Clinics in obstetrics and gynaecology
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Certain infections, such as UTI, may have an increased incidence during pregnancy owing to physiological changes. Between 2 and 10% of pregnant women have covert or asymptomatic bacteriuria which is associated with an increased incidence of acute symptomatic UTI in later pregnancy if left untreated. Thus antenatal screening to detect the presence of bacteriuria is justified. ⋯ Most antibiotics cross the placenta and are excreted in breast milk. Some agents, such as the beta-lactams, are considered safe in pregnancy and breast-feeding women while other antibiotics are contraindicated owing to risk of toxicity (often rare) or teratogenicity (often theoretical). Caution is necessary with many agents which may cause side effects or toxicity although this does not necessarily contraindicate their use in pregnancy.(ABSTRACT TRUNCATED AT 400 WORDS)
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Hypertensive diseases are among the most common of all pregnancy complications. Significant elevations of blood pressure can be missed if inflexible criteria are used. ⋯ The antihypertensive drugs in current use have a good safety record with regard to both mother and baby. The management of hypertension during pregnancy ideally requires the close cooperation of obstetrician and physician.
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Clin Obstet Gynaecol · Mar 1986
Surgical techniques of uterine evacuation in first- and second-trimester abortion.
Induced abortion is an ancient procedure. Vacuum curettage is a recent innovation and is demonstrably superior to other methods for first-trimester abortions. Patient selection, patient preparation and the necessary instruments are described. ⋯ Evacuation is by means of large-bore vacuum cannula system and large ovum forceps. General anaesthesia is avoided because it increases the risk of perforation and haemorrhage. Adjuncts to D&E are described: intraoperative real-time ultrasound, intracervical vasopressin, two days' treatment with laminaria tents, and Hern's technique combining laminaria with intra-amniotic infusion of urea prior to D & E.
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Clin Obstet Gynaecol · Mar 1986
Comparative StudyRole of abortion in control of global population growth.
No nation desirous of reducing its growth rate to 1% or less can expect to do so without the widespread use of abortion. This observational study, based on the experience of 116 of the world's largest countries, supports the contention that abortion is essential to any national population growth control effort. The principal findings are: Except for a few countries with ageing populations and very high contraceptive prevalence rates, developed countries will need to maintain abortion rates generally in the range of 201-500 abortions per 1000 live births if they are to maintain growth rates at levels below 1%. ⋯ The data in this report suggest that actual alternatives are high death rates of infants and children or widespread use of contraception and abortion. African nations tend to have the very lowest abortion rates and the very highest infant and child death rates. To avoid a world with deteriorating social, economic and political stability, with the concomitant loss of personal and national security, we must ensure that safe abortion is made available to all who wish to use this service.