{
    "abstract": "A health policy which concentrates scarce resources on high risk individuals or groups theoretically should lead to earlier diagnosis of the condition at a lower cost for the collectivity. Pregnancy and birth the physiological processes that usaully unfold normally. Risk may be defined as increased probability of a complication such as abortion, stillbirth, prematurity, hypotrophy, or delayed death as a function of certain indicators or risk factors related to maternal age, marital status, partiy, obstetrical history, health status before and during pregnancy, nutritional status, and socioeconomic situation. There are no completely risk-free pregnancies, and not all risk factors are equally serious. It is rare that only 1 risk factor is present; several risk factors usually coexist and their combined action aggravates and risk. Social indicators and factors such as poverty, low sociocultural level, and heavy work have a particularly great weight in cases of multifactorial risk. Some elements creating increased risk, such as small maternal size, are not avoidable, while others such as smoking during pregnancy may be avoided. In each case, risks should be carefully specified in terms of the possible pathology associated with them. The medical history and first prenatal consultation can disclose events prior to the pregnancy that would threaten it, including morphological anomalies such as small size or insufficient or excessive weight; illnesses such as heart or kidney disease, epilepsy, or diabetes, and complications during previous pregnancies or deliveries, such as abortion, premature delivery, or toxemia. Anomalies of the current pregnancy observed at the first prenatal visit might include too short pregnancy interval; unfavorable conditions related to maternal age, spacing, or ages of existing children, illegitimacy, or heavy work; anomalies in the general condition such as toxemia, excessive fatique, or use of alcohol, tobacco, or drugs; and obstetrical anomalies such as hemorrhage, infection, or excessive fetal volume. Lack of prenatal care constitutes a risk factor in itself. A strategy to furnish adequate preventive and curative services for high risk women requires at the national level better health planning, definition of the functions of different categories of health personnel, and development of appropriate training programs. In concrete terms, the strategy may translate into such activities as more frequent prenatal visits, increased household assistance by family members or paid workers, bed rest, or early transfer to a well-equipped hospital. In developing countries, better basic health services and corrdination between levels of care will probably be the most important interventions for controlling infant morbidity and mortality, but improved maternal nutrition and other measures to assure adequate birth weight should not be overlooked.",
    "authors": [
        {
            "affiliation": null,
            "firstname": "E",
            "initials": "E",
            "lastname": "Semana"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": null,
    "journal": "Imbonezamuryango = Famille, sante, developpement",
    "keywords": [
        "Delivery Of Health Care",
        "Diseases",
        "Economic Factors",
        "Health",
        "Health And Welfare Planning",
        "Health Services",
        "Health Services Evaluation",
        "High Risk Women",
        "Infant Mortality",
        "Maternal Health Services",
        "Maternal Mortality",
        "Maternal-child Health Services",
        "Medicine",
        "Mortality",
        "Organization And Administration",
        "Pregnancy",
        "Pregnancy Complications--etiology",
        "Prenatal Care",
        "Primary Health Care",
        "Program Evaluation",
        "Programs",
        "Reproduction",
        "Social Planning"
    ],
    "methods": null,
    "publication_date": "1987-04-01",
    "pubmed_id": "12341550",
    "results": null,
    "title": "[High risk pregnancy: isolation and prevention].",
    "xml": "<Element 'PubmedArticle' at 0x78850326f600>"
}