Cover
Title Page
Copyright Page
Contents
List of Contributors
Foreword
Preface
Acknowledgments
Part 1 Factors of High-Risk Pregnancy
Chapter 1 Overview of High-Risk Pregnancy
Chapter 2 Nutrition in Pregnancy
Fetal growth
Body mass index, weight gain, and adverse pregnancy outcomes
Obesity
Nutrition assessment and counseling
Food security
Energy intake during pregnancy
Healthy dietary pattern in pregnancy
Multivitamins
Micronutrients in pregnancy
Iron
Folate/folic acid
Calcium
Vitamin D
Iodine
Vitamin toxicity
Caffeine consumption in pregnancy
Seafood consumption in pregnancy
Multifetal pregnancy
Nutrition during lactation
Conclusion
References
Chapter 3 Alcohol and Substance Use Disorder
Introduction
Screening and testing for substance use disorder
Alcohol
Maternal effects
Effects on the fetus
Prenatal treatment
Opioids
Maternal effects
Effects on the fetus
Prenatal treatment
Intrapartum and postpartum care
Cannabis
Stimulants
Vaping (E-cigarettes)
Benzodiazepines
References
Chapter 4 Environmental Agents and Reproductive Risk
Background incidence of adverse outcome
Biologic evidence of toxicity
General principles
Specific agents
Lead
Mercury
Pesticides and herbicides
Polychlorinated biphenyls
Polybrominated diphenyl ethers
Organic solvents
Perfluorochemicals
Video display terminals
Bisphenol A
Phthalates
Air pollutants
References
Part 2 Genetics
Chapter 5 Genetic Screening for Mendelian Disorders
Family history
Mendelian inheritance
Carrier screening
Carrier screening guidelines
Hemoglobinopathies
Cystic fibrosis
Spinal muscular atrophy
Fragile X syndrome
Jewish genetic diseases
Prenatal diagnosis
Newborn screening. Chapter 10 Interpreting Intrapartum Fetal Heart Tracings
Components of EFM documentation
Baseline FHR
Baseline FHR variability
Accelerations
Decelerations
Uterine contractions
Changes and trends in FHR over time
Interpretation of EFM
Category I
Category III
Category II
Management of FHR abnormalities in labor
Placement of internal monitors (intrauterine pressure catheter, fetal scalp electrode)
Tachysystole with fetal heart rate changes
Maternal hypotension
Maternal repositioning
Intravenous fluid bolus
Maternal hyperoxygenation
Amnioinfusion
Fetal stimulation
Future directions
References
Part 4 Maternal Disease
Chapter 11 Sickle Cell Anemia
Hemoglobin SCD
Hemoglobin S/-thalassemia disease
Management during pregnancy
Acute pain
Chronic pain
Prophylactic red blood cell transfusions
Other treatments
Fetal assessment
Labor and delivery
Genetic evaluation
CASE PRESENTATION
References
Chapter 12 Anemia
Consequences
Causes of anemia in pregnancy
Diagnostic workup and treatment
Macrocytic anemia
Normocytic anemia
Microcytic anemia
Iron supplementation in pregnancy
Treatment of iron deficiency anemia
References
Chapter 13 Thrombocytopenia
Maternal thrombocytopenia
Gestational thrombocytopenia
Autoimmune thrombocytopenia
HELLP
Thrombotic thrombocytopenic purpura and atypical hemolytic uremic syndrome
Other causes
Fetal thrombocytopenia
Autoimmune thrombocytopenia
Alloimmune thrombocytopenia
References
Chapter 14 Inherited and Acquired Thrombophilias
Overview of hemostasis changes during pregnancy
Inherited thrombophilias
Factor V Leiden
Prothrombin gene mutation (G2021A)
Protein C deficiency
Protein S deficiency
Antithrombin deficiency
Acquired thrombophilia. Antiphospholipid antibody syndrome
Management considerations in patients with inherited or acquired thrombophilia
Inherited thrombophilia
Antiphospholipid antibody syndrome
Summary
References
Chapter 15 Thromboembolic Disorders
Physiology of hemostasis
Platelet plug formation
The coagulation cascade
Endogenous anticoagulants
Pathophysiology of and risk factors for thrombosis in pregnancy
Diagnosis of venous thromboembolism
Deep venous thrombosis
Pulmonary embolus
Conclusion
References
Chapter 16 Cardiac Disease in Pregnancy
Risk assessment and risk-appropriate care
Antenatal care and optimization
First trimester
