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Maternal skeletal disorders 

Maternal skeletal disorders
Chapter:
Maternal skeletal disorders
Author(s):

Harini Narayan

DOI:
10.1093/med/9780199673643.003.0017
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date: 30 October 2020

Epidemiology, genetics, aetiology, pathogenesis, clinical features, availability of prenatal testing, impact on pregnancy and vice versa, importance of pre-pregnancy assessment and counselling, and multidisciplinary management are presented for achondroplasia, osteogenesis imperfecta (OI), and kyphoscoliosis. Associated feto-maternal complications, decisions regarding mode of delivery, and anaesthetic risks are addressed in the fact files for each condition. Varieties of OI with differing prognosis, multidisciplinary management where the mother has OI or the fetus is suspected to have OI, increased maternal morbidity/mortality when severe cardiopulmonary compromise occurs, and the risk of postpartum haemorrhage due to platelet dysfunction and tissue fragility are discussed. Referral of severe cases to tertiary centres is incorporated in the care pathway. Risks of respiratory compromise and pulmonary hypertension in severe kyphoscoliosis and the need for early multi-specialist referral are highlighted, as is clear documentation and communication of plans for intrapartum/postnatal care. Patient information is provided for each topic.

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