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Epidemiology of pre-eclampsia and the other hypertensive
disorders of pregnancy
Jennifer A. Hutcheon, PhD, Post-Doctoral Fellowa,*,
Sarka Lisonkova, MD, PhD, Post-Doctoral Fellowa,
K.S. Joseph, MD, PhD, Professora,b
aDepartment of Obstetrics and Gynaecology, University of British Columbia, 4500 Oak Street, Vancouver, V6H 2N1, Canada
bSchool of Population and Public Health, University of British Columbia, Vancouver, Canada
natural history
Hypertensive disorders of pregnancy include chronic hyperten-
sion, gestational hypertension, pre-eclampsia and chronic hyper-
complicates about 3% of pregnancies, and all hypertensive disor-
ders affect about five to 10% of pregnancies. Secular increases in
chronic hypertension, gestational hypertension and pre-eclampsia
have occurred as a result of changes in maternal characteristics
(such as maternal age and pre-pregnancy weight), whereas
declines in eclampsia have followed widespread antenatal care
and use of prophylactic treatments (such as magnesium sulphate).
Determinants of pre-eclampsia rates include a bewildering array of
risk and protective factors, including familial factors, sperm
exposure, maternal smoking, pre-existing medical conditions
(such as hypertension, diabetes mellitus and anti-phospholipid
syndrome), and miscellaneous ones such as plurality, older
maternal age and obesity. Hypertensive disorders are associated
with higher rates of maternal, fetal and infant mortality, and
severe morbidity, especially in cases of severe pre-eclampsia,
eclampsia and haemolysis, elevated liver enzymes and low plate-
lets syndrome.
? 2011 Elsevier Ltd. All rights reserved.
* Corresponding author. Tel.: þ1 604 875 2000x4800; Fax: þ1 604 875 2987.
E-mail address: email@example.com (J.A. Hutcheon).
Contents lists available at ScienceDirect
Best Practice & Research Clinical
Obstetrics and Gynaecology
journal homepage: www.elsevier.com/locate/bpobgyn
1521-6934/$ – see front matter ? 2011 Elsevier Ltd. All rights reserved.
Best Practice & Research Clinical Obstetrics and Gynaecology 25 (2011) 391–403
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Hypertensive disorders of pregnancy constitute an enigmatic and clinically challenging group of
pregnancy complications that are responsible for a substantial burden of illness in both industrialised
and less industrialised countries. This review outlines the disease definitions, global burden of
disease, natural history, and unresolved epidemiologic questions of the hypertensive disorders of
Definitions and classification of hypertensive disorders of pregnancy
The primary clinical entities that comprise the hypertensive disorders of pregnancy include chronic
hypertension, gestational hypertension, pre-eclampsia and chronic hypertension with superimposed
pre-eclampsia. A major challenge in the study of hypertension in pregnancy has been the development
of precise definitions for each of these entities, but universal agreement on disease definitions remains
Chronic hypertension
Chronic (pre-existing) hypertension is defined as a hypertension (systolic blood pressure ?
140 mmHg or diastolic blood pressure ?90 mmHg) that is diagnosed before pregnancy or before 20
weeks gestation.1Hypertension first diagnosed after 20 weeks gestation, and which persists 12 weeks
postpartum, is also considered chronic hypertension.
Gestational hypertension
Gestational hypertension is defined as hypertension that develops in pregnancy after 20 weeks
gestation and which returns to normal within 12 weeks postpartum.1The latter part of the definition
means that this diagnosis is made retrospectively in the postpartum period.
Pre-eclampsia is a systemic syndrome that is typically characterised by new-onset hypertension
and proteinuria in pregnancy (with proteinuria defined as the urinary excretion of ?300 mg of protein
in 24 h).1Pre-eclampsia is characterised by poor placental perfusion and a systemic disease process
that can involve multiple organ systems.2,3Recent guidelines of the Society of Obstetric Medicine of
Australia and New Zealand4recommend that a diagnosis of pre-eclampsia be made when hypertension
arises after 20 weeks gestation and is accompanied by any one of the following complications: renal,
haematological, hepatic or neurologic involvement, pulmonary oedema, fetal growth restriction or
placental abruption. One diagnostic criterion, namely fetal growth restriction, seems problematic
because, by definition, it eliminates all fetal growth restriction among women with gestational
Atypical pre-eclampsia may occur as hypertension associated with systemic symptoms, abnormal
haematological tests or elevated liver enzymes but without proteinuria.1Similarly, pre-eclampsia can
occur without hypertension when gestational proteinuria is associated with the systemic manifesta-
tions.5Other atypical forms of pre-eclampsia include cases that occur before 20 weeks gestation
(usually associated with gestational trophoblast disease) and those that manifest more than 48 h after
Chronic hypertension with superimposed pre-eclampsia
Chronic hypertension with superimposed pre-eclampsia is diagnosed when a woman with chronic
hypertension develops new-onset proteinuria, thrombocytopoaenia or any of the other systemic
features of the pre-eclampsia syndrome.1
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Neurologic involvement in the form of generalised tonic–clonic convulsions in women with pre-
eclampsia is termed eclampsia, if the seizures cannot be attributed to any other cause (such as epilepsy,
cerebral infection, tumour or ruptured aneurysm).1
Haemolysis, elevated liver enzymes and low platelets syndrome
Haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is a severe form of pre-
eclampsia. The manifestations of this syndrome (i.e. haaemolysis, elevated liver enzymes and a low
platelet count)1are presumed to indicate hepatocellular injury. Such injury can include unruptured
hepatic and subcapsular haematomatas.
Older terms and concepts
Labels such as 'pregnancy-induced hypertension' and 'pregnancy-associated hypertension', previ-
ously used to describe the syndrome of hypertension in pregnancy with or without proteinuria and
oedema, have been replaced by the more specific entities described above. Hyperuricaemia is
a common feature of pre-eclampsia but is not generally considered to be diagnostic.4The diagnosis of
hypertension based on a relative increase criterion (i.e. a 30 mmHg increase in systolic pressure or
a 15 mmHg increase in diastolic pressure compared with previous levels) has been abandoned in
favour of the absolute normative blood pressure cut-off of 140/90 mmHg.1
Disease severity
Numerous different classifications for disease severity in pre-eclampsia have been proposed. Criteria
have been based on the severity of hypertension (e.g. a systolic pressure ?160 mmHg, diastolic pressure
?110 mmHgonatleasttwooccasions6 hapart,6orboth),timingofdelivery(e.g.delivery<34weeks7),and
pregnancy outcome (e.g. pre-eclampsia complicated by fetal death, preterm birth or eclampsia8). Other
criteriausedtoidentifyseverepre-eclampsiaincludeproteinuriaof5 gorhigherina24-hurinespecimenor
3þ or greater on two random urine samples, oliguria of <500 ml in 24 h, cerebral or visual disturbances,
pulmonary oedema or cyanosis, epigastric or right upper-quadrant pain, impaired liver function, throm-
bocytopoaenia, fetal growth restriction and gestational age at onset of pre-eclampsia <34 weeks.9,10
However, most of the components in criteria for disease severity do not predict adverse maternal or
perinatal outcomes.11The recent development of a clinical prediction model for risk of adverse maternal
Global burden of illness
Hypertensive disorders of pregnancy complicate roughly 5–10% of pregnancies.13A World Health
Organization review identified hypertension as the single leading cause of maternal mortality in
industrialised countries, accounting for 16% of deaths.14In Africa and Asia, hypertensive disorders
accounted for 9% of maternal deaths, whereas, in Latin America and the Caribbean, the figure was over
25%.14Hypertensive disorders of pregnancy are annually responsible for about 25,000 maternal deaths
in Africa, 22,000 maternal deaths in Asia, 3,800 maternal deaths in Latin America and the Caribbean
and 150 maternal deaths in industrialised countries.
Natural history
Incidence and temporal trends
Accurate estimates of the incidence of pre-eclampsia are difficult to obtain because of a lack of stand-
ardisation of diagnostic criteria in population databases.15,16Pre-eclampsia complicates about 3% of
J.A. Hutcheon et al. / Best Practice & Research Clinical Obstetrics and Gynaecology 25 (2011) 391–403
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pregnancies in the USA.17,18Reports from other industrialised countries have also yielded estimates
on the Swedish, Danish and Norwegian Medical Birth Registers (3.0%, 4.5%, and 3.0%, respectively).7,14,20
Higher estimates have been reported in some studies, with an incidence of 8.4% reported from Wash-
ington State21and rates of 8.7% (mild pre-eclampsia) and 1.7% (severe pre-eclampsia) reported from Nova
Scotia.6These variations likely reflect both differences in maternal characteristics between populations
(such as the age distribution) and diagnosis. For instance, the Nova Scotia study6defined mild pre-
Pre-eclampsia rates have increased in the USA, with age-adjusted rates rising from 2.4% between
1987 and 1988 to 2.9% of deliveries between 2003 and 2004.17Norwegian data also showed increasing
rates, from 3.7% between 1988 and 1992 to 4.4% between 1998 and 2002.20Pre-eclampsia rates are
subject to seasonal and regional variation. In northern regions, pre-eclampsia is more common in
winter births21,22whereas, in Zimbabwe, incidence has been associated with precipitation patterns.23
In Finland, women in Northern regions have a two-fold higher risk of pre-eclampsia compared with
women in Southern regions.24
Risk factors
Risk factors for pre-eclampsia represent a bewildering array of causative antecedents that reflect
the disease's complexity. They can be loosely categorised into broad groups.
