Table 1 The Antepartum Risk Score (APRS) Tool [18] used to measure prenatal medical risk
Score | Risk Factor | Score | Risk Factor |
|---|---|---|---|
Pre-pregnancy | Current Obstetrical | ||
1 | Age ≤ 17 at deliverya | 2 | Diagnosis of large for datesc |
2 | Age ≥ 35 at delivery | 3 | Diagnosis of small for datesc |
1 | Weight ≥ 91 kgb | 2 | Polyhydramnios or oligohydramnios |
1 | Weight ≤ 45 kg | 3 | Multiple pregnancya |
1 | Height < 152 cm | 3 | Malpresentation (breech or transverse lie) |
1 | Diabetes – Controlled by diet only | 2 | Membranes ruptured before 37 weeks |
3 | Diabetes – Insulin used | 1 | Bleeding < 20 weeks |
3 | Diabetes – Retinopathy documented | 3 | Bleeding ≥ 20 weeks |
1 | Heart Disease – Asymptomatic (no affect on daily living) | 2 | Gestational hypertension |
3 | Heart Disease – Symptomatic (affects daily living) | 1 | Proteinuria ≥ 1+ |
2 | Hypertension – 140/90 or greater | 1 | Gestational diabetes documented |
3 | Hypertension – Antihypertensive Drugs | 3 | Blood antibodies (Rh, Anti C, Anti K, etc.) c |
2 | Chronic Renal Disease Documented | 1 | Anemia (Hgb< 100 gm. per L) |
1 | Other medical disorders e.g. epilepsy, severe asthma, lupus | 1 | Pregnancy > 41 weeks |
3 | Cervical surgeryc | 1 | Poor weight gain (26-36 weeks <0.5kg/week or weight loss) |
Past Obstetric | 3 | Major fetal anomalyc | |
3 | Neonatal death(s) | 3 | Acute medical disorder (acute asthma, thyrotoxicosis, UTI, etc)c |
3 | Stillbirth(s) | Substance Use | |
1 | Abortion 12-20 weeks and birth weight <500 gramsd | 1 | Smoker – anytime during pregnancy |
1 | Delivery at 20-37 weeks | 3 | Alcohol – ≥ 3 drinks on any one occasion during pregnancy |
2 | Cesarean section | 3 | Alcohol – ≥ 1 drink per day throughout pregnancy |
1 | Small for dates - 5th percentile | 3 | Drug dependent |
1 | Large for dates - 95th percentile | ||
1 | RH Isoimmunization - unaffected infantc | ||
3 | RH Isoimmunization - affected infantc | ||
1 | Major fetal anomaly e.g. Chromosomal, Heart, CNS defect | ||