Congenital cystic adenomatoid malformations of the lung (CCAMs) were originally described by Ch'In and Tang in 1949 as rare lung lesions occurring in premature or stillborn infants with anasarca. In 1977 Stocker et al divided CCAM into three types based on their clinical and pathological features. The nomenclature has since changed to congenital pulmonary airway malformations (CPAMs) to reflect the possible absence of cystic changes and the probable underlying pathogenesis of different types. CPAMs are relatively rare congenital abnormalities with a reported incidence varying from 1 in 10,000 to 1 in 35,000. There is a slight male predominance, but no racial predilection has been noted. This review will outline the current nomenclature and features of different types of CPAMs, highlight possible mechanisms underlying the development of CPAMs, review current antenatal imaging modalities and interventions, address the debate surrounding the postnatal management of CPAMs, and suggest areas for future research.

Inherited bleeding disorders pose a particular challenge for pregnancy and the puerperium, due to both the inheritance risk to the fetus and the bleeding risk to the mother. Women at risk require counselling to address the following questions

1. 1 Will I bleed?

2. 2 What treatment do I need?

3. 3 Can I pass it on to my children?

The third stage of labour is defined as the period following the completed delivery of the newborn until the completed delivery of the placenta and its attached membranes. Whilst to the exhausted labouring woman this stage may be an afterthought, it is a crucial time for fetal-to-neonatal transition. Major changes in anatomy and physiology occur in both mother and baby. It has also been described as ‘potentially the most hazardous part of childbirth, largely due to the risk of postpartum haemorrhage (PPH) on placental separation. Despite this, the current management guidelines are based on an ‘eclectic combination of historical, anecdotal, philosophical and research-based factors.

There has been a marked increase in the prevalence of twins, triplets and higher-order multiple pregnancies over the last 20 years due, in part, to delayed childbearing, but more significantly associated with the widespread introduction of assisted reproductive techniques. Once viability is confirmed these pregnancies pose a series of unique challenges to the obstetrician as the dynamic of the maternal – fetal relationship changes when there are two, or more, fetuses to consider. With the exception of postmaturity, all obstetric complications are more common in multiple pregnancies. Australian data shows perinatal mortality rates of 7, 25 and 63 per 1,000 births for singleton, twin (RR 3.4) and triplet (RR 8.5) pregnancies respectively; with similar rates reported in the UK and USA. While multiple pregnancies account for only 2% of births, they account for 20% of neonatal admissions and 12% of perinatal deaths – with a 5-fold increase in deaths before 1 year of age.