Faculty Opinions recommendation of Topiramate in pregnancy: preliminary experience from the UK Epilepsy and Pregnancy Register.

2008 ◽  
Author(s):  
Alison Pack ◽  
Elizabeth E Gerard
Keyword(s):  
The Uk ◽  
In Pregnancy

scholarly journals Iodine and pregnancy – a UK cross-sectional survey of dietary intake, knowledge and awareness

2015 ◽  
Vol 114 (1) ◽  
pp. 108-117 ◽  
Author(s):  
E. Combet ◽  
M. Bouga ◽  
B. Pan ◽  
M. E. J. Lean ◽  
C. O. Christopher
Keyword(s):  
Iodine Intake ◽  
Dietary Recommendations ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Nutritional Recommendations ◽  
Level Of Confidence ◽  
Healthy Growth ◽  
The Uk ◽  
The Right ◽  
In Pregnancy

Iodine is a key component of the thyroid hormones, which are critical for healthy growth, development and metabolism. The UK population is now classified as mildly iodine-insufficient. Adequate levels of iodine during pregnancy are essential for fetal neurodevelopment, and mild iodine deficiency is linked to developmental impairments. In the absence of prophylaxis in the UK, awareness of nutritional recommendations during pregnancy would empower mothers to make the right dietary choices leading to adequate iodine intake. The present study aimed to: estimate mothers' dietary iodine intake in pregnancy (using a FFQ); assess awareness of the importance of iodine in pregnancy with an understanding of existing pregnancy dietary and lifestyle recommendations with relevance for iodine; examine the level of confidence in meeting adequate iodine intake. A cross-sectional survey was conducted and questionnaires were distributed between August 2011 and February 2012 on local (Glasgow) and national levels (online electronic questionnaire); 1026 women, UK-resident and pregnant or mother to a child aged up to 36 months participated in the study. While self-reported awareness about general nutritional recommendations during pregnancy was high (96 %), awareness of iodine-specific recommendations was very low (12 %), as well as the level of confidence of how to achieve adequate iodine intake (28 %). Median pregnancy iodine intake, without supplements, calculated from the FFQ, was 190 μg/d (interquartile range 144–256μg/d), which was lower than that of the WHO's recommended intake for pregnant women (250 μg/d). Current dietary recommendations in pregnancy, and their dissemination, are found not to equip women to meet the requirements for iodine intake.

Psychiatric causes of maternal deaths: Lessons from the Confidential Enquiries into Maternal Deaths

2014 ◽  
Author(s):  
Margaret R. Oates
Keyword(s):  
Maternal Death ◽  
Cardiac Disease ◽  
Maternity Care ◽  
Marked Reduction ◽  
Blood Transfusions ◽  
Maternal Deaths ◽  
Illegal Abortion ◽  
The Uk ◽  
The 19Th Century ◽  
In Pregnancy

The UK Confidential Enquiries into Maternal Deaths, published triennially, are over 50 years old. Its forebears are even older; enquiries into maternal deaths began early in the 19th century in Scotland. In the 20th century the numbers of women dying from childbirth has steadily declined, influenced by many factors, including improved public health and maternity care, smaller family size, blood transfusions, and antibiotics, to name but a few. The introduction of the Abortion Act in 1967 was followed by a marked reduction of deaths in pregnancy from the consequences of illegal abortion. The rate and causes of maternal death have always been influenced by changes in reproductive epidemiology and technology, and continue to be so. Maternal deaths in pregnancy and in the 6 weeks following delivery are required to be reported to the Coroner, if directly related to childbirth. However, there are other causes of maternal death due to conditions exacerbated by pregnancy: for example, diabetes, cardiac disease, epilepsy. These are referred to as indirect deaths. Women who die from conditions unrelated to pregnancy or childbirth are counted and described as coincidental deaths. Over the years as the direct causes of maternal death have fallen, the indirect causes of maternal death have achieved more prominence and case ascertainment has improved. Improvements in medical care and in particular intensive care have resulted in some women developing their fatal condition within 6 weeks of childbirth, only to die beyond it. For this reason, the UK Enquiry extended their period of surveillance beyond 6 weeks to include late maternal deaths, both a small number of late direct deaths and a larger number of late indirect deaths. Suicide in pregnancy and following delivery has always been included in the Enquiries. However, prior to 1994 the cases were not separately analysed and were included in the group of late Coincidental Deaths (i.e. not thought to be related to pregnancy or childbirth). The 1994–1996 Enquiry, under the Directorship and Editorship of Dr Gwyneth Lewis and Professor James O’Drife, heralded a change in presentation of the Enquiry.

