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Books on the topic 'Fetal outcomes'

Author: Grafiati
Published: 4 June 2021
Last updated: 27 April 2022

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1

Agarwal, Nikhil. Toxic exposure in America: Estimating fetal and infant health outcomes. Cambridge, MA: National Bureau of Economic Research, 2009.

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2

Su, Min. Factors affecting adverse fetal, neonatal, and maternal outcomes in the Term Breech Trial. Ottawa: National Library of Canada, 2003.

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3

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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4

Patrias, Karen. Effects of corticosteroids for fetal maturation on perinatal outcomes: January 1985 through December 1993, plus selected earlier citations : 715 citations. Bethesda, Md. (8600 Rockville Pike): 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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5

Dées, Molnár, Decsi Tamás, Hunty Anne, and SpringerLink (Online service), eds. Early Nutrition Programming and Health Outcomes in Later Life: Obesity and Beyond. Dordrecht: Springer Netherlands, 2009.

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6

Consensus, Development Conference on the Effect of Corticosteroids for Fetal Maturation on Perinatal Outcomes (1994 Bethesda Md ). Report of the Consensus Development Conference on the Effect of Corticosteroids for Fetal Maturation on Perinatal Outcomes, February 28, 1994-March 2, 1994, Bethesda, Maryland. Bethesda (Md.): National Cancer Institute, 1994.

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7

Bové, Frank James. Population-based surveillance and etiological research of adverse reproductive outcomes and toxic wastes. [New Jersey]: New Jersey Dept. of Health, 1992.

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8

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

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9

Making women pay: The hidden costs of fetal rights. Ithaca, N.Y: Cornell University Press, 2000.

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10

Infertility and pregnancy loss: A guide for helping professionals. San Francisco: Jossey-Bass, 1988.

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11

Zena, Stein, and Susser Mervyn, eds. Conception to birth: Epidemiology of prenatal development. New York: Oxford University Press, 1989.

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12

National Center for Health Statistics (U.S.), ed. Maternal weight gain and the outcome of pregnancy, United States, 1980: An analysis of maternal weight gain during pregnancy by demographic characteristics of mothers and its association with birth weight and the risk of fetal death. Hyattsville, Md: U.S. Dept. of Health and Human Services, Public Health Service, National Center for Health Statistics, 1986.

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13

Evans, Lilliana R. Recurrent Pregnancy Loss: Prevalence, Risk Factors and Outcomes. Nova Science Publishers, Incorporated, 2016.

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14

Kvale, Janice Keller. MATERNAL AND NEONATAL OUTCOMES ASSOCIATED WITH SELECTED INTRAPARTUM INTERVENTIONS (FETAL STRESS, CESAREAN). 1994.

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15

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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16

Olutoye, Olutoyin A., ed. Anesthesia for Maternal-Fetal Surgery. Cambridge University Press, 2021. http://dx.doi.org/10.1017/9781108297899.

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With advances in ultrasound, birth defects are increasingly detected during pregnancy and may be amenable to surgical correction before delivery, to improve outcomes. This essential book discusses the different birth defects that can be treated during pregnancy and the important anesthetic considerations for the mother and fetus undergoing these procedures. Experts in the fields of anesthesiology, maternal fetal medicine, surgery, and pediatrics have come together to develop the content of this book. Enhanced throughout with full color images and illustrations, the book covers important topics such as spina bifida, twin-twin transfusion syndrome, sacrococcygeal teratoma, and lung masses, as well as fetal cardiac intervention, intrauterine transfusion, ex utero intrapartum treatment, and multidisciplinary approaches to fetal surgery. An invaluable guide for pediatric and obstetric anesthesiologists, anesthesiology, obstetrics, and surgical trainees, nurse anesthetists, and maternal-fetal medicine specialists.
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17

Glover, Vivette, Thomas G. O’Connor, and Kieran O’Donnell. Maternal mood in pregnancy: fetal origins of child neurodevelopment. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198749547.003.0003.

