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  • Harrison's Internal Medicine Part 1. Introduction to Clinical Medicine Chapter 7. Medical Disorders during Pregnancy Medical Disorders during Pregnancy: Introduction Approximately 4 million births occur in the United States each year. A significant proportion of these are complicated by one or more medical disorders. Three decades ago, many medical disorders were contraindications to pregnancy.

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  • Thyroid Disease (See also Chap. 335) In pregnancy, the estrogen-induced increase in thyroxine-binding globulin causes an increase in circulating levels of total T 3 and total T4. The normal range of circulating levels of free T4, free T3, and thyroidstimulating hormone (TSH) remain unaltered by pregnancy. The thyroid gland normally enlarges during pregnancy. Maternal hyperthyroidism occurs at a rate of ~2 per 1000 pregnancies and is generally well tolerated by pregnant women. Clinical signs and symptoms should alert the physician to the occurrence of this disease.

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  • Marfan Syndrome (See also Chap. 357) This is an autosomal dominant disease, associated with a high risk of maternal morbidity. Approximately 15% of pregnant women with Marfan syndrome develop a major cardiovascular manifestation during pregnancy, with almost all women surviving.

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  • Diabetes Mellitus in Pregnancy: Treatment Pregnancy complicated by diabetes mellitus is associated with higher maternal and perinatal morbidity and mortality rates. Preconception counseling and treatment are important for the diabetic patient contemplating pregnancy and can reduce the risk of congenital malformations and improve pregnancy outcome. Folate supplementation reduces the incidence of fetal neural tube defects, which occur with greater frequency in fetuses of diabetic mothers.

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  • Gastrointestinal and Liver Disease Up to 90% of pregnant women experience nausea and vomiting during the first trimester of pregnancy. Occasionally, hyperemesis gravidarum requires hospitalization to prevent dehydration, and sometimes parenteral nutrition is required. Crohn's disease may be associated with exacerbations in the second and third trimesters. Ulcerative colitis is associated with disease exacerbations in the first trimester and during the early postpartum period.

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  • Gestational Hypertension This is the development of elevated blood pressure during pregnancy or in the first 24 h post partum in the absence of preexisting chronic hypertension and other signs of preeclampsia. Uncomplicated gestational hypertension that does not progress to preeclampsia has not been associated with adverse pregnancy outcome or adverse long-term prognosis. Renal Disease (See also Chaps. 272 and 280) Normal pregnancy is characterized by an increase in glomerular filtration rate and creatinine clearance.

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  • During its integration, Vietnam’s economy has undergone macroeconomic instability which negatively affected the economic growth and limited the benefits derived from integration. Due to macroeconomic instability caused by the lack of efficiency in managing foreign capital flows, foreign trade imbalance resulting from prolonged import surplus, mainly from the Chinese market, and the budget deficit from domestic and foreign debts, it is more challenging to ensure economic security.

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  • Investigation on the impact of US anti-dumping measures during the “catfish war” on Vietnamese pangasius exports. The Vietnamese pangasius industry has faced anti-dumping (AD) measures imposed by the United States of America (USA). This dispute between the USA and Vietnam is known as the “Catfish War”.

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  • The paper presents the detailed data of gas demand for power, fertilizer and other industries in Vietnam during 2011–2015, as well as forecasted data for 2016–2025 and 2026– 2035 phases. The results demonstrate that the domestic gas industry cannot meet the market requirement, the inadequacy is estimated of 30%. Liquefied natural gas (LNG) receiving terminal installation for import is considered as a feasible solution to the problem.

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  • IELTS is not held on set dates during the year. Test centres can arrange an IELTS administration at any time, according to local need.

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  • Các giới từ “during, for và while” thường được dùng với cụm từ chỉ thời gian. Chúng ta hãy xem sự khác nhau khi sử dụng giữa “during, for, và while”. 1/ Cách sử dụng “during” Giới từ “during” + danh từ được dùng để đề cập một sự việc gì xảy ra ở một thời điểm xác định nhưng nó không cho chúng ta biết nó xảy ra bao lâu. Vídụ: - Nobody spoke during the presentation. Không ai nói chuyện trong suốt buổi thuyết trình. - We get plenty of snow here during the winter.

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  • Cách sử dụng "During", "For" và "While" Các giới từ during, for, và while thường được dùng với cụm từ chỉ thời gian. Chúng ta hãy xem sự khác nhau khi sử dụng giữa during, for, và while.

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  • Care for pregnant women differs fundamentally from most other medical endeavours. ‘Routine’ care during pregnancy and birth interferes in the lives of healthy people, and in a process which has the potential to be an important life experience. It is diffi cult to measure the extent to which our efforts may, for example, disturb the development of a confi dent, nurturing relationship between mother and baby. The harmful effects we measure in randomised trials are limited to those we have predicted may occur.

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  • On September 15, 2008, Lehman Brothers, the fourth-largest U.S. investment bank, filed for bankruptcy, marking the largest bankruptcy in U.S. history and the burst of the U.S. subprime mortgage crisis. Concerns about the soundness of U.S. credit and financial markets led to tightened global credit markets around the world. Spreads skyrocketed. International trade plummeted by double digits, as figure O.1 illustrates. Banks reportedly could not meet customer demand to finance international trade operations, leaving a trade finance “gap” estimated at around $25 billion.

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  • A comprehensive review essential for those preparing to take the midwifery (AMBC) or women’s health nurse practitioner certification (NCC) examinations. The Midwifery & Women’s Health Nurse Practitioner Certification Review Guide was developed for both of these nursing specialties because of the many commonalities they share that enhance the delivery of care to women during their life span.

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  • Tham khảo tài liệu 'module 7: minimizing the impact on network operations during a domain restructure', công nghệ thông tin, chứng chỉ quốc tế phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả

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  • Tham khảo tài liệu 'module 4: minimizing the impact on network operations during an upgrade', công nghệ thông tin, chứng chỉ quốc tế phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả

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  • Tham khảo tài liệu 'in your opinion, should there be schoolfor pupils during weekends as well?', ngoại ngữ, kỹ năng viết tiếng anh phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả

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  • Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Radiation Oncology cung cấp cho các bạn kiến thức về ngành y đề tài: Randomized controlled trial of live lactobacillus acidophilus plus bifidobacterium bifidum in prophylaxis of diarrhea during radiotherapy in cervical cancer patients...

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  • WWF-Norway has, during the writing of this report, received great interest both from industry, governments and other NGOs. WWF hopes that addressing this issue will contribute in the long quest for protecting the biodiversity in our oceans. The report looks into the raw materials used for feed in aquaculture, specifically of salmon and trout. It examines the sustainability of the fisheries which are exploited to produce the feed, the added pressure the fish farming industry puts on those stocks, the efficiency of feeding fish to carnivorous fish, and some of the alternatives....

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