Medical Disorders in Pregnancy, An Issue of Obstetrics and Gynecology Clinics PDF
Preview Medical Disorders in Pregnancy, An Issue of Obstetrics and Gynecology Clinics
Medical Disorders in Pregnancy Editors ERIKA PETERSON JUDITH U. HIBBARD OBSTETRICS AND GYNECOLOGY CLINICS OF NORTH AMERICA www.obgyn.theclinics.com Consulting Editor WILLIAM F. RAYBURN June 2018 • Volume 45 • Number 2 ELSEVIER 1600JohnF.KennedyBoulevard(cid:1)Suite1800(cid:1)Philadelphia,Pennsylvania,19103-2899 http://www.theclinics.com OBSTETRICSANDGYNECOLOGYCLINICSOFNORTHAMERICAVolume45,Number2 June2018ISSN0889-8545,ISBN-13:978-0-323-58407-4 Editor:KerryHolland DevelopmentalEditor:KristenHelm ª2018ElsevierInc.Allrightsreserved. ThisperiodicalandtheindividualcontributionscontainedinitareprotectedundercopyrightbyElsevier,andthefollow- ingtermsandconditionsapplytotheiruse: Photocopying Singlephotocopiesofsinglearticlesmaybemadeforpersonaluseasallowedbynationalcopyrightlaws.Permission ofthePublisherandpaymentofafeeisrequiredforallotherphotocopying,includingmultipleorsystematiccopying, copyingforadvertisingorpromotionalpurposes,resale,andallformsofdocumentdelivery.Specialratesareavailable foreducationalinstitutionsthatwishtomakephotocopiesfornon-profiteducationalclassroomuse.Forinformation onhowtoseekpermissionvisitwww.elsevier.com/permissionsorcall:(+44)1865843830(UK)/(+1)2152393804 (USA). DerivativeWorks Subscribersmayreproducetablesofcontentsorpreparelistsofarticlesincludingabstractsforinternalcirculation within their institutions. Permission of the Publisher is required for resale or distribution outside the institution. PermissionofthePublisherisrequiredforallotherderivativeworks,includingcompilationsandtranslations(please consultwww.elsevier.com/permissions). ElectronicStorageorUsage PermissionofthePublisherisrequiredtostoreoruseelectronicallyanymaterialcontainedinthisperiodical,including anyarticleorpartofanarticle(pleaseconsultwww.elsevier.com/permissions).Exceptasoutlinedabove,nopartofthis publicationmaybereproduced,storedinaretrievalsystemortransmittedinanyformorbyanymeans,electronic, mechanical,photocopying,recordingorotherwise,withoutpriorwrittenpermissionofthePublisher. Notice NoresponsibilityisassumedbythePublisherforanyinjuryand/ordamagetopersonsorpropertyasamatterof productsliability,negligenceorotherwise,orfromanyuseoroperationofanymethods,products,instructionsorideas contained in the material herein. Because of rapid advances in the medical sciences, in particular, independent verificationofdiagnosesanddrugdosagesshouldbemade. Althoughalladvertisingmaterialisexpectedtoconformtoethical(medical)standards,inclusioninthispublicationdoes notconstituteaguaranteeorendorsementofthequalityorvalueofsuchproductoroftheclaimsmadeofitbyits manufacturer. ObstetricsandGynecologyClinics(ISSN0889-8545)ispublishedquarterlybyElsevierInc.,360ParkAvenueSouth,New York,NY10010-1710.MonthsofissueareMarch,June,September,andDecember.PeriodicalspostagepaidatNew York,NY,andadditionalmailingoffices.Subscriptionpriceperyearis$313.00(USindividuals),$652.00(USinstitutions), $100.00(USstudents),$393.00(Canadianindividuals),$823.00(Canadianinstitutions),$225.00(Canadianstudents), $459.00(internationalindividuals),$823.00(internationalinstitutions),and$225.00(internationalstudents).Toreceive student/residentrate,ordersmustbeaccompaniedbynameofaffiliatedinstitution,dateofterm,andthesignature ofprogram/residencycoordinatoroninstitutionletterhead.Orderswillbebilledatindividualrateuntilproofofstatus isreceived.ForeignairspeeddeliveryisincludedinallClinicssubscriptionprices.Allpricesaresubjecttochange