Hypertensive disease

2020 ◽  
pp. 493-520
Author(s):  
Eleanor Lewis ◽  
Stuart Davies
Keyword(s):  
Critical Care ◽  
Wide Spectrum ◽  
Mode Of Delivery ◽  
Disease Process ◽  
Hypertensive Disease ◽  
System Disease ◽  
Critical Care Management ◽  
Labour Ward ◽  
The Uk ◽  
In Pregnancy

Hypertension affects ~1 in 10 pregnant women in the UK, whilst pre-eclampsia (PET) complicates 2–8% of pregnancies. Hypertensive disease is the 4th leading cause of direct deaths, with recent triennium deaths due to intracerebral causes. This chapter explores the pathophysiology of hypertensive disease and its current management in pregnancy, including the treatment of eclampsia on labour ward. PET is a multi-system disease, which may present across a wide spectrum of organs. Therefore, the anaesthetic plan of management is greatly influenced by the extent of the disease process and which systems may be involved. This chapter provides detailed recommendations for the anaesthetic plan of care, whichever mode of delivery is indicated, and the peripartum critical care management required.

scholarly journals UK internet antenatal dietary advice: a content accuracy and readability analysis

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Anne Sidnell ◽  
Penelope Nestel
Keyword(s):  
Maternal Nutrition ◽  
Hypovitaminosis D ◽  
Dietary Advice ◽  
Web Pages ◽  
Median Percentage ◽  
Significant Difference ◽  
The Us ◽  
Commercial Sources ◽  
The Uk ◽  
In Pregnancy

AbstractNutrition in pregnancy is important for the health of the mother and infant. Suboptimal maternal nutrition can result in poor pregnancy outcomes for the infant such as low birth weight, hypovitaminosis D, and neural tube defects. Theinternet is a popular source of dietary advice in pregnancy, but there are no regulations to control the quality of information provided,and poor accuracy and readability can hinder its usefulness.The purpose of this study was to examine the accuracy and readability of online pregnancy-related diet and nutrition information regardless of geographical origin when searching from the UK. The accuracy was assessed against UK government advice and the readability using theFlesch Readability Ease (FRE) tool. Three commonly searched themes were examined;foods to avoid, foods to eat, and supplements.130 web pages were rated for accuracy and readability. Descriptive and non-parametric tests were used and Spearman's Correlation used to explore the relationship between accuracy and readability.Eighty-three (64%) web pages contained accurate and inaccurate advice, 23 (18%) were accurate, 21 (16%) were inaccurate, and three (2%) lacked relevant advice. The median percentage accuracy of all advice was 83 (LQ, UQ) (48,100). Eighty-seven pages (67%) scored below the recommended FRE for public web pages. The median FRE was 55 (46, 61) defined as ‘fairly difficult’. There was a weak positive correlation between accuracy and readability of web pages, rho = 0.241, p = 0.006. There was no significant difference in accuracy of web page by theme. Readability of web pages on supplements was more difficult than foods to avoid and foods to eat. Web pages from the UK (58%) were more accurate, difference of median 33 (16, 40) p < 0.001 and more readable, difference of median 9.1 (5.0, 13.1) p < 0.001 than those from outside the UK. Web pages from commercial sources (76%) were significantly less accurate than those from non-for-profit organisations, difference of median -8 (-29, 0.00) p = 0.019. 27% of web pages originated from the US. Dietary advice for pregnancy from the US differs from that in the UK.Despite the popularity of internet searching, much pregnancy-related dietary advice online is inaccurate and difficult to comprehend. Contradictory advice may interrupt the process of making improvements to diet in pregnancy, and result in negative health outcomes for mother and infant. Healthcare professionals can support women by guiding them to accurate advice, which should only be provided by those qualified in nutrition or dietetics.

