1. What are the factors that categorize a pregnancy as high-risk?

a. Advanced maternal age ­– Pregnant women over age 35 have a higher risk of
gestational diabetes, preeclampsia and intrauterine growth restriction.
b. Pre-existing medical conditions – A woman’s health plays a big role in her
pregnancy. Those with high blood pressure, diabetes, lung, kidney or heart
problems, or autoimmune or sexually transmitted diseases have a higher risk of
miscarriage or other complications.
c. Co-occurring medical conditions – Conditions that occur during pregnancy like
preeclampsia (high blood pressure) or gestational diabetes can be dangerous or
even fatal to the pregnant woman or her fetus if they are not medically treated.
d. Pregnancy-related issues – Certain infections, a shortened cervix or a previous
premature birth may put the pregnant woman and her fetus at risk for
premature labor.
e. Multiple pregnancy – Carrying multiples (e.g., twins, triplets, etc.) also increase a
woman’s risk for premature labor, gestational diabetes and high blood pressure.
f. Placenta previa –Placenta previa is another pregnancy-related issue that may put
the woman at risk during pregnancy and delivery. This condition causes excessive
bleeding, especially if a woman has contractions. In this case, doctors may
schedule a cesarean section to minimize the bleeding risks to the mother and
baby.
g. Depression – Depression in pregnant women may result in a preterm birth, low
birth weight and a higher incidence of cesarean section.
h. Blood disorders – Blood disorders, like sickle cell disease, can increase a women’s
risk of urinary tract infections, fetal loss, preterm labor and intrauterine growth
restriction during pregnancy.
i. Obesity – Obesity affects approximately 35% of all women of reproductive age.
Being obese during pregnancy increases the risk of preeclampsia, gestational
diabetes, miscarriage, stillbirth and recurrent miscarriage.
j. Gestational diabetes –Diabetes occurs in 13% of pregnancies in Nevada and tight
control of sugars can decrease the risk of preeclampsia, cesarean delivery and
injury in the birth process

2. The process of shock due to blood loss – hypovolemia

● Hypovolemia is a condition that occurs when your body loses fluid, like blood or
water. Fluids are essential to keep your organs functioning. Symptoms of
hypovolemia include weakness, fatigue and dizziness. Treatment with IV fluids
rehydrates and replenishes the fluid your body lost.

3. Discuss the immediate assessment of vaginal bleeding during pregnancy.

● When a pregnant woman experiences vaginal bleeding, it is important to seek
medical attention right away. A doctor will ask about the timing and amount of
the bleeding, perform an examination, and run tests to figure out what is causing
it. The bleeding could be caused by something minor like a cervical polyp, or

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 something more serious like a miscarriage or ectopic pregnancy. The treatment
will depend on the cause of the bleeding and how far along the pregnancy is.

4. Enumerate the emergency interventions for bleeding in pregnancy.

a. Massage uterus and expel clots
b. Apply bimanual uterine compression
c. Apply aortic compression
d. Give oxytocin
e. Give misoprostol
f. Give ergometrine
g. Remove placenta and fragments manually
h. Repair the tear and empty bladder

References:
● Center, H. R. P. (2019, March 28). 10 Risk Factors for High-Risk Pregnancy. High Risk
Pregnancy Center. https://hrpregnancy.com/10-risk-factors-for-high-risk-pregnancy/
● Hypovolemia. (2022, October 5). Cleveland Clinic.
https://my.clevelandclinic.org/health/diseases/22963-hypovolemia
● NCBI - WWW Error Blocked Diagnostic. (n.d.).
https://www.ncbi.nlm.nih.gov/books/NBK326667/

Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403