Lorna Kemble Pregnancy and Birth

Interassay Variation NormalPregnancy

Mon, 23 Apr 2012 13:31:53 GMT

Interassay variation between different quantitative serum tests and between different qualitative urine tests can cause confusion and misdiagnosis of pregnancy. Most clinical laboratories participate in external proficiency testing through the College of American Pathologists CAP . CAP surveys have been the biggest indicator of interassay variation. The five most recent CAP surveys each with a single hCG preparation of 2307 to 2324 testing laboratories showed 1.50- to 1.59-fold variations from...

37 the elite athlete NutritionPregnancy

Mon, 23 Apr 2012 12:32:13 GMT

The elite athlete experiences limitations and physiological changes in pregnancy similar to the recreational athlete, including ligament relaxation, change in posture, and weight gain. These changes may in turn impact a woman's competitive ability and increase her desire for strenuous training, making her more prone to injury 12 . The elite athlete should be aware that pregnancy is not a time for improving competitive fitness, but instead she should focus on remaining physically active,...

The kidneys MorningSickness

Mon, 23 Apr 2012 11:25:22 GMT

Kidney Essence is derived from both the mother and the father, so there is a hereditary influence determining a person's constitution. The Essence is stored in the Kidneys but has a fluid nature and circulates all around the body. Kidney Essence determines growth, sexual development, reproduction, conception and pregnancy. See Ch. 14 for a discussion of Kidney Essence in relation to the baby. During pregnancy, a strain can be put on the Qi and Essence of the Kidneys, so the pre-existing state...

Box 22 Priscilla Whites last classification DiabetesPregnancy

Sat, 21 Apr 2012 12:17:44 GMT

Gestational diabetes Abnormal glucose tolerance test, euglycemia maintained by diet alone. Diet alone insufficient, insulin required Class A Diet alone sufficient, any duration or onset age Class B Onset at the age of 20 or older, duration lt 10 years Class C Onset between the ages of 10 and 19, or duration 10-19 years Class D Onset before the age of 10, duration gt 20 years, background retinopathy or hypertension not Class R Proliferative retinopathy or vitreous hemorrhage Class F Nephropathy...

Childbirth Labour Delivery And Immediate Postpartum Care FamilyPlanning

Sat, 21 Apr 2012 11:11:56 GMT

m EXAMINE THE WOMAN IN LABOUR OR WITH RUPTURED MEMBRES FIRST STAGE OF LABOUR 1 WHEN THE WOMAN IS NOT IN ACTIVE LABOUR FIRST STAGE OF LABOUR 2 N ACTIVE LABOUR RESPOND TO PROBLEMS DURING LABOUR AND DELIVERY 1 If fetal heart rate lt 120 or gt 160 bpm RESPOND TO PROBLEMS DURING LABOUR AND DELIVERY 2 RESPOND TO OBSTETRICAL PROBLEMS ON ADMISSION 2 D4 RESPOND TO OBSTETRICAL PROBLEMS ON ADMISSION 1 RESPOND TO OBSTETRICAL PROBLEMS ON ADMISSION 2 SECOND STAGE OF LABOUR DELIVER THE BABYAND GIVE IMMEDIATE...

283 adrenergic receptor blockers DuringBreastfeeding

Sat, 21 Apr 2012 08:55:11 GMT

i-blockers acebutolol, alprenolol, atenolol, betaxolol, bisoprolol, Celiprolol, Carvedilol, esniolol, labetalol, rnetoprolol, nadolol, nebivolol, oxprenolol, pindolol, propranolol, sotalol, and timolol have a wide spectrum of activity, and are often used to treat hypertension. There are two types of 3-receptors i -receptors predominate in the heart, and -receptors mediate relaxation dilatation of vascular and other smooth muscle e.g. in the airways and blood vessels . Metoprolol is...

Antenatal care explained MorningSickness

Fri, 20 Apr 2012 03:52:19 GMT

The first 'booking-in' visit 54 Detecting abnormalities of the fetus 58 AFP alpha-fetoprotein test 60 Chorionic villus sampling CVS 62 Getting off the conveyor belt 64 Antenatal maternal infections 64 The aims of antenatal care are, first and foremost, to look after the health and safety of the mother and to ensure delivery of a healthy baby. Monitoring the health of mother and baby throughout the pregnancy allows for the early detection and treatment of any problems. A vital element in good...

Kratochwil E Eisenhut L. Der Fruheste Nachweis Der Fatalen Herzaction Durch Ultrascall. EctopicPregnancies

Thu, 19 Apr 2012 20:18:54 GMT

1. Kratochwill E, Eisenhut L. Der fr heste nachweis der fatalen herzaction durch ultrascall. Geburtsh Frauenheik 1967 27 176-80. 2. Waldenstrom U, Axelsson O, Nilsson S. Sonographic dating of pregnancies conceived after contraceptive pill therapy. Ultrasound Obstet Gynecol 1993 3 23-25. 3. Barlow DH. Short- and long-term risks for women having IVF - what is the evidence Hum Fertil 1999 2 102-6. 4. Rizk B, Tan SL, Morcos S, et al. Heterotopic pregnancies after in vitro fertilization and embryo...

551Weight Loss Strategies for Prepregnancy and Postpartum NutritionPregnancy

Thu, 19 Apr 2012 04:10:56 GMT

Weight loss is not recommended during pregnancy however, overweight and obese women should be advised to aim for a moderate weight loss prior to conception and postpartum. To help motivate women in their efforts, health care providers and obstetricians should clearly define the risks associated with overweight and obesity in pregnancy and beyond. Consultation with a registered dietitian RD should be considered, as these individuals can provide assistance in the assessment of current eating...

2646 Ribavirin DuringBreastfeeding

Wed, 18 Apr 2012 14:43:21 GMT

Ribavirin is an antiviral with broad-spectrum activity. Severe viral infections, like hepatitis C in combination with interferon then and respiratory syncytial virus RSV infection in young infants. may be an indication. It was found to be teratogenic and or embry-olethal in several animal studies. The infants of nine women who were treated with ribavirin for severe measles during the second half of pregnancy did not have an increased incidence of anomalies Atmar 1992 . A woman treated at 7...

Glucose alterations in gestational diabetes mellitus DiabetesPregnancy

Tue, 17 Apr 2012 18:27:07 GMT

Independent of the mechanisms involved, in GDM, there is a relative lack of insulin during a period of time with high insulin needs to compensate the insulin resistance that develops in the third trimester of pregnancy. When gestational diabetes develops, in the maternal tissues, where glucose uptake is insulin-dependent, this is further decreased and hyperglycemia develops. Because the materno-placenta-fetal transfer of glucose is concentration-dependent9 under conditions of maternal...

