Additional Information
Book Details
Abstract
The Midwives’ Guide to Key Medical Conditions is designed to help practitioners manage pregnancy and childbirth in women with systemic disease, recognize the early onset of disease-related pregnancy complications, and determine when it may be necessary to refer patients to another member of the healthcare team. The volume is ideal for all midwives, whether qualified or in training.
- Written by well-known authorities in the field to ensure that the information is perfectly tailored to the midwifery student
- Accessible writing style and clear artwork program helps make learning easy
- Recaps on the underlying anatomy and physiology for the relevant body system
- Explains the normal physiological changes that occur during pregnancy
- Summarises the relative risk of the specific disorder in the context of overall maternal mortality
- Explains the pathophysiology of a given condition, with emphasis on its impact on pregnancy
- Explores the relevant management the neonate and the likely impact of the medical disorder on future pregnancies
- Places particular emphasis on the management of critical illness and medical emergencies
- Risk management and the use of pathways of care
- Management of obesity
- Sepsis and infectious diseases
- Additional pre-existing chronic disorders
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| The Midwives' Guide to Key Medical Conditions: Pregnancy and Childbirth | iii | ||
| Copyright | iv | ||
| Contents | v | ||
| Preface | vii | ||
| Acknowledgements | ix | ||
| Chapter One: The midwife's role | 1 | ||
| Introduction | 1 | ||
| Prenatal care | 4 | ||
| Intrapartum care | 5 | ||
| Postnatal care | 5 | ||
| The midwife | 5 | ||
| References | 6 | ||
| Chapter Two: Hypertensive conditions | 7 | ||
| Introduction | 7 | ||
| Relevant anatomy and physiology | 7 | ||
| Control of blood pressure | 10 | ||
| Central regulation | 10 | ||
| Hormonal regulation | 10 | ||
| Autoregulation | 11 | ||
| Hypertension in the general population | 11 | ||
| Aetiology | 11 | ||
| Pathophysiology of hypertension | 11 | ||
| Essential hypertension | 11 | ||
| Secondary hypertension | 12 | ||
| Signs and symptoms | 12 | ||
| Diagnosis | 12 | ||
| Treatment | 12 | ||
| Lifestyle changes | 12 | ||
| Drug therapy | 12 | ||
| Prognosis | 13 | ||
| The heart | 13 | ||
| The brain | 13 | ||
| The kidneys | 13 | ||
| The eyes | 13 | ||
| Hypertension in pregnancy and childbirth | 13 | ||
| Overview | 13 | ||
| Relevant physiological changes in the cardiovascular system in pregnancy | 13 | ||
| Hypertensive diseases of pregnancy | 14 | ||
| Classification of hypertensive disorders in pregnancy | 14 | ||
| Chronic hypertension | 14 | ||
| Diagnosis | 14 | ||
| Management of Chronic hypertension | 14 | ||
| Complications of chronic hypertension in pregnancy | 14 | ||
| Chronic hypertension with superimposed pre-eclampsia | 14 | ||
| Gestational hypertension | 15 | ||
| Causes of gestational hypertension | 15 | ||
| Diagnosis | 15 | ||
| Management | 15 | ||
| Maternal condition | 15 | ||
| Fetal condition | 15 | ||
| Pre-eclampsia | 15 | ||
