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Clinical Review

beyond the evidence

BMJ 2004; 329 doi: (Published 14 October 2004) Cite this as: BMJ 2004;329:903
  1. Gillian Hawthorne (, consultant diabetologist1,
  2. Maggie Blott, consultant obstetrician2
  1. 1 Newcastle Diabetes Centre, Newcastle General Hospital, Newcastle upon Tyne NE4 6BE
  2. 2 Department of Obstetrics, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP
  1. Correspondence to: G Hawthorne

    Tommy's story shows the difficulty that is often encountered when looking after women with complex medical problems in pregnancy.1 There is simply insufficient evidence to customise the personal risk for a woman with diabetic complications who wishes to become pregnant. Women like Tommy need consensual advice and support from a highly skilled, well informed, multidisciplinary team with a good understanding of the complexity of the issues and the necessary skills to provide the required care. Good preconception care should, and in this case did, underpin the …

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