withoutnotice.POSTMASTER:SendaddresschangestoObstetricsandGynecologyClinics,ElsevierHealthSciences Division,SubscriptionCustomerService,3251RiverportLane,MarylandHeights,MO63043.CustomerService: Telephone: 1-800-654-2452(U.S.and Canada);314-447-8871(outsideU.S.and Canada).Fax: 314-447-8029. E-mail: [email protected] (for print support); journalsonlinesupport-usa@elsevier. com(foronlinesupport). Reprints.Forcopiesof100ormoreofarticlesinthispublication,pleasecontacttheCommercialReprintsDepartment, ElsevierInc.,360ParkAvenueSouth,NewYork,NewYork10010-1710.Tel.:212-633-3874;Fax:212-633-3820; E-mail:[email protected]. Obstetrics and Gynecology Clinicsof North America is also published in Spanish by McGraw-Hill Interamericana EditoresS.A.,P.O.Box5-237,06500,Mexico;inPortuguesebyReichmannandAffonsoEditores,RiodeJaneiro, Brazil;andinGreekbyPaschalidisMedicalPublications,Athens,Greece. Obstetrics and Gynecology Clinics of North America is covered in MEDLINE/PubMed (Index Medicus), Excerpta Medica,CurrentConcepts/ClinicalMedicine,ScienceCitationIndex,BIOSIS,CINAHL,andISI/BIOMED. PrintedintheUnitedStatesofAmerica. MedicalDisordersinPregnancy Contributors CONSULTING EDITOR WILLIAMF.RAYBURN,MD,MBA AssociateDean,ContinuingMedicalEducationandProfessionalDevelopment, DistinguishedProfessorandEmeritusChair,ObstetricsandGynecology,Universityof NewMexicoSchoolofMedicine,Albuquerque,NewMexico EDITORS ERIKAPETERSON,MD AssociateProfessor,DepartmentofObstetricsandGynecology,Director,Divisionof Maternal-FetalMedicine,Co-DirectorFetalConcernsCenterofWisconsin,Medical CollegeofWisconsin,Milwaukee,Wisconsin JUDITHU.HIBBARD,MD ProfessorEmeritus,Professor,ViceChair,DepartmentofObstetricsandGynecology, DivisionofMaternal-FetalMedicine,MedicalCollegeofWisconsin,Milwaukee,Wisconsin AUTHORS KASSIEJ.BOLLIG,MD ResidentPhysician,DepartmentofObstetrics,GynecologyandWomen’sHealth, UniversityofMissouriSchoolofMedicine,Columbia,Missouri JOANBRILLER,MD ProfessorofMedicine,DirectoroftheHeartDiseaseinWomenProgram,Divisionof Cardiology,Professor,DepartmentofObstetricsandGynecology,UniversityofIllinoisat Chicago,Chicago,Illinois SABRINACRAIGO,MD ProfessorofObstetricsandGynecology,DirectorofMaternal-FetalMedicine,Tufts UniversitySchoolofMedicine,TuftsMedicalCenter,Boston,Massachusetts MEREDITHO.CRUZ,MD,MPH,MBA AssistantProfessor,DepartmentofObstetricsandGynecology,DivisionofMaternal-Fetal Medicine,MedicalCollegeofWisconsin,Milwaukee,Wisconsin JEFFREYM.DENNEY,MD,MS,FACOG AssistantProfessor,DepartmentofObstetricsandGynecology,Sectionof Maternal-FetalMedicine,WakeForestUniversitySchoolofMedicine,Winston-Salem, NorthCarolina CARAD.DOLIN,MD DivisionofMaternal-FetalMedicine,DepartmentofObstetricsandGynecology,NewYork UniversityLangoneHealth,NewYork,NewYork iv Contributors JENNIFERE.DOMINGUEZ,MD,MHS AssistantProfessor,DepartmentofAnesthesiology,DivisionofWomen’sAnesthesia, DukeUniversityMedicalCenter,Durham,NorthCarolina MAURICEDRUZIN,MD ProfessorofObstetrics,ObstetricsandGynecology,StanfordUniversity,Stanford Hospital,Stanford,California MEGANE.FOELLER,MD Maternal-FetalMedicineFellow,ObstetricsandGynecology,StanfordUniversity, StanfordHospital,Stanford,California TIMOTHYM.FOELLER,MD ClinicalInstructor,InternalMedicine,StanfordHealthCare–Valleycare,Pleasanton, California KIMBERLYB.FORTNER,MD AssociateProfessor,DepartmentofObstetricsandGynecology,DivisionDirector, Maternal-FetalMedicine,TheUniversityofTennesseeMedicalCenter,Knoxville, Tennessee LORIEM.HARPER,MD,MSCI