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Books on the topic 'Adverse pregnancy outcomes'

Author: Grafiati
Published: 4 June 2021
Last updated: 25 January 2023

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1

Rohilla, Minakshi, ed. Recurrent Pregnancy Loss and Adverse Natal Outcomes. Boca Raton: CRC Press, 2020.: CRC Press, 2020. http://dx.doi.org/10.1201/9780429435027.

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2

J, Hitchcock Penelope, MacKay H. Trent, and Wasserheit Judith N, eds. Sexually transmitted diseases and adverse outcomes of pregnancy. Washington, D.C: ASM Press, 1999.

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3

J, Hitchcock Penelope, MacKay H. Trent, and Wasserheit Judith N, eds. Sexually transmitted diseases and adverse outcomes of pregnancy. Washington, D.C: ASM Press, 1999.

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4

Hitchcock, Penelope J., H. Trent MacKay, Judith N. Wasserheit, and Roberta Binder, eds. Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. Washington, DC, USA: ASM Press, 1999. http://dx.doi.org/10.1128/9781555818210.

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5

United Nations Population Fund. Office for the Pacific. and Fiji Ministry of Health, eds. Teenage deliveries and risk of adverse outcomes: A hospital based case-control study. Suva, Fiji: UNFPA Office for the Pacific, 2007.

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6

Studies, Illinois Division of Epidemiologic. Adverse pregnancy outcomes in Illinois: County-specific prevalence and related infant mortality, 1989-1998. Springfield, IL: Illinois Dept. of Public Health, Division of Epidemiologic Studies, 2000.

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7

Fornoff, J. E. Birth defects and other adverse pregnancy outcomes in Illinois, 1995-1999: A report on county-specific incidence. Springfield, Ill: Illinois Dept. of Public Health, Division of Epidemiologic Studies, 2002.

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8

Fornoff, J. E. Birth defects and other adverse pregnancy outcomes in Illinois, 1997-2001: A report on county-specific incidence. Springfield, Ill: Illinois Dept. of Public Health, Division of Epidemiologic Studies, 2003.

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9

RN, Edwards Grace, and Baby Lifeline, eds. Adverse outcomes in maternity care: Implications for practice, applying the recommendations of the confidential enquiries. Edinburgh: Books for Midwives, 2004.

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10

Patrias, Karen. Effect of corticosteroids for fetal maturation on perinatal outcomes: January 1985 through December 1993, plus selected earlier citations : 715 citations. Bethesda, Md: U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, National Library of Medicine, Reference Section, 1994.

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11

Walker, Mark Clarence. A systematic review of factor V Leiden and adverse pregnancy outcome. Ottawa: National Library of Canada, 2003.

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12

Anesthesia and the fetus. Chichester, West Sussex: Wiley-Blackwell, 2013.

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13

International, Conference on Male Mediated Developmental Toxicity (2nd 2001 Montreal Quebec). Advances in male mediated developmental toxicity. New York: Kluwer Academic/Plenum Pub., 2003.

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14

International Conference on Male-Mediated Developmental Toxicity (3rd 2005 University of Bradford). Male-mediated developmental toxicity. Cambridge, UK: RSC Publishing, 2007.

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15

H, Brinkworth Martin, and Anderson Diana, eds. Male-mediated developmental toxicity. Cambridge, UK: Royal Society of Chemistry, 2007.

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16

F, Olshan Andrew, Mattison Donald R, and International Conference on Male-Mediated Developmental Toxicity (1992 : Pittsburgh, Pa.), eds. Male-mediated developmental toxicity. New York: Plenum Press, 1994.

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17

Bernard, Robaire, and Hales Barbara F, eds. Advances in male mediated developmental toxicity. New York: Kluwer Academic/Plenum Publishers, 2003.

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18

Rohilla, Minakshi. Recurrent Pregnancy Loss and Adverse Natal Outcomes. Taylor & Francis Group, 2020.

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19

Rohilla, Minakshi. Recurrent Pregnancy Loss and Adverse Natal Outcomes. Taylor & Francis Group, 2020.

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20

Rohilla, Minakshi. Recurrent Pregnancy Loss and Adverse Natal Outcomes. Taylor & Francis Group, 2020.

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21

Rohilla, Minakshi. Recurrent Pregnancy Loss and Adverse Natal Outcomes. Taylor & Francis Group, 2021.

