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CHAPTER 7 - Antenatal care for women with pre-existing medical, obstetric or mental health conditions

Published online by Cambridge University Press:  05 July 2014

Jessica Moore
Affiliation:
St George’s Hospital NHS Trust
Baskaran Thilaganathan
Affiliation:
St George’s Hospital NHS Trust
Tahir Mahmood
Affiliation:
Forth Park Hospital, Kilcaldy
Philip Owen
Affiliation:
Glasgow Royal Infirmary
Sabaratnam Arulkumaran
Affiliation:
St George’s University London
Charnjit Dhillon
Affiliation:
Royal College of Obstetricians and Gynaecologists, London
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Summary

Women with pre-existing medical and obstetric problems are at increased risk of complications in pregnancy. Such high-risk pregnancies result in increased maternal, fetal and neonatal morbidity and mortality. In 2008, the National Institute for Health and Clinical Excellence (NICE) issued guidelines for routine antenatal care of healthy pregnant women. Common medical conditions that confer a higher risk to the pregnancy but are often unrecognised at referral are obesity and mental health disorders. Integrated care pathways can be used as tools to incorporate local and national guidelines into everyday practice, manage clinical risk and meet the requirements of clinical governance. Training programmes for midwives, obstetricians, GPs and psychiatrists should include perinatal psychiatric disorders. The needs of the local population must be taken into account when planning a service in terms of providing the correct care, particularly in areas where there are large numbers of women from migrant and ethnic minority populations.
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Publisher: Cambridge University Press
Print publication year: 2010

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