| Incidence | 16 | ||
| Aetiology | 16 | ||
| Pathophysiology | 16 | ||
| Signs and symptoms | 17 | ||
| Diagnosis | 17 | ||
| Pathological changes to body systems | 18 | ||
| Management of hypertensive disorders of pregnancy | 19 | ||
| Prevention | 19 | ||
| Prenatal care | 19 | ||
| Mild to moderate pre-eclampsia | 20 | ||
| Severe pre-eclampsia | 21 | ||
| Treatment in labour | 22 | ||
| Postnatal | 22 | ||
| Complications of hypertensive disorders of pregnancy | 22 | ||
| Fulminating pre-eclampsia | 22 | ||
| Eclampsia | 22 | ||
| Prognosis | 23 | ||
| Treatment | 23 | ||
| HELLP syndrome | 24 | ||
| Midwifery management | 25 | ||
| Prognosis | 26 | ||
| Future pregnancies | 26 | ||
| The neonate | 26 | ||
| Support group | 26 | ||
| References | 26 | ||
| Chapter Three: Cardiac conditions | 29 | ||
| Introduction | 29 | ||
| Relevant anatomy and physiology | 29 | ||
| Physiological changes in pregnancy | 31 | ||
| Cardiac disease in pregnancy | 31 | ||
| Pathophysiology of cardiac disease | 32 | ||
| Acquired cardiac disorders | 32 | ||
| Rheumatic heart disease | 32 | ||
| Ischaemic heart disease and myocardial infarction | 33 | ||
| Peripartum cardiomyopathy | 33 | ||
| Cardiac arrhythmias | 33 | ||
| Tachycardia | 34 | ||
| Atrial fibrillation | 34 | ||
| Ventricular fibrillation | 35 | ||
| Congenital heart disease | 35 | ||
| Signs and symptoms | 37 | ||
| Diagnosis | 37 | ||
| Management of pregnancy and birth | 38 | ||
| Preconception care | 38 | ||
| Pregnancy | 39 | ||
| Labour | 39 | ||
| Puerperium | 40 | ||
| Midwifery management | 41 | ||
| The neonate | 43 | ||
| Future pregnancies | 43 | ||
| References | 43 | ||
| Chapter Four: Thromboembolic conditions | 45 | ||
| Introduction | 45 | ||
| Relevant anatomy and physiology | 45 | ||
| Haemostasis (cessation of bleeding) | 48 | ||
| Pathophysiology of thromboembolism | 48 | ||
| Aetiology | 49 | ||
| Thrombophilia | 49 | ||
| Thromboembolic related conditions | 50 | ||
| Varicose veins | 50 | ||
| Deep vein thrombosis | 51 | ||
| Signs and symptoms | 51 | ||
| Diagnosis | 51 | ||
| Treatment | 51 | ||
| Prognosis | 52 | ||
| Thrombophlebitis and phlebothrombosis | 52 | ||
| Treatment | 52 | ||
| Pulmonary embolism | 52 | ||
| Disseminated intravascular coagulation | 53 | ||
| Thromboembolic disorders in pregnancy | 53 | ||
| Introduction | 53 | ||
| Physiological changes in pregnancy | 54 | ||
| Incidence | 55 | ||
| Prevention | 55 | ||
| Prenatally | 55 | ||
| Labour | 55 | ||
| Puerperium | 56 | ||
| Deep vein thrombosis | 56 | ||
| Pulmonary embolism | 56 | ||
| Management and treatment of collapse due to PE | 57 | ||
| Role of the midwife in the care of a woman with a pulmonary embolism | 57 | ||
| Neonatal considerations | 57 | ||
| Future pregnancies | 57 | ||
| References | 57 | ||
| Chapter Five: Haematological conditions | 59 | ||
| Introduction | 59 | ||
| Relevant anatomy and physiology | 60 | ||
| Blood | 60 | ||
| Plasma | 60 | ||
| Erythrocytes | 61 | ||
| Leucocytes | 62 | ||
| Thrombocytes | 63 | ||
| Classification of blood | 64 | ||
| ABO blood groups | 64 | ||
| Rhesus factor | 64 | ||
