Risk factors for severe maternal morbidity

A new study shines light on the risk factors for severe maternal morbidity and the reason why morbidity is rising. Population-Based Study of Risk Factors for Severe Maternal Morbidity by Gray et al. appears in the current issue of Pediatric and Perinatal Epidemiology.

The authors begin by explaining the rationale for looking beyond maternal deaths to severe maternal complications:

The overall quality of maternal health care has traditionally been measured by maternal mortality. However, in the US and other industrialised countries where maternal death is rare, severe maternal morbidity (SMM), or ‘near miss’, has been utilised as a new indicator of the quality of maternal health…

And they note that SMM is rising.

Severe maternal morbidity during delivery hospitalisation was estimated to occur in 5.1 of every 1000 US deliveries from 1991 to 1993, affecting approximately 20 000 women annually. Rates of SMM are increasing, with 4.5 per 1000 deliveries in 1991–1994 and 5.9 per 1000 deliveries in 1999–2003…

The authors sought to investigate risk factors for SMM and why it might be rising.

We conducted a population-based case–control study linking birth certificate records to hospital discharge data from the Comprehensive Hospital Abstract Reporting System (CHARS) for all Washington State singleton and multiple births from 1987 to 2008…

The distribution of maternal demographic and obstetric characteristics among cases and controls was examined. Maternal characteristics included age, race, level of education, marital status, maternal smoking during pregnancy, payer source, parity and preexisting conditions. Adequacy of prenatal care as measured by the Kotelchuck index, delivery method, having a multiple birth, delivering a low birthweight infant.

What did they find?

… Receipt of a blood transfusion was the most common qualifying SMM and occurred in nearly half of all cases, followed by hysterectomy (11.2%), and respiratory failure (10.9%)… Our study did not assess severe haemorrhage and uterine rupture as unique SMM categories, although transfusion is a surrogate for severe haemorrhage and uterine rupture commonly is associated with hysterectomy.

Which risk factors increased the likelihood of SSM?

Between 1987 and 2008, 9485 women had one or more SMM in Washington State. Women with SMM were more likely to be older, non-White race/ethnicity, unmarried, to have a lower level of education, to be at the extremes of parity, to have a pre-existing medical condition and to receive Medicaid/Medicare compared with controls. Women with SMM were more likely to have a multiple birth, to deliver by caesarean, to deliver a low birthweight or preterm infant and to have received intensive prenatal care as compared with controls.

In the chart below, I’ve highlighted the risk factors that are most strongly associated with severe maternal morbidity.

 

What can we say about these findings?

1. None of the 5 most important risk factors modifiable, either by the patient or her provider. These are advanced maternal age, race, pre-existing medical condition, twins or higher order multiples and previous C-section.

2. Homebirth advocates like to pretend that these are not risk factors, but they are and all women who face them should be counseled that they are not safe candidates for homebirth. Natural childbirth advocates also like to pretend that these are not risk factors but, as usual, they are wrong. Women who face these risk factors may need additional monitoring and interventions in order to have a safe birth.

3. The increase in severe maternal morbidity can be explained by the rise in prevalence of the risk factors. Maternal age has increased, and therefore the incidence of pre-existing medical conditions have also increased. The incidence of twins and higher order multiples has also increased.

4. Previous C-section is a major risk factor. Unfortunately, the study did not distinguish between women who attempted a VBAC and women who scheduled a C-section, so we cannot determine if it the previous C-section that is the risk factor or whether the complications are a result of attempted VBAC.

5. Contrary to the insinuations of NCB advocates, it is not the overuse of technology that leads to poor maternal outcomes, it is the underuse of technology. The authors note:

Although this study investigated risk factors at the level of the patient, both provider and health care system factors may also play a critical role in the development of SMM. In a study investigating the preventability of maternal mortality and severe morbidity, 45% of near-miss morbidities were deemed preventable; provider factors were identified as the source of preventability in approximately 93% of these instances, including failure to identify high-risk status, lack of referral to a tertiary care centre, and in the greatest proportion incomplete or inappropriate management…

The bottom line is that the increase in severe maternal morbidity reflects the changing demographics of the childbearing population, not the quality of obstetric care. And when it comes to the quality of obstetric care, the main problem is underuse of technology, not overuse. Therefore, increased reliance on midwives has little to no place in any efforts to reduced severe maternal morbidity and homebirth has no role at all.

