[Unexpected risks during labour and delivery following a low risk pregnancy (author's transl)]. / Unvorhergesehene Geburtsrisiken nach risikofreier Schwangerschaft.

ABSTRACT

Of the maternity patient of the Munich perinatal study from 1975-1977 54.4% were considered to be low risk at the end of the pregnancy. Of these every third patient (17%) developed at least one risk during labour and delivery. These were considered to be consequence risks if they and been present at the onset of labour and delivery or progress risks if they developed during labour and delivery. The progress risks were defined as unpredictable and occurred in 4.7% of the total study. In this group the incidence of spontaneous delivery was only 36.0% compared with 88.5% in the compare group. The perinatal mortality of 6.9% was three times higher than for women who remained low risk during labour and delivery. The commonest unpredictable risks are anomalies of presentation. Acidosis and pyrexia during labour and delivery and emergency risks occur most often in women who start labour and delivery with existing risks. For these so-called progress risks with a high incidence of operative deliveries an operating room must be available at all times in the interest of mother and fetus. The monitoring of the fetus must also be available. Even following a low risk pregnancy monitoring and operation may become necessary.