| Physiological changes in the cardiovascular system and blood in pregnancy | 65 | ||
| Anaemia | 65 | ||
| Iron requirements during pregnancy | 66 | ||
| Classification of anaemia | 66 | ||
| Signs and symptoms of anaemia | 66 | ||
| Anaemia in pregnancy | 66 | ||
| Excessive or prolonged blood loss | 67 | ||
| Malabsorption | 68 | ||
| Iron deficiency anaemia | 69 | ||
| Signs and symptoms | 69 | ||
| Diagnosis | 69 | ||
| Effect of iron deficiency anaemia on pregnancy | 69 | ||
| Management during pregnancy and birth | 69 | ||
| Midwife's role | 70 | ||
| Folic acid deficiency anaemia | 71 | ||
| Signs and symptoms | 71 | ||
| Management of folic acid deficiency anaemia | 71 | ||
| Midwife's role | 71 | ||
| Vitamin B12 (hydroxocobalamin) deficiency | 71 | ||
| Management | 72 | ||
| G6PD deficiency | 72 | ||
| Haemoglobinopathies | 73 | ||
| Sickle cell disease | 73 | ||
| Sickle cell trait | 74 | ||
| Signs and symptoms | 74 | ||
| Diagnosis | 75 | ||
| Management of sickle cell disease | 75 | ||
| Effect of sickle cell disease on pregnancy | 76 | ||
| Antenatal management | 76 | ||
| Labour and birth | 77 | ||
| Postnatal care | 78 | ||
| Thalassaemia | 78 | ||
| α-Thalassaemia | 78 | ||
| α-thalassaemia major | 79 | ||
| β-thalassaemia | 79 | ||
| β-thalassaemia trait | 79 | ||
| β-thalassaemia major (cooley's anaemia) | 79 | ||
| Pregnancy and thalassaemia | 79 | ||
| Thrombocytopenia in pregnancy | 80 | ||
| Gestational thrombocytopenia | 81 | ||
| Idiopathic thrombocytopenic purpura | 81 | ||
| Management | 82 | ||
| Heparin-induced thrombocytopenia | 82 | ||
| Chapter Six: Respiratory conditions | 91 | ||
| Introduction | 91 | ||
| Relevant anatomy and physiology | 92 | ||
| Ventilation | 92 | ||
| Control of ventilation | 94 | ||
| Asthma | 94 | ||
| Causes of asthma | 95 | ||
| Pathophysiology of asthma | 95 | ||
| Signs and symptoms | 97 | ||
| Chapter Seven: Renal conditions | 111 | ||
| Introduction | 111 | ||
| Relevant anatomy and physiology | 111 | ||
| Glomerular filtration | 112 | ||
| Selective tubular reabsorption | 112 | ||
| Tubular secretion | 112 | ||
| Other functions of the nephron | 113 | ||
| Concentration of urine | 113 | ||
| Blood pressure regulation | 113 | ||
| Manufacture of erythrocytes | 113 | ||
| Synthesis of vitamin D | 114 | ||
| Other structures of the renal system | 114 | ||
| Renal disease | 114 | ||
| Aetiology | 115 | ||
| Infection | 115 | ||
| Chronic renal disease | 115 | ||
| Acute renal failure | 115 | ||
| Pathophysiology | 115 | ||
| Signs and symptoms | 116 | ||
| Diagnosis | 117 | ||
| Urinalysis | 117 | ||
| Bacteriological tests | 117 | ||
| Biochemical tests | 117 | ||
| Renal function tests | 117 | ||
| Other tests | 118 | ||
| Treatment | 118 | ||
| The renal system in pregnancy | 118 | ||
| Introduction | 118 | ||
| Physiological changes in pregnancy | 119 | ||
| Incidence | 119 | ||
| Asymptomatic bacteriuria | 119 | ||
| Cystitis | 119 | ||
| Pyelonephritis | 120 | ||
| Chronic renal disease | 120 | ||
| Acute renal failure | 121 | ||
| Renal transplant | 121 | ||
| Effect on fetal outcome | 121 | ||
| Midwife's management | 121 | ||