Familial factors. A family history of pre-eclampsia increases the risk of pre-eclampsia substantially and
womenwhose mothers havepre-eclampsia are more likelytohave pre-eclampsia.25Menwhofathered
a pregnancy with pre-eclampsia are more likely to father another pregnancy complicated by pre-
eclampsia in other women.26
Primipaternity and sperm exposure. Nulliparous women have a three-fold higher risk of pre-eclampsia
compared with multiparous women.27The primipaternity hypothesis28suggests that risks of pre-
eclampsia are increased among women who have limited exposure to their partner's sperm. Evidence
in favour of this hypothesis includes the lower risk of pre-eclampsia among multiparous women,
among women who have had a previous pregnancy loss, and following prolonged pre-pregnancy co-
habitation; and the higher risk of pre-eclampsia observed among women who use barrier contra-
ception and those who change partners. An increased birth interval is the alternative explanation
offered for the latter phenomenon,29although the evidence for this has been disputed.30Further
support for the primipaternity hypothesis comes from studies involving infertile couples. Women not
previously exposed to their partners sperm (e.g. women conceiving following intracytoplasmic sperm
injection for azoospermia, with sperm obtained sugically) have a three-fold higher risk of pre-
eclampsia compared with women previously exposed to their partners sperm (e.g. women conceiving
after in-vitro fertilization or intracytoplasmic sperm injection, with sperm obtained from ejaculate).31
Pre-existing medical conditions. Women with pre-existing hypertension32or diabetes mellitus33are at
a substantially higher risk of pre-eclampsia. Women with anti-phospholipid syndrome,34the other
thrombophilias,35autoimmune disease,36kidney disease,37and infertility38are also at higher risk.
Smoking. Numerous studies have shown that smoking reduces pre-eclampsia occurrence by about 50%
in a dose-dependent manner.39The association is not seen with snuff. Women who smoke in early
pregnancyand quit do not have a reduced risk, whereas those who start smoking in late pregnancy and
those who smoke throughout pregnancy are protected.40This suggests that, although generally
deletrious in terms of pregnancy outcomes, the combustion products of tobacco have a protective
effect in late pregnancy.
Miscellaneous factors. Pre-eclampsia in a previous pregnancy is a strong predictor of pre-eclampsia in
a subsequent pregnancy, especially given an early gestational age at first delivery.41Some studies have
failed to replicate this finding, however.8Older maternal age,27obesity27,32and multiple pregnancy32
J.A. Hutcheon et al. / Best Practice & Research Clinical Obstetrics and Gynaecology 25 (2011) 391–403
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also increase the risk of pre-eclampsia. Other reported risk factors for pre-eclampsia include infec-
tions42and residence at high altitude.43
Maternal effects
Pre-eclampsia and eclampsia were responsible for 0.85 (95% CI 0.54 to 1.35) maternal deaths per
100,000 maternities between 2003 and 2005 in the UK.44Similarly, hypertensive disorders of preg-
nancy were responsible for 0.60 (95% CI 0.34 to 1.03) maternal deaths per 100,000 live births in Canada
between 1999 and 2004.45Such deaths constitute about 14–15% of maternal deaths in these two
countries. Data from the UK show a steady downward temporal trend in maternal deaths from pre-
eclampsia and eclampsia.44Nevertheless, declines have been relatively modest in the UK and Canada.
The risks of serious complications such as acute renal failure and pulmonary oedema are 10 to 30-
fold higher among women with severe pre-eclampsia or eclampsia,17and pre-eclampsia has been
identified as the leading reason for intensive care unit admissions in the puerperal period.46Women
with pre-eclampsia have a 70% higher risk of placental abruption (RR¼1.7, 95% CI 1.5-2.0),47with risk
increasing with increasing disease severity.48
Effects on fetus and infant
Although stillbirth rates among women with pre-eclampsia have decreased considerably in recent
decades, studies from industrialised countries such as Norway show that women with pre-eclampsia
have a 35% higher risk of stillbirth.49Studies from less industrialised nations show that pre-eclampsia
is associated with a two-fold increased risk of stillbirth (95% CI 1.6-4.1).50
Women with severe pre-eclampsia have an 80-fold increased risk of iatrogenic preterm delivery
before 33 weeks and a 40-fold increased risk between 33 and 36 weeks.6These excess risks for
iatrogenic early delivery play a large role in the four-fold increase in low birth weight rates observed in
the offspring of women with pre-eclampsia.51Neonatal mortality is about two-fold higher among
infants of mothers with pre-eclampsia, and this increased risk has remained relatively constant during
recent decades.49Offspringof womenwith pre-eclampsia arealso at increased riskof lowApgarscores,
febrile seizures, encephalopathy, and neonatal intensive care unit admission.51?54Interestingly, infants
born at very preterm ages as a result of pre-eclampsia have a reduced risk of cerebral white matter
damage and cerebral palsy compared with infants born very preterm for other reasons.55
The relationship between pre-eclampsia and fetal growth is complex. Compared with infants born
towomenwithout pre-eclampsia, infants born towomenwith pre-eclampsia have a three- to four-fold
increased risk of being small for gestational age (a birthweight <10th percentile).51,56However, the risk
of intrauterine growth restriction is much more pronounced at preterm gestation than at term.57At
preterm gestation, infants born after pre-eclampsia are 10–25% smaller56,58than their peers of similar
gestational age. In contrast, at term gestation, they are at a significantly increased risk of being either
small for gestational age or large for gestational age, resulting in no difference in average weight or
In-utero exposure to pre-eclampsia has been associated with long-term health effects for the
offspring. Offspring of pregnancies complicated by pre-eclampsia have higher levels of systolic and
diastolic blood pressure in childhood and adolescence than their peers from uncomplicated preg-
nancies.59Also, increased risks of hospitalisation due to metabolic disorders, epilepsy and other
complications have been noted.60,61Long-term follow-up studies have shown increased risks of stroke
and a trend towards increased risk of coronary heart disease at age 60–70 years.62It is unclear whether
these increased risks reflect a causal effect of in-utero exposure to pre-eclampsia, or shared genetic or
environmental factors.
Recurrence in subsequent pregnancy
Women with pre-eclampsia have a 7–15% chance of developing pre-eclampsia in a subsequent
pregnancy, compared with a 1% chance for women with no pre-eclampsia in their first pregnancy.7,8
The risk of pre-eclampsia in a third pregnancy increases to 30% if a woman's first two pregnancies
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were complicated by pre-eclampsia,10whereas the risk remains at 1% for women with no history of
pre-eclampsia. The risk of recurrence is influenced bygestational age atonset and plurality of the index
Long-term sequelae
A consistent association has been found between pre-eclampsia and long-term risk of cardiovas-
cular and metabolic disease in the mother. Women with pre-eclampsia have a three- to four- fold
increased risk of developing chronic hypertension and an approximately two-fold increased risk of
ischaemic heart disease, stroke and venous thromboembolism.64Studies show that cardiovascular risk
factors such as dyslipidaemia and elevated blood pressure are present years before pregnancy in
women who subsequently developed pre-eclampsia, suggesting that the pre-eclampsia may be
a manifestation of a common disease process.65
Studies have reported both decreased66and increased67risks of cancer after pre-eclampsia, with
a meta-analysis reporting a null effect.64The overall increase mortality risk after pre-eclampsia (RR
1.49, 95 % CI 1.1-2.1]) is largely driven by increased risk of death due to cardiovascular disease.64
Other hypertensive disorders
Pre-existing (chronic) hypertension
Between 1 and 4% of women aged 18–29 years, and 5–15% of women aged 30–39 years in the USA
(1999–2004) have chronic hypertension.68The US Nationwide Inpatient Survey estimated that 1.7% of
pregnancies in 2004 were complicated by pre-existing hypertension, a 50% increase since 1998.17
Increases in obesity and maternal age are likely to be responsible for this temporal increase.
Ratesof perinatal mortality, preterm delivery, and small gestational ageinfants are all two-tothree-
fold higher in this group of women compared with normotensive women,33,69whereas rates of serious
maternal morbidity (i.e. acute renal failure, pulmonary oedema and adult respiratory distress
syndrome) can be nine-fold higher.17Women with pre-existing hypertension have a three-fold
increased risk of death compared with normotensive women.17The increased risk is often mediated
through the increased risk of developing superimposed pre-eclampsia, which is estimated to be 20–
25%.33,69,70Although the risks of adverse outcomes increase significantly with the development of
superimposed pre-eclampsia,33,70women with pre-existing hypertension without pre-eclampsia do
remain at increased risk.33
Gestational hypertension
Gestational hypertension complicates roughly 2–3% of pregnancies in the USA.16,17As with pre-
eclampsia and pre-existing hypertension, rates of gestational hypertension have been increasing in
recent decades from 10.7 to 30.6 per 1,000 deliveries reported between 1987 and 2004.16Womenwith
gestational hypertension are at increased risk of developing super-imposed pre-eclampsia and about
17% of womenwith gestational hypertension subsequently develop pre-eclampsia.71Although women
with gestational hypertension are at increased risk of serious obstetric complications compared with
normotensive women, risks to the mother are considerably less than for the other hypertensive
disorders of pregnancies.17Maternal risks associated with gestational hypertension are generally less
than two-fold higher, compared with two- to nine-fold higher risk among women with mild pre-
eclampsia or pre-existing hypertension. Severity of hypertension is an important predictor of risks,
however, and women with severe gestational hypertension are at higher risk of adverse maternal and
perinatal outcomes than women with mild pre-eclampsia.72
The incidence of eclampsia has been estimated to be 2.7 cases per 10,000 births in 2005 in the UK,73
5.7 per 10,000 deliveries in Canada in 2007,745.0 per 10,000 maternities in Denmark, Norway and
Sweden between 1998 and 2000,756.0 per 10,000 deliveries in the Netherlands,76and 8.2 per 10,000
J.A. Hutcheon et al. / Best Practice & Research Clinical Obstetrics and Gynaecology 25 (2011) 391–403
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deliveries in the USA between 1996 and 2004.17The frequency of eclampsia in less industrialised
countries is substantially higher and estimates range from 16–69 per 10,000 births.77
Unlike the hypertensive disorders of pregnancy in general, rates of eclampsia have declined in
industrialised countries in recent decades. The rate of eclampsia in the UK decreased from 4.9/10,000
maternities (95% CI 4.5 to 5.4) in 199278to 2.7 cases per 10,000 births (95% CI 2.4 to 3.1) in 2005.73This
45% decrease reflects a continued temporal decline over the past century, with reductions of over 90%
observed since the 1920s.79In the USA, the age-adjusted frequency of eclampsia decreased non-
significantly from 10.4 per 10,000 deliveries between 1987 and 1995 to 8.2 per 10,000 deliveries
between 1996 and 2004.17Improved access to antenatal care, early delivery of womenwith severe pre-
eclampsia, and use of magnesium sulphate80are believed to be responsible for the reductions.
