BJOG : an international journal of obstetrics and gynaecology
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Multicenter Study
Increased risk of low birthweight and small for gestational age infants among women with tuberculosis.
As the relationship between tuberculosis (TB) and fetal outcomes remains unclear, this study used a 3-year nationwide population-based data set to determine the risk of adverse pregnancy outcomes [low birthweight (LBW), preterm birth and small for gestational age (SGA) infants] among women with TB. ⋯ We concluded that women diagnosed with TB during pregnancy are at increased risk for having LBW and SGA babies, compared with unaffected mothers. We suggest that clinicians should make women with TB aware of the potential risks before planning a child.
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Pregnancy in women with pulmonary hypertension (PH) is reported to carry a maternal mortality rate of 30-56%. We report our experience of the management of pregnancies using a strategy of early introduction of targeted pulmonary vascular therapy and early planned delivery under regional anaesthesia. ⋯ Although the risk of mortality in pregnant women with PH remains significant, we describe improved outcomes in fully counselled women who chose to continue with pregnancy and were managed with a tailored multiprofessional approach involving early introduction of targeted therapy, early planned delivery and regional anaesthetic techniques.
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Spectral analysis of heart-rate variability is used to monitor autonomic nervous system fluctuations. The low-frequency component is associated with sympathetic and parasympathetic modulation and the high-frequency component is associated with parasympathetic modulation. The objective was to study whether changes in low-frequency or high-frequency power of heart-rate variability occur in case of fetal distress. ⋯ The autonomic nervous system of human fetuses at term responds adequately to severe stress during labour. Normalised low and high frequency power of heart-rate variability might be able to discriminate between normal and abnormal fetal condition.
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To assess causes, trends and substandard care factors in maternal mortality in the Netherlands. Design Confidential enquiry into the causes of maternal mortality. ⋯ Maternal mortality in the Netherlands has increased since 1983-1992. Pre-eclampsia remains the number one cause. Groups at higher risk for complications during pregnancy should be better identified early in pregnancy or before conception, in order to receive preconception advice and more frequent antenatal visits. There is an urgent need for the better education of women and professionals concerning the danger signs, and for the training of professionals in order to improve maternal health care.