Intoduction

Question 1

Define High Risk Pregnancy

Answer 1

A pregnancy in which both the mother and fetus are at high risks for complications, morbidity, or mortality.

Question 2

What is the importance of detecting a high risk pregnancy?

Answer 2

Risks are identified and acted upon with appropriate care and prevention for the best maternal and fetal health outcome.

Question 3

Percentage of Maternal Deaths:
During pregnancy:
During labor and delivery:
After childbirth (first week):

Answer 3

During pregnancy: 20-25%
During labor and delivery: 40-50%
After childbirth (first week): 25-40%

Question 4

Risk Factors in Pregnancy

Answer 4

• Genetics
• Biophysical risk
• Nutritional Status

Question 5

Biophysical Risk Factors in Pregnancy

Answer 5

Obstetrical history
Psychosocial risks
Lifestyle
Drugs
Psychological status
Stress
Type of work

Question 6

Socio-Demographic Risk Factors in Pregnancy

Answer 6

Low income
Lack of prenatal care
Age (<18 or >35)
Parity (>5)
Marital status
Residence
Ethnicity

Question 7

Danger Signs of Pregnancy

Answer 7

Spotting or vaginal bleeding
Persistent vomiting
Chills, headache and fever
Clear fluid discharges from the vagina
Abdominal/chest pain
Pregnancy Induced Hypertension (PIH)
Absence, increase, or decrease in fetal movements
Anasarca (generalized edema)
Dysuria
Visual changes, overwhelming tiredness
Breathing problems
Thoughts of self/fetal harm

Question 8

What are teratogens?

Answer 8

Any factor (physical or chemical) that have adverse effects on the fertilized ovum, embryo, or fetus.

Question 9

What are the three factors that influence the amount of damage caused by teratogens?

Answer 9

Strength, affinity, and timing

Question 10

Teratogenic Maternal Infections

Answer 10

Sexually transmitted or systemic infection which might be viral, bacterial, or protozoan that crosses to the placenta giving serious injury to the fetus.

Question 11

TORCH Syndrome and Torch screen

Answer 11

Torch syndrome refers to any of a group of infections in newborns due to one of the TORCH infectious agents having crossed the placenta during pregnancy. Torch screen is a group of blood tests to determine whether these infections exist in either the pregnant mother or the newborn.

Question 12

Torch

Answer 12

TOXOPLASMOSIS
- A protozoan infection due to contact with uncooked meat or handling of animals like cats and ingesting contaminated soil
- Symptoms are body malaise and a posterior cervical lymph adenopathy
- It will cause CNS damage to the fetus like hydrocephalus, microcephaly, intracerebral calcification and retinal deformities
- Pyrimethamine is an antiprotozoan agent and the drug of choice

Question 13

tOrch

Answer 13

OTHER AGENTS
Rubeola, mumps, varicella, poliomyelitis, influenza, viral hepatitis, coxsackie virus

Question 14

toRch

Answer 14

RUBELLA (GERMAN MEASLES)
- A communicable disease characterized by swollen glands caused by rubella virus.
- Mother experiences mild rashes and systemic illnesses.
- Fetal damages include deafness, IUGR, dental & facial clefts, cataracts, mental & motor challenges, cardiac defects (PDA & pulmonary stenosis), thrombocytopenia purpura
- Rubella immunization 3 months before pregnancy

Question 15

torCh

Answer 15

CYTOMEGALOVIRUS
- A herpes virus transmitted through droplet infection.
- Causes severe neurological challenges to the fetus( hydrocephalus, microcephaly, spasticity) eye damages (optic atrophy and chorioretinits), deafness, or chronic liver disease,
- Large petechiae may cover the child’s skin
- Can be prevented by taking care with the sharing of utensils and toothbrushes with the child, avoiding kissing the child’s mouth, cleaning items the child uses, and practicing good handwashing

Question 16

torcH

Answer 16

HERPES SIMPLEX VIRUS (GENITAL HERPES INFECTION)
- If the infection occurs in the first trimester, effects include congenital anomalies or spontaneous miscarriages.
- If it occurs in the second or third trimester, there is a high incidence of premature birth.

Question 17

Teratogenicity of Cigarettes

Answer 17

• Growth retardation
• Low birth weight in infants resulting from vasoconstriction of the uterine vessels which is an effect of nicotine that limits the blood supply to the fetus.

Question 18

Teratogenicity of Alcohol

Answer 18

• High congenital deformities like craniofacial deformity (short palpebral fissures, thin upper lip and upturned nose, small head circumference) and cognitive impairment as a result of the mother’s poor nutritional status

Question 19

Teratogenicity of Drugs

Answer 19

• Pregnant women should not be taking any drugs or food supplement not prescribed or approved by the their HC professionals
• Drugs should not be taken unless prescribed by the physician

Question 20

Environmental Teratogens

Answer 20

Radiation is a potent teratogen because of the high proportion of rapidly growing cells present.
Chemical teratogens like metal and chemical hazards and lead from paints and plastics.