Risks of serious adverse maternal and perinatal outcomes are high among women with eclampsia.
In industrialised countries, the case fatality rate is below 1%, but severe maternal complications (such
as coma, stroke and acute respiratory distress) occur in 10–30% of cases.73,77,81About 5–8% of preg-
nancies complicated by eclampsia result in a perinatal loss.77,81,82
Heterogeneity of pre-eclampsia
Considerable heterogeneity in pregnancy outcomes is evident depending on gestational age at
onset of pre-eclampsia. For example, maternal mortality rates are 24 times higher when pre-eclampsia
onset occurs at less than 28 weeks compared with onset at term gestation.83Infants of mothers with
pre-eclampsia at preterm gestation are significantly smaller than their non-pre-eclampsia peers of
similar gestation, whereas infants of mothers with pre-eclampsia at termgestation are at increased risk
of being either smaller or larger than their non-pre-eclampsia peers.51,58Women with early onset pre-
eclampsia (before 34 weeks) have a four-fold increased risk of stillbirth in a subsequent pregnancy,
whereas women with late-onset pre-eclampsia have no elevated risk for subsequent stillbirth.84
Finally, women with early onset pre-eclampsia have considerably higher risks of recurrence in
subsequent pregnancies than women with a later disease onset.41
Haemodynamic and placental morphology studies also suggest that pre-eclampsia is a heteroge-
neous entity. Women who subsequently develop early onset pre-eclampsia have high vascular resis-
tance and low cardiac output before disease onset (at 20–22 weeks), whereas women who
subsequently developed pre-eclampsia at or beyond 34 weeks have low vascular resistance at 20–22
weeks.85The placental lesions characteristic of pregnancies with pre-eclampsia are considerably more
common in women with an earlier disease onset.86
These observations have lead several authors to propose that, like diabetes, several distinct
subtypes of pre-eclampsia exist.87,88The early, more severe subtype may be associated with underlying
genetic or environmental factors that result in abnormal placentation. In contrast, the later-onset, less
severe subtype may be a consequence of factors such as obesity, diabetes, cardiovascular disorders or
multi-fetal pregnancy.
Modification of the effect of pre-eclampsia on perinatal mortality by gestational age
Intersecting perinatal mortality curves
A paradoxical relationship between hypertension in pregnancy and gestational age-specific (and
birth-weight-specific) perinatal mortality has been reported in several studies.89,90At term gestation,
neonatal mortality rates are higher among infants of women with hypertension in pregnancy
compared with infants of women without hypertension. The opposite is true at preterm gestation
(Fig. 1). This phenomenon is also observed with stillbirth (Fig. 1). Such paradoxical effects are not
unique to hypertensive disorders of pregnancy but are also seen when examining risk factors such as
maternal smoking, race, plurality and parity. For example, low-birth-weight infants of smokers have
better survival compared with the low-birth-weight infants of non-smokers, whereas the opposite is
true at higher birth weights. This general phenomenon is known as the 'paradox of intersecting
perinatal mortality curves' and, although various explanations have been proposed (see below), there
is no consensus regarding the underlying cause.91
J.A. Hutcheon et al. / Best Practice & Research Clinical Obstetrics and Gynaecology 25 (2011) 391–403
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The stress hypothesis
Increased level of maternal cortisol due to stress factors, such as hypertension, can lead to accel-
erated lung maturation92and a lower risk of respiratory distress syndrome, intraventricular haemor-
rhage and neonatal death.92,93
Haig's hypothesis
The evolutionary theory of maternal–fetal genetic conflict also provides a rationale for higher
neonatal survival among preterm infants born to mothers with hypertension.94Maternal hypertension
may represent an adaptive process that occurs in response to unmet nutritional and oxygen demands
Fig.1. Gestational age-specific fetal mortality rates per 1000 total births (A) and gestational age-specific neonatal mortalityrates per
1000 live births (B) among women with and without pregnancy-induced hypertension, USA,1999–2002 (National Center for Health
Statistics cohort linked birth-infant death files).
J.A. Hutcheon et al. / Best Practice & Research Clinical Obstetrics and Gynaecology 25 (2011) 391–403
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Fig. 2. Fetal and neonatal mortality rates among women with and without gestational hypertension/pre-eclampsia, with (A) birth-
weight-specific mortality expressed in relative terms (as the number of standard deviations from the subpopulation mean [i.e.,as
per 1000 fetuses at risk. Data from the USA,1999–2002 (National Center for Health Statistics cohort linked birth-infant death files).
J.A. Hutcheon et al. / Best Practice & Research Clinical Obstetrics and Gynaecology 25 (2011) 391–403
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of the fetus.95Genotypes that promote infant survival may include genes responsible for fetal ability to
affect maternal physiology in early gestation leading to hypertension.
The relative birth weight hypothesis
The paradox has also been explained as an artefact arising from an incorrect conceptualisation of
gestational age and birth weight.96Viewing gestational age or birth weight in relative rather than
absolute terms resolves the paradox (Fig. 2A). Neonatal mortality rates are higher among infants born
to women with hypertension in pregnancy at all relative birth weights. A similar resolution of the
paradox is seen when relative gestational age is used.
The fetuses-at-risk approach
An alternative formulation of perinatal mortality, using fetuses at risk for stillbirth or neonatal
death, also resolves the paradox. As all fetuses in ongoing pregnancies are at risk of being stillborn, this
formulation uses the number of fetuses in ongoing pregnancies at each week of gestation as the
denominator for stillbirth rates (as opposed to conventional calculations which use the number of total
births at each week of gestation).97A similar formulation is used for neonatal mortality.91,98Under the
fetuses-at-risk approach, women with hypertension in pregnancy have higher rates of stillbirth and
neonatal death at all gestational ages compared with normotensive women (Fig. 2B and C).
Hypertensive disorders of pregnancy include chronic hypertension, gestational hypertension, pre-
eclampsia and chronic hypertension with superimposed pre-eclampsia. Pre-eclampsia, the hallmarks
of which include poor placental perfusion and systemic involvement, is a heterogeneous disease, with
a distinct and more severe clinical profile when gestation at disease onset is less than 34 weeks. Pre-
eclamspia complicates about 3% of pregnancies, and all hypertensive disorders affect about five to 10 of
pregnancies. Secular increases in chronic hypertension, gestational hypertension and pre-eclampsia
have occurred as a result of changes in maternal characteristics (i.e. maternal age and pre-pregnancy
weight), whereas declines in eclampsia have followed widespread antenatal care and use of prophy-
lactic treatments (i.e. magnesium sulphate). Determinants of pre-eclampsia rates include risk and
protective factors, such as familial factors, sperm exposure, maternal smoking, pre-existing medical
conditions, plurality, older maternal age and obesity. Hypertensive disorders of pregnancy are asso-
ciated with higher rates of maternal and fetal and infant mortality, and severe morbidity, especially in
cases of severe pre-eclampsia, eclampsia and HELLP syndrome. Women with hypertension in preg-
nancy show the paradoxof intersecting perinatal mortalitycurves; perinatal mortality rates at preterm
gestation are unexpectedly lower among mothers with hypertensive disorders (compared with peri-
natal mortality rates among mothers without hypertension inpregnancy), whereas the opposite is true
at later gestation.
Practice points
? Pre-eclampsia and the other hypertensive disorders of pregnancy are responsible for
a substantial fraction of the burden of maternal and perinatal morbidity and mortality
? In industrialised countries, rates of pre-eclampsia, gestational hypertension and chronic
hypertension have increased in recent years, whereas rates of eclampsia have decreased
? An early gestational age at onset for pre-eclampsia is associated with a significantly worse
prognosis for mother and infant.
J.A. Hutcheon et al. / Best Practice & Research Clinical Obstetrics and Gynaecology 25 (2011) 391–403
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Conflict of interest
None declared.
JAH was supported by post-doctoral fellowship awards from the Canadian Institutes of Health
Research and the Michael Smith Foundation for Health Research (MSFHR). SL was supported by a post-
doctoral fellowship award from MSFHR. KSJ holds a career scientist award from the Child and Family
Research Institute, Vancouver, Canada.
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United States, 1987–2004. Am J Hypertens 2008; 21: 521–526.
*18. Kuklina EV, Ayala C & Callaghan WM. Hypertensive disorders and severe obstetric morbidity in the United States. Obstet
Gynecol 2009; 113: 1299–1306.
