Research in maternal medicine

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Abstract

The Scale of the Problem Whilst pregnancy is a positive time for many, the stark reality of maternal death continues to occur across the globe in the twenty-first century. Maternal medicine research has a crucial role to play in improving pregnancy outcomes, understanding why women die in pregnancy and advancing our knowledge of prevention and treatment of maternal morbidity. There has been a major shift in the relative proportions of causes of maternal death in high-income settings such as the United Kingdom and Ireland, from direct obstetric causes (such as pre-eclampsia and post-partum haemorrhage) to deaths from pre-existing or new onset medical and mental health conditions. In the 2012-2014 report, 60% of mothers died from medical problems in pregnancy (cardiac, neurological, and other disease) and 40% from direct complications of pregnancy (with deaths from suicide now reclassified as direct deaths). The majority of women who died from indirect causes had medical or mental health problems before they became pregnant. One of the major messages emerging from the most recent Confidential Enquiry was that women with medical and mental health problems need appropriate joint specialist and maternity care, together with pre-pregnancy advice on appropriate management of their condition. For many conditions the optimal management is based on expertise rather than evidence from large clinical studies. Hence, clinical and mechanistic research into medical conditions in pregnancy has a vital role in expanding our knowledge to inform best practice. Approach to Maternal Medicine Research As with clinical practice in maternal medicine, it can be useful to think of the interaction between pregnancy and a medical condition as shown in Table C.1. Much of the research in this field seeks to elucidate one or more characteristics of this interaction; in an ideal world each research study would address all of these aspects as it is difficult to consider maternal and fetal aspects in isolation but in reality the scope of a study may be limited by time and funding constraints.

Original languageEnglish
Title of host publicationIntroduction to Research Methodology for Specialists and Trainees
PublisherCambridge University Press
Pages226-234
Number of pages9
ISBN (Electronic)9781107585775
ISBN (Print)9781107699472
DOIs
Publication statusPublished - 1 Jan 2017

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