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HIGH-RISK PREGNANCY

Unresolved Problems of Screening, Management, and Prognosis

From the Department of Maternal and Child Health, School of Hygiene and Public Health, and the Department of Obstetrics and Gynecology, The Johns Hopkins University School of Medicine. Baltimore. Maryland

In the field of maternal and child health the concept of the highrisk pregnancy has been used in many studies. However, it is still beset by problems that must be solved if any real progress is to be made. The ideal of a simple, reliable screening technique has not yet been achieved. Present methods are not only complex, they are not well validated. High-risk factors must be quantified if the values of various regimens of obstetric care are to be measured and if prognostic success is to be attained. Moreover, efforts at prediction should not cease with the current pregnancy but should extend to subsequent reproductive performance. This long-range approach to prognosis could not only improve patient care during the current pregnancy but could also become an essential factor in achieving optimal results throughout reproductive life. An extensive bibliography of studies of high-risk pregnancies is presented.