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ANTENATAL CARE FOR HIGH RISK PREGNANCIES

Bashaer Abdulkareem Matouq , Rahaf Fadil Alturkistani , Nawfal Hamad Alsufayan , Lama Mohammed Alomar , Reem Fawzi Damanhuri , Ghufran Essa Al Khalfan , Lujain Saud M Alrabghi , Amina Abduljalil Hasan Abdulla Maraj , Fatima Jawad Alissa , Mohammed Saleh Alaskar , Nada Tawfiq Danish

Introduction: Intrauterine growth restriction (IUGR) is the inhibition of fetal growth and failure of the fetus to maintain its growth. There has been a significant association between stillbirth and fetal growth restriction. Both are attributed due to a complex pathology arising from an interaction among maternal conditions, placenta and hormonal regulation. The term small for gestational age (SGA), often recognized as having a birth weight below the 10th percentile of an accepted reference standard, is usually used as a substitution measure for IUGR. It is estimated that about thirty million newborns per year suffers from intrauterine growth restriction in developing countries. To avoid complications associated with intrauterine growth restriction, it is essential to notice the condition and once noticed, take the appropriate actions to asses fetal well being in association with proper interference in case of fetal distress (for example early delivery) [1,10]. The main goal of this review is to study the screening and surveillance interventions that can help prevent stillbirths associated with IUGR. Aim of work: In this paper we review the methods used to detect IUGR in high risk pregnancies.Methodology: We did a systematic search for antenatal care for high risk pregnancies in the emergency department using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). All relevant studies were retrieved and discussed. We only included full articles.Conclusions: The detection and management of IUGR using maternal BMI screening, symphysis-fundal height measurement and targeted ultrasound may be effective method of reducing IUGR related stillbirths. So far there are no no studies available to check the effect of these methods. The doppler velocimetry of umbilical and fetal arteries for surveillance of diagnosed high risk pregnancies could lead to a decrease of twenty nine percent (95 % CI 2% to 48 %) in perinatal mortality. Overall, there is insufficient amount of studies to recommend fetal movement counting. More studies are needed to check this method particularly in developing countries. Key words: Antenatal care, high risk pregnancy, management, surveillance.

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