Therapeutic Problems in Pregnancy

ISBN-13: 9789401179294 / Angielski / Miękka / 2012 / 165 str.

P. J. Lewis

Opis

The image of obstetrics as a largely manipulative art has changed radically in recent years. The risk to a healthy mother of pregnancy and labour has been markedly reduced and morbidity not mortality is the yardstick by which the quality of maternal care is judged. We are now able to devote far more attention to the fetus whose growth patterns and behaviour in utero can be studied in detail by modern and sophisticated technical aids with a resultant improvement in perinatal mortality. A patient with a pre-existing general disease, however, still presents a problem which is best managed by close co-operation between obstetrician and physician. Essential hypertension, diabetes, heart disease, thyroid disease and epilepsy are examples of disorders which require great care throughout pregnancy and during labour if good maternal and fetal results are to be obtained. There are many questions still to be answered. What is the place of hypotensive therapy in essential hypertension complicating pregnancy? When should delivery take place in the pregnant diabetic? How should the patient be delivered? What should be her management during labour? What is the risk of fetal abnormality in the epileptic patient who becomes pregnant whilst on anti-epileptic drugs? These questions and others have been the subject of a recent symposium in the Institute of Obstetrics and Gynaecology.

Spis treści

1: Hypertension in Pregnancy.- 1 The use of antihypertensive drugs in pregnancy.- 2 Antihypertensive drugs and uterine blood flow.- 3 The effect of antihypertensive drugs on the fetus.- 4 Fetal outcome in pregnancies complicated by severe hypertension treated with propranolol.- 5 The management of hypertension in the pregnant woman.- 2: Cardiovascular Therapy.- 6 Heart disease, parturition and antibiotic prophylaxis.- 7 Drug treatment and prophylaxis of thromboembolism in pregnancy.- 3: Medical Disorders.- 8 Thyroid therapy in pregnancy.- 9 The drug treatment of epilepsy in pregnancy.- 10 Epilepsy, anticonvulsants and abnormal babies.- 11 Diabetic therapy and pregnancy.- 4: Drugs and the Fetus.- 12 Maternal drug therapy and enzyme induction in the fetus and newborn.- 13 Maternal drug therapy and neonatal jaundice.- 14 The influence of maternal drug administration on human fetal breathing movements in utero.