Management of Obstetric Complications in High‑Risk Deliveries: An Updated Review

High‑risk delivery encompasses clinical situations that substantially increase the likelihood of adverse maternal and neonatal outcomes, requiring appropriate infrastructure, a trained multidisciplinary team, and evidence‑based protocols. This review aims to synthesize the principal obstetric complications that threaten perinatal safety and discuss updated prevention and management strategies. To that end, a systematic search was conducted in the PubMed, SciELO, LILACS, and Cochrane Library databases, covering publications from 2015 to 2024. Original studies, systematic reviews, and guidelines addressing postpartum hemorrhage, shoulder dystocia, eclampsia, umbilical cord prolapse, and acute fetal distress were selected. Findings confirm that standardized protocols, pharmacological prophylaxis, and training in realistic simulations can reduce maternal mortality from postpartum hemorrhage by up to 60%, decrease neonatal neurological sequelae, and improve safety indicators. Incorporation of artificial intelligence into cardiotocography enhances diagnostic accuracy for fetal distress, while WHO‑based obstetric checklists reduce adverse events by 23%. It is concluded that the integration of scientific evidence, technological innovation, and humanization of care is crucial to mitigate risks and optimize outcomes in high‑risk deliveries, in alignment with global maternal mortality reduction goals.