High-risk pregnancies present life-threatening challenges to two of your patients: the mother and her fetus. The direct, exemplary guidance in Protocols for High-Risk Pregnancy enables you to better understand your patients’ conditions devise optimum management strategies maximize the outcome and minimize the complications for both the mother and her fetus. To enhance clinical relevance, each protocol is written as if the patient were present. Evidence to support an intervention is given where it exists. The authors’ experience provides additional wise counsel. Key references provide the springboard for a deeper understanding of a topic. In this more compact and fully updated sixth edition, new protocols include: Amniotic fluid disorders, Depression, Fetal growth restriction, HIV, Indicated late preterm and early term birth, Malaria, Noninvasive prenatal diagnosis. Designed for clinical practice by the leaders of two generations of maternal-fetal medicine, no obstetrician or obstetric health care provider can afford to miss Protocols for High-Risk Pregnancy.
1 Tobacco, Alcohol, and the Environment 3
Jorge E. Tolosa and George Saade
2 Ionizing Radiation 14
Robert L. Brent
3 Depression 27
Kimberly Yonkers
Part II Antenatal Testing
4 Prenatal Detection of Fetal Chromosome Abnormality 35
Fergal D. Malone
5 Fetal Echocardiography 48
Joshua A. Copel
6 Clinical Use of Doppler 54
Henry L. Galan
7 Antepartum Testing 65
Michael P. Nageotte
8 Fetal Blood Sampling and Transfusion 71
Alessandro Ghidini
Part III Maternal Disease
9 Maternal Anemia 81
Alessandro Ghidini
10 Sickle Cell Disease 88
Marc R. Parrish, John Morrison
11 Isoimmune Thrombocytopenia 97
Richard L. Berkowitz, Sreedhar Ghaddipati
12 Autoimmune Disease 104
Charles J. Lockwood
13 Antiphospholipid Antibody Syndrome 115
Charles J. Lockwood
14 Inherited Thrombophilias 119
Andra H. James
15 Cardiac Disease 128
Katharine D. Wenstrom
16 Peripartum Cardiomyopathy 139
F. Garry Cunningham
17 Thromboembolism 143
Alan Peaceman
18 Renal Disease 150
Susan Ramin
19 Obesity 157
Raul Artal
20 Diabetes Mellitus 163
Mark B. Landon, Steven G. Gabbe
21 Thyroid Disorders 172
Stephen F. Thung
22 Acute and Chronic Hepatitis 180
Patrick Duff
23 Asthma 188
Michael Schatz
24 Epilepsy 196
Men-Jean Lee
25 Chronic Hypertension 203
Baha M. Sibai
26 Cytomegalovirus, Genital Herpes, Rubella, Syphilis, and Toxoplasmosis 213
Brenna L. Hughes
27 Influenza, West Nile Virus, Varicella-Zoster, and Tuberculosis, 222
Jeanne S. Sheffield
28 Malaria 232
Richard M.K. Adanu
29 Human Immunodeficiency Virus Infection 238
Jane Hitti
30 Parvovirus B19 Infection 245
Maureen P. Malee
31 Group B Streptococcus 251
Mara J. Dinsmoor
32 Acute Abdominal Pain Due to Nonobstetric Causes 260
Fred M. Howard
33 Gallbladder, Fatty Liver, and Pancreatic Disease 270
Jeffrey R. Johnson
Part IV Obstetric Problems
34 First Trimester Vaginal Bleeding 281
John T. Queenan Jr.
35 Cervical Insufficiency 288
John Owen
36 Nausea and Vomiting 298
Gayle Olson
37 Fetal Death and Stillbirth 306
Robert M. Silver
38 Abnormal Amniotic Fluid Volume 315
Thomas R. Moore
39 Preeclampsia 329
Baha M. Sibai
40 Fetal Growth Restriction 340
Henry L. Galan
41 Rh and Other Blood Group Alloimmunizations 353
Kenneth J. Moise Jr
42 Preterm Labor 363
Vincenzo Berghella
43 Premature Rupture of the Membranes 369
Brian Mercer
44 Indicated Late-Preterm and Early-Term Deliveries 383
Catherine Y. Spong
45 Prevention of Cerebral Palsy 388
Dwight J. Rouse
46 Amnionitis 392
George A. Macones
47 Third Trimester Bleeding 398
Yinka Oyelese
48 Amniotic Fluid Embolus 406
Robert Resnik
Part V Labor and Delivery
49 Induction of Labor 411
Deborah A. Wing
50 Intrapartum Fetal Heart Rate Monitoring 418
Roger K. Freeman
51 Breech Delivery 423
G. Justus Hofmeyr
52 Vaginal Birth After Cesarean 428
James R. Scott
53 Placenta Accreta 435
Robert M. Silver
54 Shoulder Dystocia 445
Robert Gherman
55 Twins, Triplets and Beyond 451
Mary E. D’Alton
56 Postpartum Hemorrhage 462
David S. McKenna
Appendix A: Evaluation of Fetal Health and Defects 470
Lynn L. Simpson
Index 483