Clinical Management of High-Risk Pregnancies an Evidence-Based Multidisciplinary and Technology-Integrated Analytical Framework

Dr. Alpana Bansal, Shilki Sharma, Anupama Choudhary

High-risk Pregnancy; Antenatal Surveillance; Doppler Velocimetry; Cardiotocography; Thrombophilia; Advanced Maternal Age; Obstetric Critical Care; Precision Medicine; Multidisciplinary Obstetrics; Digital Health Monitoring.

High-risk pregnancies contribute disproportionately to maternal and perinatal morbidity and mortality despite advancements in obstetric surveillance and tertiary care infrastructure. Effective management requires integration of clinical expertise, structured antenatal monitoring, multidisciplinary coordination, and emerging digital health innovations. This analytical study evaluates determinants, management strategies, and clinical outcomes among 480 high-risk pregnancies managed in a tertiary care institution over four years. Multivariate logistic regression demonstrated that hypertensive disorders (β=0.52, p<0.001), thrombophilia (β=0.41, p<0.001), advanced maternal age (β=0.36, p<0.01), and inadequate antenatal compliance (β=0.44, p<0.001) significantly predicted adverse maternal outcomes. Structured Doppler monitoring reduced fetal compromise risk by 38% (p<0.01). The final predictive model explained 79% of variance in adverse maternal-fetal outcomes (R²=0.79). Findings support a systems-based management framework combining classical obstetric evidence, personalised thromboprophylaxis, psychosocial assessment, and AI-assisted risk stratification. High-risk pregnancy care must transition from reactive intervention to proactive, digitally enhanced, multidisciplinary management to optimise maternal and neonatal survival.

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