When do pregnant women attend for antenatal care?
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Biomedical subjects
Publications and source records attributed to G Chamberlain.
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A prepregnancy clinic was set up to provide a single referral centre where women not yet pregnant but who were worried about problems when they became so could obtain advice. In the first 18 months 56 women attended. The outstanding feature is the concern of many women and their doctors about previous premature labour or late spontaneous abortion.
The use of oral contraception by women doctors on the Medical Register for England and Wales in 1975 was studied and related to the outcome of their pregnancies. Nearly two thirds had used oral contraception at some time, but less than one third of their pregnancies had followed its use. Users tended to be younger at the time of the survey and to smoke in pregnancy more often. After allowing for these associations a poor outcome was just slightly more common in pregnancies occurring after OC use, particularly in conceptions occurring within a month or after a year of cessation. In contrast conceptions occurring in the 2nd or 3rd month after cessation had an unusually favourable outcome. It therefore seems likely that at least some of this weak association between oral contraception and poor outcome may be explained by factors that determine the length of time it takes to conceive. Overall it seems that any real risk to pregnancies conceived after cessation of oral contraception must be very small and outweighed by the undoubted advantages of its use.
A survey of pregnancies occurring in 3502 women doctors provided an opportunity to examine the relationship between early fetal loss and birth weight. This was found to be complex. The most important observations were that the mean birth weight of babies preceding a spontaneous fetal loss was lower than that of livebirths preceding another livebirth, and that in the subgroup of women with repeated early losses, mean birth weight fell with increasing pregnancy order. In contrast, mean birth weight of the first livebirth following a single spontaneous abortion was higher, though not significantly, than that of livebirths in the first pregnancy.
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A survey has been made of the outcome of the pregnancies of 5700 women doctors first registered in England and Wales in 1950 or later. Conceptions that occurred when the mother was in an anaesthetic appointment resulted in smaller babies, higher stillbirth-rates, and more congenital malformations of the cardiovascular system than the pregnancies of other women doctors. There was no significant difference in the spontaneous-abortion rate between the two groups. A pronounced effect of age on this rate was evident among all groups examined.
The self-examination habits of 155 women wearing an intrauterine device have been analyzed. One-third were persistently unable to find the tail. There was a loose relationship between the type of device, the length of the tail, and failure to detect. The more parous and those of higher social class were more adept at detection, as were those who examined themselves each month.
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