Planned home birth.

With increasing medical advances and the ability to rescue the mother and her baby, there has been a growth in the number of women who deliver in hospital facilities. This allows full care to be provided if required [1]. Maternal and perinatal mortality has fallen accordingly. This improvement in mother and baby outcomes has produced a conception of maternity safety in the developed world and a call for the return to home birth. This has concerned the obstetricians and particularly the paediatricians who feel that this produces unacceptable risk to the mother and her baby. However, evidence, mostly from Europe but some from the US, suggests that home birth can be relatively safe in the right circumstances. This needs a fully integrated comprehensive maternity care network that is supportive and responsive. The question is whether this should be supported to help improve the safety of home birth or resisted because home birth in many situations is inherently unsafe.

Ectopic pregnancy.

Ectopic pregnancy is a major gynecologic emergency, which results in significant morbidity for the mother and inevitable loss of the pregnancy. Its presentation can be varied from minor symptoms to sudden collapse. It produces a diagnostic dilemma and a management problem. With advances in medical care, most women survive ectopic pregnancy and many will be diagnosed early enough to allow conservative management with the resulting lower morbidity and possible anatomic conservation. This article covers what is currently known about the etiology of this condition, the best approach to the diagnoses and management and the long-term consequences for the women concerned.