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22

Baud, David, and Léo Pomar, eds. Emerging Virus Infections in Adverse Pregnancy Outcomes. MDPI, 2022. http://dx.doi.org/10.3390/books978-3-0365-5273-6.

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23

Rohilla, Minakshi. Recurrent Pregnancy Loss and Adverse Natal Outcomes. Taylor & Francis Group, 2020.

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24

Wasserheit, Judith N., Penelope J. Hitchcock, and H. Trent MacKay. Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. Wiley & Sons, Limited, John, 2014.

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25

Illinois adverse pregnancy outcomes reporting system: Assessment and recommendations. [Springfield, Ill.]: Illinois Dept. of Public Health, [Adverse Pregnance Outcomes Reporting System], 2001.

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26

Gluckman, Sir Peter, Mark Hanson, Chong Yap Seng, and Anne Bardsley. Effects of maternal age on pregnancy outcomes. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780198722700.003.0034.

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Maternal age on both ends of the reproductive spectrum (teenage and 35+) is associated with increased risk of adverse pregnancy outcomes, as compared with the age range from 20–34 years old. Some of the increase in pregnancy complications in older mothers is caused by underlying age-related health issues such as hypertension and diabetes, the prevalence of which increases linearly with age. The risks associated with young maternal age are more related to nutritional deficits and the fact that pregnant adolescents may still be growing themselves. Poor fetal growth often seen in adolescent pregnancies possibly results from competition for nutrients. Maternal bone loss is also a concern, as adolescent diets are commonly low in calcium and vitamin D. Pregnant adolescents may benefit from calcium supplementation to compensate for the increased need for their own bone growth and should at minimum receive vitamin D supplements, as recommended for all pregnant women.
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27

Rohilla, Minakshi. Approach to Women with Recurrent Pregnancy Loss and Prior Adverse Perinatal Outcomes. Taylor & Francis Group, 2020.

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28

Wong, Matthew Roy. Methodological and ethical issues in the study of maternal smoking and adverse pregnancy outcomes. 2000.

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29

Illinois. Division of Epidemiologic Studies., ed. Birth defects and other adverse pregnancy outcomes in Illinois, 1998-2002: A report on county-specific incidence. [Springfield, Ill.]: Illinois Dept. of Public Health, Division of Epidemiologic Studies, 2004.

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30

Illinois. Division of Epidemiologic Studies., ed. Birth defects and other adverse pregnancy outcomes in Illinois, 2001-2005: A report on county-specific incidence. [Springfield, Ill.]: Illinois Dept. of Public Health, Division of Epidemiologic Studies, 2007.

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31

Okun, Michele L. Sleep and pregnancy. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198778240.003.0013.

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Pregnant women experience a greater degree of sleep disturbance than their non-pregnant counterparts. Complaints range from sleep maintenance issues to excessive daytime sleepiness. Emerging evidence suggests that there is variability in sleep patterns and complaints which manifest differently among pregnant women. Moreover, it is well accepted that sleep disturbance can dysregulate normal immune and endocrine processes that are critically important to the health and progression of gestation. A possible consequence of sleep disturbance is an increased risk for adverse pregnancy outcomes. Then again, many endogenous and exogenous factors, including pregnancy-related physiological, hormonal, and anatomic changes, as well as lifestyle changes, can impact the degree and chronicity of sleep disturbance. Alas, there is still much to learn in terms of what women can/should expect with regard to the timing, degree, frequency, and/or severity of a specific pregnancy-related sleep disturbance(s), despite the number of published studies evaluating what sleep during pregnancy encompasses.
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32

Glover, Vivette. Maternal Stress During Pregnancy and Infant and Child Outcome. Edited by Amy Wenzel. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199778072.013.006.

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Many independent prospective studies show maternal stress, anxiety, or depression during pregnancy poses an increased risk for her child to have a wide range of adverse outcomes including emotional problems, ADHD or conduct disorder, or impaired cognitive development. Several studies have shown that these adverse outcomes are independent of possible confounding factors, such as postpartum anxiety and depression. Most children are not affected, and those who are can be affected in different ways, probably due to different genetic vulnerabilities and the quality of postpartum care. An evolutionary explanation for the observed changes is proposed. Underlying mechanisms are just starting to be understood: altered function of the placenta, allowing more of the stress hormone cortisol to pass through to the fetus, may well be important, as may epigenetic changes. The implications are that improved emotional care of pregnant women should improve outcomes for their children to a clinically significant degree.
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33

Pastrakuljic, Aleksandra. The role of the placenta in adverse fetal outcomes associated with maternal cocaine use and cigarette smoking in pregnancy. 2000.

