High Blood Pressure

See pregnancy complications

Premature birth

See pregnancy complications

Growth Restriction

RCOG Guideline under development

Macrosomia
Irion O, Boulvain M.
Induction of labour for suspected fetal macrosomia (Cochrane Review).
In: The Cochrane Library, Issue 1, 2002. Oxford: Update Software, Abstract.

Two trials of 313 women were included. In a non diabetic population, induction of labour for suspected macrosomia did not reduce the caesarean section or instrumental delivery rate and there was no difference in neonatal morbidity.

Previous caesarean section
Rosen MG. Dickinson JC. Westhoff CL.
Vaginal birth after cesarean: a meta-analysis of morbidity and mortality. 1991
Obstetrics & Gynecology 77(3): 465-70, Abstract.

As meta-analysis of 31 studies with a total of 11,417 trials of labour examining outcomes of those women undergoing vaginal birth after caesarean section.

Postpartrum Haemorrhage

see pregnancy complications

Post Natal Depression

Ray KL, Hodnett ED.
Caregiver support for postpartum depression (Cochrane Review).
In: The Cochrane Library, Issue 1, 2002. Oxford: Update Software, Abstract.

Two studies of 137 women were included. Although there was potential for bias in one study, professional or social support was associated with a reduction in postnatal depression.

Hoffbrand S, Howard L, Crawley H.
Antidepressant treatment for post-natal depression (Cochrane Review).
In: The Cochrane Library, Issue 1, 2002. Oxford: Update Software, Abstract.
Only one trial was of sufficient quality to be included. This concluded that fluoxetine was as effective as cognitive behavioural therapy in the short term.

Lawrie TA, Herxheimer A, Dalton K.
Oestrogens and progestogens for preventing and treating postnatal depression (Cochrane Review).
In: The Cochrane Library, Issue 1, 2002. Oxford: Update Software, Abstract.

Progestogens do not reduce postnatal depression and long-acting norethisterone enanthate is associated with an increased incidence. Oestrogens have been shown to improve depression but their side effects in the postnatal period may limit usage.

See also:
Chapter 11 Deaths from Psychiatric Causes.
Why Mothers Die: The Confidential Enquiries into Maternal Deaths in the United Kingdom, http://www.cemd.org.uk.

Review and key recommendations following deaths from severe mental illness.

Miscarriages

RCOG Green Top Guideline No.25 Early Pregnancy Loss - management
http://www.rcog.org.uk/guidelines.asp?PageID=106&GuidelineID=8
Evidenced bases review of the management of miscarriage

Recurrent miscarriage:
RCOG Green Top Guideline Recurrent Miscarriage No. 17
http://www.rcog.org.uk/guidelines.asp?PageID=106&GuidelineID=18
An evidenced based review of tests and management for the 1% of women suffering > 3 miscarriages.

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