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|Hilder et al. examined 171 527 births in the North East Thames Region in London and reported that the rate of stillbirth increased six-fold from 0.35 per 1000 ongoing pregnancies at 37 weeks of gestation to 2.12 per 1000 pregnancies at 43 weeks (Figure 1). When neonatal and post-neonatal mortality rates are included, the overall risk of death increased from 0.7 per 1000 ongoing pregnancies at 37 weeks to 5.8 per 1000 pregnancies at 43 weeks1.|
|A contemporary view of the human placenta.
Our current knowledge of the human placenta is briefly reviewed. Particular stress is placed upon the considerable functional reserve capacity of the placenta, the unimportance of most visible abnormalities of the placenta, the lack of any evidence that the placenta ages during gestation and the lack of significance of placental weight. The effects on the placenta of infection and of maternal cigarette smoking are considered and the concept of placental insufficiency critically discussed. It is concluded that most cases of 'placental insufficiency' are, in reality, examples of maternal vascular insufficiency resulting from inadequate placentation during the early stages of pregnancy.
|Suspect Diagnoses Come with Biophysical Profiling
by Gloria Lemay
© 2004 Midwifery Today, Inc. All rights reserved.
[Editor's note: This article first appeared in Midwifery Today Issue 69, Spring 2004.]
Many North American women are being told at the very end of their pregnancies to go to an ultrasound clinic and have a biophysical profile done. Most are impressed by the thoroughness of their practitioner and have no idea what this test involves or what sort of harm could follow from consenting to this diagnostic procedure. They will probably not be told that there is no scientific basis for having faith in the test results and that no improvement in health has been proved from large numbers of fetuses being "profiled." Certainly, no one will mention that the only benefits of the procedure are: 1) the ultrasound clinic will earn $275; and 2) the medical practitioner will be able to cover themselves legally in the very rare instance that a baby might die in utero.
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