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High-risk obstetrics: Perinatal outcome in relation to a broadened approach to obstetric care for patients at special risk

Richard H. Aubry, MD, Robert E. L. Nesbitt Jr., MD

American Journal of Obstetrics and Gynecology, Volume 105, Issue 2, 15 September 1969, Pages 241–247


A special clinical facility was set up to provide exemplary, individualized care to high-risk obstetric patients and to serve as a model to test the effects of broadening the scope and intensity of obstetric supervision. A method of identifying patients at risk was devised and an intensified screening and diagnostic program was instituted. Even among the disadvantaged groups, gradations of risk and variable demands for intensified and expanded care were demonstrated. Previously undetected, underlying ills were encountered in almost one third of the patients. More than one-quarter required antepartal hospitalization for diagnostic work-up and treatment. The finding of improved perinatal salvage rates based on a comparison with this vulnerable group's past obstetric record would seem to justify extending prenatal investigations and concentrating greater effort on those patients at risk


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Commentaries by Editor Prof. Jim Thornton