scholarly journals Risk perceptions among high-risk pregnant women in Nepal: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sushma Rajbanshi ◽  
Mohd Noor Norhayati ◽  
Nik Hussain Nik Hazlina

Abstract Background A woman’s perception of risk affects her decisions about seeking obstetric care and following prescribed regimens of care. This study explored the perceptions of high-risk pregnancy among women with high-risk factors. Methods A qualitative study was conducted in the Morang district, Nepal. A phenomenological approach was used. In-depth interviews were conducted with 14 participants. Postpartum women with one risk factor for high-risk pregnancy who non-adhere to referral hospital birth were selected purposively. Thematic analysis was done to generate themes and categories. Findings Two main themes emerged in this study: (i) knowledge and understanding of risk and (ii) normalizing and non-acceptance of risk. The participants had inadequate knowledge of risk in pregnancy and childbirth. Their information source was their personal experiences of risk, witnessing their close relatives, and community incidents. The participants perceived pregnancy as a normal event and did not consider themselves as at risk. They tended to deny risk and perceived that everything was fine with their pregnancy. Conclusions The findings of this study provide a glimpse into how women perceived risk and the reasons that lead them to deny the risks and gave home birth. In the presence of risk factors in pregnancy, some women were not convinced that they were at risk. An antenatal check-up should be utilized as a platform to educate women, explore their intentions, and encourage safer births.

2021 ◽  
Vol 26 (2) ◽  
pp. 168
Author(s):  
Talat Khadivzadeh ◽  
Zahra Shojaeian ◽  
Ali Sahebi ◽  
Hossein Kareshki ◽  
Fatemeh Tara

2021 ◽  
Vol 6 (2) ◽  
pp. 185-191
Author(s):  
Hiral Parekh ◽  
Sneha Chaudhari

This was a prospective study conducted in pregnant patients with high risk factors who got admitted in the Department of Obstetrics and Gynaecology at Care Hospital, Jamnagar during the period from May 2018 to September 2020. Background: High-risk pregnancies causes many adverse perinatal outcomes. Doppler ultrasound is a non-invasive technique to study the feto-maternal circulation to guide the clinical management. Objective: This study aims at evaluating the role of colour Doppler in high-risk pregnancies and their perinatal outcome. Materials and Methods: This was a prospective study carried out for 29 months in the Department of Radiology with antenatal women in the age group of 18-35 years with singleton pregnancy of gestational age of <28 weeks to >35 weeks having high-risk factors considered in study. The risk factors considered were pregnancy induced hypertension (PIH), gestational diabetes, anemia, oligohydramnios, polyhydramnios and IUGR. Doppler study of umbilical artery and fetal middle cerebral artery (MCA) arteries was done and amniotic fluid index (AFI) was measured. Parameters in the form of resistive index, pulsatility index, and systolic/diastolic ratio were taken. obstetric history was taken with regular interval follow up. Results: The study was carried out with 50 patients. High-risk pregnancy was more common in the age group of 21-25 years. The most common high-risk factor in pregnancy was oligohydramnios which accounted for 30% of cases. Out of 50 high-risk pregnancies, 5 (10 %) of cases resulted in intrauterine growth restriction (IUGR). Out of 50 high-risk cases, in 36 cases, umbilical artery findings were abnormal. 3 patients had intrauterine death (IUD) and 27 patients had poor perinatal outcome. Umbilical artery abnormality showed significant sensitivity and negative predictive value for adverse (poor + IUD) perinatal. Correlation was seen between high risk pregnancy and need of emergency caesarean section and induction and associated adverse perinatal outcome. Conclusion: Combination of different arterial waveform study enhance the diagnostic accuracy in identifying those intrauterine growth restricted foetuses that were at risk. Keywords: Colour Doppler, high risk pregnancy, perinatal outcome.


Author(s):  
Jong Yun Hwang

High-risk pregnancy is the probability of adverse pregnancy outcome is increased over the general pregnant population. Some high-risk pregnancy is the result of a medical condition present before pregnancy. In other cases, a medical condition that develops during pregnancy causes a pregnancy to become high risk. The reason why high-risk pregnancy is important is detecting the risk factors for high risk pregnancy early and preventing the complicated pregnancy. Korean society of Obstetrics and Gynecology (KSOG) announced the classification of high-risk pregnancy including 95 risk factors: obstetrics risk factors, medical risk factors, physical risk factors and risk factors of current pregnancy. However, this announcement of high-risk pregnancy by KSOG was limited for maternal-fetal healthcare providers to apply their working and making policy. First this didn't include the conception of the complicated pregnancy and high-risk delivery. Second this did not separate the risk factors depend on before and during pregnancy. This review briefly evaluates the classification of high-risk pregnancy by KSOG and suggest the new classification including the complicated pregnancy and high-risk delivery for maternal-fetal healthcare providers.