Trackbacks/Pingbacks

  1. sanicur - September 17, 2021

    sanicur

    […]The facts talked about within the write-up are a number of the top offered […]

  2. Kingpen - September 17, 2021

    Kingpen

    […]The data talked about within the article are several of the top available […]

  3. ushanka hat - September 14, 2021

    ushanka hat

    […]the time to read or check out the subject material or web sites we’ve linked to beneath the[…]

  4. matryoshka dolls for sale - September 14, 2021

    matryoshka dolls for sale

  5. 피망슬롯머니 - September 11, 2021

    피망슬롯머니

    […]Wonderful story, reckoned we could combine several unrelated data, nonetheless genuinely worth taking a look, whoa did 1 learn about Mid East has got a lot more problerms at the same time […]

  6. 메이저사이트 - September 10, 2021

    메이저사이트

    […]please take a look at the internet sites we comply with, like this one, because it represents our picks through the web[…]

  7. christensen arms ridgeline for sale - September 10, 2021

    christensen arms ridgeline for sale

  8. magic mushrooms - September 10, 2021

    magic mushrooms

    […]always a massive fan of linking to bloggers that I appreciate but do not get a good deal of link love from[…]

  9. basil school vadodara - September 9, 2021

    basil school vadodara

    […]Wonderful story, reckoned we could combine a handful of unrelated data, nonetheless really worth taking a appear, whoa did one particular discover about Mid East has got far more problerms as well […]

  10. kendriya vidyalaya venkatagiri - September 9, 2021

    kendriya vidyalaya venkatagiri

    […]Here is a great Blog You might Discover Exciting that we Encourage You[…]

  11. best in ottawa - September 9, 2021

    best in ottawa

    […]Every after in a when we select blogs that we study. Listed beneath are the latest web pages that we decide on […]

  12. best male strokers - September 8, 2021

    best male strokers

    […]just beneath, are many entirely not connected web pages to ours, nevertheless, they may be certainly really worth going over[…]

  13. 1xbit movie - September 8, 2021

    1xbit movie

    […]usually posts some extremely exciting stuff like this. If you are new to this site[…]

  14. thrusting vibrator - September 8, 2021

    thrusting vibrator

  15. masturbating - September 7, 2021

    masturbating

    […]although internet sites we backlink to below are considerably not connected to ours, we feel they are really really worth a go by, so have a look[…]

  16. vibrating penis rings - September 7, 2021

    vibrating penis rings

    […]one of our guests a short while ago encouraged the following website[…]

  17. what is masturbation - September 7, 2021

    what is masturbation

  18. sex toy facts - September 7, 2021

    sex toy facts

    […]The data talked about inside the report are a number of the ideal readily available […]

  19. pocket pussy - September 6, 2021

    pocket pussy

    […]check beneath, are some completely unrelated websites to ours, on the other hand, they are most trustworthy sources that we use[…]

  20. twitter download - September 4, 2021

    twitter download

    […]The info mentioned inside the write-up are a number of the most beneficial available […]

  21. Here - September 4, 2021

    Here

  22. https://ctrlcoin.io - Trade now - September 4, 2021

    https://ctrlcoin.io – Trade now

    […]one of our guests just lately recommended the following website[…]

  23. jogar online - September 4, 2021

    jogar online

    […]the time to study or visit the content or websites we have linked to beneath the[…]

  24. site de streaming - September 3, 2021

    site de streaming

    […]Here are several of the sites we advise for our visitors[…]

  25. streaming gratuit - September 3, 2021

    streaming gratuit

  26. enclosed car transport - September 2, 2021

    enclosed car transport

    […]one of our visitors not too long ago advised the following website[…]

  27. streamcomplet - September 2, 2021

    streamcomplet

    […]although sites we backlink to beneath are considerably not related to ours, we really feel they’re really worth a go by, so have a look[…]

  28. Decentralized P2P Network For Secured Loans - September 1, 2021

    Decentralized P2P Network For Secured Loans

    […]one of our visitors recently encouraged the following website[…]

  29. escort istanbul - September 1, 2021

    escort istanbul

    […]one of our visitors not too long ago encouraged the following website[…]

  30. Dank Vapes - August 31, 2021

    Dank Vapes

    […]we came across a cool website that you may possibly take pleasure in. Take a appear for those who want[…]

  31. Google - August 31, 2021

    Google

    Every as soon as inside a while we pick out blogs that we study. Listed beneath are the newest web pages that we pick out.

