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BMJ 2003;327 (13 September), doi:10.1136/bmj.327.7415.0-b
An improved understanding of the pathophysiology of pre-eclampsia and prematurity has resulted in advances in prediction and prevention. In a clinical review Shennan (p 604) discusses new developmentsincluding haemodynamic screening tests and low dose aspirin in pre-eclampsia, and cervical scanning and tocolytic treatments such as oxytocin antagonists in prematurity. The author says that the trend towards operative deliveries, as well as a reconsideration of old policies, has resulted in new strategies to limit interventions. These include the external cephalic version of breech babies, questioning the routine use of electronic fetal heart monitoring, and improvements of epidural techniques with low dose drugs.
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Credit: ANTONIA REEVE/SPL
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