19. Stone P, Cook D, Hutton J et al. Measurements of blood pressure, oedema and proteinuria in a pregnant population of New
Zealand. Aust N Z J Obstet Gynaecol 1995; 35: 32–37.
20. Dahlstrom BL, Engh ME, Bukholm G & Oian P. Changes in the prevalence of pre-eclampsia in Akershus County and the rest
of Norway during the past 35 years. Acta Obstet Gynecol Scand 2006; 85: 916–921.
21. Rudra CB & Williams MA. Monthly variation in pre-eclampsia prevalence: Washington State, 1987–2001. J Matern Fetal
Neonatal Med 2005; 18: 319–324.
Research agenda
? A standardised disease definition that is consistent with the occurrence of adverse maternal
and perinatal outcomes.
? Improved surveillance of incidence and outcomes of hypertensive disorders of pregnancy in
developing countries.
? A better understanding of the reasons for the heterogeneity in risk factors and outcomes
within pre-eclampsia subtypes.
J.A. Hutcheon et al. / Best Practice & Research Clinical Obstetrics and Gynaecology 25 (2011) 391–403
Page 12
22. Phillips JK, Bernstein IM, Mongeon JA et al. Seasonal variation in pre-eclampsia based on timing of conception. Obstet
Gynecol 2004; 104: 1015–1020.
23. Wacker J, Schulz M, Fruhauf J et al. Seasonal change in the incidence of pre-eclampsia in Zimbabwe. Acta Obstet Gynecol
Scand 1998; 77: 712–716.
24. Kaaja R, Kinnunen T & Luoto R. Regional differences in the prevalence of pre-eclampsia in relation to the risk factors for
coronary artery disease in women in Finland. Eur Heart J 2005; 26: 44–50.
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*26. Lie RT, Rasmussen S, Brunborg H et al. Fetal and maternal contributions to risk of pre-eclampsia: population based study.
27. Hartikainen AL, Aliharmi RH & Rantakillo PT. A cohort study of epidemiologic associations and outcomes of pregnancies
with hypertensive disorders. Hypertens Pregnancy 1998; 17: 31–41.
28. Robillard PY, Hulsey TC, Alexander GR et al. Paternity patterns and risk of pre-eclampsia in the last pregnancy in mul-
tiparae. J Reprod Immunol 1993; 24: 1–12.
29. SkjaervenR,WilcoxAJ&LieRT.Theintervalbetweenpregnanciesandtheriskofpre-eclampsia.NEnglJMed2002;346:33–38.
30. Dekker G & Robillard PY. The birth interval hypothesis-does it really indicate the end of the primipaternity hypothesis.
J Reprod Immunol 2003; 59: 245–251.
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eclampsia. Lancet 2002; 359: 673–674.
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ulation-based cohort study. Am J Epidemiol 1998; 147: 1062–1070.
33. McCowan LM, Buist RG, North RA & Gamble G. Perinatal morbidity in chronic hypertension. Br J Obstet Gynaecol 1996; 103:
34. Yasuda M, Takakuwa K, Tokunaga A et al. Prospective studies of the association between anticardiolipin antibody and
outcome of pregnancy. Obstet Gynecol 1995; 86: 555–559.
35. van Pampus MG, Dekker GA, Wolf H et al. High prevalence of hemostatic abnormalities in women with a history of severe
pre-eclampsia. Am J Obstet Gynecol 1999; 180: 1146–1150.
36. Smyth A, Oliveira GH, Lahr BD et al. A systematic review and meta-analysis of pregnancy outcomes in patients with
systemic lupus erythematosus and lupus nephritis. Clin J Am Soc Nephrol 2010; 11: 2060–2068.
37. Murakami S, Saitoh M, Kubo T et al. Renal disease in women with severe pre-eclampsia or gestational proteinuria. Obstet
Gynecol 2000; 96: 945–949.
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44. Confidential Inquiry into Maternal and Child Health. Saving mothers' lives: reviewing maternal deaths to make motherhood
safer: 2003–2005 2007. London.
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47. Ananth CV, Savitz DA & Williams MA. Placental abruption and its association with hypertension and prolonged rupture of
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48. Hogberg V, Rasmussen S & Irgens LM. The effect of smoking and hypertensive disorders on abruptio placentae in Norway
1999-2002. Acta Obstet Gynecol Scand 2007; 86: 304–309.
*49. Basso O, Rasmussen S, Weinberg CR et al. Trends in fetal and infant survival following pre-eclampsia. JAMA 2006; 296:
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J Obstet Gynecol 2000; 183: 148–155.
52. Badawi N, Kurinczuk JJ, Keogh JM et al. Antepartum risk factors for newborn encephalopathy: the Western Australian
case-control study. BMJ 1998; 317: 1549–1553.
53. Friedman SA, Schiff E, Kao L & Sibai BM. Neonatal outcome after preterm delivery for pre-eclampsia. Am J Obstet Gynecol
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54. Vestergaard M, Basso O, Henriksen TB et al. Pre-eclampsia and febrile convulsions. Arch Dis Child 2003; 88: 726–727.
55. McElrath TF, Allred EN, Boggess KA et al. Maternal antenatal complications and the risk of neonatal cerebral white matter
damage and later cerebral palsy in children born at an extremely low gestational age. Am J Epidemiol 2009; 170: 819–828.
56. Odegard RA, Vatten LJ, Nilsen ST et al. Pre-eclampsia and fetal growth. Obstet Gynecol 2000; 96: 950–955.
57. Long PA, Abell DA & Beischer NA. Fetal growth retardation and pre-eclampsia. Br J Obstet Gynaecol 1980; 87: 13–18.
*58. Rasmussen S & Irgens LM. Fetal growth and body proportion in pre-eclampsia. Obstet Gynecol 2003; 101: 575–583.
59. Ferreira I, Peeters LL & Stehouwer CD. Pre-eclampsia and increased blood pressure in the offspring: meta-analysis and
critical review of the evidence. J Hypertens 2009; 27: 1955–1959.
60. Wu CS, Sun Y, Vestergaard M et al. Pre-eclampsia and risk for epilepsy in offspring. Pediatrics 2008; 122: 1072–1078.
61. Wu CS, Nohr EA, Bech BH et al. Health of children born to mothers who had pre-eclampsia: a population-based cohort
study. Am J Obstet Gynecol 2009; 201: 269.e1–269.e10.
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62. Kajantie E, Eriksson JG, Osmond C et al. Pre-eclampsia is associated with increased risk of stroke in the adult offspring: the
Helsinki birth cohort study. Stroke 2009; 40: 1176–1180.
63. Trogstad L, Skrondal A, Stoltenberg C et al. Recurrence risk of pre-eclampsia in twin and singleton pregnancies. Am J Med
Genet A 2004; 126A: 41–45.
64. Bellamy L, Casas JP, Hingorani AD & Williams DJ. Pre-eclampsia and risk of cardiovascular disease and cancer in later life:
systematic review and meta-analysis. BMJ 2007; 335: 974.
65. Magnussen EB, Vatten LJ, Smith GD et al. Hypertensive disorders in pregnancy and subsequently measured cardiovascular
risk factors. Obstet Gynecol 2009; 114: 961–970.
66. Terry MB, Perrin M, Salafia CM et al. Pre-eclampsia, pregnancy-related hypertension, and breast cancer risk. Am J Epidemiol
2007; 165: 1007–1014.
67. Calderon-Margalit R, Friedlander Y, Yanetz R et al. Pre-eclampsia and subsequent risk of cancer: update from the Jerusalem
Perinatal Study. Am J Obstet Gynecol 2009; 200: 63.e1–63.e5.
68. Cutler JA, Sorlie PD, Wolz M et al. Trends in hypertension prevalence, awareness, treatment, and control rates in United
States adults between 1988–1994 and 1999–2004. Hypertension 2008; 52: 818–827.
69. Rey E & Couturier A. The prognosis of pregnancy in women with chronic hypertension. Am J Obstet Gynecol 1994; 171:
70. Sibai BM, Lindheimer M, Hauth J et al. Risk factors for pre-eclampsia, abruptio placentae, and adverse neonatal outcomes
among women with chronic hypertension. National Institute of Child Health and Human Development Network of
Maternal-Fetal Medicine Units. N Engl J Med 1998; 339: 667–671.
71. Saudan P, Brown MA, Buddle ML & Jones M. Does gestational hypertension become pre-eclampsia? Br J Obstet Gynaecol
1998; 105: 1177–1184.
72. Buchbinder A, Sibai BM, Caritis S et al. Adverse perinatal outcomes are significantly higher in severe gestational hyper-
tension than in mild pre-eclampsia. Am J Obstet Gynecol 2002; 186: 66–71.
*73. Knight M. Eclampsia in the United Kingdom 2005. BJOG 2007; 114: 1072–1078.
74. Liu S, Joseph KS, Bartholomew S et al. Temporal trends and regional variations in severe maternal morbidity in Canada,
2003 to 2007. J Obstet Gynecol Canada 2010; 32: 847–855.
75. Andersgaard AB, Herbst A, Johansen M et al. Eclampsia in Scandinavia: incidence, substandard care, and potentially
preventable cases. Acta Obstet Gynecol Scand 2006; 85: 929–936.
76. Zwart JJ, Richters A, Ory F et al. Eclampsia in the Netherlands. Obstet Gynecol 2008; 112: 820–827.
77. Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol 2009; 33: 130–137.
78. Douglas KA & Redman CW. Eclampsia in the United Kingdom. BMJ 1994; 309: 1395–1400.
79. Leitch CR, Cameron AD & Walker JJ. The changing pattern of eclampsia over a 60-year period. Br J Obstet Gynaecol 1997;
104: 917–922.
