Andrew McCarthy

Most medical conditions in this age group do not result in serious morbidity, though many have the potential to do so, that is, epilepsy, asthma and migraine. It is important that women receive good advice pre-pregnancy about the potential impact of their medical condition and enter pregnancy with appropriate confidence about routine medication or specific management plans to alter treatment in the first trimester. This necessitates that they have ready access to specialist help once they become pregnant. Some compromise in effectiveness of medical treatment for long-term conditions is potentially involved and it is clearly appropriate that these issues will have been addressed prior to pregnancy, that is, anticoagulation in high-risk patients or renal protection with angiotensin converting enzyme (ACE) inhibitors.

There are a variety of medical disorders which may impact on a mother's health during pregnancy and the puerperium. These may be classified as those that are incidental to the pregnancy and where no exacerbation is expected as a result of pregnancy and those that are clearly prone to exacerbation due to pregnancy. The latter are of greatest concern to obstetricians, but incidental problems leading to serious morbidity also require careful coordinated care and care pathways are often less robust for these conditions.

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