References NormalPregnancy

Tue, 17 Apr 2012 12:05:49 GMT

1. Wilcox AJ, Baird DD, Weinberg CR. Time of implantation of the conceptus and loss of pregnancy. N Engl J Med 1999 340 1796-1799. 2. Wilcox AJ, Baird DD, Dunson D, McChesney R, Weinberg CR. Natural limits of pregnancy testing in relation to the expected menstrual period. JAMA 2001 286 1759-1761. 3. Daya S. Human chorionic gonadotropin increase in normal early pregnancy. Am J Obstet Gynecol 1987 156 286-290. 4. Pittaway DE, Reish RL, Wentz AC. Doubling times of human chorionic gonadotropin...

References Esl DiabetesPregnancy

Tue, 17 Apr 2012 09:59:39 GMT

1. Desoye G, Shafrir E. Placental metabolism and its regulation in health and diabetes. Mol Aspects Med 1994 15 505-682. 2. Desoye G, Shafrir E. The human placenta in diabetic pregnancy. Diabetes Rev 1996 4 70-89. 3. Shafrir E, Desoye G. Pregnancy in diabetic animals. In Hod M, Jovanovic L, DiRenzo GC, DeLeiva A, Langer O, eds. Textbook of Diabetes and Pregnancy. London Martin Dunitz 2007. 4. Kalhan SC, D'Angelo LJ, Savin SM, Adam PA. Glucose production in pregnant women at term gestation....

Incidence and prevalence of diabetes in the region DiabetesPregnancy

Tue, 17 Apr 2012 01:21:04 GMT

Diabetes continues to be a major concern for public health in the Americas and, unfortunately, its prevalence is likely to increase in Latin America and the Caribbean countries due to the demographic changes these countries are experiencing. According to King et al.,7 the number of diabetic people in the Americas is expected to rise from 35 million in 2000 to 64 million in 2025, and the incidence of diabetes in Latin America will increase from 52 to about 62 around 40 million people ,7 as a...

114 Risk communication prior to pharmacotherapeutic choice DuringBreastfeeding

Mon, 16 Apr 2012 18:02:33 GMT

Drug administration during pregnancy means that both the mother and unborn child are exposed. The drug or metabolite concentration may be even higher in the embryonic or fetal compartment than it is in the mother. The fetus as an additional patient therefore demands a strict pharmacotherapeutic approach, as it is imperative to try to restore maternal health without endangering the development of the child. In severe conditions, such as bronchial asthma, diabetes melli-tus, epilepsy or...

289 Diazoxide DuringBreastfeeding

Mon, 16 Apr 2012 17:26:00 GMT

Diazoxide is fully absorbed when given orally, and has a half-life of between 20 and 40 hours. It readily crosses ihe placenta, and fetal plasma concentrations are similar to those in ihe mother. After bolus injection, observable hypotensive states can be prevented with continual infusion, or repeated small doses Duley 1995 . its use should be reserved for the treatment of hypertensive crises. Diazoxide has a diabetogenic effect on the metabolism Sweetman 2002 . Case reports showed...

Tides in Breastfeeding Practice HumanLactation

Sun, 15 Apr 2012 13:59:38 GMT

Mary Margaret Coates and Jan Riordan Throughout the world today, an infant is apt to receive less breastmilk than at any time in the past. Until the 1940s, the prevalence of breastfeeding was high in nearly all societies. Although the feeding of manufactured milks and baby milks had begun before the turn of the century in parts of Europe and North America, the practice spread slowly during the next decades. It was still generally limited to segments of population elites, and it involved only a...

2810 Magnesium sulfate DuringBreastfeeding

Sun, 15 Apr 2012 02:46:44 GMT

Magnesium sulfate, although not actually an antihypertensive, has proven valuable in the treatment of pre-eclampsia. Magnesium sulfate is the drug of choice for treatment of seizures in eclampsia Oettinger 1993 . In a group of 31 fetuses where the mothers were administered the drug i.v. as an initial loading dose of 4-6g, followed by an infusion of 2-3.5 g h. magnesium sulfate was found not to be harmful Gray 1994 . A significantly lower risk of repeated convulsions in eclampsia was seen in a...

55 Cystic Fibrosis 57 MidwiferyManagement

Sat, 14 Apr 2012 18:33:20 GMT

The issues in pregnancy are the same as in the non-pregnant woman, but are more exaggerated. Adequate dietary supplementation Prenatal diagnosis, with careful consideration of termination of pregnancy, becomes an issue. The most serious complications are related to the further compromise of a woman with respiratory failure and pulmonary hypertension. It is important to remember that this can lead to maternal mortality Antibiotic therapy may be complicated in CF, and in some circumstances...

Preconception Issues And Care Ltx MidwiferyManagement

Sat, 14 Apr 2012 16:55:10 GMT

Ideally, all women should be able to make an informed choice about pregnancy based on both maternal and fetal risks, long term prognosis and alternative options such as contraception, termination of pregnancy, adoption, surrogacy and IVF. Encourage realistic expectations, and advocate active preparation for pregnancy. This includes Ensuring easy access to multi-disciplinary care Pre-pregnancy surgery or intervention e.g. change of valve type consider risk of surgery versus reduction in...

284 Hydralazine and dihydralazine DuringBreastfeeding

Fri, 13 Apr 2012 14:17:42 GMT

Hydralazine and dihydralazine are structurally similar vasodilator drugs that have been used for the treatment of hypertension in pregnancy for over 40 years. Following oral administration, up to 80 percent absorption occurs, and approximately 66 percent of the drug is deactivated in the liver. The half-life is 2-8 hours. Hydralazine and dihydralazine cross the placenta well, and cord-blood drug concentrations may exceed those in the mother Franke 1986 . Although results from animal studies...

Fetal Risk Summary Fsg BreastFeeding

Thu, 12 Apr 2012 17:18:27 GMT

Alprazolam, a member of the benzodiazepine class of agents, is used for the treatment of anxiety. Although no congenital anomalies have been attributed to the use of alprazolam during human pregnancies, other benzodiazepines e.g., see Diazepam have been suspected of producing fetal malformations after 1st trimester exposure. In pregnant rats, the drug produced thoracic vertebral anomalies and increased fetal death only at the highest dose 50 mg kg tested 1 . Researchers described the effects of...

Geographical variations in the prevalence of GDM DiabetesPregnancy

Thu, 12 Apr 2012 12:21:27 GMT

Prevalence of GDM varies from one region to another in the same country. Though the overall prevalence of GDM in India was 16.55 , the frequency varied from 12 to 21 in different parts of the country.9 A low prevalence of GDM was observed in the hilly areas of Jammu and Kashmir14 north India 4.4 , Imphal15 north-east India 2.2 , and in Yercaud16 south India 3.5 . This low prevalence could be attributed to the lifestyle adapted by the people living in the hostile terrain. The prevalence of GDM...

C57BL6J mice DiabetesPregnancy

Thu, 12 Apr 2012 11:20:46 GMT

The non-obese, non-diabetic BL 6J mice, the genomic host of the ob ob mutation, when placed on an affluent fat and sucrose-rich diet become hypertensive and insulin resistant with first-phase insulin release disappearing at 6 months of age.95-97 Abnormalities, characterized by increased outflow from the sympathetic nervous system, deranged beta-cell function and adipocyte metabolism were found to be responsible for the resultant IGT and insulin-resistance syndrome. No hyper-phagia or elevation...

