High-Risk Pregnancy Risk Stratification & Care Planning
Stratify high-risk pregnancies and generate evidence-based care plans with clinical reasoning
What You Can Do
You can rapidly assess complex obstetric histories, identify and weight competing risk factors, and stratify patients into appropriate risk categories that determine surveillance intensity and referral needs. The skill generates evidence-based care plans tailored to each phase of pregnancy, documents your clinical reasoning in formats that meet professional standards, and produces handoff documentation that clearly communicates risk level and management strategy to physicians and care team members.
Features
captures medical, obstetric, social, and fetal risk factors across all three trimesters
assesses and stratifies risk separately for antepartum, intrapartum, and postpartum periods
recommends midwife-led, collaborative, or physician-led care based on cumulative risk score
generates individualized surveillance schedules (NST frequency, ultrasound timing, lab monitoring)
specifies monitoring intensity, labor management considerations, and transfer thresholds
records rationale for scope-of-practice decisions and referral triggers in ACOG/ACNM-compliant format
produces clear, structured communication for physician consultation and care transitions
identifies complications and disposition needs based on pregnancy course and delivery outcomes
Example Output
Example 1: Gestational Diabetes + Advanced Maternal Age
Risk Stratification Summary:
- Antepartum Risk Level: High
- Intrapartum Risk Level: Moderate-High
- Postpartum Risk Level: Moderate
Recommended Care Model: Collaborative (midwife with physician oversight)
Antepartum Protocol:
- Weekly NSTs starting at 34 weeks
- Biweekly amniotic fluid assessment
- Maternal glucose monitoring logs weekly
- Fetal growth ultrasound at 36 weeks
Clinical Reasoning: GDM + maternal age 40 increases stillbirth risk; aneuploidy screening completed with normal results supports expectant management to 39 weeks with intensive fetal surveillance.
Example 2: Preeclampsia Superimposed on Chronic Hypertension
Risk Stratification Summary:
- Antepartum Risk Level: Very High
- Intrapartum Risk Level: Very High
- Postpartum Risk Level: High
Recommended Care Model: Physician-led (specialist collaboration required)
Antepartum Protocol:
- Twice-weekly NSTs + AFI starting at 28 weeks
- Weekly labs (CBC, CMP, LFTs, 24-hr urine protein)
- Daily BP monitoring with home log submission
- Delivery planning initiated at 36 weeks; delivery by 37 weeks if severe features present
Intrapartum Plan: Continuous cardiotocography, arterial line placement, epidural anesthesia recommended, magnesium sulfate, antihypertensive protocol per protocol
Consultation Documentation for Physician: Risk stratification summary with clear thresholds for magnesium initiation, delivery urgency, and postpartum ICU admission criteria.
What's Included
- SKILL.md instruction file: comprehensive framework and decision logic for risk stratification
- Risk Assessment Template: structured worksheet capturing medical history, obstetric factors, social determinants, and fetal findings
- Risk Stratification Matrix: evidence-based criteria (ACOG/ACNM standards) for assigning antepartum/intrapartum/postpartum risk levels
- Care Plan Generator Template: outputs individualized surveillance schedules, monitoring protocols, and intervention thresholds by risk category
- Interdisciplinary Handoff Checklist: structured communication format for physician consultation, referral, and care transitions
- Clinical Reasoning Documentation Framework: prompts for recording rationale behind scope-of-practice decisions and risk-informed recommendations
Who It's For
- Nurse midwives managing pregnant patients across community and hospital settings
- Obstetric nurses assessing and triaging high-risk admissions
- Physician assistants and nurse practitioners in obstetrics needing rapid risk stratification
- Clinical educators teaching high-risk pregnancy assessment to midwifery and nursing students
- Care coordinators preparing handoff documentation and consultation requests
Best For
- Initial intake risk assessment across all trimesters and clinical presentations
- Re-stratification when new diagnoses emerge or clinical status changes
- Antepartum testing protocol development tailored to individual risk profiles
- Care transition documentation (community to hospital, standard risk to high-risk management)
- Intrapartum surveillance planning and labor management strategy selection
- Postpartum complication assessment and disposition decision-making
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