Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
  1. Home
  2. Search

Refine search

Refine search

Access:
Content type:
Publication date:
Apply
Subject: Show more
Journals Show more
Publishers: Show more
Societies Show more
Series: Show more
Collections: Show more

Actions for selected content:

Select all | Deselect all
  • View selected items
  • Export citations
  • Download PDF (zip)
  • Save to Kindle
  • Save to Dropbox
  • Save to Google Drive

Save Search

You can save your searches here and later view and run them again in "My saved searches".

Please provide a title, maximum of 40 characters.
Cancel
×

13 results

  • Chapter 21 - Optimal Antenatal Care in Multiple Pregnancy
  • Edited by Leanne Bricker, Julian N. Robinson, Baskaran Thilaganathan, St George's Hospital Medical School, University of London
  • Book: Management of Multiple Pregnancies
  • Published online: 11 October 2022
  • Print publication: 27 October 2022, pp 221-232
  • View extract

    Summary

    In multiple pregnancy there is increased risk of adverse outcome for both mother and babies. Providing high quality antenatal care to optimize outcomes and effectively identify and manage complications is crucial. There are a number of additional elements of care recommended which herald the need for more monitoring and contact with healthcare professionals with appropriate expertise. Additionally, women and their families require emotional support and accurate reliable information to help navigate the anxiety and stress of these higher risk pregnancies. Early pregnancy care focuses on accurate gestational dating, determining chorionicity and amnionicity, and screening for fetal complications. Later in pregnancy care concentrates on identifying and managing growth pathology, preterm birth, maternal complications, and planning for delivery. Evidence to guide management of these challenging pregnancies is often lacking, in particular there is limited evidence to guide management for triplet and higher order multiple pregnancy. Fortunately, expert-led international guidelines to inform and support health care professionals to deliver the required care have been shown objectively to improve outcomes when implemented.

Management of Multiple Pregnancies
  • Management of Multiple Pregnancies
  • A Practical Guide
  • Edited by Leanne Bricker, Julian N. Robinson, Baskaran Thilaganathan
  • Published online: 11 October 2022
  • Print publication: 27 October 2022
  • View description
    Multiple pregnancies are associated with higher risks for both mother and babies. Women with multiple pregnancies have an increased risk of miscarriage, anemia, hypertensive disorders, haemorrhage, and postnatal illness. These pregnancies are more likely to need an operative delivery, and maternal mortality is generally 2.5 times that of singleton births. Fetuses are at increased risk for anatomic and genetic anomalies, growth abnormalities, prematurity, and several physiological problems related to monochorionicity. This book provides a much needed, up-to-date guide to the management of multiple pregnancies. Presented with a uniform approach to all chapters, information is easily navigable, evidence-based, and highly practical. Heavily illustrated, particularly with ultrasound images – the cornerstone of management of multiple pregnancies - this book will appeal to obstetricians and specialists in maternal-fetal medicine, midwives and ultrasonographers and will improve outcomes for mothers and babies.
  • Chapter 4 - Planning for elective and emergency problems
  • from Section 1 - General non-medical considerations
  • Edited by Marc van de Velde, Helen Scholefield, Lauren A. Plante
  • Book: Maternal Critical Care
  • Published online: 05 July 2013
  • Print publication: 04 July 2013, pp 26-42
  • View extract

    Summary

    This chapter presents an overview on the current recommendations and guidelines that may be implemented to improve the management of planned and unplanned urgent high-risk obstetric patients and prevent fatal outcomes for both mothers and their babies. Reviewing morbidity and mortality data over the 10 years from 2000 reveals an increase in the proportion of indirect causes of maternal deaths and demonstrates that many of the case-fatalities were women who did not receive pre-pregnancy counseling or any specific medical management. The chapter discusses two examples of multidisciplinary care planning: for women who have placenta previa with acreta and have had a previous cesarean section and for women with a serious comorbidity. The goal of rapid response teams (RRTs) is to bring critical expertise and equipment to the patient without delay, in a timely manner, and to provide a solution to the problem in a standardized manner.