Relationship Between Clinical, Placentary, Obstetric and Neonatal Aspects and Intrauterine Growth in High Risk Pregnancies

Abstract

Objective: to analyze clinical, placental and obstetric aspects of women with and without high-risk pregnancy, and their relationship with intrauterine growth deviations and neonatal aspects.Method: this is a cross-sectional descriptive study. Data collection was based on an analysis of the medical records of women with and without high-risk pregnancy and newborns, and anatomopathological characterization of the placenta.Results: 265 placentas were analyzed, 130 (49.06%) women with high-risk pregnancy and newborns with intrauterine growth deviations. A higher occurrence of placental changes was found in high-risk pregnancy and uterine growth deviations in comparison to cases without high-risk pregnancy (p≤0.001). High-risk pregnancies with intrauterine growth deviations were associated with placental changes (p≤0.001). Intrauterine growth deviations was related to birth weight in cases of high-risk pregnancy compared to normal gestation (p=0.014).Conclusion: a higher occurrence of placental anatomopathological changes was found in maternal and fetal surfaces in cases of high-risk pregnancy and intrauterine growth deviations. DESCRIPTORS:Fetal growth retardation. High risk pregnancy. Neonatology. Placenta. Newborn. RELAÇÃO ENTRE OS ASPECTOS CLÍNICOS, PLACENTÁRIOS, OBSTÉTRICOS E NEONATAIS E O CRESCIMENTO INTRAUTERINO NA GESTAÇÃO DE ALTO RISCO RESUMOObjetivo: analisar aspectos clínicos, placentários e obstétricos de mulheres com e sem gestação de alto risco e sua relação com desvios de crescimento intrauterino e aspectos neonatais.Método: trata-se de um estudo descritivo transversal. A coleta de dados baseou-se em análise dos prontuários das mulheres com e sem gestação de alto risco e dos recém-nascidos, e análise anatomopatológica placentária.Resultados: foram estudadas 265 placentas, 130 (49,06%) de mulheres com gestação de alto risco e recém-nascidos com desvios de crescimento intrauterino. Houve maior ocorrência de alterações placentárias em gestação de alto risco e Desvios de crescimento uterino comparadas aos casos sem gestação de alto risco (p≤0,001). Gestação de alto risco com Desvios de crescimento intrauterino possui associação com alterações placentárias (p≤0,001). desvios de crescimento intrauterino está relacionado ao peso ao nascer em casos com gestação de alto risco, comparados com gestação normal (p=0,014).Conclusão: existe maior ocorrência de alterações anatomopatológicas placentárias nas faces materna e fetal nos casos com gestação de alto risco e desvios de crescimento intrauterino. DESCRITORES:Retardo do crescimento fetal. Gravidez de alto risco. Neonatologia. Placenta. Recém-nascido.http://dx.doi.org/10.1590/0104-07072017005520015Texto Contexto Enferm, 2017; 26(2):e5520015Salge AKM, Silva RCR, Guimarães JV, Ramalho WS, Abdalla DR, Abdalla GR1 2/9 RELACIÓN ENTRE LOS ASPECTOS CLÍNICOS PLACENTARIOS, OBSTÉTRICOS Y NEONATALES Y EL CRECIMIENTO INTRAUTERINO EN LA GESTACIÓN DE ALTO RIESGO RESUMENObjetivo: analizar aspectos clínicos, placentarios y obstétricos de mujeres con y sin gestación de a...

Case management as a high-risk prenatal care strategy

“…Prenatal care is recommended during pregnancy as a strategy to improve maternal and neonatal outcomes, particularly important for pregnant women with moderate to high-risk, as it assists in the control and prevention of adverse outcomes (1) . The level of care adopted in this period are responsible for harmful outcomes for obstetric and neonatal health (2)(3) , which lead to increased morbidity and mortality in this population (4)(5) .…”

“…Despite the implementation of programs and improvements achieved, it is known that many maternal and infant deaths can be avoided through the implementation of proven and effective interventions (3,8) . Therefore, it is possible to use case management in high-risk prenatal care.…”