Why are
women at higher risk of complications after total hip or knee replacement surgery?
Obstetricians have a hugely important role to play in Irish maternity services particularly in the care of
women at high risk of complications, however home births are outside the scope of their practice, they have no working knowledge or expertise in the area and therefore should not be expected to be brought into the process in an ad hoc manner.
Not exact matches
Women in their thirties and forties have diminished fertility, are
at higher risk of miscarriage and are more likely to experience birth
complications requiring a caesarean section.
Flint and colleagues suggested that when midwives get to know the
women for whom they provide care, interventions are minimised.22 The Albany midwifery practice, with an unselected population, has a rate for normal vaginal births
of 77 %, with 35 %
of women having a home birth.23 A review
of care for
women at low
risk of complications has shown that continuity
of midwifery care is generally associated with lower intervention rates than standard maternity care.24 Variation in normal birth rates between services (62 % -80 %), however, seems to be greater than outcome differences between «
high continuity» and «traditional care» groups
at the same unit.25 26 27 Use
of epidural analgesia, for example, varies widely between Queen Charlotte's Hospital, London, and the North Staffordshire NHS Trust.
Most studies
of homebirth in other countries have found no statistically significant differences in perinatal outcomes between home and hospital births for
women at low
risk of complications.36, 37,39 However, a recent study in the United States showed poorer neonatal outcomes for births occurring
at home or in birth centres.40 A meta - analysis in the same year demonstrated
higher perinatal mortality associated with homebirth41 but has been strongly criticised on methodological grounds.5, 42 The Birthplace in England study, 43 the largest prospective cohort study on place
of birth for
women at low
risk of complications, analysed a composite outcome, which included stillbirth and early neonatal death among other serious morbidity.
When a
woman conceives
at age 35 or older, she has a
higher risk of developing
high -
risk pregnancy
complications such as gestational diabetes or preeclampsia.
If I have a healthy, low
risk pregnancy, with a history
of successful,
complication free, vaginal births, then my
risk should be even lower than the statistical
risk because the statistical
risk includes
women who are
at a
higher risk than myself, if that makes sense.
And
of course if a
woman is having an induction for medical indications related to an increased
risk of stillbirth (post dates,
high blood pressure, poor fetal growth), it is likely that her baby is also
at risk for intrapartum
complications necessitating a C - section, regardless
of whether or not she was induced.
Well, the vast majority
of women give birth in the hospital, especially those
at the
highest risk for
complications, so
of course there is a larger absolute number dying in the hospital.
4 5 Others have advocated home birth for
women at high risk of obstetric
complications, 6 7 and trends to abandon
risk assessment for home birth are apparent in both Australia8 and the United States.9
When this 20 %
risk of death is compared to the 0.02 % rate
of cord prolapse during labor
at homebirth that might have a better outcome if it happened in hospital, this means that a low
risk woman has a 1000 times
higher chance
of having a life threatening
complication either to her life or her fetus / newborns life
at planned hospital birth, than if she plans to have an attended homebirth with a well - trained practitioner.
Women with PCOS can struggle to become pregnant and are
at high risk of pregnancy
complications.
Women were classified as being
at low
risk of complications in eight studies (Begley 2011; Flint 1989; Harvey 1996; Hicks 2003; MacVicar 1993; McLachlan 2012; Turnbull 1996; Waldenstrom 2001) and as «low and
high» and «
high» in six studies (Biro 2000; Homer 2001; Kenny 1994; North Stafford 2000; Rowley 1995; Tracy 2013).
Pregnant
women and young children, among others (e.g., adults 65 years
of age and older, people with certain medical conditions) are
at high risk of developing flu - related
complications.
As a final stage
of development, two authors (VS and CR) assessed usability and feasibility by using the ResQu Index in a systematic review on maternal and perinatal outcomes related to place
of birth for
women at low
risk of obstetric
complications in
high - income countries.
If a pregnant
woman with
high blood pressure and no history
of headache suddenly develops a headache that quickly gets worse, she could be
at risk for pregnancy
complications, including preeclampsia, which put both the mother and fetus
at risk.
In
women with a singleton pregnancy between 34 weeks to 36 6/7 weeks
of gestation who are
at high risk for preterm birth within the next seven days (but before 37 weeks
of gestation), SMFM recommends treatment with betamethasone, a corticosteroid demonstrated to decrease neonatal
complications in preterm infants.
Influenza remains a major health problem in the United States, resulting each year in an estimated 36,000 deaths and 200,000 hospitalizations.4 Those who have been shown to be
at high risk for the
complications of influenza infection are children 6 to 23 months
of age; healthy persons 65 years
of age or older; adults and children with chronic diseases, including asthma, heart and lung disease, and diabetes; residents
of nursing homes and other long - term care facilities; and pregnant
women.4 It is for this reason that the Centers for Disease Control and Prevention (CDC) has recommended that these groups, together with health care workers and others with direct patient - care responsibilities, should be given priority for influenza vaccination this season in the face
of the current shortage.1 Other
high - priority groups include children and teenagers 6 months to 18 years
of age whose underlying medical condition requires the daily use
of aspirin and household members and out -
of - home caregivers
of infants less than 6 months old.1 Hence, in the case
of vaccine shortages resulting either from the unanticipated loss
of expected supplies or from the emergence
of greater - than - expected global influenza activity — such as pandemic influenza, which would prompt a greater demand for vaccination5 — the capability
of extending existing vaccine supplies by using alternative routes
of vaccination that would require smaller doses could have important public health implications.
Anti-viral treatment can literally be a lifesaver for folks
at higher risk of complications from the flu, including the elderly, young children, pregnant
women, and those with underlying medical issues (such as diabetes, cancer, or heart or lung disease).
However, you need to be aware
of the fact that such marriages are
at high risks with further
complications and problems when a man gets old and a
woman is still young and energetic.
Other people
at high risk for serious flu
complications, who should strongly consider a flu shot if they haven't gotten one yet, include those with underlying medical conditions such as asthma, diabetes, heart disease and neurological conditions; pregnant
women; those younger than 5 years or older than 65 years
of age; and anyone with a weakened immune system.