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Women experience as many symptoms of anxiety, depression, and stress during pregnancy as in the postnatal period. This can affect not only the woman herself but also the development of her fetus, and have long-term effects on several different outcomes including the cognitive ability and behaviour of her child, although most children are not affected. The particular outcomes affected may depend on the timing of the exposure, specific genetic vulnerabilities, and the quality of postnatal care provided. Recent research has shown that increased maternal anxiety is associated with altered placental function, and a greater association between maternal and fetal cortisol. This interrelationship of hormonal associations during the fetal stage could potentially impact on fetal/infant outcomes, and supports the need for continuing research in the field. Chapter 3 covers studies on maternal mood in pregnancy and explores the underlying mechanisms and types of stress.
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18

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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19

Assessment of Fetal Alcohol Spectrum Disorders. Organización Panamericana de la Salud, 2020. http://dx.doi.org/10.37774/9789275122242.

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Fetal alcohol spectrum disorders (FASD) represent a range of physical, mental, and behavioral disabilities caused by alcohol use during pregnancy, or prenatal alcohol exposure (PAE). FASDs are considered to be one of the leading preventable causes of developmental disability. Despite its high prevalence, FASD is often misdiagnosed or underdiagnosed, making interventions more challenging or delayed. Earlier diagnosis yields greater benefits for affected children, which include a reduction in secondary disabilities such as substance use disorders and learning and cognitive disabilities leading to school failure, and improved life outcomes. Most importantly, diagnosis provides a context for understanding a child’s behavior. When the environment surrounding a child with an FASD opts to focus on the child’s strengths as a means for intervention, there is a greater likelihood of that child achieving success as an adult. Diagnosis of FASD is further beneficial to the extent that it leads to a reduction of future births of children with FASD. This publication was initially developed for use in Spanish-speaking countries of the Americas and is intended to serve as a training workbook for providers of various disciplines to learn about the fundamentals of diagnosing FASD and to apply them to several case scenarios. It also discusses ethical implications of diagnosing FASD to the mother and child. Target audiences include physicians, psychologists, allied health professionals, social workers, and other providers that may encounter individuals affected by FASD. It is ideally used as a supplement for in-person training by experts in the fields of dysmorphology, epidemiology, and neuropsychology.
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20

Jacques, Sharon Lee. THE EFFECT OF A NURSING INTERVENTION DURING THE THIRD TRIMESTER ON MATERNAL-FETAL ATTACHMENT AND PREGNANCY OUTCOMES. 1995.

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21

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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22

Groundwater Recharge with Reclaimed Water: Birth outcomes in Los Angeles County 1982-1993. RAND Corporation, 1999.

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23

R, Bale Judith, Stoll Barbara J, Lucas Adetokunbo O, and Institute of Medicine (U.S.). Committee on Improving Birth Outcomes., eds. Improving birth outcomes: Meeting the challenges in the developing world. Washington, DC: National Academies Press, 2003.

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24

1917-, Bové Frank James, Fulcomer Mark C, Klotz Judith B, Dufficy Ellen M, and New Jersey. State Dept. of Health., eds. Population-based surveillance and etiological research of adverse reproductive outcomes and toxic wastes. [New Jersey]: New Jersey Dept. of Health, 1992.

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25

1917-, Bové Frank James, Fulcomer Mark C, Klotz Judith B, Dufficy Ellen M, and New Jersey. State Dept. of Health., eds. Population-based surveillance and etiological research of adverse reproductive outcomes and toxic wastes. [New Jersey]: New Jersey Dept. of Health, 1992.

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26

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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27

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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28

Medforth, Janet, Linda Ball, Angela Walker, Sue Battersby, and Sarah Stables. Infections and sepsis. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198754787.003.0009.

