Management of high-risk pregnancy: report of a combined obstetrical and neonatal intensive care unit.

The methodology, equipment and personnel required to carry out an intensive-care program in the management of high-risk pregnancies have been outlined. The perinatal mortality rate has been determined and its etiology has been analyzed.There appear to be three conditions in which the degree of high risk is such as to warrant provision of the complete facilities of the service we described, viz., (a) severe pre-eclampsia; (b) marked intrauterine growth retardation with placental insufficiency as determined from serial measurements of uterine growth and estriol determinations; and (c) irreversible labour in premature pregnancies where a birth weight of 2200 g. or less is anticipated. Numerous other conditions that we have monitored have perhaps had their good outcome because of monitoring facilities. A less sophisticated and more easily applied method of monitoring should be available within the context of routine labour and delivery rooms.There is a pressing need to re-evaluate and change some of our methods of educating our undergraduate, postgraduate and practising physicians and to provide continuing education in the realm of prenatal care and recognition of high-risk pregnancy. Regionalization and centralization of this type of intensive care for high-risk pregnancies are required.Indispensable to the success of this type of project is the incorporation, without physical, emotional or intellectual barriers, of both a pediatric and an obstetrical component within the intensive-care unit.