User:Adam Harangozó (NIHR WiR)/sandbox/2

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Postpartum care

Early postnatal hospital discharge

Based on interviews with 40 pregnant women, a study in the UK found that pregnant women need clear and comprehensive information about the care they can expect after giving birth.

A 2018 UK national survey found that women were less satisfied with their care after the pregnancy than before and during. Based on interviews with 40 pregnant women, a study found that pregnant women need clear and comprehensive information about what they can expect from postnatal care. The involved mothers-to-be also highlighted an anxiety about being judged for seeking support.

A UK study based on interviews with 40 pregnant women highlighted a fear of having to leave the hospital too early or having to stay too long. According to their feedback, the ideal situation would be more control over the length of stay and making a joint decision with staff.

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In the UK women from some minority backgrounds had a more challenges in accessing mental health services in the first year after their pregnancy compared to White British women.

During and after their pregnancy, one in five mothers experience mental health problems. Accessing help can be difficult due to fears of being stigmatised or simply being unaware of the services offered. Women from Black African, Asian and White Other backgrounds often face extra barriers when accessing services for mental health problems. When they managed to access services they were more likely to be detained in the hospital involuntary.

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Chronic kidney disease

Complications of pregnancy

Pre-existing disease in pregnancy

Around 3% of pregnant women have advanced stage chronic kidney disease (CKD). Pregnancy itself puts extra strain on the kidney and combined with CKD it can result in further impaired kidney function. According to a study in the UK, half of the babies of women with CKD were born prematurely or with low birthweight. This risk was even higher if the women had high blood pressure, protein leaking into their urine or stable levels of creatinine which should otherwise fall during pregnancy.

According to a study in the UK, pregnant women living with CKD had their kidney function impaired in nine months as much as living with the disease for 1,7 to 4,9 years.

Preterm birth

According to a study in the UK, half of the babies of women with CKD were born prematurely or with low birthweight. This risk was even higher if the women had high blood pressure, protein leaking into their urine or stable levels of creatinine that should otherwise fall during pregnancy.

Creatinine

high blood pressure and protein in urine is a sign for both pre-eclampsie and CKD, it could go to those articles.

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The current NICE guideline recommends a watchful waiting policy for pre-eclampsia in women between 34 and 37 weeks of pregnancy. A study involving 900 pregnant women with pre-eclampsia found that a planned delivery within 48 hours of diagnosis were better for the health of the mother. At the same time, babies were more likely to be admitted to the neonatal unit. Analysis of long-term results is still needed to see if the babies will have any development delays.

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Following an ultrasound that suggested a problem, genetic testing can be carried out to look at the condition in detail. These tests can still have uncertain results, a possibility that the parents need to be made aware of beforehand to avoid further anxiety.