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This chapter includes the latest guidance on antenatal screening for infections, viral infections, bacterial infections, rubella antibodies (latest guidance), syphilis, HIV screening, and group B haemolytic Streptococcus. Other infections, such as coughs and colds, influenza, urinary tract infections, chickenpox, toxoplasmosis, and postnatal infections, and recognition and management of sepsis are included. Discussions includes diagnosis, the latest recommendations for treatment options, potential outcomes, and fetal effects.
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29

Russo, Francesca, Tim Van Mieghem, and Jan Deprest. Fetal medicine, fetal anaesthesia, and fetal surgery. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0007.

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Advances in prenatal imaging and the introduction of screening policies enable identification of high-risk pregnancies which can be followed up more meticulously. First-trimester evaluation is also used for assessment of risk for fetal anomalies. Further investigation may reveal a fetal anomaly. When the prognosis is poor, and treatment cannot wait until birth, fetal intervention may be warranted. This can be medical or surgical, some as simple as a needle-guided fetal blood transfusion. Over the last two decades, fetal surgery has become more popular, boosted by instrument development for minimal access fetal surgery and by successful clinical trials. More recently, open fetal surgery has become more popular again, following a successful trial on in utero repair of neural tube defects. Though not a lethal condition, prenatal surgery improves outcome as demonstrated in a randomized controlled trial. In the latter half of pregnancy, surgical intervention on the fetus requires adequate fetal anaesthesia.
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30

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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31

Wiles, Kate, Kate Bramham, and Catherine Nelson-Piercy. Kidney disease. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0044.

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This chapter describes the physiological adaptations to pregnancy in women with and without renal disease, reports pregnancy outcomes in women with both acute kidney injury and chronic kidney disease, and discusses a management strategy for antenatal and peripartum care. Acute kidney injury (AKI) is difficult to define in pregnancy because of the physiological increase in glomerular filtration. A normal creatinine can mask renal injury in pregnancy. This chapter considers important causes of AKI in pregnancy including pre-eclampsia, HELLP syndrome, thrombotic microangiopathy, acute fatty liver of pregnancy, systemic lupus erythematosus, urinary tract infection, and obstruction. The trend in the developed world for delaying pregnancy and the increasing prevalence of obesity mean that greater numbers of pregnancies will be complicated by chronic kidney disease. Maternal and fetal complications increase with worsening prepregnancy renal function including the development of pre-eclampsia, fetal growth restriction, premature delivery, and fetal loss. Prepregnancy counselling and the intrapartum management for women with lupus nephritis, immunoglobulin A nephropathy, polycystic kidney disease, and diabetic nephropathy are discussed. Renal replacement therapies in pregnancy including both dialysis and renal transplantation are considered, and practical guidance on renal biopsy, anaesthesia, and the pharmacology of renal disease in pregnancy is offered.
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32

1917-, Bové Frank James, New Jersey. State Dept. of Health., and National Center for Environmental Health and Injury Control (U.S.). Division of Birth Defects and Developmental Disabilities., eds. Population-based surveillance and etiological research of adverse reproductive outcomes and toxic wastes.: A cross-sectional study. [New Jersey]: New Jersey Dept. of Health, 1992.

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33

1917-, Bové Frank James, New Jersey. State Dept. of Health., and National Center for Environmental Health and Injury Control (U.S.). Division of Birth Defects and Developmental Disabilities., eds. Population-based surveillance and etiological research of adverse reproductive outcomes and toxic wastes.: A case-control study. [New Jersey]: New Jersey Dept. of Health, 1992.

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34

Catto-Smith, Anthony G., ed. Fecal Incontinence - Causes, Management and Outcome. InTech, 2014. http://dx.doi.org/10.5772/57038.

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35

L, Keen Carl, Bendich Adrianne, and Willhite Calvin C, eds. Maternal nutrition and pregnancy outcome. New York, N.Y: New York Academy of Sciences, 1993.

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36

Liu, Lynn. Sleep Disorders and Pregnancy. Edited by Emma Ciafaloni, Cheryl Bushnell, and Loralei L. Thornburg. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190667351.003.0023.