80. Altman D, Carroli G, Duley L et al. Do womenwith pre-eclampsia, and their babies, benefit from magnesium sulphate? The
Magpie Trial: a randomised placebo-controlled trial. Lancet 2002; 359: 1877–1890.
81. Kullberg G, Lindeberg S & Hanson U. Eclampsia in Sweden. Hypertens Pregnancy 2002; 21: 13–21.
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gravidas. Eur J Obstet Gynecol Reprod Biol 2010; 149: 165–169.
85. Valensise H, Vasapollo B, Gagliardi G & Novelli GP. Early and late pre-eclampsia: two different maternal hemodynamic
states in the latent phase of the disease. Hypertension 2008; 52: 873–880.
86. Egbor M, Ansari T, Morris N et al. Morphometric placental villous and vascular abnormalities in early- and late-onset pre-
eclampsia with and without fetal growth restriction. BJOG 2006; 113: 580–589.
*87. Ness RB & Roberts JM. Heterogeneous causes constituting the single syndrome of pre-eclampsia: a hypothesis and its
implications. Am J Obstet Gynecol 1996; 175: 1365–1370.
88. von Dadelszen P, Magee LA & Roberts JM. Subclassification of pre-eclampsia. Hypertens Pregnancy 2003; 22: 143–148.
89. Chen XK, Wen SW, Smith G et al. Pregnancy-induced hypertension is associated with lower infant mortality in preterm
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J.A. Hutcheon et al. / Best Practice & Research Clinical Obstetrics and Gynaecology 25 (2011) 391–403


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High school students found their victim on a dating site
Four teens have been charged with an anti-gay attack on a 63-year-old man in northeastern France.
The assault took place at around 7.40pm on 2 February in a parking lot in Nancy.
The victim went there expecting a rendez-vous with a young man he met on a dating site but instead walked straight into an ambush.
The four boys beat him with an iron bar and stole his mobile phone and car.
The attackers, aged 15 to 17, attend the same high school. They admitted to the crime but denied any homophobic intent.
Forbidden words also include 'obese,' 'palm oil' and 'Muslim'
Nutella on Tuesday (24 February) launched an online marketing campaign in France inviting consumers to customize a jar of the chocolate spread with a personalized message.
'Here you can create your custom messages and share them with those you love!' the campaign website reads.
That is, as long as the person you love is not a 'lesbian.'
Internet users quickly discovered that they were not allowed to certain words in their messages, including the word 'lesbienne.'
Terry Sweeney was on show in mid-1980s - was target of terrible AIDS joke by a visiting Chevy Chase
Terry Sweeney was nowhere to be seen during NBC's recent Saturday Night Live 40th anniversary special.
He wasn't the only one of the former Not Ready for Prime Time Players to not be featured but he was the only one who is an openly gay male.
Sirius XM Radio talk show host Frank DeCaro was among those outraged by what he considered a slight.
'Leaving Terry Sweeney -- the only openly gay male cast member in the forty-year history of Saturday Night Live -- out of the anniversary special doesn't sit well with me,' DeCaro wrote in a Facebook post.
State media attacks the openly gay chair of a human rights report on the hermit kingdom
North Korea has gone on another homophobic rant against the openly gay chair of a 2013 report condemning Pyongyang's human rights record.
The Korean Central News Agency last month published an editorial demanding the US retract and apologize for the UN Commission Of Inquiry.
It claimed that a North Korean defector gave false testimony and the report 'is now being ridiculed and censured by the international community.'
The two year prison sentence is being appealed
A Swedish man will be in jail for two years in Tunisia for 'homosexual acts', authorities said this weekend.
The man in his 50s, who has been living in France for years, was imprisoned on 4 February.
The Swedish Foreign Ministry has protested the arrest, with the sentence being appealed.
'[Sweden] has highlighted its belief in equal rights regardless of sexual orientation as a fundamental principle of democracy,' said Victoria Bell, a Swedish Foreign Ministry spokeswoman told AFP.
The author of the Vampire's Angel series shares his travel stories with Gay Star News.
Author Damian Serbu and his husband Paul are passionate travellers. From exploring the 13th century Castle Poenari in Romania to family celebrations in Costa Rica. We caught up with them recently to swap travel stories.
What's your favourite holiday destination?
Narrowing it to one place is impossible!
Top court breaks a long-standing agreement between the two countries
France's highest appeals court Wednesday (28 January) allowed a gay man to marry his Moroccan partner, despite the North African kingdom's refusal to recognize same-sex marriage.
France legalized gay marriage in 2013. However, a 1981 agreement said marriages between French and Moroccan nationals were subject to the laws of their respective countries.
Dominique and Mohammed first took the case to court after a city hall in France had refused to wed them, citing the 1981 convention.
First time a French court convicts over anti-gay abuse on the social network
Three Parisians were fined this week for inciting violence against LGBTI people on Twitter, the first time a French court has convicted for anti-gay abuse on the social network.
One was fined €300 ($348) while the other two were forced to pay €500 ($579) for using the hashtag 'let's burn the gays on...' (#brûlonslesgayssurdu).
'Expect dead bodies if you continue to provocate', the politician warns
A Lithuanian politician has warned a gay group that it is 'playing with fire' and its activities could lead to a massacre similar to what happened in Paris.
Algirdas Vaclovas Patackas, previously of the Way of Courage political party, told the leader of gay rights group LGL to expect 'dead bodies' if they continue to 'provocate'.
He was referring to the tragic killings in France earlier this month, where 12 people in the offices of satirical magazine Charlie Hebdo were killed by extremists.
Judge says the politician is entitled to privacy as his private life was not widely known and he never intended to publicly reveal his sexual orientaton
A court in Paris on Wednesday ordered French gossip magazine Closer to pay €20,000 (US$24,400) in damages for 'invasion of privacy' for outing the far-right National Front party's Vice-President Florian Philippot as gay.
The magazine was also ordered to publish the court's verdict on its front page and pay Philippot €3,500 for his legal fees.
Earlier this month, the magazine published four pages of photographs taken in Vienna showing Philippot and an unnamed man whose face was blurred out and alledged to be his boyfriend.
Dust down your sequins – France's first gay carnival slated for February 2015
Fluff up your feathers, stock up on glitter and get that headdress sorted – a new gay and lesbian carnival, or 'Queernaval,' is to launch in Nice, France next year.
The free event will take place in the sunshine city on the 27 February, with a burlesque procession passing through the streets of Nice Old Town.
Its organizers – including Jean-Louis Longo of July's Pink Parade, the city's annual gay pride event – promise an evening of 'feathers, sequins and extravagant make-up.'
Magic anti-HIV pill or just an excuse for bareback sex?
PrEP is the new buzzword in HIV. It's a pill to reduce your chance of getting the virus.
But the treatment is still in trials and public information is patchy at best.
So as we prepare for World AIDS Day on 1 December, here's what every gay and bisexual man needs to know about PrEP.
What is PrEP?
It means 'pre-exposure prophylaxis' and is a medical term for providing 'treatment' to prevent you getting something.
French and Mediterranean styles collide in picturesque beachside town
It's one of the oldest cities in Europe – and one of the most vibrant on the Mediterranean coast. Welcome to Marseille, south of France, a city with 26 centuries of history, and still transforming.
A mix of cultures indeed, next to the harbour you'll find African markets, Italian communities (the border is not far), crowds of tourists and students from all over the world, Corsican, Spanish: all of them trying to preserve their traditions but also trying, at the same time, to hone Marseille's reputation as a truly multicultural tourist destination.
Same-sex marriage is a controversial issue in predominantly Catholic France and has drawn hundreds of thousands of protesters onto the streets
In what is said to be his strongest comment on the issue, former French president Nicolas Sarkozy on Saturday called for the country's same-sex marriage laws to be scrapped.
Eight Pacific nations still have anti-gay laws
The Pacific island nation of Palau has decriminalized gay sex in a revision of its penal code.
The new criminal laws came into force at the end of July but were only announced today.
At Palau's last Universal Periodic Review at the UN Human Rights Council in 2011, France, Norway and Spain all made recommendations that the country repeal its anti-gay laws, which were accepted by the government.
This new criminal code was passed by the Palau National Congress and signed into law by President Tommy Remengesau Jr in April.
Organizers claim 500,000 protesters took to the streets of Paris
Tens of thousands of anti-gay marriage protesters yesterday marched against IVF and surrogacy for gay couples in Paris and Bordeaux.
Organizers Manif Pour Tous (Protest for All) estimated 500,000 attended the rally in the captial but police put the number at 70,000.
Police said 7,500 people took to the streets of Bordeaux while organizers claimed 30,000 attendance.
In an attempt to calm protestors ahead of the rally, Prime Minister Manuel Valls said surrogacy 'is and will remain banned in France.'
Horseback rides, foodie markets and private wine cellar parties are just a few ways Winerist takes wine tasting to the next level
The only thing more delicious than wine, is pairing a wine tasting experience with local food and culture from the region.
Whether you're into deep, robust reds or sparkling bubbles, wine tasting should be a fun and approachable experience.
Winerist, founded by two wine-loving women from Moldova, elevates the wine-tasting experience by putting guests in the hands of the coolest wine-related guides, restaurants and hotels, and putting together exciting packages for oenophiles (aka lovers of wine).
The Iris Prize Festival 2014 will feature the work of the world's best LGBTI filmmakers
LGBTI film lovers are excited as the Iris Prize is set to begin next week.
The world's finest LGBTI filmmakers will gather in Cardiff for the seventh time, welcoming guests from US, Germany, Australia, Ireland, Israel, France and many more.