268 Quinolones DuringBreastfeeding

Wed, 11 Apr 2012 12:41:59 GMT

Quinolones impair bacterial DNA metabolism by inhibiting DNA gyrase. They have bactericidal activity at normal doses at higher doses they have also bacteriostatic properties by inhibiting bacterial RNA and protein synthesis. Quinolones have a high affinity for cartilage and bone tissue this affinity is highest in immature cartilage. Pipemidic acid, cinoxacin, and nalidixic acid belong to the group of older quinolones. They concentrate in the urinary tract. Few data on their safety during...

2112 Nonsteroidal antiinflammatory drugs NSAIDs DuringBreastfeeding

Tue, 10 Apr 2012 09:56:41 GMT

NSAIDs are the mainstay of antirheumatic therapy. Pregnancy-related conditions such as premature labor, polyhydramnios, and pregnancy induced hypertension have also been indications for treatment with NSAIDs. This group of medications includes many drugs, and the number is still growing, so it is impossible to review them all. The most commonly used are acemetacin, azapropazon, diclofenac, etofenamat, fenbufen, flufenamic acid, flurbiprofen, ibuprofen, indomethacin, indoprofen, hetoprofen,...

Karen Watkins MB ChBHons MRCOG MidwiferyManagement

Tue, 10 Apr 2012 08:25:42 GMT

Lead Obstetrician for Intrapartum Care and Maternal Medicine at The Royal Cornwall Hospital, Truro Karen graduated in 1993 with honours. She completed her basic training in Obstetrics and Gynaecology then in 1998 she became Clinical Research Fellow for the Magpie Trial, a large international randomised trial investigating magnesium sulphate and its role in preventing eclampsia. Following this, Karen worked for a number of years in Australia and during this time was awarded 'Best of Free...

Female Factor Subfertility PregnancyChildbirth

Tue, 10 Apr 2012 06:48:26 GMT

In the female, any factor that prevents the sperm from reaching the egg ovum in the fallopian tube will result in subfertility refer to Figure 5.3 . Anovulation failure of the ovaries to produce an egg This commonly results from stress, excessive weight loss or exercise, poor nutrition, chronic medical conditions, inherent ovarian problems such as polycystic ovarian syndrome or previous ovarian surgeries. They usually manifest as an absence, delay or irregularity in the menses. Figure 5.3...

2629 Quinine DuringBreastfeeding

Sun, 08 Apr 2012 12:38:51 GMT

Quinine is the oldest antimalarial agent. It has a good and rapid sch-izonticide activity against the erythrocytic forms of all Plasmodium species. In spite of relatively high toxicity and a narrow therapeutic range, it is used more often for the treatment of chloroquine-resistant malaria today. Concentrations in the fetus are just as high as in the mother, and arc potentially toxic. There are some reports describing eye defects and hearing loss in children after use of quinine in pregnancy....

references Oft NutritionPregnancy

Sat, 07 Apr 2012 16:56:42 GMT

1. Ahlqvist M, Wirfalt E 2000 Beliefs concerning dietary practices during pregnancy and lactation. A qualitative study among Iranian women residing in Sweden. Scand J Caring Sci 14 105-111 2. Ebomoyi E 1988 Nutritional beliefs among rural Nigerian mothers. Ecol Food Nutr 22 43-52 3. Frankel B 1977 Childbirth in the ghetto. R amp E Research, San Francisco, Calif. 4. Kay MA 1977 Health and illness in a Mexican-American barrio. In Spicer EH ed Ethnic Medicine in the Southwest. University of...

Teenage Sex Is Just Like Adult Sex TeenPregnancy

Fri, 06 Apr 2012 21:31:20 GMT

Even more than the economic and adult-teen aspects of teen sex and pregnancy, the uncanny parallels between teen and adult sexual outcomes are the most ignored factor of all. In fact, teenage sex is a closely controlled behavior, reflecting the sexual behaviors of adults around them. Where and when adults have high rates of pregnancy, abortion, birth, unwed birth, STD, and HIV AIDS, so do teenagers. The chief complication is that high rates of poverty shift a population's sexual outcomes to...

2711 Poliomyelitis vaccine DuringBreastfeeding

Wed, 04 Apr 2012 23:15:04 GMT

Oral polio vaccine Sabin contains attenuated live poliomyelitis viruses of all three poliovirus types. It is no longer recommended for routine vaccinations because in very rare cases it may cause poliomyelitis. The inactivated form of the vaccine Salk , mostly in combinations with other vaccines injection , is now preferred. When there were outbreaks of poliovirus in Israel and Finland, mass oral polio vaccinations of the population, including pregnant women, were performed. Based on the...

Eisbn 1592597874 NormalPregnancy

Wed, 04 Apr 2012 18:23:25 GMT

Library of Congress Cataloging-in-Publication Data Handbook of clinical laboratory testing during pregnancy edited by Ann M. Gronowski. p. cm. -- Current clinical pathology Includes bibliographical references and index. ISBN 1-58829-270-3 alk. paper 1. Obstetrics--Diagnosis--Handbooks, manuals, etc. 2. Prenatal diagnosis Handbooks, manuals, etc. manuals, etc. 4. manuals, etc. 5. Diagnosis, Laboratory--Handbooks, manuals, etc. DNLM 1. Prenatal Diagnosis--methods--Handbooks. 2. Fetal...

Nucleosides DiabetesPregnancy

Tue, 03 Apr 2012 23:38:39 GMT

Nucleosides such as adenosine or thymidine are rapidly taken up by cells. The characteristics of transport are consistent with facilitated diffusion, i.e. transport along a downhill concentration gradient by carrier-mediated transport mechanisms. Transport has a broad specificity including both purine and pyrimidine nucleosides. In the human placenta these transporters have been identified at the microvillous and basal membrane of the syncytiotrophoblast. Distinct from other tissues such as...

Cord and fetal membranes DiabetesPregnancy

Tue, 03 Apr 2012 23:16:32 GMT

The length of the cord at term is between 40 and 70 cm and the diameter is usually between 1 and 3 cm. A short or excessively long cord is related to an increased risk for fetal damage. Marginal cord insertion or velamentous cord insertion, which probably are due to disturbed implantation, may be also associated with fetal or neonatal damage. Histopathologic features such as thrombosis of vessels or the observation of a single artery should be already suspected by a macroscopic analysis of cord...

Jane Scullion BAHons RGN MSc MidwiferyManagement

Tue, 03 Apr 2012 16:13:47 GMT

Respiratory Nurse Consultant at University Hospitals of Leicester NHS Trust Honorary Senior Lecturer at De Montfort University Clinical Research Fellow at Aberdeen University Jane Scullion is a Respiratory Nurse Consultant working across the interface of primary and secondary care with patients with chronic respiratory diseases and developing respiratory services. She has published widely and presented both nationally and internationally. Specialist Midwife - Diabetes at the University...

