Features of High Risk Pregnancy among Women Attending a District Hospital in Greater Cairo : A Case Control Study

Abstract

Background: A high-risk pregnancy (HRP) refers to any medical condition or pathology that puts the mother, fetus, or neonate at increased risk for morbidity or mortality during pregnancy or childbirth. Objectives: The current study aimed to detect main features of high risk pregnancy among women attending antenatal care clinics at a district hospital in Greater Cairo to achieve finally safe motherhood and better outcome of the pregnancy. Methods: A case control study was used where pregnant women attending antenatal care at gynecological outpatient clinics of (Abol-Monagga district hospital (MOH), Shobra El-Khema district, Greater Cairo) were investigated three days weekly during January and February 2015 for being at high risk pregnancy using a modified form of Morrison and Olsen scoring tool to form the case group (141women), while women whose pregnancy was proved to be normal or at low risk were included as a control group (181 women). Results revealed that the main current associated morbidities of the high risk pregnancy women included anemia in (17%),gestational DM (14%),pregnancy induced hypertension (13%)and gynecological disorders in(27%).The most prominent features which were significantly related to development of HRP among studied women included obesity (31.2%), history of previous pregnancy associated morbidities (24.8%), previous delivery with CS (24.1%), multigravidae (32.6 %), multiparity (19.9 %), recurrent abortions (14.2 %) and complicated previous pregnancy outcome in (31.9%), while insignificantly detected factors included un-optimal maternal reproductive age ( 35 years), working during pregnancy, illiteracy, (+ve) husband consanguinity, non practicing regular physical activities during pregnancy, (+ve) past history of infertility and family history of morbidities. Conclusion and recommendations: Comparing (HRP) women with normal and low risk group revealed a higher prevalence of current morbidities such as anemia, DM and HTN among (HRP) women in addition to other risk factors such as obesity, multigravidae, multiparity, past history of delivery with CS, recurrent abortions and complicated previous pregnancy outcome. The study recommended proper screening techniques to be used for all pregnant women attending antenatal care clinics to pick up the factors that qualify the pregnant women to be at high risk. Preconception assessment and counseling are strongly encouraged and should include the provision of specific information concerning the risk factors which predispose to risky pregnancy.