'It is bigger and better than ever before, with the number of feature length movies doubled to 16,' festivla chair Andrew Pierce said.
'I always think of Iris as family. Granted a rather bigger family today than we knew back in 2007 when the world's finest LGBT filmmakers gathered in Cardiff for the first time.
Female same-sex couples will now be allowed to adopt babies born of IVF and other medically assisted procedures
France's highest civil court has given married lesbians more adoption rights.
The Court of Cassation has said even though gay couples are still banned from using IVF and other medical ways to assist with reproduction, that is not enough to prevent gay women their legal right to adopt their married partner's child.
As these female same-sex couples are stopped from accessing fertility treatment in France, it has sent many of them to Belgium or Spain.
Grandmother demands libraries stock books that don't exist to balance literature supporting LGBTI families
Laurie Higgins is a Christian grandmother with a limited professional background. She has worked as 'cultural analyst' for The Illinois 'Family' Institute for six years, and before that was employed in the 'writing center' for a high school. The Institute is one of 23 hate groups in Illinois tracked by the Southern Poverty Law Center.
A commemorative set of stamps honoring Finnish gay erotic artist Touko Laaksonen, AKA Tom of Finland, have been pre-ordered by people in 178 countries – busting all sales records for the country's postal service
Stamps commemorating Finnish gay erotic artist Touko Laaksonen, who published his drawings under the name Tom of Finland, have been the biggest sellers in the history of Finland's Posti postal service, with people pre-ordering the stamps in 178 countries.
The stamps went on sale on Monday, with the biggest overseas orders coming from Sweden, Britain, the United States and France.
Brad Pitt and Angelina Jolie have married after nine years together, breaking a longstanding pledge to not get married until same-sex couples can, though we suspect most will forgive them after years of speaking out for the LGBTI community
Long time Hollywood allies of the LGBTI community Brad Pitt and Angelina Jolie have reneged on a 2006 pledge to not get married until same-sex marriage is legalized across America but we suspect most people will forgive them after years of advocacy by the couple for gay rights.
The couple were reported to have married in France on Saturday in a small private ceremony in a chateau near Nice.
The couple were married by a Californian judge who also provided their marriage license.
The late gay designer Yves Saint Laurent loved the Marjorelle gardens so much he and his partner saved the grounds from being converted into a hotel, breathing new life into the spectacularly-designed grounds
The bright blue walls of the garden were a surprise in London's dreary real estate market, a welcome sight after a slew of despondent and pathetic flats I was looking to rent.
'I modeled the space after the Yves Saint Laurent gardens in Marrakech,' the landlord told me.
Obviously, I took the flat, but I also took to the Internet to learn more about this garden I had known nothing about, and was already in love with.
It might seem weird to have an obsession with a garden, but I've been there.
The Le Couvent d'Hérépian, a boutique spa hotel in a former convent, is the ultimate gateway to enjoy the stunning countryside and delicious food of the High Languedoc
Hidden in the stunning countryside of High Languedoc, France, the little town of Hérépian is so secluded most people in the region haven't heard of it.
Guidebooks and mass tourism have passed it by.
At the center of its muddle of narrow streets, Le Couvent d'Hérépian (the old convent) is even more of a secret. It's so elegantly understated we had to ask a local to point it out to us even when we were in the small square right next to it.
Egypt and Sierra Leone put forward a resolution at the UN Human Rights Council on the 'protection of the family' which was passed without language inclusive of LGBTI families with the help of Russia
The United Nations Human Rights Council has passed a resolution on the 'protection of the family,' but attempts to have it amended to recognize there are a variety of family structures – including those headed by LGBTI people – were blocked.
The resolution was put forward by diplomats from Egypt and Sierra Leone during the Human Rights Council's 26th Session yesterday and calls for a plenary panel on the protection of the family and its members at the Human Rights Council's September Council session.
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chin up greeting cards, chin greeting cards, face greeting cards, profile greeting cards, face greeting cards, nose greeting cards, lips greeting cards, eyes greeting cards, pine greeting cards, pine needles greeting cards, rock greeting cards
� Chris Sotiriadis An interesting rock formation I came across while backpacking up to Maggie Lake in Algonquin Park one summer.
Chris Sotiriadis is a self taught fine art artist living in London, ON - Canada. When not working for Western Libraries he can be found outdoors on hiking and walking trails in and around the London area honing his artistic skills as a conduit for the natural environment to express itself. In the last decade, Chris has worked primarily with water as his medium of choice, drawing from his life experience to show how it is a mirror for humanity. His water abstracts demonstrate how water not only reflects but remembers, given the proper conditions, memories of the past that can resurface and communicate to us in the present. Shows to Date: June 2009 - Ice-Painting Quartet at Spencer Gallery in The D. B. Weldon Library, Western...
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Playground Safety
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Teacher Child Interaction
Partnership for Children of Lincoln & Gaston Counties
Monday, March 18, 2013 from 6:30 PM to 8:00 PM (EDT)
The Partnership for Children of Lincoln & Gaston Counties is a nonprofit organization that provides services for local families and children through Smart Start, North Carolina's award-winning early childhood initiative.
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Carmel, Maine (map) | 2078485515
Sites: 50 | Latest Rate: $13.00 |
|Clean Restrooms:
|Clean Showers:
This is a very clean, well maintained park. The downside is, it's not quiet!! They say in their ad that it's quiet, but the freeway circles back near the park and you hear the trucks gear down all night long! It makes it very hard to sleep. - Roidon621


text:
- Reviews
- Gear
- Artists
- How-to
- Lessons
- Premier Blogs
- Win Stuff
Rig Rundown - Victor Wooten & Regi Wooten
June 7, 2011
PG's Rebecca Dirks is On Location at the Northern Lights Theater at Potawatomi Bingo Casino in Milwaukee, WI, where she catches up with bassist Victor Wooten and his brother Regi Wooten (guitarist) to find out what they are currently using for guitars, amps, and effects during their tour with the Stanley Clarke Band.Read More
Raveonettes: Grave-Pop Serenades
May 17, 2011
The Raveonettes' Sune Rose Wagner and Sharin Foo talk about their ambient-rock evolution on "Raven in the Grave", strategies for avoiding pattern-based songwriting, and how multiple reverb pedals can create a harmonically raging wall of sound.Read More
Warren Haynes: Working-Class Hero
May 17, 2011
Warren Haynes takes us inside "Man in Motion", his first solo album in 15 years. Plus, co-producer Gordie Johnson and bassist George Porter Jr. discuss working with one of rock's busiest guitar slingers.Read More
Joel Kosche: Smashing Young Man
May 17, 2011
Joel Kosche talks about how persistence and ambition paved the way from dead-end gigging on the Atlanta circuit to becoming the guitar tech—and then the main axe man— for the chart-topping rock band Collective Soul. Plus, he gives us the lowdown on his go-to studio amps—which he designed and built from scratch.Read More
Rig Rundown - Luther Dickinson
May 11, 2011
PG's Charles Saufley is On Location at the Roxy in Hollywood, CA, where he catches up with North Mississippi Allstars and Black Crowes guitarist Luther Dickinson. In this segment, Luther Dickinson talks about the gear he's currently using on the North Mississippi Allstars' tour, which includes Fuch Amps, Gibson, Hagstrom, Epiphone, and Hofner hollowbody guitars, and Radial Engineering, Boss, and other guitar effects stompboxes.Read More
Interview: Elliot Easton - Hello Again
May 9, 2011
The Cars'' Elliot Easton talks about reuniting with his chart-topping new wave bandmates and using a bunch of guitars from his amazing collection to record their classic-sounding new album, Move Like This.Read More
Rig Rundown - G.Love
May 4, 2011
PG's Chris Kies is On Location at the Majestic Theater in Madison, WI, where he catches up with guitarist G.Love. In this Rig Rundown, G.Love shows off his pedalboard (Electro-Harmonix Wiggler, EHX Q-Tron, RC Booster, Keeley Compressor, Boss Digital Delay, Boss Flanger), amps (Ampeg J-20 Jet and Fender Deluxe Reverb), and guitars (Gretsch G.Love Signature Corvette, Gretsch Black Penguin, Gretsch Black Falcon, Gretsch 60th Anniversary, and several Gibson acoustics).Read More
Interview: Moving Mountains - Making Waves
May 4, 2011
Greg Dunn and Frank Graniero of Moving Mountains talk gear, recording, and balancing a full-time tour schedule while still in college.Read More
Brian Setzer: The Thrill Is Anything But Gone
April 19, 2011
Brian Setzer breaks down his love-hate relationship with vintage Gretsches and the roots that fed the dizzying array of styles—from bluegrass banjo to archtop jazz and rockabilly revelry—on his new album "Setzer Goes Instru-MENTAL!"Read More
Thursday: Melody vs. Discord
April 19, 2011
Tom Keeley and Steve Pedulla of the influential post-hardcore band Thursday discuss the importance of roots, how trust and respect empower their dual-guitar partnership, and how broken gear and effects accidents brought fresh sounds to their new album, "No Devoluci—n".Read More


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Description from the manager
- 2 bedrooms
- 2 bathrooms
- Sleeps 6
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Bedrooms: 2
Bathrooms: 2
Sleeps: 6
Type: Apt. / CondoA Place at the Beach 2G
Description from the manager
PLACE AT THE BEACH PHASE I - 277 West First Street Unit 2G- This condo is on the second floor, on the oceanfront. It has two bedrooms and two baths on one level. One bedroom has a king bed and TV, and the 2nd bedroom has two single beds. There is also a queen sleeper sofa in the living room. The small harvest table has two benches. Amenities include seasonal community pool, outside shower, central heat and air, dishwasher, microwave oven, blender, ceiling fans, and secured Wi-Fi. There are hibachi grills on the opposite side of the building away from the pool. The coin operated laundry is in a building next to the pool. The private balcony...Read more
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A Place at the Beach 2G
Ocean Isle Beach, North Carolina
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I am not a Reform Jew, but I confess that I am often envious of the publications of the Reform movement. Whether I agree with their answers or not, I am impressed by the fact that they ask the right questions, the questions that are on the minds and hearts of our people today. So,...