AssociateProfessor,DepartmentofObstetricsandGynecology,Divisionof Maternal-FetalMedicine,TheUniversityofAlabamaatBirmingham,WomenandInfants Center,Birmingham,Alabama SARAHHARRIS,MS UniversityofNorthCarolinaatChapelHillSchoolofMedicine,ChapelHill,NorthCarolina JUDITHU.HIBBARD,MD ProfessorEmeritus,Professor,ViceChair,DepartmentofObstetricsandGynecology, DivisionofMaternal-FetalMedicine,MedicalCollegeofWisconsin,Milwaukee, Wisconsin DANIELL.JACKSON,MD,MS AssistantProfessor,DepartmentofObstetrics,GynecologyandWomen’sHealth, UniversityofMissouriSchoolofMedicine,Columbia,Missouri AMANDAJ.JOHNSON,MD DepartmentofObstetricsandGynecology,DivisionofMaternal-FetalMedicine,Medical CollegeofWisconsin,Milwaukee,Wisconsin CRESTAW.JONES,MD DepartmentofObstetrics,GynecologyandWomen’sHealth,DivisionofMaternal-Fetal Medicine,UniversityofMinnesotaMedicalSchool,Minneapolis,Minnesota SARAHJ.KILPATRICK,MD,PhD Chair,DepartmentofObstetricsandGynecology,DivisionofMaternal-FetalMedicine, Cedars-SinaiMedicalCenter,LosAngeles,California DIANAKOLETTIS,MD Maternal-FetalMedicineFellow,TuftsMedicalCenter,Boston,Massachusetts MICHELLEA.KOMINIAREK,MD,MS DivisionofMaternal-FetalMedicine,DepartmentofObstetricsandGynecology, NorthwesternUniversity,Chicago,Illinois Contributors v JUDETTELOUIS,MD,MPH AssociateProfessor,DepartmentofObstetricsandGynecology,Divisionof Maternal-FetalMedicine,MFMDivisionChief,FellowshipDirector,UniversityofSouth Florida,Tampa,Florida ANNAMCCORMICK,DO DepartmentofObstetricsandGynecology,MedicalCollegeofWisconsin,Milwaukee, Wisconsin CLAUDIANIEUWOUDT,MD ResidentPhysician,DepartmentofObstetricsandGynecology,TheUniversityof TennesseeMedicalCenter,Knoxville,Tennessee JOHNA.OZIMEK,DO,MS StaffPhysicianI,DepartmentofObstetricsandGynecology,DivisionofMaternal-Fetal Medicine,Cedars-SinaiMedicalCenter,LosAngeles,California ERIKAPETERSON,MD AssociateProfessor,DepartmentofObstetricsandGynecology,Director,Divisionof Maternal-FetalMedicine,Co-DirectorFetalConcernsCenterofWisconsin,Medical CollegeofWisconsin,Milwaukee,Wisconsin KRISTENH.QUINN,MD,MS,FACOG AssistantProfessor,DepartmentofObstetricsandGynecology,Sectionof Maternal-FetalMedicine,WakeForestUniversitySchoolofMedicine,Winston-Salem, NorthCarolina CALLIEF.REEDER,MD ResidentPhysician,DepartmentofObstetricsandGynecology,TheUniversityof TennesseeMedicalCenter,Knoxville,Tennessee LINDASTREET,MD AssistantProfessor,DepartmentofObstetricsandGynecology,Divisionof Maternal-FetalMedicine,MedicalCollegeofGeorgia,AugustaUniversity,Augusta, Georgia RONANSUGRUE,MD,MPH ClinicalFellow,DepartmentofObstetricsandGynecology,BrighamandWomen’s Hospital,HarvardMedicalSchool,Boston,Massachusetts AMELIAL.M.SUTTON,MD,PhD AssistantProfessor,DepartmentofObstetricsandGynecology,Divisionof Maternal-FetalMedicine,TheUniversityofAlabamaatBirmingham,WomenandInfants Center,Birmingham,Alabama GEETAK.SWAMY,MD SeniorAssociateDeanClinicalResearch,AssociateProfessor,DepartmentofObstetrics andGynecology,Director,ObstetricsClinicalResearch,DukeUniversityMedicalSystem, Durham,NorthCarolina ALANT.N.TITA,MD,PhD Professor,DepartmentofObstetricsandGynecology,DivisionofMaternal-Fetal Medicine,TheUniversityofAlabamaatBirmingham,WomenandInfantsCenter, Birmingham,Alabama vi Contributors NEETAL.VORA,MD DivisionofMaternal-FetalMedicine,DepartmentofObstetricsandGynecology, UniversityofNorthCarolinaatChapelHillSchoolofMedicine,ChapelHill,NorthCarolina CHLOEZERA,MD,MPH AssistantProfessor,DivisionofMaternal-FetalMedicine,BrighamandWomen’s Hospital,HarvardMedicalSchool,Boston,Massachusetts MedicalDisordersinPregnancy Contents