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Ante-natal care, screening and child health surveillance
Published in Jackie Musgrave, Health and Wellbeing for Babies and Children, 2022
Child health surveillance has its roots in midwifery (the profession that provides assistance and medical care to women before, during and after birth) and the development of ante-natal care because of concern about the number of maternal deaths in childbirth in the 1920s. The aim was to identify problems prior to labour commencing (McIntosh 2021). Midwifery and obstetrics (the branch of medicine that specialises in providing care to women during pregnancy and childbirth and afterbirth) continued to develop as specialisms over the last century. Advances in midwifery and obstetric medicine not only led to reduced maternal mortality but also to reduce neo-natal (newborn) mortality.
Critical Care
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Jaimie Maines, Lauren A. Plante
Neither the SOFA nor the qSOFA score has been validated in pregnancy, and there are physiologic reasons to suspect that they may not perform well, particularly in relating to the BP criterion. Healthy pregnant women may have a normal systolic BP < 100mmHg. The Society of Obstetric Medicine Australia New Zealand (SOMANZ), recognizing that neither the SOFA nor qSOFA score account for the normal physiology of pregnancy, have proposed a modified screening tool for sepsis in pregnancy; see Tables 42.8 and 42.9 [130]. Further work is needed before these tools can be fully implemented.
Hypertension
Published in Daryl Dob, Griselda Cooper, Anita Holdcroft, Philip Steer, Gwyneth Lewis, Crises in Childbirth Why Mothers Survive, 2018
Michael Kinsella, Mark Scrutton
Although the consultant referred to in many reports is the obstetrician, the need for involvement of other senior specialists is also often made explicit. In addition to the obstetric anaesthetist, this may include intensive-care specialists, haematologists, renal physicians, obstetric medicine specialists, and general and vascular surgeons. The continuing involvement of the obstetrician in the care of their patient while she is on the ICU is important, as cases of over-hasty discharge from the ICU have occurred.
Obstetrics and gynaecology: one specialty or two?
Published in Journal of Obstetrics and Gynaecology, 2023
In the UK, there is broadly 75% female to 25% male gender split existing within O&G. It is noteworthy that female trainees are less likely to take up surgical gynaecology advanced training skills modules (ATSMs), particularly advanced laparoscopic surgery (44%) or oncology (59%) compared to their male counterparts. Female trainees are more likely to take up medical gynaecology ATSMs such as menopause (87%), paediatric and adolescent gynaecology (96%) and vulvar disease (84%). In addition, the uptake of obstetric ATSMs is higher amongst female trainees; most notable for advanced antenatal practice (88%), high risk pregnancy (93%) and obstetric medicine (91%) (RCOG 2022). Perhaps, separating O&G will make both specialties more attractive, as individuals would not be compelled to be trained in both, which may result in better recruitment and retention.
Lessons learned from proteome analysis of perinatal neurovascular pathologies
Published in Expert Review of Proteomics, 2020
Paloma Menéndez-Valladares, Noelia Sola-Idígora, Alejandro Fuerte-Hortigón, Irene Alonso-Pérez, Cristina Duque-Sánchez, Ana M. Domínguez-Mayoral, Patricia Ybot-González, Joan Montaner
HIE is a neurovascular pathology that produces global ischemia. HIE is one of the most serious complications of childbirth affecting term neonates, caused by an inadequate flow of oxygen to the baby’s brain as a result of a hypoxic-ischemic event during the prenatal, intrapartum, or postnatal period [14]. Despite advances in obstetric medicine, the incidence of HIE remains high (1–8 per 1,000 newborns in developed countries) and no new effective therapies beyond hypothermia have been discovered [14,15]. It is estimated that by the age of 2, up to 60% of babies with HIE will die or have severe disabilities, including mental retardation, epilepsy, and cerebral palsy [15].
Expression of NEDD4L and ENaC in Urinary Extracellular Vesicles in Pre-eclampsia
Published in Hypertension in Pregnancy, 2023
P.Y.M. Leung, M Katerelos, S. Choy, N Cook, M Lee, K Paizis, A Abboud, J. A. Manning, P.F Mount, D.A Power
This cross-sectional study was approved by the Mercy Health Human Research Ethics Committee (R14–28) and written informed consent was obtained. Participants with pre-eclampsia (PE) as per diagnostic criteria from the Society of Obstetric Medicine of Australia and New Zealand were recruited (n = 20) (17). The control group consisted of normotensive pregnant (NP) women (n = 20). Other inclusion criteria included age greater than 18 years, second or third trimester and no history of cardiac disease, renal disease, or diabetes. Patients were recruited from the Mercy Hospital for Women between 1 May 2015 to 30 July 2021.