Prenatal Diagnosis
Risk Factors Selected risk factors for NTDs are listed in Table 14-1, and genetic factors represent the largest category. Isolated NTDs display multifactorial inheritance. The recurrence risk is approximately 3…
Vaginal Delivery
Delivery of the Head With each contraction, the vulvovaginal opening is dilated by the fetal head to gradually form an ovoid and finally, an almost circular opening (Fig. 27-1). This…
The Puerperium
INVOLUTION OF THE REPRODUCTIVE TRACT Birth Canal Return to the nonpregnant state begins soon after delivery. The vagina and its outlet gradually diminish in size but rarely regain their nulliparous…
Neoplastic Disorders
FIGURE 63-1 Proportion of malignancies during pregnancy and within 12 months of delivery in 4.85 million women from the California Cancer Registry. GI = gastrointestinal. (Data from Smith, 2003.) PRINCIPLES…
Thromboembolic Disorders
The likelihood of developing a thrombosis during pregnancy is especially increased in women with certain genetic risk factors. Indeed—and likely related—after personal history of thrombosis, the next most important individual…
Abnormal Labor
Inadequate cervical dilation or fetal descent: Protracted labor—slow progress Arrested labor—no progress Inadequate expulsive effort—ineffective pushing Fetopelvic disproportion: Excessive fetal size Inadequate pelvic capacity Malpresentation or position of the fetus…
Endocrine Disorders
Thyroid Physiology and Pregnancy Maternal thyroid changes are substantial, and normally altered gland structure and function are sometimes confused with thyroid abnormalities. These alterations are discussed in detail in Chapter…
Physiology of Labor
FIGURE 21-1 The phases of parturition. FIGURE 21-2 Composite of the average dilatation curve for labor in nulliparous women. The curve is based on analysis of data derived from a…
Diabetes Mellitus
Type 1: β-Cell destruction, usually absolute insulin deficiency Immune-mediated Idiopathic Type 2: Ranges from predominantly insulin resistance to predominantly an insulin secretory defect with insulin resistance Other types Genetic mutations…
Hematological Disorders
FIGURE 56-1 Mean hemoglobin concentrations (black line) and 5th and 95th percentiles (blue lines) for healthy pregnant women taking iron supplements. (Data from the Centers for Disease Control and Prevention,…