Foreword:Team-BasedCareofPregnantWomenwithChallenging MedicalDisorders xiii WilliamF.Rayburn Preface:MedicalDisordersinPregnancy xv ErikaPetersonandJudithU.Hibbard MaternalMortalityintheTwenty-FirstCentury 175 JohnA.OzimekandSarahJ.Kilpatrick Maternalmortalityplaguesmuchoftheworld.Therewere303,000maternal deathsin2015representinganoverallglobalmaternalmortalityratioof216 maternaldeathsper100,000livebirths.IntheUnitedStates,thematernal mortalityratiohadbeendecreasinguntil1987,remainedstableuntil1999, andthenbegantoincrease.Racialdisparitiesexistintheratesofmaternal mortalityintheUnitedStates,withmaternaldeathaffectingahigherpropor- tion of black women compared with white women. To reduce maternal mortality,nationalorganizationsintheUnitedStateshavecalledforstan- dardizedreviewofcasesofmaternalmorbidityandmortality. CancerinPregnancy 187 AnnaMcCormickandErikaPeterson Thisarticlereviewssomeofthemorecommontypesofcancerthatmaybe encounteredduringpregnancy.Itreviewstheuniquechallengeswiththe diagnosisandtreatmentofbreast,cervical,hematologic,andcoloncan- cersinpregnantpatients. OpioidUseDisordersandPregnancy 201 AmandaJ.JohnsonandCrestaW.Jones Opioidusedisorderpresentsanincreasedriskofcomplicationsinpreg- nancy, particularly when untreated. To optimize outcomes, medication- assisted treatment using methadone or buprenorphine as a part of a comprehensive care model is recommended. Neonatal abstinence syn- dromeandpoorfetalgrowthremainsignificantcomplicationsofthisdis- orderdespitematernaltreatment. PregnancyinWomenwithObesity 217 CaraD.DolinandMichelleA.Kominiarek Pregnancyinwomenwithobesityisanimportantpublichealthproblemwith short- and long-term implications for maternal and child health. Obesity complicatesalmostallaspectsofpregnancy.Giventhegrowingprevalence ofobesityinwomen,obstetricprovidersneedtounderstandtherisksasso- ciatedwithobesityinpregnancyandtheuniqueaspectsofmanagementfor viii Contents womenwithobesity.Empathicandpatient-centeredcare,alongwithknowl- edge,canoptimizeoutcomesforwomenandchildren. ManagementofObstructiveSleepApneainPregnancy 233 JenniferE.Dominguez,LindaStreet,andJudetteLouis Thespectrumofsleep-disorderedbreathing(SDB)rangesfrommildsnor- ingtoobstructivesleepapnea,themostsevereformofSDB.Currentrec- ommendationsaretotreatthesewomenwithcontinuouspositiveairway pressuredespitelimiteddata.SDBinearlyandmidpregnancyisassoci- atedwithpreeclampsiaandgestationaldiabetes.Pregnantwomenwitha diagnosis of obstructive sleep apnea at delivery were at significantly increasedriskofhavingcardiomyopathy,congestiveheartfailure,pulmo- naryembolism,andin-hospitaldeath.Theseeffectswereexacerbatedin thepresenceofobesity.Postpartum,thesewomenareatriskforrespira- torysuppressionandshouldbemonitored. MaternalGeneticDisordersinPregnancy 249 SarahHarrisandNeetaL.Vora The life expectancy and quality of life of women with genetic disorders continues to improve, resulting in more women reaching reproductive ageanddesiringfertility.Itisbecomingincreasinglyimportantthatobste- triciansbecomefamiliarwithcommongeneticdisordersandtheirassoci- ated risks in pregnancy. The authors review pregnancy in women with variousgeneticdisorders,includingreviewofpregnancyoutcomes,man- agement recommendations, and genetic risk assessment. Most data on pregnanciesinwomenwithgeneticconditionsarebasedoncasereports andliteraturereviews.Additionalstudies,includingpregnancyregistries, are needed to improve our understanding and care of this patient population. MaternalCongenitalHeartDiseaseinPregnancy 267 MeganE.Foeller,TimothyM.Foeller,andMauriceDruzin