List of Articles
- Seizure Disorders and Pregnancy
Roughly one out of every 100 pregnancies occurs in a woman with epilepsy. These pregnancies present a unique challenge to obstetricians and neurologists due to the interrelationship of the effects of epilepsy and pregnancy, the variable effects of anti-convulsant medications on mother and fetus, and the changes in pharmacokinetics of these medications during pregnancy. The obstetricians and neurologist should work together prior to conception and throughout the patient's pregnancy to determine the safest and most effective medical therapy. Furthermore, the pediatrician selected by the patient to care for her baby should be included in pre-pregnancy discussions to address the potential increase in congenital malformations, the potential for neonatal sedation with certain medications, and questions concerning breast-feeding. The purpose of this document is to provide the current information on this issue and to offer practical advice on managing patients. - Fetal Alcohol Syndrome: Recognition & Prevention
Maternal alcohol abuse is associated with impaired fetal growth; virtually all neonates with fetal alcohol syndrome (FAS) will exhibit significant growth restriction. The physicians should counsel patients presenting with drug or alcohol problems and refer them to an appropriate treatment resource when available. Physicians who detect the serious medical condition of addiction (drugs and/or alcohol) are obligated to intervene during pregnancy or Preconceptional counseling. On the one hand, no person has a right to use illegal drugs, and a pregnant woman has a moral obligation to avoid use of both illicit drugs and alcohol in order to safeguard the welfare of her fetus. On the other hand, effective intervention with respect to substance and alcohol abuse by a pregnant or a non-pregnant woman requires that a climate of respect and trust exist within the physician-patient relationship. Patients who begin to disclose behaviors that are stigmatized by society may be harmed if they feel that their trust is met with disrespect. - Asthma In Pregnancy
Acute asthma attacks render both the mother and fetus vulnerable to progressive hypoxia and potentially disastrous results. Early studies of pregnant women with asthma revealed high rates of perinatal complications, including perinatal loss, prematurity, preeclampsia, and low birth-weight. Prospective studies performed in the last decade demonstrate essentially normal perinatal outcomes with modern management of asthma. Poor outcomes with some evidence of increased perinatal mortality and morbidity are also seen if the intensity of asthma therapy is decreased. Pregnant patients with asthma should be managed proactively to achieve a good perinatal outcome. Initial and ongoing assessment of the severity of an asthmatic woman's condition facilitates the stepwise addition of medication to optimize control of symptoms and prevent acute attacks. Educating patients is the key to their ability to use medication appropriately and initiate treatment before an acute disease process becomes critical. - Smoking during Pregnancy
The perinatal complications associated with maternal tobacco use include preterm delivery, premature rupture of membranes, spontaneous abortion, ectopic pregnancy, low birth weight, intra-uterine growth restriction, placental abruption, placenta previa, still birth, and sudden infant death syndrome (SIDS). Smoking cessation and the resources available are also discussed. Screening for tobacco use can be done efficiently as a vital sign at every clinical visit. Tobacco control is one of the most rational, evidence-based policies in medicine. The Millennium Development Goals do not include an explicit target for reducing tobacco use, but this article explains how lower tobacco use could contribute to their achievement.
Women's Health & Education Center
Dedicated to Women's and Children's Well-being and Health Care Worldwide
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Dedicated to Women's and Children's Well-being and Health Care Worldwide
www.womenshealthsection.com