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The primary goal for all involved in the care of women in labor is a healthy mother and baby after delivery. For most pregnancies, which are low risk, delivery by cesarean section appears to pose greater risk of maternal morbidity and mortality than vaginal delivery and can have significant implications for future pregnancies.
Prolonged or post-term pregnancies are associated with an increased risk of perinatal mortality and morbidity when compared with pregnancies ending at term. This adverse outcome is mainly associated with placental insufficiency, meconium aspiration syndrome, macrosomia, and birth injury.
For many years it was taken to indicate the presence of hypoxia, leading to fetal acidosis. However, we have become more aware of the importance to the fetus of variables such as maternal/fetal temperature, chorioamnionitis, passage of meconium into the amniotic fluid (which can lead to meconium aspiration syndrome), and trauma, including events such as cord prolapse and head compression (which can occur from excessive molding even in spontaneous labor, but is more commonly associated with forceps and difficult cesarean deliveries).
This comprehensive and authoritative text on heart disease in pregnancy - one of the leading causes of maternal death - will be of value to a wide audience of obstetricians, cardiologists, anaesthetists, midwives, and cardiac nurses. It provides consensus guidelines of great practical value in a compact and convenient format. Written by a multidisciplinary team, it covers both maternity and cardiac care. Contents range from pre-conception counselling and contraception, through practical templates for antenatal and intrapartum care, to long-term outcome for both mother and baby. It covers all causes of heart disease, both congenital and acquired. Thoroughly updated, this new edition has reorganised the consensus statements about priorities in management. In addition, each chapter now starts with a summary of 'Practical Practice Points' to aid quick revision when seeing a patient with a specific problem. A new section on heart and lung transplantation has been added since the first edition.