A guide for essential practice NewbornCare

Tue, 03 Apr 2012 00:06:42 GMT

Department of Making Pregnancy Safer Integrated Management of Pregnancy and Childbirth Pregnancy, Childbirth, Postpartum and Newborn Care World Health Organization Geneva 2006 WHO Library Cataloguing-in-Publication Data Pregnancy, childbirth, postpartum and newborn care a guide for essential practice. At head of title Integrated Management of Pregnancy and Childbirth. 1.Labor, Obstetric 2.Delivery, Obstetric 3.Prenatal care 4.Perinatal care -methods 5.Postnatal care - methods 6.Pregnancy...

Palpation and position of the baby MorningSickness

Mon, 02 Apr 2012 22:09:33 GMT

As pregnancy advances, more information than just the fundal height will be needed and the midwife will carry out an abdominal examination at every visit. After emptying her bladder, the woman should lie flat, supported by pillows if necessary, with only her abdomen exposed. She should be as relaxed and at ease as possible. There are three stages to the examination. 1 Inspection - to note the size and shape of the uterus. The size should correspond with the estimated dates and period of...

Endocrinological tests EctopicPregnancies

Mon, 02 Apr 2012 17:09:48 GMT

In most cases of early pregnancy assessment, hCG and progesterone assays are not required unless the location of the pregnancy is in doubt. Knowledge of the 'normal' increases in hCG levels in early pregnancy are useful as a guide after a non-diagnostic ultrasound of pregnancy of unknown location, provided they are combined with other features such as clinical symptoms, other ultrasound findings and progesterone results.5,6 The hCG 'doubling time' is used as a guide to the viability and...

Rationale for universal screening DiabetesPregnancy

Mon, 02 Apr 2012 03:13:25 GMT

Selective screening based on risk factors scored poorly in predicting GDM.22 If selective screening is employed, it is likely that 16 of GDM women will go undetected.23 Further selective screening recommended by ADA may be applicable for women belonging to the ethnic group with low prevalence of GDM. Whereas, among ethnic groups in South Asian countries, Indian women have the highest frequency of GDM necessitating universal screening.24 The recognition of glucose intolerance during pregnancy is...

Introduction PrematureInfants

Sat, 31 Mar 2012 19:41:49 GMT

Although several texts provide extensive written descriptions of the newborn infant, the senses of touch, hearing, and especially sight, create the most lasting impressions. Over a period of almost five decades, my brother Jack Rudolph diligently recorded, in pictorial form, his vast experiences in physical examination of the newborn infant. Atlas of the Newborn reflects his selection from the thousands of color slides in his collection, and truly represents the art of medicine as applied to...

Prolactin DiabetesPregnancy

Sat, 31 Mar 2012 06:33:46 GMT

During pregnancy, maternal prolactin levels increase 7- to 10-fold. Gustafson et al.27 reported that the basal insulin concentration and post-challenge glucose and insulin responses were greater in women with hyperprolactinemia than in healthy controls. These findings were supported by studies showing that the culture of pancreatic islet cells with prolactin induces an increase in insulin secretion.28 Skouby et al.29 investigated the relationship between the deterioration in glucose tolerance...

Clinical Symptoms And Risk Factors For Ectopic Pregnancy EctopicPregnancies

Fri, 30 Mar 2012 20:49:24 GMT

When evaluating pregnant women in the first trimester, it is very important to take into account the history and symptomatology. The Figure 3.4 Blood in the pouch of Douglas seen as ground glass fluid on transvaginal scan. Reproduced from Condous et al. Ultrasound Obstet Gynecol 2003 2 420-30. Figure 3.4 Blood in the pouch of Douglas seen as ground glass fluid on transvaginal scan. Reproduced from Condous et al. Ultrasound Obstet Gynecol 2003 2 420-30. end of the fallopian tube. It is very...

Fabrics PregnancyPhotography

Fri, 30 Mar 2012 20:07:56 GMT

There are thousands of fabrics available today, but only those that are thin, lightweight, and have texture will work well as attire for your subject. Some of the most effective fabrics for draping over and around the human form are gauze, tulle, muslin, silk, crepe, stretch velvet, and chiffon. In the past, the color selection available for each of these fabric types was rather limited. Today, muslin is not just available in the traditional beige but in numerous colors too. For unique colors...

2517 Castor oil DuringBreastfeeding

Fri, 30 Mar 2012 19:15:24 GMT

Castor oil oleum ricini is a triglyceride that is hydrolyzed in the small intestine to release glycerol and ricinoleic acid. This causes a laxative effect by irritating the intestinal mucosa. Castor oil is a laxative with a harsh action it is not appropriate for long-term therapy. In addition, it has a vei unpleasant taste. No specific embryotoxic effects have been observed in human beings however, studies during early pregnancy have to our knowledge not been reported. Many authors warn against...

Breast Feeding Summary Fet BreastFeeding

Fri, 30 Mar 2012 11:13:19 GMT

Amoxapine and its metabolite are excreted into breast milk. A 29-year-old woman suffering from depression was treated with approximately 250 mg day of amoxapine 2 . She developed galactorrhea and oligomenorrhea. Milk samples were collected after 10 and 11 months of therapy and analyzed for amoxapine and the active metabolite, 8-hydroxyamoxapine. The levels of the parent compound at the sample collection times were both less than 20 ng mL, but the metabolite was present in both samples, 45...

Introduction Afj DiabetesPregnancy

Fri, 30 Mar 2012 07:55:50 GMT

A diseased foetus without his placenta is an imperfect specimen, and a description of a foetal malady, unless accompanied by a notice of the placental condition, is incomplete. Deductions drawn from such a case cannot be considered as conclusive, for in the missing placenta or cord may have existed the cause of the disease and death. During intrauterine life the foetus, the membranes, the cord and the placenta form an organic whole, and disease of any part must react upon and affect the...

234Total Energy Cost of Pregnancy NutritionPregnancy

Thu, 29 Mar 2012 23:52:45 GMT

The total energy cost of pregnancy in well-nourished women has been estimated from the sum of BMR or TEE and energy deposited in laying down maternal and fetal tissues 14 . Gestational weight gain is a major determinant of the incremental energy needs during pregnancy because it reflects not only energy deposition, but also the increase in BMR and TEE resulting from the energy cost of metabolism and moving a larger body mass. Using the gestational weight gain recommended by IOM for pregnant...

Parvovirus MorningSickness

Thu, 29 Mar 2012 19:24:13 GMT

In childhood, human parvovirus causes erythema infectiosum or fifth disease, which is sometimes mistaken for rubella or German measles. It may also be called 'slapped face syndrome' because of the reddened appearance of a child's face. Infection is commonly asymptomatic. In pregnancy, if the fetus is infected this causes anaemia and fluid retention or hydrops. In approximately half of all cases of fetal infection, miscarriage or still birth occurs but in the remainder the anaemia and hydrops...

