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How to Assess & Treat Common Pregnancy Complications

Case Presentation The EMS crew of Station 4 is called to the home of a pregnant female who’s complaining of abdominal pain and vaginal bleeding that began occurring after a fall. The crew learns that she slipped on a wet floor and fell on her abdomen. She advises the lead paramedic that she’s 30 weeks pregnant and that it’s her second pregnancy. During questioning, the paramedic learns that the patient has not sought prenatal care due to severe financial difficulties and lack of insurance.  
jems.com
over 5 years ago
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24

Preeclampsia FAQs

Preeclampsia can appear at any time during pregnancy, delivery and up to six weeks post-partum, though it most frequently occurs in the final trimester and resolves within 48 hours of delivery. Preeclampsia can develop gradually, or come on quite suddenly, even flaring up in a matter of hours, though the signs and symptoms may have gone undetected for weeks or months.  
preeclampsia.org
over 5 years ago
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7
248

Pre-eclampsia. Effect of pre-eclampsia during pregnancy. | Patient

Pre-eclampsia is a complication of pregnancy. Women with pre-eclampsia have high blood pressure, protein in their urine, and may develop other symptoms...  
patient.info
over 5 years ago
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6

Placenta-on-a-Chip to Study Pregnancy, Develop New Drugs Safe for the Fetus |

A) The device’s upper (blue) and lower (red) chambers are separated by a semi-permeable membrane. B) Researchers placed maternal cells in one chamber and f  
medgadget.com
over 5 years ago
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Powders of iron plus other micronutrients for home (point-of-use) fortification of foods consumed by pregnant women | Cochrane

Pregnant women are particularly vulnerable to nutrient deficiencies due to the requirements of the growing baby during the pregnancy. In low-income countries, many women have diets with low content of vitamins and minerals, and they participate in long hours of physical labour. They are also exposed to recurrent infections, which make nutritional deficiencies worse. Thus, lack of adequate nutrition can contribute to the poor health of these women their babies.  
cochrane.org
over 5 years ago
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Antibiotic prophylaxis during the second and third trimester in pregnancy to reduce adverse pregnancy outcomes and morbidity | Cochrane

Antibiotics are administered to pregnant women during the second and third trimester of pregnancy (before labour) to prevent bacteria in the vagina and cervix affecting the pregnancy. Infection by some infectious organisms in a woman’s genital tract can cause health problems for the mother and her baby, and has been associated with preterm births. This review of eight randomised trials involved approximately 4300 women in their second or third trimester. We found that antibiotics did not reduce the risk of preterm prelabour rupture of the membranes (one trial, low quality of evidence), or the risk of preterm birth (six trials, high quality of evidence). Preterm delivery was reduced in pregnant women who had a previous preterm birth and an imbalance of bacteria in the vagina (bacterial vaginosis) during the current pregnancy. There was no reduction in preterm delivery in pregnant women with previous preterm birth without a bacterial imbalance during the current pregnancy (two trials). Postpartum endometritis, or infection of the uterus following birth, was reduced overall (three trials, moderate quality of evidence), as well as in a trial of high-risk women who had a previous preterm birth (one trial, moderate quality of evidence). No reduction in neonatal illness was observed. Outcomes of interest were available in trials with high losses to follow-up. We could not estimate the side effects of antibiotics since side effects were rare; however, antibiotics may still have serious side effects on women and their babies.  
cochrane.org
over 5 years ago
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24

Effect of administration of antihelminthic for soil-transmitted helminths during pregnancy | Cochrane

Intestinal worms (helminths) contribute to iron-deficiency anaemia as they feed on blood and cause further bleeding by releasing anticoagulant compounds. They also affect the supply of nutrients and cause anorexia, vomiting and diarrhoea. Pregnancy complicated by maternal hookworm infection poses a serious threat to the health of mothers and their babies, especially in developing countries. Women who are anaemic during pregnancy are more likely to have ill health, give birth prematurely, and have low birthweight babies with low iron reserves. Antihelminthic drugs are highly effective and have minimal side-effects but information on their use during pregnancy is limited. The major concern is that the drugs may cause malformation of the fetus (teratogenic effects). We examined the research published up to 31 January 2015 on the impact of giving a single antihelminthic treatment in the second trimester of pregnancy on maternal anaemia and pregnancy outcomes.  
cochrane.org
over 5 years ago
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Drinking in pregnancy 'significant' cause of childhood brain damage - BBC News

One of the UK's leading experts in child health is calling for stronger warnings on alcohol to alert women to the dangers of drinking while pregnant.  
bbc.co.uk
over 5 years ago
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3
118

Molecular mechanisms within fetal lungs initiate labor

Researchers have identified two proteins in a fetus' lungs responsible for initiating the labor process, providing potential new targets for preventing preterm birth. They discovered that the proteins SRC-1 and SRC-2 activate genes inside the fetus' lungs near full term, leading to an inflammatory response in the mother's uterus that initiates labor.  
sciencedaily.com
over 5 years ago
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5

