Browsing by Author "Tahlak, Muna"

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    FIGO (International Federation of Gynecology and Obstetrics) initiative on fetal growth: Best practice advice for screening, diagnosis, and management of fetal growth restriction
    (2021) Tahlak, Muna
    Executive Summary: Fetal growth restriction (FGR) is defined as the failure of the fetus to meet its growth potential due to a pathological factor, most commonly placental dysfunction. Worldwide, FGR is a leading cause of stillbirth, neonatal mortality, and short- and long-term morbidity. Ongoing advances in clinical care, especially in definitions, diagnosis, and management of FGR, require efforts to effectively translate these changes to the wide range of obstetric care providers. This article highlights agreements based on current research in the diagnosis and management of FGR, and the areas that need more research to provide further clarification of recommendations. The purpose of this article is to provide a comprehensive summary of available evidence along with practical recommendations concerning the care of pregnancies at risk of or complicated by FGR, with the overall goal to decrease the risk of stillbirth and neonatal mortality and morbidity associated with this condition. To achieve these goals, FIGO (the International Federation of Gynecology and Obstetrics) brought together international experts to review and summarize current knowledge of FGR. This summary is directed at multiple stakeholders, including healthcare providers, healthcare delivery organizations and providers, FIGO member societies, and professional organizations. Recognizing the variation in the resources and expertise available for the management of FGR in different countries or regions, this article attempts to take into consideration the unique aspects of antenatal care in low-resource settings (labelled “LRS” in the recommendations). This was achieved by collaboration with authors and FIGO member societies from low-resource settings such as India, Sub-Saharan Africa, the Middle East, and Latin America.
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    A literature review and best practice advice for second and third trimester risk stratification, monitoring, and management of pre-eclampsia
    (2021) Tahlak, Muna
    Abstract: Pre-eclampsia is a multisystem disorder that typically affects 2%–5% of pregnant women and is one of the leading causes of maternal and perinatal morbidity and mortality, especially when the condition is of early onset. Globally, 76 000 women and 500 000 babies die each year from this disorder. Furthermore, women in low-resource countries are at a higher risk of developing hypertensive disorders of pregnancy and pre-eclampsia compared with those in high-resource countries. This is because socioeconomic, educational, and environmental disadvantages have historically beset vulnerable communities, leading to nutritional disparities, poor-quality diet, obesity, and diabetes (before and during pregnancy), thus increasing the rates of pregnancy complications, in particular pre-eclampsia. Pre-eclampsia has been traditionally defined as the onset ofhypertension accompanied by significant proteinuria after 20 weeks of gestation. Recently, the definition of pre-eclampsia has been broadened. Now the internationally agreed definition of pre-eclampsia is that proposed by the International Society for the Study of Hypertension in Pregnancy (ISSHP). According to ISSHP, pre-eclampsia is defined as systolic blood pressure at ≥140 mmHg and/or diastolic blood pressure at ≥90 mmHg on at least two occasions measured 4 hours apart in previously normotensive women and is accompanied by ≥1 of the following new-onset conditions at or after 20 weeks of gestation:..(Continued)