  32. بديل تروكولر - August 31, 2021

    بديل تروكولر

    […]we came across a cool internet site that you could possibly appreciate. Take a appear if you want[…]

  33. پسر ایرانی - August 30, 2021

    پسر ایرانی

    […]Here is a superb Blog You may Come across Exciting that we Encourage You[…]

  34. how to use lifelike dildo - August 30, 2021

    how to use lifelike dildo

    […]just beneath, are various completely not connected web-sites to ours, however, they are surely really worth going over[…]

  35. realistic dildo - August 30, 2021

    realistic dildo

  36. vibrating handjob stroker - August 29, 2021

    vibrating handjob stroker

  37. best p spot massagers - August 29, 2021

    best p spot massagers

    […]just beneath, are a lot of absolutely not connected web-sites to ours, however, they may be certainly really worth going over[…]

  38. ruay lotto - August 28, 2021

    ruay lotto

  39. lottovip สมัคร - August 27, 2021

    lottovip สมัคร

    […]the time to study or pay a visit to the content or sites we have linked to below the[…]

  40. ground leases - August 26, 2021

    ground leases

    […]Here are several of the web-sites we recommend for our visitors[…]

  41. web hosting reviews - August 25, 2021

    web hosting reviews

    […]usually posts some incredibly interesting stuff like this. If you are new to this site[…]

  42. lottovip สมัคร - August 24, 2021

    lottovip สมัคร

    […]although web-sites we backlink to beneath are considerably not connected to ours, we feel they are in fact worth a go via, so have a look[…]

  43. service in canada - August 24, 2021

    service in canada

    […]very few websites that transpire to become in depth below, from our point of view are undoubtedly nicely really worth checking out[…]

  44. Realistic Maturbator - August 24, 2021

    Realistic Maturbator

    […]The info talked about in the report are some of the most beneficial offered […]

  45. Best Male Masturbator Reviews - August 24, 2021

    Best Male Masturbator Reviews

    […]The details mentioned inside the post are several of the best obtainable […]

  46. service in canada - August 24, 2021

    service in canada

    […]always a large fan of linking to bloggers that I like but do not get a whole lot of link like from[…]

  47. classic vibrators - August 23, 2021

    classic vibrators

  48. Oxygen concentrator for sale - August 23, 2021

    Oxygen concentrator for sale

    […]one of our guests lately recommended the following website[…]

  49. male stroker - August 23, 2021

    male stroker

    […]Sites of interest we have a link to[…]

  50. remote control panty vibe - August 23, 2021

    remote control panty vibe

    […]usually posts some quite intriguing stuff like this. If you are new to this site[…]

  51. best prostate massager - August 23, 2021

    best prostate massager

  52. fun88 - August 22, 2021

    fun88

    […]always a major fan of linking to bloggers that I adore but really don’t get a whole lot of link appreciate from[…]

  53. Restaurants Nanaimo - August 21, 2021

    Restaurants Nanaimo

    […]Sites of interest we’ve a link to[…]

  54. Vietnamese Food Nanaimo - August 21, 2021

    Vietnamese Food Nanaimo

    […]one of our guests just lately suggested the following website[…]

  55. Buy Marijuana Online - August 21, 2021

    Buy Marijuana Online

    […]Every as soon as in a even though we pick blogs that we study. Listed below are the most current websites that we decide on […]

  56. buy exotic weed online - August 21, 2021

    buy exotic weed online

    […]check beneath, are some absolutely unrelated web-sites to ours, having said that, they may be most trustworthy sources that we use[…]

  57. prostate sex toys - August 16, 2021

    prostate sex toys

    […]just beneath, are many completely not related websites to ours, nevertheless, they are surely really worth going over[…]

  58. mersin escort - August 16, 2021

    mersin escort

    […]Sites of interest we’ve a link to[…]