Forgetfulness and clumsiness Pregnant Women 2

Thu, 29 Mar 2012 19:13:32 GMT

Until she was pregnant, Joanne never would have believed that misplacing keys, bumping into furniture, and dropping things could be real side effects of pregnancy. We don't know of any medical explanation for these effects, but some women do feel they're more scatterbrained and clumsy. If it happens to you, don't worry. You're not losing your mind. Look at it this way Now you have an excuse for having forgotten your best friend's birthday. And rest assured you'll go back to being your...

Insulin and hypoglycemic compounds DiabetesPregnancy

Thu, 29 Mar 2012 18:40:53 GMT

The passage of plasma proteins across the human placental barrier in humans is a highly selective process. It cannot be predicted on a simple way based on physical properties, i.e. protein binding, lipid solubility or molecular weight. In diabetic pregnancy, the safe use of insulin, insulin analogs and oral hypoglycemic agents relies on the absence of transfer from maternal to fetal circulation. It has been known for years that free maternal insulin does not cross the materno-fetal barrier...

2516 Anthraquinone derivatives DuringBreastfeeding

Thu, 29 Mar 2012 15:29:23 GMT

Anthraquinone derivatives with a laxative action occur in a number of plants folia sennae, rhizoma rhei, cortex frangulae, and aloe. They have a laxative effect by directly stimulating colonic smooth muscles. Anthraquinone derivatives occur as glycosides. After the sugar portion is cleaved in the intestine, these agents are partially absorbed and excreted in the urine colored . Anthraquinone derivatives do not appear to be teratogenic. Reported experience is the most extensive with senna...

The Eastern philosophy of childbirth MorningSickness

Thu, 29 Mar 2012 12:01:45 GMT

The Yellow Emperor 1963 said 'After the person's connection, the Jing is first composed. Then the Jing composes the brain and the bone marrow. The bones become the Stem, the vessels become the Ying, the muscles become firm. The flesh becomes a wall, the Jing is hard and then the hair and body grow'. The chapter on preconception discusses the importance of getting healthy, regulating periods and correcting imbalances before becoming pregnant. In my experience, a woman's physical and emotional...

Threatened Miscarriage EctopicPregnancies

Thu, 29 Mar 2012 03:40:29 GMT

Women who present in the first trimester with vaginal bleeding with or without lower abdominal pain are given the label of a threatened miscarriage. This is a common first trimester problem occurring in up to one-third of pregnancies.19 This condition requires an ultrasound scan to establish the viability of the pregnancy. If the uterus contains an embryopositive cardiac activity, then the woman can be reassured that she has a viable intrauterine pregnancy. If the crown-rump length CRL is at...

Foreword PrematureInfants

Thu, 29 Mar 2012 01:06:31 GMT

Sir William Osler stated, There is no more difficult task in medicine than the art of observation. The late Arnold Jack Rudolph was an internationally renowned neonatolo-gist, a teacher's teacher, and, above all, one who constantly reminded us about how much could be learned by simply observing, in his case, the newborn infant. This color atlas of neonatology represents a distillation of more than 50 years of observing normal and abnormal newborn infants. The Atlas begins with a section on the...

2617 Other local conazole antimycotics DuringBreastfeeding

Wed, 28 Mar 2012 17:06:30 GMT

Bifonazole, croconazole, econazole, fenticonazole, isoconazole, ketoconazole, omoconazole, oxiconazole, sertaconazole, sulcona-zole, and tioconazole are imidazole derivatives, and structurally and functionally related to clotrimazole. No teratogenic effects have been observed as a result of local treatment with these antimycotics. For econazole, these findings were confirmed in a population-based case control study Czeizel 2003A . They are, however, less tried than clotrimazole and miconazole...

Conclusion Flu DiabetesPregnancy

Wed, 28 Mar 2012 16:05:48 GMT

GDM women are at increased risk of future diabetes as are their children and following generations. 1.King H, Aubert RE, Herman WH. Global burden of diabetes, 1995-2025. Prevalence, numeric estimates and projections. Diabetes Care 1998 21 1414-31. 2. Ben Haroush A, Yogev Y, Hod M. Epidemiology of gestational diabetes mellitus. In Hod M, Jovanovic L, Di Renzo GC, de Leiva A, Langer O, eds. Textbook of Diabetes and Pregnancy, 1st edn. London Martin Dunitz, Taylor amp Francis 2003, pp. 64-89. 3....

Modern Myths Unsexy Realities TeenPregnancy

Wed, 28 Mar 2012 12:59:00 GMT

Sex, Love, and Psychology Series Judy Kuriansky, Series Editor Santa Barbara, California Denver, Colorado Oxford, England All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, except for the inclusion of brief quotations in a review, without prior permission in writing from the publisher. Library of Congress Cataloging-in-Publication Data...

Use of Pregnancy Calendar Wheel PregnancyChildbirth

Wed, 28 Mar 2012 10:00:39 GMT

Most obstetricians are familiar with the pregnancy calender wheel Figure 8.1 . It helps estimate the EDD based on the LMP or dating scan. Do not be too worried if you have irregular periods or cannot recall your LMP. The most accurate dating is from Your baby's heart can be seen after 6 weeks of LMP. At this stage, the baby's length is now 4 mm. The embryonic period starts and your baby's organs start to form. Hair begins to sprout by then. Brain waves can also be detected. Your baby's heart...

Concluding remarks DiabetesPregnancy

Wed, 28 Mar 2012 08:02:56 GMT

Autoimmune GDM appears to be the result of the variable expression of autoimmunity against the beta cell, challenged by the higher functional demand associated with the insulin-resistant state of pregnancy. In this respect, autoimmune gestational diabetes can be considered a distinct clinical entity. There are different time-course patterns in the progression of autoimmune GDM from the restoration of normal glucose tolerance when pregnancy is over even with eventual disappearance of autoimmune...

2312 Nonselective 3adrenergic agonists DuringBreastfeeding

Tue, 27 Mar 2012 18:47:56 GMT

Non-selective -adrenergic agonists are not recommended for asthma treatment. Some of ihesc drugs are used in oral OTC drugs for the common cold. These combinations do not follow good therapeutic practices, and arc not recommended during pregnancy. Hexoprenaline, isoprenaline, and orciprenaline Hexoprenaline, isoprenaline isoproterenol , and orciprenaline have a stimulating effect on .Vrcceptors. They are non-selective . -adrenergic agents that act on both and fij-receptors, and therefore have...

Cytokine Shift DuringPregnancy

Tue, 27 Mar 2012 14:58:11 GMT

The proliferation, invasion and differentiation of trophoblast cells during implantation is a tightly controlled process coordinated by a system of intercellular signals mediated by cytokines, growth factors and hormones.13,14 An extensive array of cytokines is produced at the tropho-blast-maternal interface that contributes to the well being of the feto-placental unit. Furthermore, these cytokines to a great extent regulate maternal immune responses, which play an important role for a...

2634 Tuberculosis and pregnancy DuringBreastfeeding

Tue, 27 Mar 2012 08:30:54 GMT

The indications for treatment of active tuberculosis in pregnant women are no different from those for non-pregnant women. Transmission and infection arc felt to be the same as in the nonpregnant individual, and pregnancy does not seetn to influence the course of the disease Laibl 2005, Tripathy 2002. Espinal 1996 . Untreated tuberculosis represents a greater hazard to the mother and her fetus than does the treatment of the disease Bothamley 2001, Raju 1998, Brost 1997 . There are slight...