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34

Olson-Chen, Courtney. Neurologic Infections in Pregnancy. Edited by Emma Ciafaloni, Cheryl Bushnell, and Loralei L. Thornburg. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190667351.003.0011.

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Despite advances in prevention, diagnosis, and treatment, infectious diseases continue to be a major cause of maternal, fetal, and neonatal morbidity and mortality. Immunologic changes in pregnancy can increase both susceptibility to certain infections and the severity of infection. Infectious diseases in pregnancy contribute to the development of congenital fetal syndromes in addition to adverse outcomes including preterm birth, stillbirth, and intrauterine growth restriction. While infections of the maternal central nervous system, or CNS, are rare during pregnancy, the potential impact can be critical.1 This chapter will cover both the types of infections within the CNS and the potential organisms that cause these infections. The chapter will also provide general management recommendations for pregnancy in order to both prevent and maintain awareness about CNS infections.
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35

Voinescu, P. Emanuela. A 27-Year-Old Woman with Epilepsy Planning for Pregnancy. Edited by Angela O’Neal. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190609917.003.0028.

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Treatment for women with epilepsy (WWE) of childbearing age should be cautiously selected, given that the benefits of treatment during potential future pregnancies have to be weighed against the adverse effects on the developing fetus. The number of antiepileptic drugs (AEDs) has increased significantly in the last 20 years, and remarkable progress has been made in characterizing their teratogenicity, adverse neonatal outcomes, and neurodevelopmental problems. Not only the AED choice, but the number of AEDs used and their dose are also important. This chapter aims to introduce some of the basic guidelines for preconception counseling.
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36

Krashin, Daniel, Natalia Murinova, and Alan D. Kaye. Prevention of Adverse Effects in Perioperative Pain Management for General and Plastic Surgeons. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190457006.003.0018.

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Postoperative pain management is a key part of perioperative care. Inadequately controlled pain contributes to poor outcomes and patient satisfaction. Overmedication with opioids for postoperative pain also leads to complications and slows recovery. Perioperative pain care starts with thorough evaluation at the preoperative visit. Multimodal pain treatment reduces the reliance on opioids and tends to improve outcomes. Many complicating factors, including pregnancy, comorbid psychological and medical conditions, addiction, and chronic opioid therapy need to be identified and addressed in a personalized pain plan. Complications including delirium and opioid-induced respiratory suppression are also discussed.
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37

Ahmed, Ahmed I., Sarah Aldhaheri, and Allison Bannick. Inherited Metabolic Diseases (IMDs) and Pregnancy. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190667351.003.0030.

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Inherited metabolic diseases (IMDs) are rare genetic disorders: clinically heterogeneous, and they can present at any age. With the expanded newborn screening panels, many of the IMDs have been successfully screened. Early diagnosis and treatment of these conditions have led to improved neurological outcomes and overall survival of these individuals, and now many of them are reaching childbearing age. Despite treatment, the potential presence of preexisting organ involvement may not only impact their fertility potentials but also may impose a higher risk of adverse maternal and fetal outcomes. Pregnancy leads to an extra strain on maternal metabolism; this may result in the manifestation of symptoms of a previously unknown disease or a progression of a known disease. This chapter will address the possible complications of some inherited disorders of metabolism that are associated with maternal or fetal neurological manifestations such as disorders of energy metabolism (eg, mitochondrial disorders, adult onset urea cycle disorders, ornithine transcarbamylase (OTC) deficiency, amino acidopathies, phenylketonuria (PKU), and impaired fatty acid oxidation disorders). We will provide special emphasis on the available potential treatments and plan of care during pregnancy and postpartum periods.
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38

Gluckman, Sir Peter, Mark Hanson, Chong Yap Seng, and Anne Bardsley. Vitamin D in pregnancy and breastfeeding. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780198722700.003.0015.