scholarly journals Obstetric medical care and training in the United Kingdom

2016 ◽  
Vol 10 (1) ◽  
pp. 40-42 ◽  
Author(s):  
Adam D Jakes ◽  
Ingrid Watt-Coote ◽  
Matthew Coleman ◽  
Catherine Nelson-Piercy
Keyword(s):  
Core Curriculum ◽  
Contributory Factor ◽  
Medical Conditions ◽  
Medical Problems ◽  
Maternal Deaths ◽  
Obstetric Medicine ◽  
Physician Role ◽  
The Uk ◽  
Maternal Medicine ◽  
In Pregnancy

The UK confidential enquiry into maternal deaths identified poor management of medical problems in pregnancy to be a contributory factor to a large proportion of indirect maternal deaths. Maternal (obstetric) medicine is an exciting subspecialty that encompasses caring for both women with pre-existing medical conditions who become pregnant, as well as those who develop medical conditions in pregnancy. Obstetrics and gynaecology trainees have some exposure to maternal medicine through their core curriculum and can then complete an advanced training skills module, subspecialise in maternal–fetal medicine or take time out to complete the Royal College of Physicians membership examination. Physician training has limited exposure to medical problems in pregnancy and has therefore prompted expansion of the obstetric physician role to ensure physicians with adequate expertise attend joint physician–obstetrician clinics. This article describes the role of an obstetric physician in the UK and the different career pathways available to physicians and obstetricians interested in maternal medicine.

scholarly journals Provision of acute medicine services for pregnant women in UK hospitals: Data from the Society for Acute Medicine Benchmarking Audit 2019

2020 ◽  
pp. 1753495X2092950
Author(s):  
Catherine Atkin ◽  
Paarul Prinja ◽  
Anita Banerjee ◽  
Mark Holland ◽  
Dan Lasserson
Keyword(s):  
Pregnant Women ◽  
Medical Problems ◽  
Acute Medicine ◽  
Hospital Size ◽  
Obstetric Medicine ◽  
Provision Of Services ◽  
Timely Access ◽  
The Uk ◽  
Local Guideline ◽  
In Pregnancy

Background Medical problems during pregnancy are the leading cause of maternal mortality in the UK. Pregnant women often present through acute services to the medical team, requiring timely access to appropriate services, physicians trained to manage medical problems in pregnancy, with locally agreed guidance available. Methods Data were collected through the Society for Acute Medicine Benchmarking Audit, a national audit of service delivery and patient care in acute medicine over a 24 hour period. Results One hundred and thirty hospitals participated: 5.5% had an acute medicine consultant trained in obstetric medicine, and 38% of hospitals had a named lead for maternal medicine. This was not related to hospital size (p = 0.313). Sixty-four units had local guidelines for medical problems in pregnancy; 43% had a local guideline for venous thromboembolism in pregnancy. Centres with a named lead had more guidelines (p = 0.019). Conclusion Current provision of services within acute medicine for pregnant women does not meet national recommendations.

scholarly journals Reflections on life-course vaccination: the England experience

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Edelstein
Keyword(s):  
Life Course ◽  
Meningococcal Disease ◽  
Age Groups ◽  
Disease Group ◽  
Life Course Approach ◽  
Group B ◽  
The Uk ◽  
The Right ◽  
The Life Course ◽  
In Pregnancy

Abstract Since the introduction of the expanded programme on immunization in the 1970s, vaccination has evolved from being an intervention of early infancy to being a programme targeting individuals at all stages of life including birth, infancy, childhood, teenage years, pregnancy and adulthood. The UK has been at the forefront of this lifelong approach to vaccination and has introduced vaccines at all stages of life in its national schedule, including vaccination against hepatitis B at birth, Meningococcal disease group B in infancy, influenza in primary school years, Meningococcal disease groups A, C, W and Y in teenage years, pertussis in pregnancy and shingles in older adults. Based on a range of studies conducted by Public Health England, This session will reflect on some of the challenges brought on by the life course approach in the UK including issues of access in different age groups, choosing the right age and settings for vaccinations, age-specific attitudes to vaccination and subsequent communication strategies, and challenges with monitoring a life-course programme.

Levetiracetam in pregnancy: Results from the UK and Ireland epilepsy and pregnancy registers

Neurology ◽  
2013 ◽  
Vol 80 (4) ◽  
pp. 400-405 ◽  
Author(s):  
E. Mawhinney ◽  
J. Craig ◽  
J. Morrow ◽  
A. Russell ◽  
W. H. Smithson ◽  
...  
Keyword(s):  
The Uk ◽  
In Pregnancy
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