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Pregnant women frequently have sleep concerns. Some concerns are related to the course of the pregnancy, some sleep disorders change during pregnancy, and others develop new onset sleep disorders during pregnancy. Having a sleep medicine professional to assist in the management of a pregnant woman to address the treatment of particular sleep disorders can be helpful in alleviating specific concerns over the course of the pregnancy. Anticipating potential interactions or how the pregnancy and the sleep disorder may affect each other may improve maternal and fetal outcomes. This chapter will review common sleep disorders that can be encountered in pregnant women.
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37

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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38

Mavi, Jagroop, Anne C. Boat, and Senthilkumar Sadhasivam. Myelomeningocele Repair. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0051.

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Myelomeningocele (MMC) is a spinal birth defect associated with significant morbidity directly related to the exposure of meninges and neural structures. Further neurological dysfunction may occur secondary to Chiari II malformation and hydrocephalus. MMC repair is typically performed postnatally within the first 24 to 48 hours of life due to the concern for infection. Prenatal MMC correction is performed in select cases after studies showed improved neurological outcomes. Anesthesia for MMC repairs can be challenging, and appropriate screening should be performed preoperatively. During postnatal repair, care must be taken when positioning the infant to avoid any pressure on the MMC sac. Anesthesia can be maintained with a combination of inhalational agents and intravenous opioids. Prenatal MMC repairs must consider both fetal and maternal safety outcomes. They can be performed through both open and fetoscopic routes, with anesthesia focused on maintaining maternal blood pressure, optimizing uterine relaxation, and adequate pain control.
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39

Isaac, Blickstein, and Keith Louis G, eds. Multiple pregnancy: Epidemiology, gestation & perinatal outcome. 2nd ed. London: Taylor & Francis, 2005.

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40

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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41

Talati, Asha N., and David N. Hackney. Neurocutaneous Disorders in Pregnancy. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190667351.003.0028.

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Neurocutaneous disorders are rare genetic conditions that can produce malformations of skin and various organ systems. During pregnancy, such conditions often require a specific course of management with coordinated care between neurology, obstetrics, and neonatology in order to promote best maternal and fetal outcomes. This chapter reviews the most common neurocutaneous conditions and best practices for management of these conditions in pregnancy. Neurocutaneous conditions discussed in this chapter include neurofibromatosis types I and II, Ehlers Danlos syndrome, Tuberous Sclerosis, Von Hippel Lindau syndrome, and Hereditary Hemorrhagic Telangiectasia. For each condition, brief overviews of disease manifestation followed by a summary of recommendations for pregnancy care path are provided.
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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

Gluckman, Sir Peter, Mark Hanson, Chong Yap Seng, and Anne Bardsley. Conceptual background to healthy growth and development. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780198722700.003.0002.

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This chapter reviews the concepts of developmental plasticity and mismatch, critical periods for exposures, and the emergent science of epigenetics to explain how relatively subtle changes in parental behaviour can affect the outcomes of pregnancy, and why there are echoes of such influences across the whole of life. Contrary to earlier belief that embryonic and fetal development is set by a genetic programme, it is now clear that the fetus responds to cues in the in utero environment and can alter its development and metabolism accordingly. The ‘decisions’ that the developing fetus makes are embedded in its biology and are based on information it receives from its mother and, through her, about the wider environment, in terms of nutrition and physical activity but also about stress and other aspects of lifestyle.
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44

Jacquemyn, Yves, and Anneke Kwee. Antenatal and intrapartum fetal evaluation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0006.

