Maternity: first guidelines for high-risk pregnancies arrive

Targeted prevention, early diagnosis and treatment in specialist centres for the main complications that can endanger the health of mothers and children . These are the priorities described in the Italian guidelines dedicated to the management of high-risk pregnancies, presented by the Italian Society of Gynaecology and Obstetrics (Sigo).

The document, the result of long and meticulous work, coordinated by Tullio Ghi, full professor of Gynaecology and Obstetrics at the Università Cattolica del Sacro Cuore and director of the Uoc of Obstetrics and Obstetric Pathology at Fondazione Policlinico Gemelli, was drafted by a large multidisciplinary panel of specialists from the main Italian birth centres and by experts in cardiology, nephrology, neonatology, psychology, diabetes, forensic medicine and representatives of patient associations, with the contribution of external international reviewers. The work, approved by the Istituto Superiore di Sanità, is published on the portal of the National Guideline System of the Iss.

The guidelines mark a real revolution in the management of complex pregnancies in Italia, which has hitherto referred to international guidelines and cover the four main areas of obstetric complications: hypertensive disorders of pregnancy (pre-eclampsia, eclampsia, gestosis), fetal growth disorders (fetal growth restriction), diabetes mellitus arising in pregnancy (gestational diabetes) and preterm delivery.

For each condition, the document indicates the most effective strategies to prevent, identify early and treat the condition itself and its most serious clinical complications for maternal and neonatal health, reiterating the need to refer the most complex pregnancies to centres of reference.

In the midst of demographic winter, pregnancies in our country are increasingly 'at risk' and precious. 'In Italia,' Professor Ghi recalls, 'the average age of the first pregnancy continues to increase, with a significant impact on the risk of obstetric complications. This makes it essential to have up-to-date clinical tools to better intercept and manage high-risk pregnancies. The epidemiological scenario shows that foreign nationals are also following this trend: they are having fewer and fewer children and at an increasingly advanced age, as if they too were adapting to Italian customs'.