Table Of Content

Table of Contents Cover Preface to the Ninth Edition Preface to the First Edition Section 1 Obstetrics Part 1 Basic Science 1 Maternal Physiology Maternal response to pregnancy The uterus The cardiovascular system The respiratory system Haematology The renal system The cerebral circulation The gastrointestinal system Energy requirements Endocrine systems Conclusion References Further reading 2 The Placenta and Fetal Membranes Structural characteristics of the human placenta Macroscopic features of the term placenta Placental development Basic structure of villi Fetal membranes Ultrasound References Further reading Part 2 Normal Pregnancy 3 Healthy Fetal Growth Estimation of gestational age Measurement of the fetus Comparing the measurement to a standard or reference International standards of fetal growth and newborn size References 4 Pre‐conception Counselling Purpose of pre‐conception counselling Who needs pre‐conception counselling? Timing of pre‐conception counselling Healthcare professionals who should undertake pre‐conception counselling General pre‐conception advice Advice regarding medications Advice related to maternal age Genetic counselling Advice regarding access to maternity care Conditions where pregnancy is not recommended Specific medical diseases Previous poor obstetric history References 5 Antenatal Care Aims of antenatal care Screening for maternal complications Screening for fetal complications Organization of antenatal care References 6 First Trimester Antenatal Screening First‐trimester Down’s syndrome screening First‐trimester screening of aneuploidies other than Down’s syndrome Diagnostic tests Non‐invasive prenatal testing First‐trimester screening of fetal structural anomalies First‐trimester screening of late obstetric complications First‐trimester screening of single gene disorders Conclusion References Part 3 Maternal Medicine 7 Hypertensive Disorders Pathophysiology Defining hypertensive disease in pregnancy Measuring blood pressure and proteinuria in pregnancy and pre‐eclampsia Risk assessment and risk reduction Chronic hypertension Gestational hypertension Pre‐eclampsia Postnatal management References 8 Heart Disease in Pregnancy Physiological adaptations to pregnancy, labour and delivery Cardiac investigations in pregnancy General considerations in pregnant women with heart disease Specific cardiac conditions Mechanical heart valves Coronary artery disease Hypertrophic cardiomyopathy Peripartum cardiomyopathy Arrhythmias Cardiac arrest Endocarditis prophylaxis References 9 Diabetes in Pregnancy Classification of diabetes in pregnancy Diagnosing diabetes and gestational diabetes The significance of maternal type of diabetes The principles of maternal glycaemic control Screening for diabetic complications Screening for non‐diabetic comorbidities Risks to the fetus of a diabetic pregnancy Managing diabetes in pregnancy Birth Postpartum care The management of gestational diabetes Neonatal and longer‐term consequences of a diabetic pregnancy Conclusion References 10 Liver and Endocrine Diseases in Pregnancy LIVER DISEASE IN PREGNANCY Normal physiological changes in pregnancy Investigation of liver disease in pregnancy Approach to the patient with suspected liver disease in pregnancy Pregnancy‐related liver disease Liver diseases incidental to pregnancy Pregnancy following liver transplantation ENDOCRINE DISORDERS IN PREGNANCY Thyroid disease Pituitary disease Adrenal disease Parathyroid disease Conclusion Acknowledgements References 11 Renal Disease Pre‐pregnancy assessment Normal pregnancy Chronic kidney disease Patients on dialysis Kidney transplant recipients Summary References 12 Haematological Problems in Pregnancy Physiological changes to the blood in pregnancy Anaemia in pregnancy Thrombocytopenia in pregnancy Sickle cell disorders Thalassaemia Prevention of haemolytic disease of the fetus and newborn Fetal/neonatal thrombocytopenia Haemostatic measures in obstetric haemorrhage Thrombosis and thromboembolism Inherited bleeding disorders Myeloproliferative disorders in pregnancy Haematological malignancy during pregnancy References 13 Maternal Infection During Pregnancy Human immunodeficiency virus Hepatitis B Rubella Syphilis