| Pregnancy | 121 | ||
| Labour | 122 | ||
| Puerperium | 122 | ||
| The neonate | 122 | ||
| References | 122 | ||
| Chapter Eight: Epilepsy and other neurological conditions | 125 | ||
| Introduction | 125 | ||
| Relevant anatomy and physiology | 126 | ||
| Transmission of information | 129 | ||
| Epilepsy | 130 | ||
| Aetiology | 130 | ||
| Incidence | 130 | ||
| Signs and symptoms | 130 | ||
| Simple partial seizure | 131 | ||
| Complex partial seizure | 131 | ||
| Generalized seizures (tonic clonic seizures) | 131 | ||
| Status epilepticus | 131 | ||
| Diagnosis | 132 | ||
| Treatment | 132 | ||
| Prognosis | 133 | ||
| Epilepsy in pregnancy | 133 | ||
| Physiological changes in pregnancy | 134 | ||
| Incidence | 135 | ||
| Preconception advice | 135 | ||
| Pregnancy | 135 | ||
| Effect of epilepsy on pregnancy | 135 | ||
| Effect of pregnancy on the condition | 136 | ||
| Labour | 136 | ||
| The puerperium | 136 | ||
| The midwife's management of the pregnant woman with epilepsy | 136 | ||
| Pregnancy | 137 | ||
| Management of a seizure | 137 | ||
| The neonate | 137 | ||
| Future pregnancies | 138 | ||
| Peripheral nerve disease | 138 | ||
| Multiple sclerosis | 138 | ||
| Myasthenia gravis | 139 | ||
| Headache/migraine | 139 | ||
| Cerebrovascular accident (stroke) | 140 | ||
| Subarachnoid haemorrhage | 141 | ||
| References | 141 | ||
| Chapter Nine: Endocrine disorders | 143 | ||
| Disorders of the endocrine system | 143 | ||
| Thyroid conditions | 143 | ||
| Relevant anatomy and physiology | 144 | ||
| Incidence | 147 | ||
| Aetiology of thyroid disease | 147 | ||
| Hyperthyroidism | 147 | ||
| Graves' disease | 147 | ||
| Thyroiditis | 147 | ||
| Toxic multinodular goitre | 147 | ||
| Toxic adenoma (single nodule) | 147 | ||
| Thyroid cancer | 147 | ||
| Pathophysiology | 147 | ||
| Diagnosis | 148 | ||
| Management | 148 | ||
| Antithyroid drug therapy | 148 | ||
| Surgery | 148 | ||
| Radio-active iodine therapy | 148 | ||
| Hypothyroidism | 149 | ||
| Clinical features of hypothyroidism | 149 | ||
| Diagnosis | 149 | ||
| Treatment | 149 | ||
| Iodine | 150 | ||
| Physiological changes in pregnancy | 150 | ||
| Thyroid function tests in pregnancy | 151 | ||
| Hyperthyroidism in pregnancy | 151 | ||
| Signs and symptoms | 151 | ||
| Diagnosis | 152 | ||
| Management | 152 | ||
| Thyroid storm | 152 | ||
| Postnatal management of hyperthyroidism | 153 | ||
| Effect of hyperthyroidism on the fetus | 153 | ||
| Breast-feeding | 153 | ||
| Hypothyroidism in pregnancy | 153 | ||
| Signs and symptoms | 154 | ||
| Diagnosis | 154 | ||
| Management | 154 | ||
| Post-partum management | 155 | ||
| Postpartum thyroiditis | 155 | ||
| Congenital hypothyroidism in the neonate | 155 | ||
| Diabetes mellitus | 155 | ||
| Introduction | 155 | ||
| Relevant anatomy and physiology | 156 | ||
| Metabolism | 158 | ||
| Carbohydrate metabolism | 158 | ||
| Fat Metabolism | 158 | ||
| Protein metabolism | 158 | ||
| Summary | 159 | ||
| Types of diabetes mellitus | 159 | ||
| Incidence | 159 | ||
| Type 1 diabetes mellitus | 159 | ||
| Aetiology | 159 | ||
| Signs and symptoms | 160 | ||
