A high-risk pregnancy is any condition associated with a pregnancy where there is an actual or potential risk to the mother or fetus. Women with risk factors for high-risk pregnancies have a one in four chance of developing complications than those with a low risk of high-risk pregnancies who have nearly one in ten. The central focus of maternal and childcare programs has been detecting at-risk pregnancies to prevent women from developing obstetric complications in childbirth. The early identification of pregnant women at risk of developing complications at birth is fundamental to antenatal care and an important strategy in preventing maternal death [1-4].

There are number of studies about high risk pregnancy in different parts of the India, such studies are limited in Himachal Pradesh. Thus the present study was conducted to evaluate the high risk pregnancy  cases admitted in labour room in Pandit Jawahar Lal Nehru Medical College and Hospital,District Chamba, Himachal Pradesh.

Objectives of the Study

To evaluate the high risk pregnancy cases  admitted in labour room in Pandit Jawahar Lal Nehru Medical College and Hospital,District Chamba, Himachal Pradesh.

• Research Approach: Descriptive survey 

• Study Design:  A retrospective review

• Setting of the study: Pandit Jawahar Lal Nehru Medical College and Hospital,District Chamba, Himachal Pradesh

• Study duration:  1^st January  2022 to 30^th June 2022

• Sample size: All type of high risk pregnancy  cases admitted in labour room during the study period

• Data collection: Data regarding the pattern of high risk pregnancy  cases was retrieved

• Permission: obtained from the concerned authorities of Civil Hospital Salooni in District Chamba, Himachal Pradesh

• Data analysis: With appropriate statistical test in terms of frequencies and percentage using epi info v7 software

In the present study we found that during the study period, a total of 159 cases of high risk pregnancy admitted in labour room in Pandit Jawahar Lal Nehru Medical College and Hospital,District Chamba, Himachal Pradesh. Among the total, there were 38 cases of pregnancy induced hypertension (3 cases of pre eclampsia and 35 cases of Gestational Hypertension), 15 cases of Anaemia (6 mild anaemia, 7 moderate anaemia and 2 severe anaemia), 52 cases of Intrahepatic cholestasis , 1 cases of Intrahepatic cholestasis  with anemia, 6 cases of gestational diabetes, 20 cases of previous caesarean section, 7 cases of twins( 1 case of twin with Polyhydramnios, 1 case pf twin with PIH and 5 cases of Twins), 3 cases of Polyhydramnios, 3 cases of oligohydramnios, 1 cases of transverse lie, 5 cases of thrombocytopenia, 4 cases of Placenta previa, 1 case of multiple disorder(pre-eclampsia with intra uterine growth retardation with oligohydramnios with thrombocytopenia), 1 case of Placenta previa with moderate anaemia and 1 case of abruption with intrauterine death.

Table 1: Distribution According to Cause of High-Risk Pregnancy

Present study was carried out to evaluate the high risk pregnancy admitted in labour room in Pandit Jawahar Lal Nehru Medical College and Hospital,District Chamba, Himachal Pradesh.

In the present study, a total of 159 cases of high risk pregnancy admitted in labour room during the study period. Among the total, there were 38 cases of pregnancy induced hypertension , 15 cases of Anaemia, 52 cases of Intrahepatic cholestasis , 1 cases of Intrahepatic cholestasis  with anemia, 6 cases of gestational diabetes, 20 cases of previous caesarean section, 7 cases of twins, 3 cases of Polyhydramnios, 3 cases of oligohydramnios, 1 cases of transverse lie, 5 cases of thrombocytopenia, 4 cases of Placenta previa, 1 case of multiple disorder, 1 case of Placenta previa with moderate anaemia and 1 case of abruption with intrauterine death. Similar pattern was noticed in the study done by  Vasavi Kolluru et al. [5].

A high-risk pregnancy can be life-threatening for the pregnant person or unborn baby. Serious complications can include Eclampsia , Preterm delivery, Cesarean delivery (C-section), Excessive bleeding during labor and delivery, or after birth, Low or high birth weight, Birth defects, Problems with baby’s brain development, Neonatal intensive care unit admission, Intensive care unit admission, Miscarriage, Stillbirth etc. [6].

Management for a high-risk pregnancy will depend on specific risk factors. Care plan may include Closer follow-up with your obstetrician, Consultation with a maternal fetal medicine (high-risk pregnancy) specialist, Consultation with other medical specialists, more ultrasounds and closer fetal evaluation, home blood pressure monitoring and Careful monitoring of medications used to manage preexisting conditions [6].

Early and regular antenatal care helps many women have healthy pregnancies and deliveries without complications. Women with high-risk pregnancies should receive care from a special team of health care providers to ensure the best possible outcomes. Through identification of mothers at risk, minimum care for all could be ensured, while providing guidelines for diversion of limited resources to those who most need them. This kind of approach is very much essential in tertiary care centers like our hospital where not only patients belonging to high-risk group but low risk category also seek medical attention.

1. Holness, N. "High-risk pregnancy." Nurs. Clin., vol. 53, no. 2, 2018, pp. 241–51.

2. Lennox, C.E. "Assessment of obstetric high risk factors in a developing country." Trop. Dr., vol. 14, no. 3, 1984, pp. 125–9.

3. Prual, A. et al. "The quality of risk factor screening during antenatal consultations in Niger." Health Policy Plan., vol. 15, no. 1, 2000, pp. 11–6.

4. Groot, A. et al. "Assessment of the risk approach to maternity care in a district hospital in rural Tanzania." Obstet. Gynecol. Int. J., vol. 40, no. 1, 1993, pp. 33–7.

5. Kolluru, V. et al. "Study of high risk scoring in pregnancy and perinatal outcome." Indian J. Obstet. Gynecol. Res., vol. 3, no. 4, 2016, pp. 407–9.

6. Cleveland Clinic. "High-risk pregnancy." Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/22190-high-risk-pregnancy. Accessed 02 June 2022.