  59. squirting dildo - August 15, 2021

    squirting dildo

    […]Every the moment in a though we select blogs that we study. Listed beneath would be the most up-to-date websites that we select […]

  60. canadianpharmacyking.com - August 14, 2021

    canadianpharmacyking.com

    […]Here are a number of the web-sites we recommend for our visitors[…]

  61. thrusting vibrator - August 14, 2021

    thrusting vibrator

    […]one of our guests lately advised the following website[…]

  62. Local Shroom Delivery - August 14, 2021

    Local Shroom Delivery

    […]Wonderful story, reckoned we could combine a number of unrelated data, nevertheless actually worth taking a appear, whoa did a single understand about Mid East has got more problerms also […]

  63. silicone kegel balls - August 14, 2021

    silicone kegel balls

    […]very couple of internet sites that come about to be comprehensive below, from our point of view are undoubtedly very well worth checking out[…]

  64. happyluke - August 13, 2021

    happyluke

    […]although web sites we backlink to below are considerably not connected to ours, we feel they’re truly worth a go as a result of, so have a look[…]

  65. pendik escort - August 13, 2021

    pendik escort

    […]Every once inside a even though we opt for blogs that we study. Listed below would be the most recent web-sites that we decide on […]

  66. zenci escort - August 13, 2021

    zenci escort

    […]Sites of interest we have a link to[…]

  67. bebek escort - August 13, 2021

    bebek escort

    […]Sites of interest we have a link to[…]

  68. International Hospital Management - August 13, 2021

    International Hospital Management

    […]below you will obtain the link to some web sites that we think you’ll want to visit[…]

  69. cleaning male sex toys - August 12, 2021

    cleaning male sex toys

    […]below you will find the link to some sites that we believe you should visit[…]

  70. male masturbator review - August 12, 2021

    male masturbator review

    […]please take a look at the web-sites we comply with, which includes this one, because it represents our picks through the web[…]

  71. best stroker for men - August 12, 2021

    best stroker for men

    […]Wonderful story, reckoned we could combine a number of unrelated data, nevertheless truly worth taking a look, whoa did one particular understand about Mid East has got much more problerms too […]

  72. silicone wand vibrator - August 12, 2021

    silicone wand vibrator

    […]here are some links to internet sites that we link to for the reason that we consider they’re really worth visiting[…]

  73. happyluke - August 11, 2021

    happyluke

    […]the time to read or go to the content material or web sites we’ve linked to below the[…]

  74. latest news - August 10, 2021

    latest news

    […]Every once in a though we opt for blogs that we read. Listed beneath are the newest web-sites that we select […]

  75. Legal Cocaine For Sale - August 10, 2021

    Legal Cocaine For Sale

    […]Sites of interest we have a link to[…]

  76. gungoren escort - August 9, 2021

    gungoren escort

    […]very couple of web-sites that happen to be detailed beneath, from our point of view are undoubtedly properly really worth checking out[…]

  77. asmr porn - August 5, 2021

    asmr porn

    […]Here is an excellent Blog You might Find Intriguing that we Encourage You[…]

  78. erotic stories - August 5, 2021

    erotic stories

    […]here are some hyperlinks to web pages that we link to simply because we assume they’re worth visiting[…]

  79. male enlargement pump - August 4, 2021

    male enlargement pump

  80. how to use penis sleeve - August 4, 2021

    how to use penis sleeve

    […]here are some hyperlinks to web-sites that we link to for the reason that we think they are worth visiting[…]

  81. butterfly vibrator review - August 4, 2021

    butterfly vibrator review

    […]one of our visitors just lately encouraged the following website[…]

  82. masturbation - August 4, 2021

    masturbation

    […]Wonderful story, reckoned we could combine a few unrelated data, nevertheless truly worth taking a appear, whoa did one particular master about Mid East has got a lot more problerms at the same time […]

  83. Treating Lung Cancer - August 4, 2021

    Treating Lung Cancer

    […]The info talked about within the report are a few of the best obtainable […]

  84. read more - July 31, 2021

    read more

    […]Here are several of the web-sites we recommend for our visitors[…]

  85. click here - July 31, 2021

    click here

    […]check below, are some totally unrelated internet sites to ours, however, they may be most trustworthy sources that we use[…]

