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‘The usual period of a woman’s going with child is nine calendar months; but there is very commonly a difference of one, two or three weeks. A child may be born alive at any time from three months: but we…
‘When the child is grown big and the mother cannot continue to provide him with enough nourishment, he becomes agitated, breaks through the membranes, and incontinently passes out into the external world free from any bonds’ Hippocrates, On Generation, 4th…
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The placenta is the central player of the maternal–fetal interface, able to communicate with both the fetus and the mother and to regulate signals from one to the other. Consequently, disturbing its development, growth, or function can have major impacts…
Recreational drug abuse has increased dramatically in recent years. Approximately 250,000 women in the United States abuse intravenous (IV) drugs, and nearly 90% of them are of childbearing age. Maternal drug addiction may result in life-threatening complications for both the…
Women with congenital heart disease have an increased risk of complications for themselves and their babies, as well as an increased risk of having children with heart disease. Ideally, genetic counseling should take place before pregnancy (see Chapter 4 ),…
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In situations when gestation carries a significant fetal or maternal risk, it may be appropriate to terminate the pregnancy. The safest time for termination is during the first trimester. Abortions may be induced by medication or performed surgically. This chapter…
High-Risk Patient Populations The highest-risk patients are those with pulmonary hypertension and those with prior peripartum cardiomyopathy. The American College of Cardiology recommendations for women with adult congenital heart disease are as follows: 1. Women of childbearing potential with congenital…