Author(s):  
Madhuri Thakur ◽  
Reeti Mehra

Background: The uterine artery Doppler has potentials for screening for complications of impaired placentation. The purpose of study was to assess the role of uterine artery color Doppler waveform analysis in second trimester for the prediction of preeclampsia in a high-risk pregnancy between 18-24 weeks of gestation.Methods: 100 women with moderate or high-risk factors for developing preeclampsia reporting to Obstetrics and Gynaecology department of Government Medical College and Hospital, Sector 32, Chandigarh were enrolled for present study. Transabdominal uterine artery doppler measurements was done at 18-24weeks of gestation in these patients. Doppler . The Doppler indices generated automatically from the machine , the Pulsatility Index (PI), Resistance Index (RI) , presence or absence of diastolic notch and S/D Ratio were recorded, and average was calculated.Results: Out of 100 patients there were 46 primigravidas with no additional risk factors, 22 pateints with two or more risk factors and there were no patients who had three or more risk factors in present study population. Preeclampsia is seen more commonly in primigravida and primigravida is considered as moderate risk factor for preeclampsia. It was found that an elevated second trimester uterine artery RI was significantly associated with developing preeclampsia later in pregnancy. The sensitivity and specificity of uterine artery Doppler velocimetry were found to be 84% and 55% respectively. Receiver operator characteristics (ROC) curves were created to demonstrate the prognostic value of RI and PI of uterine artery doppler indices at 18-24 weeks of gestation for the development preeclampsia. In addition, there were statistically significant positive correlations between mean RI of uterine artery doppler study and patients who developed preeclampsia. With a sensitivity of 84.21% it could identify 31% of the cases of preeclampsia at a false positive rate of 44.4%.Conclusions: Uterine artery doppler study can be used as a predictor of moderate strength for preeclampsia.


JMS SKIMS ◽  
2014 ◽  
Vol 17 (1) ◽  
pp. 16-19
Author(s):  
Chandra Metgud

Objectives: 1. To know the incidence of high risk pregnancy. 2. To study the pregnancy outcome in Non-risk and High-risk antenatal mothers. Study Design: Longitudinal study. Setting: Shindolli Village of Belgaum District. Participants: All women in this village who were pregnant at the start of the study and who became pregnant during the study period. Sample Size: 125. Statistical Analysis: Percentages and Chi-square Test. Results: The incidence of High risk pregnancy was noted in 51(40.80%) pregnant women. The various risk factors noted were: primigravida 18 years, grand multipara, pre-eclampsia, bad obstetric history, severe anaemia etc. Among 125 pregnancy outcome, 69(93.24%) pregnant women in the non-risk group had good outcome compared to 34(66.67%) in the high risk group. The outcome of the pregnancy was significantly associated with presence of risk factors. Conclusion: The high-risk pregnancies are due to early marriages and child bearing at an early age. In rural areas early marriages are perpetuated by tradition, belief and family needs to reduce expenditures. A high percentage of anaemia in the pregnant women was due to the fact that, majority of them belonged to low social classes which affect their dietary intake and purchasing power adversely. Another common factor noted in rural area was grand multiparity, due to the need for male child. JMS 2014;17(1):16-19


2020 ◽  
Vol 1 (2) ◽  
pp. 8-14
Author(s):  
Ketut Suarayasa ◽  
Bertin Ayu Wandira

The purpose of this study was to obtain an overview of pregnancy risk factors in pregnant women accompanied by young doctor from the IKM-KK department of the Faculty of Medicine at Tadulako University during a stase at the Primary Health Care in the city of Palu. The design of this study was descriptive in order to obtain an overview of pregnancy risk factors obtained from the checklist for assisting pregnant women. The population in this study were all pregnant women who received young doctor from the IKM-KK department in the last 2 (two) years, totaling 147 pregnant women. While the sample in this study was 3rd trimester pregnant women whose notes in the accompanying book are complete. The results showed that: 1) Compliance with the lowest Antenatal Care standard in laboratory tests (70%); 2) Pregnant Women with Low Risk Pregnancy (KRR) of 58.2%, High Risk Pregnancy (KRT) of 32.2% and Very High Risk Pregnancy (KRST) of 9.6%; 3) The three highest risk factors for pregnancy are getting pregnant too soon again <2 years (31.3%), had cesarean section (22.9%) and pre-eclampsia (16.7%); and 4) Pregnant women with very high risk pregnancies (KRST) at most (72.7%) were found in urban health centers, including: kamonji (36.3%), Singgani (18.2%) and Talise (18.2%).


2020 ◽  
Vol 73 (suppl 4) ◽  
Author(s):  
Ryanne Carolynne Marques Gomes ◽  
Marcos Venícios de Oliveira Lopes ◽  
Jaqueline Galdino Albuquerque Perrelli ◽  
Cleide Maria Pontes ◽  
Francisca Márcia Pereira Linhares ◽  
...  

ABSTRACT Objective: to analyze the NANDA-I taxonomy “maternal-fetal dyad” concept in high-risk pregnancy. Method: an integrative literature review based on the Conceptual Analysis model proposed by Walker and Avant. It was conducted at PUBMED, CINAHL, SCOPUS, LILACS and SciELO, with the descriptors: Complications of pregnancy, Risk Factors, and Pregnancy, High-Risk (from 2008-2020). Result: the sample consisted of 44 articles, which identified two attributes and 21 antecedents of the concept. Conclusion: concept analysis allowed to identify the attributes and antecedents of the “maternal-fetal dyad” concept in high-risk pregnancy, in addition to raising and clarifying ideas. It was possible to identify 12 antecedents that are not included in NANDA-I as well as the need to review the definition of the diagnosis proposed by the taxonomy.


Author(s):  
Dr. Ankita Metkari

Background: Objectives of the current study were to detect high-risk-risk-risk factors in pregnancy their presentations and to develop a simple scoring system to identify and categorize high-risk pregnancies and to predict the maternal and neonatal outcomes by comparing our results to previous studies. Methods: In this retrospective study, antepartum, intrapartum and neonatal parameters were integrated into the clinical records and the relationship of a risk score to the outcome was evaluated for 346 randomly selected pregnant patients over 7 months. Conclusions: The present study shows that we achieve comparative and better results in high-risk pregnancy, improving both maternal and fetal outcome at our institute.


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