[Concept of risk in perinatology: the obstetrician point of view (author's transl)].
Perinatal risks involve the life and health of the mother and baby. It is possible to define both medical and socio-cultural risk factors. They are frequently associated. The surveillance of pregnancy is modulated by the clinician according to his preception of these factors. One essential medical problem is to define the field of application of some examination or therapeutic procedures: to all patients or to selected groups according to clinical criteria. There is no general rule. Some types of surveillance such as serodiagnosis of rubella or toxoplasmosis, or the electronic monitoring of labour involve all women. At the opposite, progestative treatment must be given only to patients at high risk of premature labour. From the public health point of view, it doesn't seem realistic to implement different policies according to risk. Surveillance and perinatal care must apply to all pregnant women. This policy, however, must take into account a fondamental finding of recent surveys, i.e. the deficiency of prenatal surveillance among the most exposed socio-cultural categories and regions, in order to improve information about the rights and duties of the pregnant woman, the concept of risk and how it can be reduced. The role of epidemiological surveys in defining risk factors appears fundamental. Coordination among studies would be desirable. In the future they will probably aid the clinician in real time diagnosis and decision.
D005260:Female; D005313:Fetal Death; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology*; D009774:Obstetrics; D011247:Pregnancy; D011295:Prenatal Care; D011634:Public Health; D012306:Risk
La notion de risque en périnatologie: point de vue de l'accoucheur