ANTENATAL RISK SCREENING AND SCORING - A NEW LOOK

At the individual level, risk assessment is fundamental to antenatal c are. But at the program level, there are real difficulties associated with it, of which the most important is the false negatives - women wi th no (or few) risk factors who experience complications. This paper e valuates several commonly used indicators of risk in terms of both mat ernal (cephalopelvic disproportion) and fetal (low birthweight/prematu rity) outcomes. The literature shows that obstetric history is a bette r measure of risk than so-called demographic variables like age and pa rity. When assessing the utility of a risk factor, its sensitivity mus t be evaluated against the likelihood of false negatives. If risk asse ssment is practiced effectively, it must include a means of ensuring p rompt treatment for low risk women with (unexpected) complications.