Introduction Across the world, one woman dies every minute of every day from a complication of pregnancy. In high-resource settings, maternal death is rare, but the UK maternal death audit programme (MBRRACE-UK) identifies substandard care in around two-thirds of cases.…
Introduction Labour is defined as the onset of regular uterine activity, cervical effacement and dilatation with descent of the presenting part. The duration of labour is variable and is influenced by factors including parity, gestation or whether the labour was…
Introduction Induction of labour is one of the most common obstetric interventions, occurring in approximately 20% of pregnancies in the United Kingdom. It is indicated in women for whom vaginal birth is planned when the risks of continuing the pregnancy…
Introduction The purpose of monitoring the fetus in labour is to identify those who might be at increased risk of death or hypoxic injury so that delivery can be expedited and harm prevented. Fetal monitoring involves fetal heart rate (FHR)…
Introduction Labour is a challenging time for mothers and their babies. The success of labour and the ability of the fetus to negotiate a journey through the maternal pelvis depends upon the successful interaction of three variables – the ‘power’…
Introduction The natural incidence of twinning has a large geographical variation, ranging from 54 in 1000 in Nigeria, 12 in 1000 in the United Kingdom, to 4 in 1000 in Japan. This difference is almost entirely due to variations in…
Introduction Pre-term birth is defined as birth before 37 weeks’ completed gestation. It occurs in around 10% of births and affects 15 million pregnancies worldwide annually. Almost one-third of pre-term births in the United Kingdom are iatrogenic (following deliberate medical…
Definitions Hypertension Threshold values of ≥140 mmHg systolic or 90 mmHg diastolic blood pressure define hypertension in pregnancy ( Fig. 28.1 ), with blood pressure ≥160 mmHg systolic or ≥110 mmHg diastolic described as severe hypertension. Chronic hypertension Chronic hypertension is…
Introduction The focus of this chapter is on fetuses who appear to be small for their gestational age. These babies may simply be small—in other words, they are normal unborn babies who just happen to be at the lower end…
Introduction Obstetric haemorrhage is one of the leading causes of maternal mortality. Worldwide, approximately 300,000 women die during pregnancy and childbirth each year, and a quarter of these are caused by haemorrhage. Whilst most deaths occur in low-resource settings (primarily…