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High-Risk Pregnancy Management: From Prenatal Care to Postpartum Outcomes

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

Deadline for manuscript submissions: 25 July 2026 | Viewed by 729

Special Issue Editor


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Guest Editor
Department of Obstetrics & Gynecology, University of Alberta, Edmonton, AB, Canada
Interests: maternal medicine; nutrition in pregnancy; preeclampsia; preterm birth; perinatal mental health; perinatal health of disadvantaged populations; maternal and child health epidemiology; developmental physiology
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Special Issue Information

Dear Colleagues,

High-Risk Pregnancy Management: From Prenatal Care to Postpartum Outcomes is a novel supplement that unites clinical science, implementation pragmatics, equity, and postpartum mental health (including depression, anxiety, PTSD, and birth trauma) across the full perinatal continuum, while addressing the continuous changes in AI use, implementation, and liability in obstetrical practice.

Despite abundant evidence on hypertensive disorders, cardiometabolic disease, preterm birth, hemorrhage, infection, autoimmune/hematologic conditions, and perinatal mental health and substance use, translation into consistent practice remains fragmented—particularly in Indigenous, rural/remote, and resource-constrained contexts. The supplement’s objectives are to (1) consolidate practice-changing evidence on major high-risk conditions and comorbidities; (2) convert evidence into standardized pathways, algorithms, and care bundles that are feasible across levels of care; (3) apply an equity lens that directly informs clinical decisions and outcomes—providing culturally safe communication scripts, trauma- and violence-informed assessments, and shared decision aids that reduce missed diagnoses, shorten time-to-treatment, and improve continuity for Indigenous and rural/remote patients; and (4) present EMR-enabled, point-of-care decision supports and pragmatic QI methods—early-warning thresholds, order sets, and unit-level feedback—that measurably improve bedside processes (e.g., time to antihypertensive, hemorrhage escalation, steroid/magnesium administration) and reduce complications.

In parallel, the supplement will provide guidance for navigating rapid shifts in AI-enabled tools—clarifying how evolving capabilities, implementation models, and medico-legal responsibilities affect clinicians and patients, and how shared decision-making and transparent consent can balance expectations with risk.

Topic coverage spans hypertensive disorders, cardio-obstetrics, diabetes/obesity, preterm birth and perinatal inflammation, hemorrhage readiness, infectious risks, and autoimmune/hematologic management; populations and settings (adolescents, advanced maternal age, multiples, and culturally grounded Indigenous and rural/remote care including transport and virtual care); and systems building through EMR order sets, alerts, dashboards, audit and feedback, quality trend monitoring, data governance, and patient-partnered ethics—aiming to measurably improve outcomes from antenatal triage through postpartum transitions.

Submission types welcomed: Article and Review.

You may choose our Joint Special Issue in Epidemiologia.

Dr. Angela Vinturache
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • high-risk pregnancy
  • prenatal care
  • postpartum outcomes
  • postpartum mental health
  • birth trauma
  • AI in obstetrics
  • medico-legal liability
  • equity & culturally safe care
  • indigenous and rural/remote care
  • EMR-enabled decision support
  • quality trend monitoring
  • maternal morbidity and mortality
  • perinatal morbidity
  • standardized care bundles & pathways

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Published Papers (1 paper)

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Research

16 pages, 275 KB  
Article
Accuracy of Blood Loss Estimation and Identification of Factors Contributing to Early Postpartum Hemorrhage Following Vaginal Delivery
by Gabriela Afrykańska, Maja Kłopecka, Hanna Maciocha, Julia Wyszyńska, Zofia Włodarczyk, Szymon Paruszewski, Aleksandra Maria Śliwka, Artur Arkadiusz Ludwin and Paweł Jan Stanirowski
J. Clin. Med. 2026, 15(8), 3000; https://doi.org/10.3390/jcm15083000 - 15 Apr 2026
Viewed by 430
Abstract
Objective: The study aimed to assess the accuracy of two distinct methods for estimating blood loss (EBL) and to identify potential factors contributing to early-onset postpartum hemorrhage (PPH) following a vaginal delivery (VD). Methods: Women in singleton pregnancies undergoing spontaneous/induced VD were recruited [...] Read more.
Objective: The study aimed to assess the accuracy of two distinct methods for estimating blood loss (EBL) and to identify potential factors contributing to early-onset postpartum hemorrhage (PPH) following a vaginal delivery (VD). Methods: Women in singleton pregnancies undergoing spontaneous/induced VD were recruited for this prospective observational cohort study. Methods of EBL included: (1) visual assessment by an attending obstetrician (sEBL) and (2) implementation of a mathematical formula (fEBL). Early PPH was defined as a cumulative blood loss exceeding 500 mL within the first 24 h after delivery as reflected by clinical assessment. Results: During the study period, 485 women delivered vaginally, and early PPH was diagnosed in 29 cases (5.97%). Among patients with PPH, a significant increase in the duration of the 2nd (61 min. vs. 33.5 min., p < 0.05) and 3rd (13 min. vs. 7 min., p < 0.001) stages of labor, as well as in the application of a dinoprostone insert (31% vs. 10.5%, p < 0.01) was noted. Additionally, in the same cohort, uterine atony (41.4% vs. 1.5%, p < 0.001), 3rd/4th degree perineal rupture (6.9% vs. 0%, p < 0.01), fetal macrosomia (17.2% vs. 4.8%, p < 0.05) and stillbirth (6.9% vs. 0.2%, p < 0.05) occurred significantly more frequently. In both groups visual estimation of blood loss was significantly lower compared to fEBL: (PPH sEBL: 800 mL vs. fEBL 1439.6 mL, p < 0.001; control sEBL: 250 mL vs. fEBL 621.8 mL, p < 0.001). In the multivariate analysis, factors such as third stage of delivery time ≥ 30 min. (OR 11.6; 95% CI: 4.18–32.33), FBW ≥ 4000 g (OR 6.37; 95% CI: 1.54–26.3), and dinoprostone insert application (OR 4.33; 95%CI: 1.63–11.48) were selected as independent predictors of the PPH. Conclusions: Compared to mathematical formula, visual estimation of blood loss by an attending obstetrician is significantly decreased. Prolonged third stage of delivery, fetal macrosomia, and application of a dinoprostone insert are the strongest contributors to early PPH following a VD. Full article
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