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Medical Disorders and Pregnancy

• Editor's Note
• List of Articles

List of Articles

• Depression During Pregnancy
  Even though pregnancy is a period of emotional well-being, in some women, when pregnant, experience their first depressive episode, whereas others, with a history of depression, are at risk for its recurrence, suggesting that pregnant women show the same risk for depression as other women of child-bearing age. The purpose of this document is to address the maternal and neonatal risks of both depression and antidepressant medication exposure. It focuses on periconceptional and antenatal management. For the pregnant woman, the capacity to function optimally, enjoy relationships, manage pregnancy, and prepare for the infant’s birth is critical. Perinatal health can be conceptualized within a model that integrates the complex social, psychological, behavioral, environmental and biologic forces that shape pregnancy. Antenatal depression affects the health and well-being of the mother, baby, and family. Early identification and management of depressive symptoms in pregnant women may improve their sense of well-being.
  
  
• Thyroid Storm: Critical Care In Obstetrics
  The review evidence-based research and approaches for diagnosis and management of thyroid storm during pregnancy. Especially relevant is the intimate relationship between maternal and fetal thyroid function, particularly during the first half of pregnancy. Significant fetal brain development continues considerably beyond the first trimester, making thyroid hormone also important later in gestation. Importantly, although overt maternal thyroid failure during the first half of pregnancy has been associated with several pregnancy complications and intellectual impairment in offspring, it is currently less clear whether milder forms of thyroid dysfunction have similar effects on pregnancy and infant outcomes
  
  
• Parathyroid Diseases in Pregnancy
  Parathyroid diseases are uncommon in pregnancy, may produce significant perinatal and maternal morbidity and mortality if not diagnosed and properly managed. It reviews calcium homeostasis, primary hyperparathyroidism, hypoparathyroidism, and osteoporosis during pregnancy. PTH promotes resorption of calcium from the bones. Thus, all events of PTH action are directed at increasing serum calcium levels. The successful treatment of maternal PHP may transiently improve some of the clinical findings of preeclampsia and preterm labor.
  
  
• Obesity in Pregnancy
  Obesity is now epidemic in many developed countries secondary to decreased physical activity combined with an abundance of cheap, high-caloric foods. Maternal obesity increases the risk of multiple adverse pregnancy outcomes including congenital anomalies, miscarriage, preeclampsia, gestational diabetes (GDM), fetal macrosomia, and stillbirth. Obesity also is associated with multiple labor abnormalities, including an increased risk of induction of labor, post-dates pregnancy, prolonged labor, labor augmentation with oxytocin, excessive blood loss at delivery, and cesarean delivery. Obese women who are delivered by cesarean are at greater risk of complications such as longer operative times, excessive blood loss, wound infections, and post-operative endometritis. Not only are large numbers of women overweight or obese prior to pregnancy, but many women gain an excessive amount of weight during pregnancy, thus compounding their obstetrical risks and making them more likely to retain weight postpartum.
  
  

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