There are also ethical concerns about this procedure, since it is a form of abortion, and also because of concerns over which fetuses are terminated and why.Selective reduction was developed in the mid-1980s, as people in the field of assisted reproductive technology became aware of the risks that multiple pregnancies carried for the mother and for the fetuses. Care in pregnancy
Women with a multiple pregnancy are usually seen more regularly by midwives or doctors than those with singleton pregnancies because of the higher risks of complications. However, there is currently no evidence to suggest that specialised antenatal services produce better outcomes for mother or babies than ‘normal’ antenatal care. Nutrition
As preterm birth is such a risk for women with multiple pregnancies, it has been suggested that these women should be encouraged to follow a high-calorie diet to increase the birth weights of the babies. Evidence around this subject is not yet good enough to advise women to do this because the long term effects of the high-calorie diets on the mother are not known. Cesarean section or vaginal delivery
A study in 2013 involving 106 participating centers in 25 countries came to the conclusion that, in a twin pregnancy of a gestational age between 32 weeks 0 days and 38 weeks 6 days, and the first twin is in cephalic presentation, planned Cesarean section does not significantly decrease or increase the risk of fetal or neonatal death or serious neonatal disability, as compared with planned vaginal delivery.
Prognosis
Without treatment, individuals with impetigo typically get better within three weeks. Complications may include cellulitis or poststreptococcal glomerulonephritis. Rheumatic fever does not appear to be related. Epidemiology
Globally, impetigo affects more than 162 million children in low- to middle-income countries. The rates are highest in countries with low available resources and is especially prevalent in the region of Oceania. The tropical climate and high population in lower socioeconomic regions contribute to these high rates. Children under the age of 4 in the United Kingdom are 2.8% more likely than average to contract impetigo; this decreases to 1.6% for children up to 15 years old. As age increases, the rate of impetigo declines, but all ages are still susceptible. History
Impetigo was originally described and differentiated by William Tilbury Fox around 1864. The word impetigo is the generic Latin word for skin eruption, and it stems from the verb impetere to attack (as in impetus). Before the discovery of antibiotics, the disease was treated with an application of the antiseptic gentian violet, which was an effective treatment. References
External links
Impetigo at Curlie
Impetigo and Ecthyma at Merck Manual of Diagnosis and Therapy Professional Edition