Pregnancy (usually considered < 16): o Usually no problems with size of pelvis

“At Risk” Pregnancies

 

·        Adolescent Pregnancy (usually considered < 16):

o   Usually no problems with size of pelvis 

o   Psychological and social problems: stability of relationship, financial (no DPB until 16), may conceal pregnancy or have poor access to care, if very young may involve incest ® criminal offence, need ­ support after birth

o   Obstetric problems:

§  Inaccurate dates

§  Compliance issues

§  Pre-diagnosis exposure to alcohol/drugs

§  Smoking

§  ­Risk for pre-eclampsia (more likely to have less immunological tolerance to partner)

·        Elderly Primagravid (> 35): 

o   ­Risk of chromosomal abnormality, twins, pre-eclampsia (more likely to have essential hypertension, SLE or renal disease), DVT, thyroid disease, gestational diabetes, labour problems

o   IVF pregnancy ® ­risk of prematurity, IUGR 

o   ­Risk of fibroids (which double in size in pregnancy) ® malpresentation, outgrow blood supply (® pain) but usually little problem to pregnancy 

·        Grand Multip (>= 5 pregnancies)

o   Fe deficiency 

o   Precipitate labour: can ® uterine rupture due to ­ efficiency

o   Post-partum: relaxes quickly ® APH

o   Lie can be very unstable

 

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Medicine Study Notes : Reproductive and Obstetrics : 'At Risk' Pregnancies |


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