The homeless pregnant woman.

Women who are pregnant and homeless constitute a unique group at significant risk of adverse foetal and maternal outcomes. Despite this heightened risk profile, social housing support to this group of women is less than satisfactory. Concerted effort and more collaborative working is needed by all who provide social, and healthcare services to homeless pregnant women, to improve the lot of these women. Clear definitions and legislative provisions in respect of the homeless will go a long way in reducing ambiguity and close loopholes which currently act to deny the homeless pregnant woman social housing support at a time when it is most needed.

Iron deficiency anaemia in pregnancy: The role of parenteral iron.

Maternal and perinatal morbidity and mortality remain major challenges in the delivery of safe maternity care worldwide. Anaemia in pregnancy is an important contributor to this dismal picture, especially where blood transfusion services are poorly developed. An early diagnosis and treatment of iron deficiency anaemia in pregnancy using the new generation dextran-free parenteral iron preparations can save lives and reduce morbidity in selected pregnancies. It is time to cast aside the fears associated with the use of the old parenteral iron preparations which were associated a high incidence of anaphylaxis, and embrace the use of new parenteral iron products which have better side effect profiles and can deliver total dose infusions without the need for test dosing. In selected women, the benefits of this treatment far outweigh any disadvantages.

Pregnancy outcome in women with autosomal dominant hypocalcaemic hypercalciuric nephrocalcinosis.

Autosomal dominant hypocalcaemic hypercalciuric nephrocalcinosis is an extremely rare clinical condition caused by an activating mutation of calcium-sensing receptor. Patients presenting with this condition are generally asymptomatic of hypocalcaemia inspite of significant lower serum calcium levels. Attempts at administering vitamin D to correct their hypocalcaemia tend to result in hypercalciuria with its attendant complications of nephrocalcinosis and renal impairment. To our knowledge there are no reports of pregnancy outcomes in women suffering with this ailment, hence this report of three pregnancies in two such women. In view of the rarity of this condition we hope it will assist professionals managing such cases.

Body piercing: a growing problem for clinicians.

Until recently body piercing was mainly confined to the ears and/or nose. In the last few years there has been a significant increase in the prevalence of body piercing which, in some instances, has had serious health consequences. This industry has the potential to significantly damage or interfere with health care. Urgent legislation is needed to remedy this situation.

Compensation for failed sterilization.

Two recent Court of Appeal decisions have modified the hitherto settled rules governing the compensation payable following failed and negligently performed sterilization. Compensation is now possible other than for the pain and suffering of the pregnancy where the child or mother is disabled.