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Vitamin D, which is synthesized in skin exposed to UV light, or is consumed in the diet, plays a key role in maintaining bone integrity via the regulation of calcium and phosphorus homeostasis. It also influences a number of extra-skeletal processes, including immune function and blood glucose homeostasis. Maternal vitamin D deficiency in pregnancy leads to poor fetal skeletal mineralization in utero that can manifest as rickets in newborns. In addition to skeletal effects, women with very low vitamin D status face increased risks of other adverse pregnancy outcomes and possible long-term effects on their own health and that of their offspring. However, controversy remains over definitions of vitamin D sufficiency and deficiency, complicating recommendations on maternal intakes. At a minimum, all pregnant women should take a supplement of 400 IU/day, in addition to sensible sun exposure and increasing their intake of food sources.
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39

Blackmore, Emma Roberston, Jessica Heron, and Ian Jones. Severe Psychopathology During Pregnancy and the Postpartum Period. Edited by Amy Wenzel. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199778072.013.15.

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Pregnancy and childbirth can represent a challenging time for women with severe mental illness. Psychotic episodes in the perinatal period can lead to multiple adverse maternal and infant outcomes. This chapter addresses a number of key questions in relation to episodes of schizophrenia and bipolar disorder during the perinatal period. The identification and management of postpartum or puerperal psychosis is detailed, along with prognosis and risk to further pregnancies. The authors present data on epidemiology, nosology, and etiology for severe perinatal episodes. In addition, the authors discuss clinical management, and in particular, ways to identify and manage women at risk.
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40

Onigu-Otite, Edore C. Fetal Exposure to Tobacco and Cannabis. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0180.

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Tobacco and cannabis are the most commonly used legal and illegal substances among pregnant women in the United States, respectively. About 12% to 25% of women smoke tobacco during pregnancy. Smoking tobacco during pregnancy and maternal exposure to environmental tobacco smoke during pregnancy is associated with a variety of adverse fetal outcomes. About 11% of women of childbearing age reported using cannabis in the preceding month. Fetal exposure to tobacco or cannabis is associated with dysregulation in development and may indicate a higher risk for neurodevelopmental and other psychiatric problems. As research has become more sophisticated, findings suggest that some of the associations between fetal exposure to cannabis and tobacco and adverse outcomes may be due to familial genetic risk factors. Separating environmental, familial, and genetic factors while disentangling their interactive effects on fetal and offspring development and neurobehavioral regulation remains a challenge in this field of study.
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41

Beck, Cheryl Tatano. Panic Attacks During Pregnancy and the Postpartum Period. Edited by Amy Wenzel. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199778072.013.26.

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Panic attacks during pregnancy and the postpartum period are associated with substantial distress and impairment in women. Although perhaps the mostly likely course of perinatal panic disorder (PPD) is that women experience no change in symptoms, there appears to be a substantial minority whose symptoms improve during pregnancy but worsen in the postpartum period. Preliminary research suggests that panic disorder is associated with adverse child outcomes; thus, antenatal screening and diagnosis of panic disorder need to become routine obstetric practice so that treatment can be initiated when indicated. Treatment for PPD often requires a combined approach of pharmacotherapeutics and psychotherapy, such as antidepressants and cognitive behavioral therapy. Much additional research, both qualitative and quantitative, is necessary to target rates of comorbidity in women with PPD, risk factors for PPD, consequences of PPD, and the assessment and treatment of PPD.
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42

Horowitz, Sandra L. “I Am Pregnant; Why Can’t I Sleep?”. Edited by Angela O’Neal. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190609917.003.0029.

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This chapter reviews the common sleep disorders of pregnancy. During pregnancy and postpartum, 84% of women report poor sleep at least a few nights a week. These problems are common, disruptive to daytime and nighttime activity, and may have multiple causes. This chapter covers aspects of insomnia and restless leg syndrome. It also discusses sleep apnea in pregnancy with related hormonal changes that may increase the incidence. There is an association of sleep apnea and pregnancy-induced hypertension, with increased adverse outcomes of pregnancy, including fetal growth retardation and premature birth. It has been suggested that treating nocturnal airflow limitation may improve gestational hypertension. The recommended therapies in this chapter may also be applied to non-pregnant patients with similar complaints.
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43

Hart, Kimberly J., and Heather A. Flynn. Screening, Assessment, and Diagnosis of Mood and Anxiety Disorders During Pregnancy and the Postpartum Period. Edited by Amy Wenzel. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199778072.013.009.

