Clinical Challenges in High-Risk Pregnancy and Delivery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 30 October 2025 | Viewed by 762

Special Issue Editor


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Guest Editor
Department of Obstetrics and Gynecology, Ospedale Madonna delle Grazie, Matera, Italy
Interests: great obstetrical syndromes; IUGR; pre-eclampsia; placental abruption; fetal demise; pPROM; gestational diabetes; recurrent abortion
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Special Issue Information

Dear Colleagues,

High-risk pregnancies present numerous clinical challenges that require careful management and monitoring. Key factors leading to high-risk pregnancies include maternal age, pre-existing medical conditions (such as hypertension or diabetes), multiple gestation, and pathological conditions included within the great obstetrical syndromes (preterm labor, preterm PROM, fetal demise, placental abruption, pre-eclampsia, IUGR). Early identification and adequate monitoring are critical for managing these risk factors and syndromes. In such cases, obstetricians must balance the health of both the mother and the fetus, often involving a multidisciplinary team. These pregnancies generate several issues regarding labor and delivery due to the fact that the placenta, in these fetuses, may be affected by different levels of malfunction. Timely interventions, such as administering corticosteroids to accelerate fetal lung maturity or controlling maternal blood pressure, can improve maternal outcomes, but only if diagnosis occurs as early as possible. High-risk pregnancies also require post-delivery care, as complications, such as hemorrhage or infection, are more likely. Therefore, effective management hinges on timely intervention, close surveillance, and coordinated care, making collaboration among specialists in maternal–fetal medicine, anesthesiology, and neonatology crucial.

Dr. Salvatore Andrea Mastrolia
Guest Editor

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Keywords

  • high-risk pregnancy
  • preeclampsia
  • cesarean section
  • maternal–fetal medicine
  • ultrasound
  • fetal monitoring
  • complications
  • delivery
  • placental abruption
  • great obstetrical syndromes

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Published Papers (1 paper)

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Review

13 pages, 714 KiB  
Review
Practical Considerations Concerning Preeclampsia Subgroups
by Peter Tamas, Balint Farkas and Jozsef Betlehem
J. Clin. Med. 2025, 14(7), 2498; https://doi.org/10.3390/jcm14072498 - 6 Apr 2025
Viewed by 656
Abstract
Preeclampsia is one of the most serious clinical syndromes which can occur during pregnancy. According to our current knowledge, preeclampsia cannot be cured. However, a significant step forward is the recognizing preeclampsia is not a homogenous syndrome, i.e., different pathological events can lead [...] Read more.
Preeclampsia is one of the most serious clinical syndromes which can occur during pregnancy. According to our current knowledge, preeclampsia cannot be cured. However, a significant step forward is the recognizing preeclampsia is not a homogenous syndrome, i.e., different pathological events can lead to the hypertension + symptoms of organ damage, occurring in the second half of pregnancy. Clinically, two kinds of preeclampsia can be distinguished. The “classic” placental preeclampsia of immunological origin is characterized by contracted blood volume, fetal growth restriction, and marked alterations in laboratory indices. Patients in this subtype are characteristically young and primiparous. Clinical symptoms appear during the late second or early third trimester and show a quick progression. The outcome in cases of placental preeclampsia is frequently serious. For preventing the most critical conditions, the necessary delivery induction usually results in a preterm newborn. The maternal preeclampsia is associated with high blood volume. The characteristic augmented gestational weight gain is mostly a condition with a multifactorial background; however, obesity seems a critical risk factor. The early clinical symptoms are leg, and then generalized edema; hypertension and proteinuria appear after that. Laboratory abnormalities are rare; even platelet count remains within the normal range. The outcome is usually favorable; however, serious organ edema can lead to eclampsia or placental detachment. In the case of both types—from the name to the therapy—new data worthy of consideration have been created, which also justifies a change in attitude. Full article
(This article belongs to the Special Issue Clinical Challenges in High-Risk Pregnancy and Delivery)
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