| Pathophysiology | 160 | ||
| Diagnosis | 160 | ||
| Management | 161 | ||
| Insulin | 162 | ||
| Type 2 diabetes mellitus | 163 | ||
| Signs and symptoms | 163 | ||
| Management | 164 | ||
| Complications of diabetes mellitus | 164 | ||
| Diabetic ketoacidosis | 164 | ||
| Pathophysiology | 164 | ||
| Signs and symptoms | 164 | ||
| Management of diabetic ketoacidosis | 165 | ||
| Diabetic hyperglycaemic hyperosmolar state (HHS) | 165 | ||
| Hypoglycaemia | 166 | ||
| Management | 166 | ||
| Prognosis | 167 | ||
| Diabetes in pregnancy | 167 | ||
| Effect of pregnancy on diabetes | 167 | ||
| Effect of diabetes on pregnancy | 168 | ||
| Physiological changes in pregnancy | 168 | ||
| Preconception care | 168 | ||
| Gestational diabetes | 170 | ||
| Diagnosis | 171 | ||
| Management of gestational diabetes | 171 | ||
| Management of diabetes in pregnancy | 171 | ||
| Management of labour and birth | 172 | ||
| Puerperium | 172 | ||
| The neonate | 173 | ||
| References | 174 | ||
| Chapter Ten: Eating disorders | 177 | ||
| Introduction | 177 | ||
| Obesity | 178 | ||
| Relevant physiology | 178 | ||
| Hypertension | 179 | ||
| Insulin resistance | 179 | ||
| Other conditions | 180 | ||
| Diagnosis | 180 | ||
| Treatment | 180 | ||
| Obesity in pregnancy and childbirth | 180 | ||
| Pregnancy complicated by obesity | 182 | ||
| Management of obesity in pregnancy and childbirth | 183 | ||
| Anorexia and bulimia | 184 | ||
| References | 185 | ||
| Chapter Eleven: The gastrointestinal system | 187 | ||
| Chapter Contents | 187 | ||
| Introduction | 187 | ||
| Relevant anatomy and physiology of the gastrointestinal tract | 187 | ||
| Inflammatory bowel disease | 188 | ||
| Inflammatory bowel disease and childbirth | 189 | ||
| Irritable bowel syndrome | 190 | ||
| Coeliac disease | 191 | ||
| Diagnosis | 191 | ||
| Treatment | 191 | ||
| Pregnancy | 191 | ||
| Appendicitis | 192 | ||
| Dyspepsia and heartburn | 192 | ||
| Management | 192 | ||
| Hiatus hernia | 192 | ||
| Symptoms | 193 | ||
| Management | 193 | ||
| Complications | 193 | ||
| Pregnancy | 193 | ||
| Neonate | 193 | ||
| Medical conditions related to the accessory organs of digestion | 193 | ||
| Relevant anatomy and physiology | 193 | ||
| Relevant physiological changes in pregnancy | 196 | ||
| Obstetric cholestasis (Intrahepatic cholestasis of pregnancy (ICP)) | 196 | ||
| Incidence | 196 | ||
| Pathophysiology | 197 | ||
| Diagnosis | 197 | ||
| Signs and symptoms | 197 | ||
| Treatment | 197 | ||
| Prognosis | 198 | ||
| The neonate | 198 | ||
| Future pregnancies | 198 | ||
| Related disorders | 198 | ||
| Gallstones | 198 | ||
| Acute fatty liver | 198 | ||
| Clinical Features | 199 | ||
| Management | 199 | ||
| Viral hepatitis (see also Ch.12) | 199 | ||
| Other causes of hepatitis | 200 | ||
| References | 200 | ||
| Bibliography | 200 | ||
| Chapter Twelve: Sepsis and infections in pregnancy and childbirth | 201 | ||
| Relevant anatomy and physiology | 201 | ||
| The lymphatic system | 201 | ||
| Lymphatic capillaries | 202 | ||
| Lymphatic vessels | 202 | ||
| Lymphatic tissues/nodules | 203 | ||
| Lymphatic ducts | 203 | ||