  86. computer doktor - July 31, 2021

    computer doktor

    […]very handful of web sites that occur to be detailed below, from our point of view are undoubtedly nicely worth checking out[…]

  87. Buy Crack Online - July 29, 2021

    Buy Crack Online

    […]Sites of interest we’ve a link to[…]

  88. baby tiger for sale - July 29, 2021

    baby tiger for sale

    […]The facts talked about in the report are several of the most effective offered […]

  89. teachings of Christ - July 28, 2021

    teachings of Christ

  90. canada pharmacy - July 27, 2021

    canada pharmacy

    […]here are some hyperlinks to sites that we link to mainly because we feel they’re worth visiting[…]

  91. canada pharmacy - July 27, 2021

    canada pharmacy

    […]please check out the web-sites we follow, including this one, as it represents our picks in the web[…]

  92. ruger american pistol for sale - July 27, 2021

    ruger american pistol for sale

    […]we came across a cool web page that you just could love. Take a appear if you want[…]

  93. glo extracts - July 26, 2021

    glo extracts

    […]Sites of interest we have a link to[…]

  94. glo cartridges for sale - July 26, 2021

    glo cartridges for sale

    […]Wonderful story, reckoned we could combine several unrelated information, nonetheless genuinely really worth taking a appear, whoa did a single understand about Mid East has got much more problerms too […]

  95. kush for sale online - July 26, 2021

    kush for sale online

    […]Every the moment inside a when we opt for blogs that we read. Listed below would be the most recent sites that we pick out […]

  96. Buy Cannabis online - July 26, 2021

    Buy Cannabis online

  97. معرفة هوية المتصل - July 26, 2021

    معرفة هوية المتصل

  98. Canada pharmacy - July 26, 2021

    Canada pharmacy

    […]please stop by the web sites we comply with, like this one, as it represents our picks through the web[…]

  99. معرفة هوية المتصل - July 26, 2021

    معرفة هوية المتصل

    […]Sites of interest we’ve a link to[…]

  100. where to buy mango juul pods 2021 - July 25, 2021

    where to buy mango juul pods 2021

    […]one of our guests not long ago suggested the following website[…]

  101. Discreet gun shop - July 25, 2021

    Discreet gun shop

    […]please check out the web sites we stick to, which includes this one particular, because it represents our picks through the web[…]

  102. software reviewer - July 25, 2021

    software reviewer

  103. hbcuex.com - July 25, 2021

    hbcuex.com

    […]usually posts some very fascinating stuff like this. If you are new to this site[…]

  104. Find out more - July 24, 2021

    Find out more

    […]Sites of interest we’ve a link to[…]

  105. Find out more - July 24, 2021

    Find out more

    […]although sites we backlink to beneath are considerably not associated to ours, we feel they are actually worth a go by, so have a look[…]

  106. zierak - July 24, 2021

    zierak

  107. sex toy reviews - July 23, 2021

    sex toy reviews

    […]Here are a few of the internet sites we advise for our visitors[…]

  108. ถาดกระดาษ - July 22, 2021

    … [Trackback]

    […] Information on that Topic: skepticalob.com/2012/11/risk-factors-for-severe-maternal-morbidity.html […]

  109. how to lose stomach fat - July 18, 2021

    how to lose stomach fat

    […]Here are a number of the web-sites we recommend for our visitors[…]

  110. king crab for sale - July 16, 2021

    king crab for sale

    […]here are some links to sites that we link to for the reason that we believe they’re really worth visiting[…]

  111. best workout sets - July 16, 2021

    best workout sets

    […]although internet sites we backlink to beneath are considerably not associated to ours, we feel they are basically really worth a go by, so have a look[…]

  112. Vape Carts For Sale - July 14, 2021

    Vape Carts For Sale

    https://theclearconcerntrate.com/ The Clear classic oil is mixed with CBD isolate and our preparatory flavorings for the best taste and consistency on the market today.