Congenital heart disease comprises most maternal cardiac diseases in pregnancy and is an important cause of maternal, fetal, and neonatal morbidityandmortalityworldwide.Pregnancyisoftenconsideredahigh- riskstateforindividualswithstructuralheartdiseaseasaconsequenceof a limited ability to adapt to the major hemodynamic changes associated with pregnancy. Preconception counseling and evaluation are of utmost importance,aspregnancyiscontraindicatedincertaincardiacconditions. Pregnancy can be safely accomplished in most individuals with careful risk assessment before conception and multidisciplinary care throughout pregnancyandthepostpartumperiod. NewInsightsinPeripartumCardiomyopathy 281 MeredithO.Cruz,JoanBriller,andJudithU.Hibbard Significantprogressinunderstandingthepathophysiologyofperipartum cardiomyopathy, especially hormonal and genetic mechanisms, has beenmade.Specificcriteriashouldbeusedfordiagnosis,butthedisease Contents ix remainsadiagnosisofexclusion.Bothlong-termandrecurrentpregnancy prognosesdependonrecoveryofcardiacfunction.Datafromlargeregis- triesandrandomizedcontrolledtrialsofevidence-basedtherapeuticshold promiseforfutureimprovedclinicaloutcomes. GestationalDiabetes:UnderpinningPrinciples,Surveillance,andManagement 299 JeffreyM.DenneyandKristenH.Quinn Gestationaldiabetesmellitus(GDM)iscarbohydrateintoleranceresulting in hyperglycemia with onset during pregnancy. This article provides clinicians with a working framework to minimize maternal and neonatal morbidity. Landmark historical and recent data are reviewed and pre- sented to provide clinicians with a quick, easy reference for recognition andmanagementofGDM.Datapresentedtieininsightswithunderlying pathophysiologic processes leading to GDM. Screening and diagnostic thresholdsarediscussedalongwithmanagementupondiagnosis.Good clinical practice regarding screening, diagnosis, and management of GDMeffectivelyreducesriskandimprovesoutcomesofwomenandfe- tusesinaffectedpregnancies. PregestationalDiabetesinPregnancy 315 RonanSugrueandChloeZera Diabetesisacommonchronicconditioninwomenofreproductiveage.Pre- conceptioncareiscrucialtoreducingtheriskofadversematernalandfetal outcomes,suchashypertensivedisorders,abnormalfetalgrowth,traumatic delivery,andstillbirth,associatedwithpoorglycemiccontrol.Insulinisthe preferredmedicationtooptimizeglucosecontrolinwomenwithpregesta- tionaldiabetes.Frequentdoseadjustmentsareneededduringpregnancy to achieve glycemic goals, and team-based multidisciplinary care may help.Postpartumcareshouldincludelactationsupport,counselingoncon- traceptiveoptions,andtransitiontoprimarycare. HypertensiveDisordersinPregnancy 333 AmeliaL.M.Sutton,LorieM.Harper,andAlanT.N.Tita Hypertensivedisordersofpregnancyareaheterogeneousgroupofcondi- tions that include chronic hypertension, gestational hypertension, pre- eclampsia, and preeclampsia superimposed on chronic hypertension. Thesedisordersaccountforasignificantproportionofperinatalmorbidity andmortalityandnearly10%ofallmaternaldeathsintheUnitedStates. Given the substantial health burden of hypertensive disorders in preg- nancy,thereisincreasinginterestinoptimizingmanagementofthesecon- ditions.Thisarticlesummarizesthediagnosisandmanagementofeachof thedisordersinthespectrumofhypertensioninpregnancyandhighlights recentupdatesinthefield. SeizuresinPregnancy 349 KassieJ.BolligandDanielL.Jackson Seizures are among the most serious neurologic complications encoun- tered in pregnancy. This article provides a foundation for the initial
The list of books you might like