Toxoplasmosis Cytomegalovirus Parvovirus B19 Herpesvirus Varicella‐zoster virus Zika virus References 14 Psychiatric Problems in Pregnancy and Post Partum Effects of untreated prenatal depression, anxiety and stress Depression during pregnancy Postpartum blues Postpartum depression Anxiety disorders Antidepressant medications during pregnancy Breastfeeding and antidepressants Benzodiazepines Non‐pharmacological treatments Bipolar disorder Psychotic disorders and postpartum psychosis Mood stabilizers Antipsychotics Breastfeeding and mood stabilizers and antipsychotics Conclusion References 15 Autoimmune Rheumatic Diseases and Other Medical Disorders in Pregnancy Background Systemic lupus erythematosus Rheumatoid arthritis and other inflammatory arthritides Scleroderma and other connective tissue diseases Ehlers–Danlos syndrome types III and IV Vasculitides in pregnancy Respiratory disorders Neurological conditions Acute abdominal complications Malignant disease Imaging in pregnancy References 16 Obesity and Pregnancy Contraception, fertility and conception Pre‐pregnancy consultation Maternal complications: gestational diabetes, pre‐eclampsia and pregnancy‐ induced hypertension Fetal complications: ultrasound, anomalies and intrauterine demise Delivery issues Postnatal care Interventions Summary References Part 4 Fetal Medicine 17 Fetal Growth Restriction Definition Consequences of growth restriction Regulation of fetal growth Assessment and investigation Monitoring SGA Timing of delivery References 18 Third Trimester Fetal Assessment Predicting preterm birth Identifying placenta praevia, placenta accreta, vasa praevia and uterine scar Predicting intrauterine growth restriction and intrapartum fetal hypoxia Predicting fetal macrosomia, risk of failure to progress and shoulder dystocia in labour Conclusion References 19 Fetal Medical Conditions Fetal thyroid function Congenital adrenal hyperplasia Fetal dysrhythmias Fetal and neonatal alloimmune thrombocytopenia Fetal anaemia References 20 Fetal Anomalies Timing and development of fetal malformations Selected fetal anomalies in specific organ systems Fetal tumours Fetal hydrops [37,38] Conclusions References 21 Multiple Pregnancy Incidence Perinatal loss Chorionicity and zygosity Miscarriage Prenatal diagnosis Maternal homeostatic responses Intrauterine growth restriction Preterm labour Complications of monochorionic twinning Labour and delivery of twins and multiple pregnancies Higher‐order multiples Conclusion References Part 5 Birth 22 Normal Mechanisms in Labour Parturition Mechanics of normal labour at term Management of uncomplicated labour and delivery Conclusions Acknowledgements References 23 Post‐term Pregnancy Definitions Incidence Aetiology Epidemiology Risks associated with post‐term pregnancy Management Women’s views of induction for post‐term pregnancy Post‐term pregnancy and home birth Clinical guidelines for management of post‐term pregnancy Practical management of post‐term pregnancy References 24 Induction and Augmentation of Labour Definition Indications for induction of labour Contraindications to induction of labour Predicting success of induction of labour Pharmacological and mechanical methods of induction of labour Augmentation of labour Complications of induction of labour Monitoring and setting during induction of labour Induction of labour at term (>37 weeks’ gestation): risks and benefits Summary References 25 Obstetric Emergencies General principles for minimizing the risk of an emergency occurring General principles for minimizing adverse consequences resulting from an emergency Collapse Haemorrhage Obstetric causes of collapse Emergency obstetric deliveries Summary References 26 Malpresentation, Malposition, Cephalopelvic Disproportion and Obstetric Procedures Malpresentation, malposition and cephalopelvic disproportion Instrumental vaginal deliveries Caesarean section Episiotomy and perineal lacerations Conclusion References 27 Fetal Monitoring During Labour Fetal physiology Labour Detecting the fetus with hypoxia The future Summary References Further reading 28 Preterm Labour Epidemiology Neonatal outcomes after preterm birth Endocrinology and biochemistry of labour Causes of preterm labour