  113. Cute Exotic Animals - July 14, 2021

    Cute Exotic Animals

    […]the time to read or take a look at the subject material or sites we have linked to beneath the[…]

  114. boho coffee table - July 14, 2021

    boho coffee table

    […]The data mentioned within the report are several of the ideal readily available […]

  115. Captain’s Bed - July 14, 2021

    Captain’s Bed

    […]although sites we backlink to below are considerably not related to ours, we feel they’re actually really worth a go by way of, so have a look[…]

  116. canada pharmacy - July 13, 2021

    canada pharmacy

    […]the time to read or take a look at the content or sites we’ve linked to beneath the[…]

  117. Roofers - July 13, 2021

    Roofers

    […]although websites we backlink to below are considerably not associated to ours, we feel they may be basically really worth a go by, so possess a look[…]

  118. escort bayan - July 13, 2021

    escort bayan

    […]The information and facts talked about in the write-up are some of the most beneficial available […]

  119. MILF Porn - July 12, 2021

    MILF Porn

    […]although websites we backlink to below are considerably not associated to ours, we feel they may be truly worth a go by means of, so possess a look[…]

  120. MURANG'A UNIVERSITY OF TECHNOLOGY - July 9, 2021

    MURANG’A UNIVERSITY OF TECHNOLOGY

    […]although web sites we backlink to below are considerably not associated to ours, we feel they may be truly really worth a go through, so possess a look[…]

  121. Restaurants - July 8, 2021

    Restaurants

    […]although internet sites we backlink to beneath are considerably not associated to ours, we really feel they may be really worth a go as a result of, so possess a look[…]

  122. Data obligasi - July 8, 2021

    Data obligasi

  123. Glock Guns for sale - July 8, 2021

    Glock Guns for sale

    […]although websites we backlink to beneath are considerably not associated to ours, we feel they are essentially really worth a go as a result of, so have a look[…]

  124. moving company - July 7, 2021

    moving company

    […]although web-sites we backlink to beneath are considerably not associated to ours, we feel they may be truly really worth a go by, so have a look[…]

  125. shop ruger guns online - July 6, 2021

    shop ruger guns online

    […]one of our guests not too long ago suggested the following website[…]

  126. thc vape carts for sale new york - July 6, 2021

    thc vape carts for sale new york

    […]one of our visitors just lately suggested the following website[…]

  127. Ruger Handguns - July 6, 2021

    Ruger Handguns

    […]the time to read or check out the subject material or web pages we’ve linked to below the[…]

  128. how long do shrooms stay in your system - July 6, 2021

    how long do shrooms stay in your system

    […]Every the moment in a while we choose blogs that we read. Listed beneath would be the most current sites that we select […]

  129. tiktok followers - July 6, 2021

    tiktok followers

    […]just beneath, are various entirely not associated sites to ours, however, they may be certainly really worth going over[…]

  130. buy weed online - July 5, 2021

    buy weed online

  131. weed near me - July 5, 2021

    weed near me

    […]Here is a good Blog You may Come across Exciting that we Encourage You[…]

  132. Seattle Weekly - July 5, 2021

    Seattle Weekly

    […]The info mentioned in the report are several of the most beneficial readily available […]

  133. buy weed online - July 5, 2021

    buy weed online

    […]the time to read or check out the content material or web pages we have linked to below the[…]

  134. buy weed online - July 5, 2021

    buy weed online

    […]the time to study or pay a visit to the content or sites we have linked to beneath the[…]

  135. BANANA RUNTZ CART - July 4, 2021

    BANANA RUNTZ CART

    […]Every once inside a when we opt for blogs that we study. Listed beneath would be the most current websites that we opt for […]

  136. thrusting vibrator - July 3, 2021

    thrusting vibrator

    […]we came across a cool web site that you may possibly get pleasure from. Take a appear when you want[…]

  137. sasha grey pocket pussy - July 3, 2021

    sasha grey pocket pussy

  138. clit massager - July 3, 2021

    clit massager

  139. bachelor's degree - July 1, 2021

    bachelor’s degree

    […]although internet websites we backlink to below are considerably not associated to ours, we feel they’re really really worth a go via, so have a look[…]

  140. delta 8 THC - June 29, 2021

    delta 8 THC

    […]one of our visitors lately recommended the following website[…]

  141. best cbd gummies - June 29, 2021

    best cbd gummies

    […]Here is a superb Weblog You may Find Fascinating that we Encourage You[…]

