Hypertension in pregnancy is associated with increased maternal and fetal morbidity and mortality I t is a common sign, reflecting a number of underlying disorders that may have different clinical outcomes. It is important that a woman with hypertension be diagnosed accurately so that the cause of the hypertension can be identified. She can then be informed about her likely clinical course and be managed appropriately. Hypertensive disorders in pregnancy are best managed with a multidisciplinary approach; the obstetrician should remain the doctor in charge and seek advice from other appropriate specialists (eg anaesthetists. neonatologists, physicians) where indicated. This document offers a framework for a team approach to the diagnosis, investigation and management of women with hypertension in pregnancy The recommendations are those of a multidisciplinary working party set up by the Australasian Society for the Study of Hypertension in Pregnancy to review and revise its previous guidelines for the detection, investigation and management of hypertension in pregnancy They are based on definitions and a classification system that reflect current knowledge. It is recommended that each obstetric unit develop its own management protocols.

The detection, investigation and management of hypertension in pregnancy: full consensus statement.

Structural analysis of placental terminal villi from growth-restricted pregnancies with abnormal umbilical artery doppler waveforms

Fetal responses to placental insufficiency: an update

Habituation in fetuses of diabetic mothers

Growth and motor development in fetuses of women with type-1 diabetes. II. Emergence of specific movement patterns

Growth and motor development in fetuses of women with type-1 diabetes. III. First trimester quantity of fetal movement patterns.

Changes with time in fetal heart rate variation, movement incidences and haemodynamics in intrauterine growth retarded fetuses: a longitudinal approach to the assessment of fetal well being

Disturbed sleep regulation is often observed in neonates of women who drank heavily during pregnancy. It is unknown if (and how) an occasional drink affects fetal sleeping behavior. In 28 near-term pregnant women we examined the effects on fetal behavioral state organization of two glasses of wine (0.25 g of ethanol/kg of maternal body weight). Simultaneous 2-h recordings of fetal heart rate and body, eye, and breathing movements were made on two successive days, once without alcohol exposure and once during maternal alcohol consumption. The study was standardized for time of day and fetal sleep state, i.e., the start of recording was either during quiet sleep (n = 16) or during active sleep (n = 12). Alcohol intake reduced fetal eye movements, disorganized behavioral state organization (rapid eye movement sleep was affected in particular), and suppressed fetal breathing activity almost completely. Modest maternal alcohol intake affects fetal behavioral state organization, which reflects an immediate effect on fetal brain function.

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L.P. Morssink

Papers

Growth and motor development in fetuses of women with type-1 diabetes. III. First trimester quantity of fetal movement patterns.

Changes with time in fetal heart rate variation, movement incidences and haemodynamics in intrauterine growth retarded fetuses: a longitudinal approach to the assessment of fetal well being

Acute maternal alcohol consumption disrupts behavioral state organization in the near-term fetus.