The day after for Trevor Noah: controversial tweets turn internet on next 'Daily Show' host
Hebrew University-UCLA exchange program aims to expand med students' horizons
Comedian Trevor Noah comes under fire for past Twitter comments
Netanyahu: Iran deal will allow nuclear breakout in less than a year
U.S. says ready to work past deadline for Iran nuclear deal if needed
Just released ADL audit shows significant increase in anti-Semitic incidents
Chris Martin, Rihanna back new Jay Z streaming music service
Boston bombing jury hears of grisly deaths, defense calls first witness
Tag: Rabbis Ruth Langer
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Adult Children Get Rite of Passage
May 29, 2003 | 8:00 pm


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Popular in Education
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Transmisión alterna Zeitgeist Colombia - 24 sep 2009, para compensar los 30 minutos que estuvimos por fuera en la transmisión de la mañana.
Esta transmisión dura 25 minutos y termina abruptamente porque volvimos a tener problemas con la conexión a Internet.
1. Lectura de preguntas frecuentes de la página de Zeitgeist Colombia. Se leyó hasta la pregunta "¿Se avocarán a la ejecución de cualquier persona de comportamiento aberrante?".
2. Saludos a oyentes de Colombia, Argentina, Inglaterra.
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An interview with DARE Officer and Sheriff Becky Dyer from 5 Moms - Stop Cough Medicine Abuse. Ms. Dyer is a DARE Officer in Hutchinson, Kansas. Ms. Dyer works to prevent substance abuse in children. Her emphasis is preventing cough medicine abuse.
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How should high school journalism advisers be preparing their students for a career in journalism? How has modern technology impacted the future of journalism? Is there going to be a need for young, trained journalists by the time today's high school students graduate from college? National award-winning student journalism adviser and Northwest Missouri State University mass communication instructor Laura Widmer discusses the latest technology's impact on journalism education. Learn what teacher
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So what is it we are fighting over? Where did it begin? How did education become what it has become?
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This music is for the babies of the 70's, that we may remind you of our mission! a lot of us have amnesia and have for gotten the way!....here's a remindera111111
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The importance of Black history? Karl X discuss's the importance of Black history with Fire Bones where they will reason ABOUT THE DESTRUCTION OF BLACK CIVILISATIONS AND CULTURES, little known facts about the slave bizness in the caribbean, the blacks of scotland, Ireland, Wales and England. Blacks of Portugal and spain, Britains role in slave trade, documents detailing Britains treatment of Afrikan people. Tune in and join the debate. Is Black history more important that Math, Science and Engli
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Join me, Bart Moyers as your host, along with my special guests and world-renowned educational experts. Get the facts and take back control of your chil
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text: We got our picture taken with the Cup too when the Bruins won. We weren't sure if the Bruins would do something like that, but psyched when they did! I was especially happy for BDL because a lot of people he knows had their photo ops during the summer by chance. I was so happy he got his chance too If you don't mind me asking, what did the Pens put on the table for you? BDL said Minnesota ticket holders get 10% for their offer. The B's are giving us a choice. 3% apr on games missed but it has to stay on account and you have to renew your tickets for next season or 1% apr on games missed which they send as a check at the end of the month.


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By: DARK_SETH
All Black Rugby Challenge releasing soon
Views: 646 | Posted: 07/25/2011
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a montage I find on the net representing the maori dance Haka performed by the All Blacks rugby team
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Check out the new quick penalty feature.
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Break some digital bones in one of the worlds most popular sports.
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An exclusive look at the action on the field.
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The true sport of keep away.
Views: 7,521 | Posted: 01/18/2006
A whole new way of playing keep away.
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The way football was meant to be played, with no protection.
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Ouya, PC
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The cult Wii RPG is headed to the New Nintendo 3DS.
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text:
Blog Archives
March 7th, 2011 at 1:01 pm
How Will 'The Event' Rate In Its Return?
After more than 3 months 'The Event' returns.[Read-More]
March 7th, 2011 at 12:18 pm
'Army Wives' Season Five Premiere Averages 4.2 Million Viewers; 'Coming Home' Averages 2.7 Million
New Reality show 'Coming Home" pulls a 1.1 adults 18-49 rating in premiere.[Read-More]
March 7th, 2011 at 11:55 am
'The Price is Right' Celebrates Its Own March Madness with a 'Home Viewer Showcase' Giveaway
ia press release: "THE PRICE IS RIGHT" CELEBRATES ITS OWN BRAND OF MARCH MADNESS WITH A "HOME VIEWER SHOWCASE" GIVEAWAY, BEGINNING THE[Read-More]
March 7th, 2011 at 11:54 am
'Breakout Kings' Scores Record Audiences for A&E
Better than premieres of 'The Glades' and USA's 'Fairly Legal' in 18-49 viewers.[Read-More]
March 7th, 2011 at 11:41 am
NBC Announces Country Music Superstar Blake Shelton as Final Musician Coach for 'The Voice'
via press release: NBC ANNOUNCES COUNTRY MUSIC SUPERSTAR BLAKE SHELTON AS FOURTH AND FINAL MUSICIAN COACH OF NEW MUSICAL COMPETITION SERIES 'The[Read-More]
March 7th, 2011 at 11:20 am
Style Network's Sunday 'Ruby' Premiere Averages 473,000 Viewers
via press release: THE STYLE NETWORK'S "RUBY" SEASON PREMIERE ON SUNDAY NIGHT DELIVERS NEARLY A HALF MILLION TOTAL VIEWERS The 4th season[Read-More]
March 7th, 2011 at 10:59 am
HGTV Dream Home Giveaway Winner is Announced March 19
via press release: WATCH THE HGTV DREAM HOME GIVEAWAY 2011 ON SATURDAY, MARCH 19 at 8 P.M. ET/PT $2 Million Grand-Prize Package[Read-More]
March 7th, 2011 at 10:50 am
Premiere Ratings for E!'s 'After Lately' + "Kourtney & Kim Take New York' and 'Holly's World'
via press release: E!'S "AFTER LATELY" SERIES PREMIERE ON SUNDAY NIGHT DRAWS NEARLY 1.2 MILLION TOTAL VIEWERS E!'s series premiere of "After[Read-More]


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Cucumber Beetle solutions... effective advice is always wonderful
I am working on my first garden and decided for it to be as eco-friendly to the bug population as I am able to bare it. I have been convinced that there can be a balance of good bug, bad bug population in your garden. Even the black widows that found home actually helped me with my grasshopper and worm problems very nicely. Unfortunately, since family w/children were coming over during the holiday I had to get rid of them. I am expect a flux in the bug eco-system even more because of those actions.
Well, my question was not about Black Widows, but about Cucumber Beetles. I am currently interested in what eats, wards, attacks, or flees these pests form the area. I am noticing a larger population now on a daily basis of these buggers.
Aware what diseases these flying buggers can transmit I have begun to swat them like flies. I really have not read up on any good bugs yet that might take care of this bad bug.
Here are links to some photos..
Hope everyone had a safe and rewarding Independence day!
Thank you for any information...
Here is a link that might be useful:
A method I have only heard about being used, but see no reason why it wouldn't work, is to use a hand-vacuum to suck them up. If you have hens, you could empty the casing into their pen, otherwise, into a bucket of soapy water. Maybe bring them into the house to cool them off - or put the vacuum in the freezer for an hour or two - so they don't promptly try to fly away as you open the vacuum? I am planning to try it on my next infestation of squash bugs.
I have also been told, albeit too late for this year, that PLANTING SEEDS into a mix of soil and cedar shavings works to keep them away. Seemingly, it doesn't work for transplants, they have to sprout in the mix.


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There are a lot of sparkling gems and minerals on display in Dynamic Earth but on Tuesday morning there was a new temporary exhibit with an unusually personal label...
Engagement ring planted in an exhibition showcase in Dynamic Earth.Image: Heath WarwickSource: Museum Victoria
But who put it there? And why?
Simone sees the showcase.Image: Heath WarwickSource: Museum Victoria
It was all part of an elaborate surprise marriage proposal by David to Simone. She thought she was visiting the museum to take some promotional photographs. All seemed perfectly normal until she spotted the showcase containing an engagement ring and the label asking 'Simone, will you marry me?'
Congratulations David and Simone! It was a lot of fun for the museum to be in cahoots with the lucky groom-to-be.
The newly-engaged couple, David and Simone.Image: Heath WarwickSource: Museum Victoria
We love receiving comments, but can't always respond.
Updates on what's happening at Melbourne Museum, the Immigration Museum, Scienceworks, the Royal Exhibition Building, and beyond.
Hi Vicki, according to information on the NSW Department of Primary Agriculture website, the Redclaw are omnivorous with a diet that includes small invertebrate...
To read the latest tweets from @museumvictoria
Follow Museum Victoria on
we just moved to hervey bay on 5 acres we have a dam out the front. the previous owners said they put red claw in the dam be we have found oceans of holes all o...