Protecting families from recurrent stillbirth

Stillbirth is a tragedy for parents and has enduring medical, psychological, social, and economic consequences. It remains a major problem in the United Kingdom; in 2013, 3286 babies were stillborn after 24 weeks of pregnancy, equating to one in every 240 births.1 Since 2011, when the UK was ranked 33rd out of 35 high income countries for stillbirths, there has been a downward trend in the stillbirth rate, but this has not yet reached the lower levels seen in Scandinavia or the Netherlands.2  
feeds.bmj.com
over 5 years ago
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Family Medicine Obstetrics

Whether you offer comprehensive pregnancy care in your primary care facility, or provide prenatal and postpartum care, this book delivers the guidance you need to optimize health for both mothers and their babies. It covers all aspects of birth care, from preconception counseling and prenatal care, through labor and delivery (both low-risk and complicated), to postpartum care and the first month of life. The completely revised third edition includes the most up-to- date, evidence-based standards of care. It offers information that is patient centered, prevention oriented, educational, and sensitive to the care of the whole woman and her family.Features a reader-friendly outline/narrative format for ease of use in daily clinical practice. Describes how to care for patients with a wide range of medical conditions during pregnancy as well as pregnancy-related conditions. Takes a whole-family approach to maternity care, with discussions of maternal and paternal adjustment, marital adjustment, sibling adjustment, single-parent families, and return-to-work issues. Provides patient and family education materials on a full range of topics, from nutrition in pregnancy to breastfeeding.Features a section on alternative medicine in maternity care. Provides detailed instruction for a wide array of procedures, including cesarean delivery, perineal repair of simple and complex lacerations, circumcision, assisted deliveries, and amnioinfusion.A continued strong emphasis on evidence-based medicine includes an ongoing summary of Level A recommendations throughout the text.A new chapter summarizes practical applications of how to incorporate continuous quality improvement and enhanced medical safety into the maternity care setting.A new section details which immunizations can be used safely during pregnancy.A section on "Centering Pregnancy" discusses this new model of care and how it incorporates longitudinal group.  
books.google.co.uk
over 5 years ago
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Novel oral anticoagulants for the treatment of deep vein thrombosis | Cochrane

Deep vein thrombosis (DVT) is a condition in which a blood clot forms in the deep vein of the leg or pelvis. It affects approximately 1 in 1000 people. If it is not treated, the clot can travel in the blood and block the arteries in the lungs. This life-threatening condition is called a pulmonary embolism (PE) and occurs in approximately 3 to 4 per 10,000 people. The chances of getting a DVT can be increased if people have certain risk factors. These include previous clots, prolonged periods of immobility (such as travelling on aeroplanes or bed rest), cancer, exposure to oestrogens (pregnancy, oral contraceptives or hormone replacement therapy), trauma and blood disorders such as thrombophilia (abnormal blood clotting). A DVT is diagnosed through determining the risk factors and performing an ultrasound of the leg veins. If a DVT is confirmed, people are treated with an anticoagulant. This medicine prevents further clots from forming. Until recently, the drugs of choice were heparin, fondaparinux and vitamin K antagonists. However, these drugs can cause side effects and have limitations. Two further classes of novel oral anticoagulants have been developed: these are called direct thrombin inhibitors (DTI) and factor Xa inhibitors. There are particular reasons why oral DTIs and factor Xa inhibitors might now be better medicines to use. They can be given orally, they have a predictable effect, they do not require frequent monitoring or re-dosing and they have few known drug interactions. This review measures the effectiveness and safety of these new drugs with conventional treatment.  
cochrane.org
over 5 years ago
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Routine ultrasound in late pregnancy (after 24 weeks' gestation) to assess the effects on the infant and maternal outcomes | Cochrane

Ultrasound can be used as a clinical diagnostic tool in late pregnancy to assess the baby's condition when there are complications, or to detect problems which may not otherwise be apparent. If such problems are identified this may lead to changes in care and an improved outcome for babies. Carrying out scans on all women is however controversial. Screening all women may mean that the number of interventions is increased without benefit to mothers or babies. Although popular, women may not fully understand the purpose of their scan and may be either falsely reassured, or unprepared for adverse findings. Existing evidence shows that routine ultrasound, after 24 weeks' gestation, in low-risk or unselected women does not provide any benefit for the mother or her baby. Thirteen studies involving 34,980 women who were randomly selected to screening or a control group (no or selective ultrasound, or ultrasound with concealed results) contributed to the review. The quality of trials was satisfactory. There were no differences between groups in the rates of women having additional scans, antenatal admissions, preterm delivery less than 37 weeks, induction of labour, instrumental deliveries or caesarean section. Babies’ birthweight, condition at birth, interventions such as resuscitation, and admission to special care were similar between groups. Infant survival, with or without congenital abnormalities, was no different with and without routine ultrasound screening in late pregnancy. None of the trials reported on the effect of routine ultrasound in late pregnancy on preterm birth less than 34 weeks, maternal psychology or mental development of babies when two years old.  
cochrane.org
over 5 years ago