Which of the following is not a high risk pregnancy?

Raj. CHO -2024

Obstetrics & Gynaecology

Easy

Appeared in: Raj. CHO -2024

Explanation

A previous uncomplicated vaginal delivery is a positive prognostic indicator for a future pregnancy.
According to obstetric guidelines, a second or third pregnancy following a normal first delivery is considered low risk.
This history suggests the mother's pelvis is adequate for childbirth and she has previously navigated pregnancy and delivery without major complications, reducing the likelihood of issues in a subsequent pregnancy.

Option B: A primigravid (first-time pregnant) woman aged 30 or older is classified as an 'elderly primigravida' and is considered high-risk.
Option C: Anemia during pregnancy is a significant medical disorder that classifies the pregnancy as high-risk.
Option D: A twin pregnancy, or any multiple gestation, is automatically categorized as high-risk.

Visual 1: Infographic: Chart categorizing common antenatal factors into 'High Risk' and 'Low Risk' columns. High-risk examples would include advanced maternal age, multiple gestation, and anemia. Low-risk examples would include a history of normal delivery.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of high-risk versus low-risk pregnancy factors as background academic context rather than a clinical decision trigger.
Accurate risk assessment during the first antenatal visit is crucial for planning the frequency of subsequent visits, the level of care required (e.g., specialist vs. midwife-led), and necessary interventions to ensure a healthy outcome for both mother and baby.
Identifying high-risk pregnancies allows for timely referral to specialized centers equipped to handle potential complications.
What if? If the 'previous vaginal delivery' was complicated by a third-degree perineal tear, shoulder dystocia, or postpartum hemorrhage, the pregnancy would be re-classified as high-risk due to the history of significant obstetric complications, warranting closer monitoring.

How to Approach the Question

First, recognize that the question asks to identify the option that is NOT a high-risk pregnancy. This is a negative-framed or 'exception' question.
Evaluate each option individually to determine if it is a known risk factor in pregnancy.
Recall or deduce that advanced maternal age for a first-time mother (primigravida over 30), anemia (a medical complication), and twin pregnancy (multiple gestation) are all well-established high-risk conditions.
Consider the remaining option: 'Previous vaginal delivery'. A history of a normal, successful delivery is generally a positive sign, suggesting the mother's body is capable of carrying and delivering a baby without major issues.
Conclude that the factor which is not a risk, and is in fact a favorable sign, is the correct answer.

Concept Tested & Keywords

Concept Tested: Identification of high-risk versus low-risk pregnancy factors.
Stem keywords: high risk pregnancy
Lead-in keywords: not
Negative lead-in flag: This is a negative-framed question asking you to identify the option that is NOT a risk factor.

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