High-risk pregnancies require more frequent visits, structured monitoring, and coordinated care. Clinit's OB/GYN module flags risk factors at booking and tracks pre-eclampsia, GDM, and preterm risk through to delivery.
Defining High-Risk Pregnancy
A pregnancy is classified high-risk when factors — maternal, fetal, or placental — increase the probability of adverse outcomes for mother or baby. In Egyptian obstetric practice, the most common high-risk designations are:
- Pre-eclampsia risk — prior pre-eclampsia, nulliparity with hypertension, BMI ≥35, antiphospholipid syndrome
- Gestational Diabetes Mellitus (GDM) — prior GDM, family history of DM2, BMI ≥30, prior macrosomia
- Preterm birth risk — prior preterm birth, short cervix on transvaginal scan, multiple pregnancy, uterine anomaly
- Fetal growth restriction (FGR) — prior SGA, maternal vascular disease, heavy smoking
Risk Stratification at Booking
Clinit prompts the clinician to complete a first-trimester risk assessment at the booking visit:
- NICE pre-eclampsia risk criteria (1 high-risk factor, or ≥2 moderate-risk factors → offer low-dose aspirin from 12 weeks)
- GDM risk criteria (WHO 2013 diagnostic thresholds for OGTT)
- Cervical length measurement — TVS at 18–24 weeks for those at preterm risk; automatic referral prompt if CL <25 mm
Pre-eclampsia Monitoring Dashboard
For any patient on low-dose aspirin prophylaxis, the OB/GYN module activates an enhanced monitoring schedule:
- BP at every visit plotted against reference ranges for gestational age
- Urine protein/creatinine ratio tracked longitudinally
- Platelet count and LFTs at each trimester
- AI alert when BP ≥140/90 on two occasions 4 hours apart — prompts immediate review
GDM Sub-record
Fasting and 2-hour glucose logs, insulin dose titration, dietary notes, growth scan scheduling (every 4 weeks from 28 weeks), and biophysical profile results.
Preterm Surveillance
Serial cervical length measurements are plotted on a curve. Clinit alerts when CL falls below 20 mm (immediate referral for cerclage assessment) or when the rate of shortening accelerates.