Second trimester
Third trimester
Multidisciplinary delivery planning
Mode of delivery
Analgesia and anesthesia
Monitoring and emergency preparedness
Postpartum and interconception care
Conclusion
References
Chapter 17 Renal Disease
Physiological changes in renal function during pregnancy
Anatomic changes in the urinary tract during pregnancy
Renal disease in pregnancy
Proteinuria
Chronic kidney disease
Mild renal insufficiency
Moderate and severe renal insufficiency
Hypertensive disorders with renal insufficiency
Renal dialysis
Renal transplantation
Management of pregnancies complicated by renal disease
Conclusion
References
Chapter 18 Pregnancy in Transplant Patients
Prepregnancy assessment and counseling
Antepartum care
Review of common agents for maintenance immunosuppression
Kidney transplant
Other organ transplant patients
Kidney-pancreas
Liver
Heart
Lung
Other transplant groups
Uterus
Intrapartum management
Obstetric emergencies
The baby
References
Chapter 19 Gestational Diabetes Mellitus
Risk factors for gestational diabetes. Therapeutic modalities in gestational diabetes
Antenatal testing
Delivery: when and how to deliver
Postpartum considerations
References
Chapter 20 Diabetes Mellitus
Initial evaluation
Regulating maternal glycemia
Management during pregnancy
Management of insulin during labor
References
Chapter 21 Thyroid Disorders
Diagnosis
Additional studies
Hypothyroidism
Implications for pregnancy
Treatment
Hyperthyroidism
Implications for pregnancy
Management
Thyroid storm management [3,4,10]
References
Chapter 22 Asthma
Definition of asthma
Effect of pregnancy on the course of asthma
Clinical observations
Mechanisms
Effect of asthma on pregnancy
Clinical observations
Mechanisms
Diagnosis of asthma during pregnancy
Management
Assessment and monitoring
Control of factors contributing to severity
Patient education
Pharmacologic therapy
Chronic asthma
Acute asthma
Management during labor and delivery
Conclusion
References
Chapter 23 Epilepsy
Contraception
Fertility
Preconception counseling
Folic acid
Seizures during pregnancy
ASM risks: Structural and neurodevelopmental teratogenicity
Management during pregnancy
Prenatal screening
ASM levels
Peripartum care
Labor and delivery
Maternal outcomes
Postpartum care
ASM management and seizure risk
Breastfeeding
Postpartum depression
Summary
References
Chapter 24 Chronic Hypertension
Definition
Diagnosis
Preconceptional counseling
Morbidity and mortality
Diagnosis and evaluation in pregnancy
Treatment during pregnancy
Antepartum fetal assessment
Delivery
Postpartum care
References
Chapter 25 Systemic Lupus Erythematosus
Epidemiology
Etiology
Pathogenesis
Differential diagnosis
Morbidity

In this new edition we have focused on including topics most critical to providing good care, each written by outstanding authorities on the subject to ensure they are focused, timely, and authoritative. This dynamic process requires adding new chapters as the evidence dictates and eliminating others so that the reader is presented with the most clinically useful contemporary information. We are delighted to ensure John T. Queenan's legacy continues in this latest edition, as we are committed to his vision and inspiration to have clear, concise protocols that ensure that busy practitioners have needed information at their fingertips. The seventh edition comes at a time when health care has experienced a pandemic, virtual visits and encounters are increasingly common, and health care settings continue to rapidly evolve. We continue to emphasize evidence-based information and clinical practicality and included chapters addressing timely topics such as infectious diseases in pregnancy, vaping, operative vaginal delivery, postpartum hemorrhage, and pregnancies in women with disabilities. To ensure applicability for health professionals in developing countries we have protocols on maternal anemia, malaria, and HIV infection

English