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Mood and anxiety disorders are highly prevalent in perinatal samples, affecting as many as 20% of childbearing women (Gavin et al., 2005). In an effort to prevent adverse outcomes associated with perinatal mood and anxiety disorders, researchers and clinicians have advocated routine screening during the perinatal period (NRC, 2009). Although, there are several screening measures for depression, many of which have been used or validated in perinatal populations, few screening tools have been developed specifically for or validated in perinatal samples for bipolar disorder or anxiety disorders. Despite the ongoing need for brief, accurate, and easily administered screening measures, it seems clear that perinatal mood and anxiety screening is associated with substantial improvement in rate of detection (Georgiopoulous et al., 1999; Georgiopoulos, Bryan, Wollan, and Yawn, 2001; Gilbody, Sheldon, and House, 2008). However, in the absence of systematic protocols to ensure further assessment, treatment, and follow-up, screening is unlikely to have a positive impact on depression-associated morbidity (Gjerdingen, Katon, and Rich, 2008; Gilbody et al., 2008; Miller et al., 2012; NRC, 2009). Preliminary evidence suggests that screening for perinatal mood and anxiety disorders, when embedded within larger systems to ensure comprehensive assessment, connection to treatment, and regular monitoring, has the potential to improve outcomes for women and their families. The question of whether screening programs can ultimately decrease depression-associated morbidity and prevent adverse outcomes cannot be answered given the existing research base (Myers et al., 2013). Although much is left to be understood about perinatal screening for mood and anxiety disorders, the impact of this research lies in potential for reducing negative maternal outcomes as well as for prevention of the negative impact of perinatal depression on the health and well-being of babies born to depressed or anxious mothers.
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44

Gluckman, Sir Peter, Mark Hanson, Chong Yap Seng, and Anne Bardsley. Pre-conception maternal body composition and gestational weight gain. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780198722700.003.0028.

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Maternal diet and body composition prior to pregnancy influence gestational weight gain and infant growth patterns. Low maternal pre-pregnancy weight, low BMI, and low attained weight throughout pregnancy are associated with impaired fetal growth, while obesity and high weight gain increases the risks of multiple adverse pregnancy outcomes and excessive fetal growth and offspring obesity. Currently the US Institute of Medicine guidelines for gestational weight gain are the only ones available for developed countries where mean maternal height is similar to that in the US. While these guidelines should be followed, attention should be given to body composition before pregnancy, and measures of body habitus such as maternal height should be taken into account.
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45

Sasso, Uma, and Emily McQuaid-Hanson. Severe Preeclampsia. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0048.

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Preeclampsia and other hypertensive diseases during pregnancy are common causes of maternal morbidity and increase the risk for adverse fetal outcomes. Women are monitored for changes in blood pressure throughout pregnancy and depending on gestational age, once such changes are noted providers may opt to move toward delivery. Blood pressure control and magnesium sulfate are the cornerstone of therapy as well as the key to preventing progression to eclampsia. A thorough understanding of this disease process is essential for anesthesiologists and other anesthesia providers to provide optimal and safe care for labor analgesia and cesarean delivery, or to manage sequelae of advanced disease processes, such as seizure.
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46

Jorge, April, and Rosalind Ramsey-Goldman. Management of special situations in systemic lupus erythematosus. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198739180.003.0009.

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In caring for patients with systemic lupus erythematosus (SLE), there are several important treatment considerations. Since many patients with SLE are female and of childbearing potential, it is important to address conception planning, contraceptive options, and the maternal and fetal risks associated with pregnancy, which are increased when there is higher SLE disease activity. It is also pertinent to address medication safety issues throughout pregnancy and lactation, as some commonly used medications can increase risks of adverse pregnancy outcomes. Additionally, patients with SLE are at higher risk for cardiovascular disease (CVD) than the general population. Therefore, these patients must undergo aggressive risk factor modification. Patients with SLE are also at increased risk for osteoporosis, and bone health is an important treatment consideration. Routine cancer screening and vaccinations are also important elements of the comprehensive treatment of the patient with SLE.
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47

Read, Jennifer S. Zika Virus. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190604813.003.0015.