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Conversation with David Lasry and Craig Zammiello
Sun, Mar 10, 2013
Times: 2:00-3:00 pm
Venue: Addison Gallery of American Art
Phillips Academy, 180 Main Street, Andover, MA 01810
0 people saved this
David Lasry, founder of Two Palms Press in New York City, and master printmaker Craig Zammiello discuss the complex ideas and processes that go into creating prints such as those featured in Stone, Wood, Metal, Mesh: Prints and Printmaking.
Introducing #PulseOfBoston, A Virtual Day In Boston
Boston is a special place, for all sorts of reasons. But what's the city...
Search All Listings Here.


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Staff very friendly and helpful. If I nee a hotel in the future I wi reserve a room there.
There was a very nice breakfast (included in the cost of the room), an updated exercise room, and my room had a refrigerator and a microwave. The staff was friendly, the hotel was quiet, and the TVs in the room were quite nice. I appeared to be in a handicap-accessible room, which was very spacious.
I couldn't get the TV in the exercise room to work. Also, the toilet chain in my room broke so that I had to take the cover off the tank and manually lift the flapper. I told the management about it at 7 am and it wasn't fixed by the time I returned at around 9:30 pm. Neither of these were a big deal, but the latter could have been for someone without rudimentary plumbing knowledge.
My husband and I stayed one night. It seemed pretty clean and the bed was comfortable. Near Dave and Busters and some restaurants. Breakfast at the hotel was better than typical (but it's not included in the price.)
The decor is a little dated, and the rooms could use a little more sound proofing. We heard some kids yelling in the hall at one point, but other than that it was quiet. It's supposed to be smoke free, however our hallway smelled like someone was smoking. Luckily, the room did not smell like smoke at all.
Pretty much everything.......the front desk was on task for check in(it was Halloween and they were dressed for it and shared the candy); being a single traveler I was given a second floor room which made me very comfortable and did not have to request it. Room was great; clean, comfortable. Special treat: restaurant/bar, Sweet Lorraine's with a very good breakfast buffet. I booked for a great rate and figured I was really in for a cheap night place: wrong. It was nothing but a good feeling from the minute I walked in.
The staff was friendly, the location was great, it was very quiet, and it was a good price. I didn't want to spend a lot on a place I'd only be crashing at.
There was a spider in my room, the linens were scratchy but the comforter was nice, not one of those quilted ones. The pillows on my king bed were all standard sized, which was odd/annoying to me, but they were soft. The continental breakfast was absolutely horrible. The coffee was watered down and the eggs were rubber. Ick. I'm not sure that I'd stay here again.
Staff was friendly and the rooms were comfortable.
The first day, housekeeping made up our room but did not replace our towels. That would have been fine except that they didn't clean our room at all the second day. I had to remind them in the morning on the second day about the fact that we were out of towels, but by the end of the day, nothing. Not sure what is going on there, but housekeeping is not very consistent.
The rooms had just been redone so they were nice. Check out is at NOON!!!
After paying through kayak.. the staff re charged me, not once but TWICE. getting a refund has been the hardest thing. Its now a week latet and still no refund. The staff seemed very incompitent and rude. I woyldnt stay at this jotel again if it was the last one in michigan. A total let down... customer service is the most important thing and this hotel doesnt have that.
They didn't clean our room on Thanksgiving Day for whatever reason.
The location of our room was on the west end of the hotel which was next to I-275, a major highway in the Detroit area but actually it was quieter compared to the rooms overlooking the courtyard
Friendly staff, great atrium, awesome rooms (everything about the suite!), comfortable overall, GREAT value! Just became my go-to place to stay on my regular trips to Detroit.
nothing to complain about.
Pool water was warm. Breakfast was delicious. Clean rooms and very spacious
Breakfast was very good
Sound you could hear the highway!
They locked the office door at 11pm and you had to pound on the door to get their attention. They have no door bell. Employee says they have a phone outside that I could have picked up and it was a direct line into their office. No signs explaining that.
Didn't like anything about this motel.
They made fraudulent charges to my MasterCard.
Look, all I care about is clean sheets/bed, a shower, and a TV. They fit the bill so I was glad. The staff was fine. Yes it is dated and the walls thin, but for the price it was great for us...we didn't care about the extras that others choose to pay more for.
Quick check - in; clean; comfortable
Walls are thin - could hear the couple next to us all night; breakfast was mediocre
The facility was nice, the $10 breakfast buffet was good. Easy to get to, right off the highway.
Room had sleep number air beds, not a standard matress. I hate air matresses, you feel every movement of your spouse and we couldn't get it adjusted properly. My wife ended up turning the pressure down to soften the bed and I ended up sleeping with my back on the box spring while she was riding high on a cloud of air.
Very quiet location. The room was spotless.
The evening staff was not very helpful. This did not take away from the overall experience.
A very friendly accommodating staff, when we went to check in as well as when we noticed a we were a few things short of toiletries. The room was quite clean and very nice. we were right next to the elevator and it may have only been used a few times but I didn't hear it once the entire night.
it was kind of hard to create a romantic lighting effect for the evening, as most of the lights were super bright and simple switches, no knobs or dials to lower the light. other then that which we quickly remedied, I had no complaints.
horrible svc. Horrible rooms. No security. Horrible staff
I liked the location. Near all the big shopping locations. Right off the freeway. Bowling and bar next door.
Only issue I had was the battery in smoke alarm was out. I had to take the battery out because I hate that chirp sound. I didn't smoke but I did light a candle and would have liked my alarm to be in working condition.
That it was the type a hotel that I needed to be out of town working
they only did linen Once a week and it was outdated although they were working on the third floor updating 9 o'clock at night
Qiuiet atmosphere and pricing
Room beds not done, tiolets dirty on every visits
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WILLIAM D. COHAN, a former senior Wall Street investment banker, is the bestselling author of The Last Tycoons and the winner of the 2007 FT/Goldman Sachs Business Book of the Year Award. He writes for The Financial Times, Fortune, the New York Times, the Washington Post, the Daily Beast, and appears frequently on CNBC.
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So all in all this is a book much like the story it is trying to tell.
This is a well written account of the dangerous speculative practices engaged in by one of the then existing major Wall Street investment banks,Bear Stearns.
Methinks there is too much protesting NOW when, back then, the making of big money had everyone looking the other way.
Very well written and an excellent accounting of the financial melt down which began on Wall Street. A great read!!Published 6 months ago by Amazon Customer
Well written book with a very good structure. Has a lot of interesting insights and is definitely a must read.Published 7 months ago by Justus Hasu
I really got a sense of the personalities and prevailing company cultures from this story. Very well done. Read morePublished 11 months ago by gappo
This story went into incredible detail on the Bear Stearns Collapse. Sometimes, too much detail. It not only went into great detail on the day by day happenings that lead to the... Read morePublished 11 months ago by brianman3
The book provides a detailed (if highly opinionated) perspective on the fall of Bear Stearns. It is as fast paced and gripping as an Elmore Leonard novel!Published 12 months ago by Frederick W. Peters
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For the finest and freshest North Carolina has to offer!
Every Wednesday from 8 AM – 1 PM
April 1 – November 18 & Tuesday November 24, 2015
The Farmers' Market at Poplar Grove was established to provide a retail outlet for local growers and producers to sell their goods directly to consumers. The market strives to educate consumers on local farm products and practices, promote the use of local products and serve the community through programming and activities.
Get to know your farmer, your baker, your artisan maker! One of the great opportunities at the Farmers' Market is the interaction with the people growing, catching, baking and producing your food and other products. Shopping with our local growers and producers for fresh produce, landscape & bedding plants, herbs, baked goods and the best in handmade art & craft items at the market is an awesome experience! The grounds of beautiful historic Poplar Grove Plantation will be open on market day, there is easy access from highway 17 and plenty of free parking. Join us on opening day and every Wednesday from 8:00 AM to 1:00 PM to meet and support our truly local growers and producers!
For market updates, any possible changes to the market schedule and to see information about weekly market products please see our Facebook page: Facebook/FarmersMarket And don't forget to 'like' us and share!
Vendor information:
If you are interested in applying to be a vendor for the 2015 market season please read the Fees, rules, regs and the By Laws to determine your eligibility for the market. Contact BJ Ryan at firstname.lastname@example.com before submitting an application and for any questions. Click here for the 2015 season Application
Gardening Expertise
The Pender County Master Gardeners hold a free Plant Clinic the 2nd Wednesday of each month at their Ask a Master Gardener booth. Stop by their booth for answers to your garden related questions! You can also bring in plants for identification or diagnosis of plant and garden problems.
Family Day at the Market ♦ June 24, 2015
Community groups and local non-profit agencies are invited to have an educational, informational booth at Family Day. Please contact us to inquire about participation in Family Day, email@example.com.
To help support the Farmers' Market, please consider donating by clicking the DONATE button today. Your donations contribute to our local economy, supprting new and family farmers and small businesses. Donations help keep vendor fees affordable, enable educational programming and special activities as well as contributing to the stability and growth of the Famers' Market at Poplar Grove. Poplar Grove is a non-profit public charity, your contribution is tax deductible to the full extent allowable by the law.


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Taking a look at the Vikings' free agents
Quarterback Matt Cassel has exercised his right to opt out of the final year of his two-year deal he signed with the Vikings last year. With his decision to void the final year of his contract, Cassel will become a free agent on March 11.
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Nyhan's interest in false beliefs dates back to early 2000, when he was a senior at Swarthmore. It was the middle of a messy Presidential campaign, and he was ... - read more
By Thomas H. Benton. Nearly six years ago, I wrote a column called "So You Want to Go to Grad School?" (The Chronicle, June 6, 2003). My purpose was to warn ... - read more
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