CLINICAL MANAGEMENT OF COMORBIDITIES IN HIGH-RISK PRENATAL CARE: AN EXPERIENCE REPORT

Abstract

This article aimed to integrate the practical experience of resident physicians at a reference maternity hospital in Anápolis, Brazil, with evidence from a systematic review on high-risk prenatal management of hypertension and gestational diabetes. The mixed-methods approach combined a two-year clinical experience report with a systematic review of 10 primary studies (N = 1,238,271 pregnant women) screened following PRISMA, NOS, and GRADE guidelines. Results showed that adopting standardized checklists eliminated subjective decision-making and enhanced diagnostic autonomy. The review validated this practice by demonstrating that inadequate prenatal care increases the risk of Severe Maternal Morbidity by 45.6% (OR = 1.456) and ICU admissions by 41.8%. Blood pressure monitoring and active care navigation accelerated preeclampsia diagnosis and low-dose aspirin initiation. In gestational diabetes, multidisciplinary care reduced glycemic dysregulation and large-for-gestational-age infants. In conclusion, protocol-driven care eliminates medical inertia, improves residency training, and optimizes maternal-fetal safety in the public health system.