Operative Vaginal Delivery
FIGURE 29-1 Decline in operative vaginal delivery rates, 1990–2010. (From Martin, 2012.) INDICATIONS If it is technically feasible and can be safely accomplished, termination of second-stage labor by operative vaginal…
Ectopic Pregnancy
Classification Nearly 95 percent of ectopic pregnancies are implanted in the various segments of the fallopian tube and give rise to fimbrial, ampullary, isthmic, or interstitial tubal pregnancies (Fig. 19-1)….
Diseases and Injuries of the Term Newborn
Surfactant Deficiency Inadequate surfactant secretion that leads to respiratory distress syndrome becomes less frequent with increasing gestational age. That said, even with a low incidence in term infants, RDS from…
Fetal Assessment
FIGURE 17-1 Fetal bladder volume measurements together with fetal heart rate (FHR) variation recorded in relation to 1F or 2F behavior states. State 1F fetal heart rate has a narrow…
Pulmonary Disorders
Pathophysiology Asthma is a chronic inflammatory airway syndrome with a major hereditary component. Increased airway responsiveness and persistent subacute inflammation have been associated with genes on chromosomes 5q that include…
Neurological Disorders
Primary Tension-type (69%) Migraine (16%) Cluster and other trigeminal autonomic cephalgias (< 1%) Other Secondary Systemic infection (63%) Head or neck trauma (4%) Cranial or cervical vascular disorders Intracranial nonvascular…
Gastrointestinal Disorders
Diagnostic Techniques Endoscopy Various methods can evaluate the gastrointestinal tract during pregnancy without reliance on x-ray techniques. Fiberoptic endoscopic instruments have revolutionized diagnosis and management of most gastrointestinal conditions, and…
Chronic Hypertension
Definition and Classification For the foregoing reasons, it seems logical that chronic hypertension would be defined as some level of sustained blood pressure that is associated with an increase in…
Preconceptional Counseling
Few randomized trials evaluate preconceptional counseling efficacy, in part because withholding such counseling would be unethical. Also, because pregnancy outcomes are dependent on the interaction of various maternal, fetal, and…