2652 Niclosamide DuringBreastfeeding

Mon, 26 Mar 2012 14:13:08 GMT

Niclosamide is an effective anthelmintic against most human ces-todes. It appears to act by inhibiting respiration of the parasite, and is hardly absorbed in the gastrointestinal tract. The drug has been widely used for a long time, and is not suspected of causing an increased risk for birth defects to date however, experience in humans is not well-documented. In a prospective follow-up study of 39 pregnant women exposed in the first trimester, one child was born with a minor malformation...

Preconception Issues And Care Swd MidwiferyManagement

Mon, 26 Mar 2012 11:51:08 GMT

Sarcoidosis is not usually a contraindication to pregnancy3. In the vast majority of women with sarcoidosis there are no pre-conception issues. Women with significant active disease need to be managed in a specialist clinic. Particular care is needed with patients treated with systemic corticosteroids due to the increased risk of diabetes mellitus and hypertension. In the rare circumstance of patients with significant respiratory failure women should be advised against pregnancy.

John R Lindsay MD Lynnette K Nieman MD InsulinResistance

Sun, 25 Mar 2012 19:16:32 GMT

Reproductive Biology and Medicine Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda MD, USA The hypothalamic-pituitary-adrenal HPA axis and the renin-angioten-sin system RAS are up-regulated during normal pregnancy. Pregnancy represents a state of relative hypercortisolism, resulting from the interaction of the maternal HPA axis and the fetal-placental unit. Consistent with a physiologic role, the RAS maintains normal sodium balance and...

Rocker Bottom Feet MusculoskeletalDisorders

Sun, 25 Mar 2012 09:19:13 GMT

Figure 1.110. Another view of the foot of the same infant. Figure 1.111. Talipes equinovarus congenital clubfoot in an infant with Poland's anomaly. Talipes equinovarus is frequently associated with congenital hip dysplasia, neural tube defects, and neuromus-cular conditions. Figure 1.111. Talipes equinovarus congenital clubfoot in an infant with Poland's anomaly. Talipes equinovarus is frequently associated with congenital hip dysplasia, neural tube defects, and neuromus-cular conditions....

54 Tuberculosis 55 MidwiferyManagement

Sun, 25 Mar 2012 04:47:22 GMT

It is well recognised that treatment for pulmonary TB is safe in pregnancy. There is better neonatal and perinatal survival if treatment is adhered to3,4. Even in multi-drug-resistant TB the benefits of treatment outweigh the risks. Of the small number of studies there seem to be few if any teratogenic effects on newborns. Transmission of pulmonary TB from mother to baby is rare there has only been a single case report of a mother with endometrial TB who transmitted TB to her unborn baby....

Last menstrual period LMP and cycle length EctopicPregnancies

Sun, 25 Mar 2012 02:59:41 GMT

Knowledge of the first day of the LMP and the cycle length in any individual can alter the Table 2.1. Correction of dates for cycle expected gestation and therefore the ultrasound findings considerably and may make the difference between seeing an early pregnancy and having a non-diagnostic scan that necessitates follow-up. Correction for cycle length is therefore important if the length deviates by 7 or more days from a 28-day cycle Table 2.1 . It should be remembered, however, that recall of...

itHMl rnibFnici TA nr MI I DiabetesPregnancy

Sat, 24 Mar 2012 18:26:56 GMT

Figure 1.1 The title page of Dr Bennewitz's thesis De diabete mellito, graviditatis symptomate,28 with translation into English. The disease appeared along with pregnancy, and at the very same time when pregnancy appeared, it appeared while pregnancy lasted, it lasted it terminated soon after the pregnancy. He showed a degree of humility when he remarked that his patient must be something of a rare bird. The case history commences on 13 November 1823, when Frederica Pape, aged 22, was admitted...

Pregnancy and diabetes before the discovery of insulin DiabetesPregnancy

Sat, 24 Mar 2012 16:27:32 GMT

A full historical review of fertility and of the outcome of pregnancy in different parts of the world is beyond the scope of this chapter, but there are a number of aspects that are of particular relevance to the story of diabetes. Medical history, in particular, is constrained by publication bias, and there is much more available data regarding Europe and North America than in other parts of the world. The geographical and ethnic differences in the distribution, development and management of...

Deficiencies MorningSickness

Fri, 23 Mar 2012 18:58:22 GMT

A number of crucial minerals are involved in the prevention of birth abnormalities, including the following. In tests, mothers who gave birth to babies with congenital malformations were found to have very low levels of manganese, as did their babies Saner et al 1985 . The best food sources are nuts, green leafy vegetables, peas, beets, egg yolks and wholegrains. Zinc deficiency is linked to low birthweight, still births and male infertility, and to difficult births and poor weight gain in...

Convenience and Cost HealthCare

Fri, 23 Mar 2012 09:14:14 GMT

Breast-feeding moms never run out of milk and don't incur the expense of buying formula. Those who breast-feed exclusively and stay at home with their baby don't have to wash or sterilize bottles, cool or heat formula, carry feeding supplies along on every outing, or run to the kitchen in the middle of the night. But if breast-feeding mothers begin to leave their baby at home, things begin to even out. They have to express and store milk, invest in equipment, and prepare and clean bottles. For...

51 The Breathless Pregnant Woman 49 MidwiferyManagement

Fri, 23 Mar 2012 02:19:02 GMT

In most cases breathlessness in pregnancy is due to a normal physiological response2. Pathological causes need to be considered when there is a clinical suspicion. The risk-benefit ratio of investigations for breathlessness needs to be evaluated. Most radiological investigations expose the woman and baby to radiation, which needs to be minimised, but chest radiography is generally regarded as safe. In extreme circumstances, in the setting of respiratory failure, whether the woman and baby are...

D H A BabyCare

Wed, 21 Mar 2012 17:37:22 GMT

An essential component of the brain, eyes and nerve cells i s doco sah ex ae noic acid DHA , an omega-3 essential fatty acid see page 19 , which th e body uses for speci fi c functi ons. This fatty acid makes up 60 percent of an adult's brain weight and 2 0 percent of a b aby' s. In women, the first pregnancy-related need for fatty acids occurs during the three months before conception, when cells in the ovaries are dividing. Healthy, viable eggs need DHA to grow and develop. DHA is also an...

Genetics immunology and gestational diabetes mellitus DiabetesPregnancy

Wed, 21 Mar 2012 02:30:54 GMT

Some GDM patients manifest evidence for autoimmunity towards beta cells insulin autoantibodies and anti-islet cell antibodies however, the prevalence of such autoimmunity has been reported to be extremely low lt 10 .62,63 Mutations in the glucokinase gene occur in no more than 5 of GDM patients.64 The inheritance of GDM was studied in a group Insulin signaling system in normal pregnancy and in gestational diabetes mellitus 75 of 100 women with previous GDM.65 The women were reinvestigated 11...