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Although generally asymptomatic or mildly symptomatic in the general population, infection with the Zika virus (ZIKV) during pregnancy may lead to severely adverse fetal and infant outcomes, including the congenital Zika syndrome (CZS). Characteristics of this syndrome that are unique to it or are not typically observed with other congenital infections comprise anomalies of the brain and cranial morphology, ocular anomalies, congenital contractures, and neurological sequelae. The full spectrum of outcomes of mother-to-child transmission (MTCT) of ZIKV appears to be large, ranging from asymptomatic infection at birth, with possible later manifestation of significant abnormalities, to obvious and severe abnormalities in the fetus and infant. Although our understanding of pathogenesis, rates, and manifestations of CZS has improved rapidly and dramatically, much remains unknown or poorly understood regarding this potentially devastating congenital infection. Because of this, a broad research agenda regarding ZIKV is being implemented.
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48

Wiles, Kate, and Catherine Nelson-Piercy. Acute kidney injury in pregnancy. Edited by Norbert Lameire and Neil Turner. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0297.

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The diagnosis of acute kidney injury in pregnancy is complicated by physiological changes to both kidney and circulation; although a serum creatinine of higher than 90 μ‎‎‎mol/L is considered diagnostic of kidney injury in pregnancy. The aetiology of acute kidney injury in pregnancy mirrors that of the non-pregnant patient with the addition of pregnancy-specific conditions such as pre-eclampsia, HELLP syndrome (haemolysis, elevated liver enzymes, low platelets), post-partum haemorrhage, and acute fatty liver of pregnancy. In early pregnancy, the major additional concerns are septic abortion and hyperemesis. Urinary tract infection is common in pregnancy. Surveillance and treatment thresholds reflect the recognized association between urinary tract infection and adverse pregnancy outcome. Obstructive nephropathy is difficult to diagnose in pregnancy due to a physiological dilatation of the renal tract. Radiological assessment and intervention to the renal tract in pregnancy are also discussed in this chapter.
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49

Chandrasekhar, Shobana, and C. LaToya Mason. Valvular Disease. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0050.

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Cardiovascular disease is a leading cause of maternal morbidity and mortality worldwide. Complex valvular heart disease accounts for approximately 30% to 50% of all cardiac diseases of pregnancy and presents significant challenges to the management of the parturient affected by it. Determination of disease severity and maternal risk assessment are especially important to development of appropriate plans of care for the labor, delivery, and immediate postpartum periods, when adverse events for both mother and fetus may occur. An understanding of the pathophysiology of the causative lesions and hemodynamic goals, thorough evaluation, and a multidisciplinary approach are key components to the successful management of these patients, allowing for appropriate selection of an anesthetic technique that balances the benefits and consequences to both mother and infant, thereby leading to optimal patient outcomes.
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50

Kendrisic, Mirjana, and Borislava Pujic. Endocrine and autoimmune disorders. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0047.

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Advanced maternal age and increasing numbers of women of childbearing age with endocrine and autoimmune disorders have become the challenge for both anaesthetists and obstetricians. Genetic studies have provided new insight into underlying causes of endocrine disorders and prenatal prediction of inheritance. The expression of endocrine disease may influence the interpretation of diagnostic laboratory testing during pregnancy. Better understanding of the pathophysiological mechanisms enables new therapeutic approaches which can compromise pregnancy outcome. Although only a small number of drugs have been shown through clinical studies to be safe for use in pregnancy, intensive therapy for chronic disease is usually needed. Thus, anaesthetic management of women with endocrine disorders in pregnancy has become more complex. The most frequently encountered endocrine disorders during pregnancy include gestational diabetes mellitus and thyroid and adrenal disorders. Gestational diabetes has become increasingly common in pregnant women. Not only does it influence pregnancy outcome, but it also carries a risk for mother and offspring of developing type 2 diabetes later in life. Intensive glucose control may prevent maternal and fetal complications and improve long-term outcome. Pregnancy itself has been found to influence the course of autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus. However, autoimmune diseases may have adverse consequences for maternal, fetal, and neonatal health. There is a relative paucity of literature concerning anaesthetic management of autoimmune diseases. Early recognition and immediate treatment of the common complications have been the key elements to achieving the ultimate goal—good pregnancy outcome.
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