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Antenatal and intrapartum fetal monitoring aim to identify the beginning of the process of fetal hypoxia before irreversible fetal damage has taken place. Fetal movement counting by the mother has not been reported to be of any benefit. The biophysical profile score, incorporating ultrasound and fetal heart rate monitoring, has not been proven to reduce perinatal mortality in randomized trials. Doppler ultrasound allows the exploration of the perfusion of different fetal organ systems and provides data on possible hypoxia and fetal anaemia. Maternal uterine artery Doppler can be used to select women with a high risk for intrauterine growth restriction and pre-eclampsia but does not directly provide information on fetal status. Umbilical artery Doppler has been shown to reduce perinatal mortality significantly in high-risk pregnancies (but not in low-risk women). Adding middle cerebral artery Doppler to umbilical artery Doppler does not increase accuracy for detecting adverse perinatal outcome. Ductus venosus Doppler demonstrates moderate value in diagnosing fetal compromise; it is not known whether its use adds any value to umbilical artery Doppler alone. Cardiotocography (CTG) reflects the interaction between the fetal brain and peripheral cardiovascular system. Prelabour routine use of CTG in low-risk pregnancies has not been proven to improve outcome; computerized CTG significantly reduces perinatal mortality in high-risk pregnancies. Monitoring the fetus during labour with intermittent auscultation has not been compared to no monitoring at all; when compared with CTG no difference in perinatal mortality or cerebral palsy has been noted. CTG does lower neonatal seizures and is accompanied by a statistically non-significant rise in caesarean delivery. Fetal blood sampling to detect fetal pH and base deficit lowers caesarean delivery rate and neonatal convulsions when used in adjunct to CTG. Determination of fetal scalp lactate has not been shown to have an effect on neonatal outcome or on the rate of instrumental deliveries but is less often hampered by technical failure than fetal scalp pH. Analysis of the ST segment of the fetal ECG (STAN®) in combination with CTG during labour results in fewer vaginal operative deliveries, less need for neonatal intensive care, and less use of fetal blood sampling during labour, without a change in fetal metabolic acidosis when compared to CTG alone.
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45

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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46

(Editor), Isaac Blickstein, and Louis G. Keith (Editor), eds. Multiple Pregnancy: Epidemiology, Gestation, and Perinatal Outcome, Second Edition (Multiple Pregnancy). 2nd ed. Informa Healthcare, 2005.

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47

Edenborough, Frank P. Fertility, contraception, and pregnancy. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780198702948.003.0012.

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This chapter describes the physiological effect of CFTR dysfunction on the development of the reproductive system. Young people with CF and their parents are poorly educated regarding sexual function and becoming parents themselves. They often wish to learn this from their CF teams. Male and female potency, reproductive genetics, and the need for genetic and general counselling before embarking on pregnancy are covered. Contraception, emphasizing the need to avoid unwanted pregnancy and sexually transmitted diseases, and assisted reproductive techniques are described. We discuss the evolving medical and obstetric management of pregnancy, including the likely need for optimizing drug treatment or escalating to more intensive treatment for intercurrent infection. Optimal delivery in the context of maternal health, fetal risks, and longer term maternal outcomes are discussed. Pregnancy post transplantation and termination of unwanted pregnancy or where the mother is too poorly to continue conclude the chapter.
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48

Balzafiore, Danielle, Thalia Robakis, Sarah Borish, Vena Budhan, and Natalie Rasgon. The treatment of bipolar disorder in women. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198748625.003.0020.

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Sex-specific effects in the clinical presentation and course of bipolar disorder in women have important treatment implications for the management of symptoms across the menstrual cycle and reproductive lifespan. Women with bipolar disorder are particularly vulnerable to premenstrual mood symptoms, menstrual abnormalities, and polycystic ovary syndrome. Special considerations include understanding the interactions between these reproductive issues, oral contraceptives, and mood-stabilizing agents. Additionally, the management of bipolar disorder during the perinatal period requires a careful approach to psychotropic medication to optimize the maintenance of mood stability while minimizing the potential for adverse risk of fetal and neonatal outcomes. Non-pharmaceutical approaches, including electroconvulsive therapy, transcranial magnetic stimulation, selected psychotherapies, and social and behavioural interventions may represent efficacious treatment options to reduce medication burden. Lastly, women with bipolar disorder may be at particular risk for worsening of affective symptoms during the menopausal transition, and strategies to reduce sleep disruption are imperative.
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49

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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50

G, Keith Louis, ed. Multiple pregnancy: Epidemiology, gestation & perinatal outcome. New York: Parthenon Pub. Group, 1995.

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