| Physiology of the lymphatic system | 203 | ||
| Lymphoid organs | 203 | ||
| The tonsils | 203 | ||
| The thymus gland | 203 | ||
| The spleen | 203 | ||
| Immunity | 204 | ||
| Vaccination | 205 | ||
| Killed or inactivated vaccine | 205 | ||
| Attenuated vaccines | 205 | ||
| Toxoid vaccine | 205 | ||
| Physiological changes in pregnancy | 205 | ||
| Introduction to sepsis and infection | 206 | ||
| Sepsis | 207 | ||
| Sepsis related to pregnancy | 207 | ||
| Principles of care | 208 | ||
| Puerperal sepsis | 209 | ||
| Factors predisposing to puerperal sepsis | 209 | ||
| Signs and symptoms of genital sepsis | 209 | ||
| Treatment | 210 | ||
| Principles of midwifery care | 210 | ||
| Streptococcal infections | 210 | ||
| Group A streptococcus | 210 | ||
| Transmission | 211 | ||
| Diagnosis | 211 | ||
| Treatment | 211 | ||
| Group B streptococcus | 211 | ||
| Signs and symptoms | 211 | ||
| Diagnosis | 212 | ||
| Management | 212 | ||
| Neonatal risks | 212 | ||
| Influenza | 212 | ||
| Transmission | 212 | ||
| Signs and symptoms | 212 | ||
| Risk factors | 212 | ||
| Treatment | 212 | ||
| Good hygiene measures | 213 | ||
| Complications | 213 | ||
| Pregnancy | 213 | ||
| Hepatitis A | 213 | ||
| Incubation | 213 | ||
| Diagnosis | 214 | ||
| Signs and symptoms | 214 | ||
| Treatment | 214 | ||
| Vaccination | 214 | ||
| Pregnancy | 214 | ||
| Hepatitis B | 214 | ||
| Transmission | 215 | ||
| Signs and symptoms | 215 | ||
| Diagnosis | 215 | ||
| In pregnancy | 215 | ||
| Management | 215 | ||
| The neonate | 215 | ||
| Hepatitis C | 216 | ||
| Signs and symptoms | 216 | ||
| Diagnosis | 216 | ||
| Treatment | 216 | ||
| Complications | 216 | ||
| In pregnancy | 216 | ||
| Sexually transmitted infections | 217 | ||
| Herpes simplex | 217 | ||
| Signs and symptoms | 217 | ||
| In pregnancy | 217 | ||
| Management | 218 | ||
| The neonate | 218 | ||
| Gonorrhoea | 218 | ||
| Transmission | 218 | ||
| Signs and symptoms | 218 | ||
| Diagnosis | 218 | ||
| Chapter Thirteen: Other medical conditions related to pregnancy and childbirth | 241 | ||
| Chapter Contents | 241 | ||
| Musculoskeletal conditions | 241 | ||
| Arthritis | 241 | ||
| Rheumatoid arthritis | 241 | ||
| Diagnosis | 242 | ||
| Treatment | 242 | ||
| Rheumatoid arthritis in pregnancy | 243 | ||
| Systemic lupus erythematosus | 243 | ||
| Signs and symptoms | 243 | ||
| Diagnosis | 244 | ||
| Treatment | 244 | ||
| Systemic lupus erythematosus in pregnancy | 244 | ||
| Antiphospholipid syndrome | 245 | ||
| Symptoms | 245 | ||
| Treatment | 245 | ||
| APS in pregnancy | 245 | ||
| Treatment in pregnancy | 246 | ||
| Raynaud's syndrome | 246 | ||
| Treatment | 246 | ||
| Raynaud's phenomenon in pregnancy | 246 | ||
| Skin diseases | 246 | ||
| Eczema | 246 | ||
| Signs and symptoms | 247 | ||
| Diagnosis | 247 | ||
| Psoriasis | 247 | ||
| Psoriasis and pregnancy | 248 | ||
| Cancer | 248 | ||
| Cervical cancer | 249 | ||
| Breast cancer | 249 | ||
| Malignant melanoma | 250 | ||
| Diagnosis | 251 | ||
| Hodgkin lymphoma | 251 | ||
| Gestational trophoblastic disease | 251 | ||
| References | 252 | ||
| Index | 255 |