Changes in intermediary metabolism during pregnancy DiabetesPregnancy

Tue, 20 Mar 2012 18:06:17 GMT

As has been shown in previous chapters, throughout pregnancy there are major changes in intermediary metabolism, changes that will facilitate the fetal needs of energy and precursors for fetal and placental growth, as well as for placental hormone synthesis. From a metabolic point of view, during gestation there are two different periods. In the first half of pregnancy, during the embryo development period, there are maternal changes that lead to storage of energy and nutri-ents.1-3 The stored...

46 Functional Heart Disease Cardiomyopathy 39 MidwiferyManagement

Tue, 20 Mar 2012 03:56:32 GMT

Cardiomyopathy symptoms are often seen in uncomplicated pregnancies. The significance may only be recognised late, when cardio-myopathy presents in an advanced state and treatment is difficult. Puerperal cardiomyopathy manifests in the third trimester, the fetus is relatively mature and can be delivered reasonably safely prior to, or at, commencement of treatment. Referral and collaboration with cardiologist, obstetric, anaesthetic and paediatric teams for combined care Clear care pathways to...

45 Inadequate Prenatal Care MentalIllness

Mon, 19 Mar 2012 15:34:33 GMT

The lack of motivation and self-esteem associated with depression during pregnancy may lead to inadequate prenatal care because depressed women are known not to seek out prenatal care until well into their pregnancies 62 . Previous studies have found that women with psychiatric disorders attend fewer than 50 of prenatal care appointments 62 . A cohort study of almost 10.6 million births found a relative risk RR of 2.8 for preterm birth in Caucasian women with inadequate prenatal care compared...

17 Pharmacokinetics in pregnancy DuringBreastfeeding

Mon, 19 Mar 2012 05:25:14 GMT

Metabolism and kinetics of medicinal products are more complicated in pregnancy than otherwise. In general, the effective concentration of a drug or its metabolites is influenced by the following the uptake, distribution, metabolism and excretion by the mother changes during pregnancy of some physiologic parameters influencing the metabolism of chemicals are summarized in Table 1.2 the passage and metabolism through the yolk sac and the placenta the distribution, metabolism and excretion by the...

264 Macrolide antibiotics DuringBreastfeeding

Sun, 18 Mar 2012 21:40:57 GMT

Macrolides inhibit bacterial protein synthesis and have bacteriostatic properties. Erythromycin is the oldest of the macrolides. Azithromycin, clarithromycin, dirithromycin, josamycin, mide-camycin, oleandomycin, and roxithromycin are newer macrolides. Azithromycin belongs to the azalides, a new class of macrolides which resemble erythromycin but have different pharmacokinetic profiles and antibacterial activity. The newer macrolides have a longer half-life and fewer gastrointestinal side...

Understanding your babys Weight gain Pregnant Women 2

Sun, 18 Mar 2012 10:04:05 GMT

Although your weight gain may follow a path all its own, your baby's own bulking-up pattern is likely to progress slowly at first, and then pick up at about 32 weeks, only to slow again in the last weeks before birth. At 14 to 15 weeks, for example, the baby puts on weight at about 0.18 ounce 5 grams per day, and at 32 to 34 weeks, 1.06 to 1.23 ounces 30 to 35 grams per day that's about half a pound or 0.23 kilograms each week . After 36 weeks, the fetal growth rate slows to about a quarter of...

2631 Primaquine DuringBreastfeeding

Sun, 18 Mar 2012 07:05:16 GMT

Primaquine, an 8-aminochinoline derivative, acts against vivax and ovale malaria by destroying the exoerythrocytic forms of the malaria parasite. It is used after suppressive therapy with chloroquine to eliminate the pathogen completely to prevent a relapse of vivax and ovale malaria. Primaquine should not be used in pregnancy because of the potential risk of hemolytic effects in the fetus. As yet, there arc no studies that permit a well-grounded risk assessment. However, there is no...

When should you see a yolk sac EctopicPregnancies

Thu, 15 Mar 2012 22:50:16 GMT

The discriminatory level for a yolk sac with transabdominal ultrasound was a mean gestation sac diameter MSD of 20 mm.9 Early TVS described a discriminatory level for the yolk sac of 8 mm.10 More recently Rowling et al.11 found that with 5 MHz transducers the yolk sac is definitively seen by a MSD of 13 mm but with newer 5-9 MHz transducers a yolk sac was definitively seen by the time the MSD was 5 mm. The presence of a larger sac with no evidence of yolk sac formation contained within it is a...

References Pah BreastFeeding

Thu, 15 Mar 2012 10:05:02 GMT

1. Moore HL, Szczech GM, Rodwell DE, Kapp RW Jr, deMiranda P, Tucker WE Jr. Preclinical toxicology studies with acyclovir teratologic, reproductive, and neonatal tests. Fund Appl Toxicol 1983 3 560-8. 2. Stahlmann R, Klug S, Lewandowski C, Bochert G, Chahoud I, Rahm U, Merker HJ, Neubert D. Prenatal toxicity of acyclovir in rats. Arch Toxicol 1988 61 468-79. 3. Chahoud I, Stahlmann R, Bochert G, Dillmann I, Neubert D. Gross-structural defects in rats after acyclovir application on day 10 of...

References 1 DuringBreastfeeding

Wed, 14 Mar 2012 10:36:08 GMT

Abs K. Honein MA. Moore CA- Maternal febrile illness, medication use, and risk of congenital renal anomalies. Birth Defects Res A 2003 67 911 -IK. Alexander FE. Putheal SL. Biondi A et al. Transplacental chemical exposure and risk of infant leukemia with MLL gene fusion. Cancer Res 2001 61 2542-6. Backos M. Pregnancy complications in women with recurrent miscarriage associated with antiphospholipid antibodies treated with low dose aspirin und heparin. Br Obstet Gynaecol 1999 106 102-7....

The ultrasound scan EctopicPregnancies

Wed, 14 Mar 2012 06:10:07 GMT

Before embarking on an ultrasound it helps to ask yourself a few questions 1. What am I trying to find out by performing 2. Does the scan need to be performed now or can it wait 3. Will the scan change my management 4. What type of scan do I need to perform i.e. transvaginal or transabdominal In the emergency setting, your decision to perform an ultrasound may not always be correct and we have all been in the situation when we wish that we had not Always be sure that you are competent to...

2655 Ivermectin and diethylcarbamazine DuringBreastfeeding

Wed, 14 Mar 2012 04:53:47 GMT

Ivermectin is a highly effective drug in the treatment of onchocerciasis river blindness and lymphatic filiriasis. Reports from animal studies do not indicate a teratogenic potential of this drug. In some cases inadvertent exposure during pregnancy has occurred without apparent adverse effects Gyapong 2003 , but data are not sufficient for risk estimation. Diethylcarbamazine is used for the treatment of filiriasis and onchocercosis. No teratogenicity was reported in animal studies. No...

