La Dr. Gómez Roig has collaborated in the group of experts that has advised the preparation of the new update of the Follow-up protocol for embaràs in Catalonia.
In June 2018, the new version of the protocol that serves as a clinical guide for professionals who care for pregnant women in our Community was published.
The importance of knowing the update of these documents and/or protocols is essential to offer good professional care to our patients.
On Institute of obstetrics and gynecology of Dr. Gómez Roig performs the control of normal and risk pregnancy, as well as a natural care for normal childbirth, based on professional guides.
At the same time, the team prioritizes respectful and human attention.
The pregnancy monitoring protocol is extensive and you can consult it at:
We make a reflection on the new classification of the risk in pregnancy.
Necessary classify the pregnancy, according to the risk?
Necessary assess and classify pregnancy, according to the risk, in the visits that are made with the specialist.
The analysis of risk to mother and fetus It is carried out with the objective of correctly focusing specialized care during pregnancy, childbirth and also the postpartum period.
This classification makes it possible to concentrate specific resources according to risk and avoid excessive medicalization of normal pregnancies.
Therefore, pregnancies are classified as: low risk, medium risk, high risk and very high risk.
The evaluation of risk during pregnancy, in the service of Obstetrics, performed at the first prenatal visit.
In addition, in all successive visits the risk is reassessed. This entails an adequacy of the classification according to the appearance or disappearance of risk factors.
How is a normal pregnancy defined?
Un normal pregnancy It is defined as that in which no risk factor is detected, although the total absence of risk does not exist.
None of the risk factors that are systematically sought can be demonstrated in these pregnancies.
The follow-up of pregnancies classified as without risk, or normal. This is carried out by the obstetric specialists.
Normal pregnancy control is performed by obstetricians and/or midwives located in a clinic. Or also in a primary care center, in the field of public health.
What is a low risk pregnancy?
Un low risk pregnancy It is one in which the pregnant woman has some physical characteristic, physiological history or pathology that does not safely cause any disease in the current pregnancy.
Despite this, they do make a disease more likely than in the population with no known risk.
In these low-risk pregnancies there is some specific type of added control. Although it will not require highly specialized resources.
In many cases of low risk pregnancyBasically, health education support is required within the reach of any specialist.
The diagnosis and monitoring of low risk pregnancies. This is also carried out by specialists in obstetrics.
The control of this pregnancy is carried out by obstetricians and also by midwives located in a clinic, or in primary care, in the field of public health.
Factors that make up the low risk group
The factors that make up the low risk group are the following:
- Pelvic abnormalities.
- low height
- Unwanted pregnancy.
- Inadequate status of the immunization schedule.
- WHO (World Health Organization) stage I cardiovascular risk.
What is a medium risk pregnancy?
El medium risk pregnancy It is one in which the pregnant woman has some physical characteristic, unfavorable obstetric history, or other conditions that may affect the normal development of the current pregnancy.
In this group, highly specialized resources are not normally required.
In many cases it is basically required to use social, health resources or also health education support. All these also within reach of the obstetrics team of a first level care center.
Regarding the diagnosis and follow-up of the medium risk pregnancies, is carried out by specialists in obstetrics.
El pregnancy control Normally it is performed by obstetricians and/or midwives located in a clinic, or in primary care, in the field of public health.
Factors that make up the medium risk group
The factors that make up the medium risk group are the following:
- Very early age.
- Pregnancy at a very advanced age.
- multiparity.
- Period between two pregnancies, or short intergenic.
- History of intrauterine growth retardation and low birth weight babies.
- Dystocic deliveries.
- Previous uterine surgery.
- previous caesarean section
- Previous sterility.
- History of placental pathology.
- History of obstetric pathology in previous pregnancies.
- Insufficient or inadequate control during the current pregnancy.
- Unfavorable socioeconomic conditions.
- Victim of gender violence.
- Personal history of mental pathology.
- Current controlled and stable mental pathology.
- First trimester metrorrhagia.
- Gestational diabetes well controlled and corrected by diet.
- Risk of infection.
- smoking habit
- Rh factor negative.
- Cardiovascular risk WHO II.
- Hereditary family history
What is a high risk pregnancy?
Un high risk pregnancy It is one in which the pregnant woman presents some of the risk factors that comprise it.
These can increase the probability of complications during the gestation period or also during childbirth. Also increasing the perinatal complications.
The purpose of evaluating the degrees of gestational risk is to prevent them.
These complications sometimes require health resources that are not normally available at the first level of care, the primary care setting. Therefore, they should refer more often to a hospital care level.
Factors that make up the high risk group
The factors that make up the high risk group are the following:
- Morbid obesity.
- The history of abortions.
- History of uterine cervical incompetence.
- Previous chromosomal abnormality.
- Previous ectopic pregnancy.
- Previous gestational trophoblastic disease.
- Previous preterm birth.
- Endocrinopathies.
- Cardiovascular risk WHO III.
- AHT prior to pregnancy.
- Twins.
- Gestational diabetes corrected with diet and insulin.
- Mild preeclampsia.
- Maternal infection diagnosed during pregnancy.
- Isoimmunization.
- Serious current mental illness.
- severe anemia.
- Suspected fetal malformation.
What is a very high risk pregnancy?
Un very high risk pregnancy It is one in which the pregnant woman presents some of the risk factors that comprise it. And that significantly increases the probability of complications during the gestation period and also during childbirth.
In general, very high risk pregnancies usually require high-tech healthcare resources.
The diagnosis, in addition to the follow-up of the pregnancies classified as very high risk It must be carried out within the different levels of care. Depending on the risk factor present and the potential complications that may arise.
Factors that make up the very high risk group
The factors that make up the very high risk group are the following:
- Severe associated pathology.
- Previous perinatal death.
- Type 1 or 2 diabetes.
- Cardiovascular risk WHO type IV.
- Syndrome of dependence on alcohol and / or other drugs.
- Diagnosed uterine malformations.
- Multiple gestation.
- Retarded intrauterine growth.
- Confirmed fetal malformation.
- Abnormal position of the placenta.
- Preeclampsia or severe hypertensive state of pregnancy.
- Threat of premature labor.
- Rupture of the membranes before term.
In the obstetrics service, Institute of Dra. Gómez Roig, we carry out the control of the normal pregnancy and also of risk based on the classification of the Protocol of the Department of Health.
A good follow-up of the protocols and agreed and recommended guides ensure good control of pregnancy, in addition to natural care for normal childbirth.
We will accompany you during the pregnancy and also during the delivery in a professional and human way at the same time. Trust us.
- About the Author
- Last tickets
Head of the Obstetrics and Gynecology Service at the Sant Joan de Déu Hospital in Barcelona. Associate Professor of Obstetrics and Gynecology and Coordinator of the Sixth Course of Medicine at the University of Barcelona, UB. Director of the Dra. Gómez Roig Institute and Coordinator of Obstetric and Gynecological Processes at the Corachan Clinic in Barcelona.