  142. delta 8 online - June 29, 2021

    delta 8 online

    […]below you will come across the link to some web-sites that we consider you should visit[…]

  143. Delta 8 - June 29, 2021

    Delta 8

    […]one of our visitors not long ago recommended the following website[…]

  144. hollow strap on - June 27, 2021

    hollow strap on

    […]Here is a great Weblog You might Obtain Exciting that we Encourage You[…]

  145. Food License in Kolkata - June 26, 2021

    Food License in Kolkata

    […]below you will obtain the link to some web sites that we believe you must visit[…]

  146. tides today at tides.today - June 24, 2021

    tides today at tides.today

    […]Sites of interest we have a link to[…]

  147. large dildo - June 22, 2021

    large dildo

    […]just beneath, are numerous entirely not associated web pages to ours, even so, they may be certainly really worth going over[…]

  148. best delta 8 thc gummies - June 22, 2021

    best delta 8 thc gummies

  149. iPhone repair mission Viejo - June 22, 2021

    iPhone repair mission Viejo

    […]just beneath, are various completely not connected web pages to ours, on the other hand, they’re certainly really worth going over[…]

  150. buy Instagram likes - June 21, 2021

    buy Instagram likes

    […]please take a look at the web-sites we comply with, like this one, because it represents our picks from the web[…]

  151. best delta 8 THC vape cartridges - June 21, 2021

    best delta 8 THC vape cartridges

    […]we came across a cool web site that you simply might appreciate. Take a look if you want[…]

  152. best delta 8 - June 21, 2021

    best delta 8

    […]one of our visitors lately proposed the following website[…]

  153. best kratom - June 21, 2021

    best kratom

    […]check beneath, are some totally unrelated web-sites to ours, nonetheless, they’re most trustworthy sources that we use[…]

  154. best kratom capsules - June 21, 2021

    best kratom capsules

  155. buy kratom - June 21, 2021

    buy kratom

    […]check below, are some entirely unrelated web sites to ours, having said that, they are most trustworthy sources that we use[…]

  156. Flip.Ca Loblaw Login - June 16, 2021

    Flip.Ca Loblaw Login

    […]the time to study or visit the subject material or web-sites we have linked to below the[…]

  157. Google - June 16, 2021

    Google

    Wonderful story, reckoned we could combine several unrelated information, nonetheless genuinely really worth taking a search, whoa did one learn about Mid East has got much more problerms also.

  158. Pound of Weed - June 16, 2021

    Pound of Weed

    […]below you will discover the link to some web pages that we consider you need to visit[…]

  159. GOLDEN RETRIEVER PUPPIES FOR SALE - June 16, 2021

    GOLDEN RETRIEVER PUPPIES FOR SALE

    […]Here is an excellent Blog You may Discover Interesting that we Encourage You[…]

  160. alligator meat online - June 15, 2021

    alligator meat online

    […]just beneath, are a lot of completely not associated internet sites to ours, having said that, they are certainly worth going over[…]

  161. how to enjoy g spot sex toys - June 15, 2021

    how to enjoy g spot sex toys

    […]The data talked about in the post are a number of the very best accessible […]

  162. Google - June 4, 2021

    Google

    Here are some hyperlinks to web sites that we link to since we consider they’re worth visiting.

  163. market forums - February 16, 2013

    Title…

    […]although sites we backlink to below are considerably not connected to ours, we feel they’re actually really worth a go by means of, so possess a look[…]…

  164. Wedding Photographers in Cyprus - February 16, 2013

    Title…

    […]we prefer to honor a lot of other internet sites around the web, even when they aren’t linked to us, by linking to them. Beneath are some webpages really worth checking out[…]…

  165. spanish - February 15, 2013

    Title…

    […]the time to read or check out the content material or websites we have linked to below the[…]…

  166. fl home owner insurance - February 15, 2013

    Title…

    […]we came across a cool web site that you may well take pleasure in. Take a search should you want[…]…

  167. iphones - February 15, 2013

    Title…

    […]usually posts some incredibly intriguing stuff like this. If you are new to this site[…]…

  168. carpet cleaning - February 15, 2013

    Title…

    […]Sites of interest we have a link to[…]…

Leave a Reply

You must be logged in to post a comment.