Explanation Of Condition Qfd MidwiferyManagement

Tue, 13 Mar 2012 23:23:24 GMT

Asthma is a common condition in western societies, affecting up to 15 and its prevalence and incidence are increasing. Asthma is a chronic inflammatory disease of the airways, which is characterised by intermittent episodes of wheeze, shortness of breath, chest tightness and cough. It is a variable disease in which, in response to certain stimuli, or triggers, inflammation and structural changes occur in the lungs. This causes airway hyper-responsiveness and variable airflow obstruction leading...

Clinical studies DiabetesPregnancy

Tue, 13 Mar 2012 20:18:40 GMT

There is paucity of information in the literature regarding outcome of pregnancy in untreated GDM. Ostlund et al.57 studied 213 women prospectively who were identified with IGT during pregnancy but remained undiagnosed and untreated. IGT was defined as fasting blood glucose level 121mg dL lt 6.7mmol L and 2-h blood glucose level 162-198mg dL gt 9 and lt 11mmol L . They compared the untreated IGT to control and treated GDMs. The rate of macrosomia gt 4000 g was 33, 16, and 30 , and LGA 25, 4 and...

Introduction 1 NormalPregnancy

Tue, 13 Mar 2012 20:13:07 GMT

Human chorionic gonadotropin hCG is a glycoprotein composed of two dissimilar subunits, a- and P-subunit, held together by charge interactions. hCG is produced by trophoblastic cells of the placenta in both pregnancy and gestational trophoblastic diseases. It is a remarkable glycoprotein in that up to 35 of the molecular weight MW is from oligosaccharide side chains. hCG is sometimes considered a mucopolysaccharide, like collagen, because of the large carbohydrate component. There is wide...

Tanu Singhal MRCOG MidwiferyManagement

Tue, 13 Mar 2012 20:03:42 GMT

Consultant Obstetrician at University Hospitals of Leicester After obtaining a medical degree in India, Tanu trained extensively in the field of Obstetrics and Gynaecology before coming to the UK in 1996. She trained further in her chosen field developing her special interest in high-risk obstetrics. She obtained the Advanced Diploma in Obstetric Ultrasound Scanning under the joint auspices of Royal Colleges of Radiology RCR and Obstetrics and Gynaecology RCOG . Tanu was among the first few...

Demographic findings in DIPAP project DiabetesPregnancy

Tue, 13 Mar 2012 18:23:22 GMT

The demographic details of the 4151 pregnant women screened in the DIPAP project are given below in Table 17.2. The proportion of GDM increased with increasing age and BMI. There was a significant association between BMI and GDM P lt 0.001 but gravida did not show significant association P gt 0.05 . The mean gestational weeks for all the women screened was 24.2 7.74. The mean gestational weeks of screening GDM and NGT women was 25.5 7.67 and 23.9 7.73, respectively. The family history of DM was...

Monitoring glycemic control DiabetesPregnancy

Tue, 13 Mar 2012 18:21:46 GMT

The continuous glucose monitoring has demonstrated that the time interval from meal to peak postprandial glucose level was approximately 90 min and was similar in all the evaluated types of diabetic pregnancies insulin treated or diet only and is not affected by the level of glycemic control. Moreover, no difference was obtained in postprandial glycemic profile between breakfast, lunch or dinner.43 Hence the present policy in India, from August 2006, is to maintain FPG lt 90 mg dL and 1.5 h...

232 Selective adrenergic agonists DuringBreastfeeding

Tue, 13 Mar 2012 14:13:41 GMT

. -adrenergic drugs specifically act at . -receptors. The intermediate-acting -adrenergic agonists bitolterol, fenoterol, metaproterenol, pir-buterol, reproterol, salbutamol albuterol , terbutaliiie, and tulobuterol, and the long-acting -adrenergic agonists jormoteral and salmeterol, belong to this group and are used for the treatment of asthma. , -agonists cause bronchodilation. They also inhibit uterine contractions in the second and third trimesters, and therefore are effective in the...

Elliot H Philipson NutritionPregnancy

Tue, 13 Mar 2012 01:14:54 GMT

Summary All multifetal pregnancies can be considered high risk due to frequent obstetrical complications associated with this type of pregnancies. Nutritional assessment with current dietary recommendations and specialized antenatal care are important for a good outcome. Maternal weight and weight gain are also important factors, but nutritional supplements, assessment of calorie intake, and adjustments as needed are crucial as well. Confounding variables must be considered, particularly when...

I Cant Get Pregnantl Is There Anything Wrong PregnancyChildbirth

Sun, 11 Mar 2012 04:51:35 GMT

Victory belongs to the most persevering. Conception can only happen when a sperm swims up into the womb before fertilizing an egg in the fallopian tube. This allows the fertilized embryo to implant or embed itself into the womb lining, where it will grow into a fetus. There is indeed a possibility that something is wrong in you or your partner if you are still not pregnant after a period of trying to conceive. An average couple in their 30s will conceive after about 6 months of trying to do so....

Pregnancy Represents an Allograft DuringPregnancy

Sun, 11 Mar 2012 01:20:33 GMT

Cases of recurrent abortions, preeclampsia or babies born with hemolytic diseases of the newborn still puzzle us with the of the question Why did your mother reject you Although, after looking at the complexity of the maternal-fetal immune interaction and the cases of successful pregnancies, with surprise and admiration the question now becomes Why didn't your mother reject you Medawar, in the early 1950s, recognized for the first time the unique immunology of the maternal-fetal interface and...

Conclusions Fxw DiabetesPregnancy

Sat, 10 Mar 2012 15:46:02 GMT

From this group's personal experience, it can be concluded that, despite late first prenatal visits, when pregnant women receive prenatal care before birth, perinatal results are acceptable. However, the question remains as to how many diabetic patients never reach prenatal care, are never detected, or approach the hospital to deliver a dead or macrosomic fetus without a final diagnosis of the pathology that has led to this end. These are the deficiencies of a developing country which lacks a...

Complete Miscarriage EctopicPregnancies

Fri, 09 Mar 2012 07:13:26 GMT

This should not be based on an ultrasound diagnosis. Women who present with heavy vaginal bleeding with clots and undergo an ultrasound scan which suggests a complete miscarriage i.e. an empty uterus with an endometrial thickness less than 15 mm , should be followed up with serum hCG levels until the diagnosis is established.24 We have described Figure 3.5 Haemorrhagic corpus luteum classic internal 'spider web'-like appearance on transvaginal scan. Figure 3.5 Haemorrhagic corpus luteum classic...

2612 Metronidazole and other nitroimidazole antibiotics DuringBreastfeeding

Thu, 08 Mar 2012 19:51:35 GMT

The nitroimidazole antibiotic metronidazole is an antibacterial and antiprotozoal agent used in trichomonas infections, amebiasis, giardiasis, bactcrial vaginosis, and anaerobic infections. It acts as an electron acceptor in the metabolism of the bacteria, and causcs growth disturbances in the susceptible microorganism. Active metabolites that interact with and disrupt the DNA-synthesis are responsible for the effect. After oral and intravenous administration, concentrations as high as those in...