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Epilepsy affects around 1 in 100 people and every year around 2500 women with epilepsy become pregnant. Although most will have an uneventful pregnancy, pregnancy for women with epilepsy carries additional risks to their wellbeing and that of their developing fetus and their infant. For some women, these risks include worsening symptoms of epilepsy, increased mortality risks and less effective treatment of other conditions and comorbidities like depression. For the developing fetus and infant, exposure to antiepileptic drugs can affect organogenesis and later development. This article highlights essential knowledge about this condition in pregnancy and considers how midwives can contribute to working collaboratively in ways that optimise pregnancy outcomes for these women. [ABSTRACT FROM AUTHOR]

Both the under 18 conception and birth rates are falling. However, despite this the United Kingdom has a high rate of teenage pregnancy compared to similar countries in Western Europe. Young mothers and their babies have poorer access to maternity care and experience worse obstetric outcomes than older mothers. It is likely that the risks associated with teenage pregnancy reflect a significant interplay between the socio-demographic status of many of these teenagers, their nutritional status and their uptake of antenatal care. This review looks at the complications associated with teenage pregnancy and how the implementation of specialized antenatal care aims to improve outcomes. [ABSTRACT FROM AUTHOR]

Background Nationally, it is recommended that women should be offered post-dates induction of labour (IOL) at 40 weeks + 10–12 days. There is evidence that an outpatient IOL service may be associated with improved maternal satisfaction. Aims A home IOL service was developed to offer women choice about where labour onset can be awaited. Methods In an attempt to fully understand key factors and improve the local IOL service, a baseline audit of care and outcomes for low-risk post-dates women was undertaken (hospital group). A home IOL service was then set up (home group) for women to await labour onset in the comfort of their own home. Once this option was available, a second audit aimed to highlight any advantages or disadvantages with the new service so as to inform future improvement. Findings Audit findings highlighted that the majority of women remained at home for between 6–14 hours and all returned to the hospital safely. Conclusions Findings from the audits undertaken before, during and after the home IOL service was implemented, highlight useful benefits for women. It is recommended that other Trusts considering implementing the same improvement carefully monitor their findings. [ABSTRACT FROM AUTHOR]

Phenylketonuria remains one of the most common inborn errors in the United Kingdom. It is detected on the newborn heel-prick screening sample allowing early treatment with a strict low phenylalanine diet supplemented with artificial amino acids, and appropriate vitamin and minerals. Although the long-term prognosis is good, there is an increasing body of evidence highlighting subtle problems in neuropsychological function with slower reaction times and poorer executive function than peers. White matter changes clearly seen on brain magnetic resonance imaging may have some relationship to these neuropsychological difficulties but their significance is not clearly understood. The diet, although successful, is difficult to follow lifelong and with its attendant risks of nutritional deficiencies needs careful specialist management. In view of these challenges new treatments such as sapropterin (a tetrahydrobiopterin analogue) and large neutral amino acids are currently being used in phenylketonuria and a human trial has started using ammonia lyase as enzyme replacement therapy. Maternal phenylketonuria syndrome remains a risk for those who conceive whilst blood phenylalanine is elevated and females must be counselled early in childhood to avoid this risk. [ABSTRACT FROM AUTHOR]

Despite the sucess of IVF over the past 40 years, funding cuts have encouraged couples to travel abroad for treatment. But, Sophie Windsor asks, could they return with more than they intended? [ABSTRACT FROM AUTHOR]

A new reporting and research system for midwifery-led settings is being rolled out to all alongside midwifery units across the UK from January 2016. The system will use monthly notifications to investigate uncommon events and conditions in midwifery-led settings. [ABSTRACT FROM AUTHOR]

The article discusses update from the UK Obstetric Surveillance System (UKOSS) on severe maternal sepsis in Great Britain from 2011-2012 based on a national case-control study. Topics include the growing rate of maternal death from sepsis in countries with advanced health systems, the rapid progression of severe sepsis highlighting the importance of following the international Surviving Sepsis Campaign guideline, and the need to regard signs of severe sepsis as an obstetric emergency.