BOOK
Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice E-Book
Robert Resnik | Charles J. Lockwood | Thomas Moore | Michael F Greene | Joshua Copel | Robert M Silver
(2018)
Additional Information
Book Details
Abstract
Long recognized as the authoritative leader in the field, Creasy and Resnik's Maternal-Fetal Medicine, 8th Edition, continues to provide the latest evidence-based guidelines for obstetric and neonatal management, helping you minimize complications and offer patients the best possible care. Written by renowned experts in obstetrics, gynecology, and perinatology, this comprehensive resource has been thoroughly updated and reflects new information in every area, including recent tremendous advances in genetics, imaging, and more.
- Focuses on complicated obstetric issues , highlighting the most commonly encountered anomalies and providing clear guidelines for obstetric and neonatal management.
- Offers comprehensive updates on rapidly changing topics, including a completely revised section on genetics and genetic technology for prenatal diagnoses, as well as an expanded imaging section on abdominal, urogenital, and skeletal imaging.
- Includes four new chapters: Molecular Genetic Technology, MRI in Obstetrical Imaging, Obesity in Pregnancy, and Pregnancy as a Window to Future Health.
- Features numerous flow charts for quick access to diagnosis and treatment protocols and to clarify complex material.
- Presents the knowledge and expertise of new editors Dr. Joshua Copel, an expert in the field of fetal therapy who has pioneered new diagnostic techniques for unborn patients and their mothers, and Dr. Robert Silver, a leader in the maternal-fetal medicine community.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Endsheet 2 | IFC2 | ||
| Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice | i | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Contributors | vi | ||
| Preface | xiv | ||
| Table Of Contents | xv | ||
| 1 Scientific Basis of Perinatal Biology | 1 | ||
| 1 Human Genetics and Patterns of Inheritance | 3 | ||
| DNA Structure | 3 | ||
| Cell Division | 3 | ||
| Meiosis | 3 | ||
| Mendel’s Laws | 4 | ||
| Mitosis | 4 | ||
| Errors in Meiosis | 4 | ||
| Triploidy | 4 | ||
| Nondisjunction | 4 | ||
| Imprinting | 5 | ||
| Trisomic Rescue | 6 | ||
| Errors in Mitosis | 9 | ||
| Germline Mosaicism | 10 | ||
| Confined Placental Mosaicism | 11 | ||
| Mendelian Inheritance | 11 | ||
| Mitochondrial Inheritance | 13 | ||
| Trinucleotide Repeats | 13 | ||
| Key Points | 14 | ||
| References | 14.e1 | ||
| 2 Molecular Genetic Technology | 15 | ||
| Detecting the Genetic Basis of Disease | 15 | ||
| Genetic Variation | 15 | ||
| Genetic Pathology | 15 | ||
| Preconceptional and Prenatal Diagnosis of Genetic Pathology | 16 | ||
| Parental Carrier Screening | 17 | ||
| Expanded Carrier Screening | 17 | ||
| Fetal Genetic Screening and Testing | 20 | ||
| Sources of Parental Genetic Material | 20 | ||
| Sources of Fetal Genetic Material | 20 | ||
| Embryo Biopsy | 20 | ||
| Noninvasive Approach: Cell-Free Fetal DNA in the Maternal Circulation | 20 | ||
| Invasive Prenatal Genetic Samples | 21 | ||
| Ontogenesis of Fetal Samples: Origins of Mosaicism | 21 | ||
| Laboratory Considerations for Amniocentesis | 21 | ||
| Amniocentesis: Mosaic Results | 21 | ||
| Laboratory Considerations for Chorionic Villus Sampling | 23 | ||
| Chorionic Villus Sampling: Maternal Contamination and Mosaicism | 23 | ||
| Other Invasive Fetal Biopsy/Diagnostic Procedures | 24 | ||
| Cytogenetic Testing: Detection of Chromosomal or Subchromosomal Abnormalities | 25 | ||
| Karyotype | 25 | ||
| Fluorescence in situ Hybridization | 25 | ||
| Chromosomal Microarray Analysis | 26 | ||
| Interpretation of Copy Number Variation | 29 | ||
| Limitations of Chromosomal Microarray Analysis | 29 | ||
| Ethical Considerations of Genetic Diagnosis in a Fetus | 30 | ||
| Genotyping/Sequencing | 30 | ||
| Hybridization Techniques: Southern Blot, Polymerase Chain Reaction | 30 | ||
| DNA Sequencing | 31 | ||
| Special Applications | 32 | ||
| Noninvasive Prenatal Screening | 32 | ||
| Expanded Applications of Cell-Free Fetal Nucleic Acid Testing | 34 | ||
| Preimplantation Genetic Testing | 34 | ||
| Preimplantation Genetic Screening for Aneuploidy | 35 | ||
| Preimplantation Genetic Diagnosis | 36 | ||
| PGD for Mendelian Disorders. | 36 | ||
| PGD for Carriers of Balanced Rearrangements. | 36 | ||
| Ethical Issues Surrounding Preimplantation Genetic Diagnosis | 37 | ||
| Conclusion | 37 | ||
| Key Points | 37 | ||
| References | 38.e1 | ||
| 3 Normal Early Development | 39 | ||
| Preimplantation Development | 39 | ||
| Implantation | 44 | ||
| Postimplantation Placental Development | 47 | ||
| Imprinting and Placental Development | 50 | ||
| Embryonic Development: From the Primitive Streak Through Gastrulation | 50 | ||
| Early Embryonic Development Postgastrulation | 52 | ||
| Neural Development | 52 | ||
| Mesodermal Patterning | 53 | ||
| Cardiac Development | 53 | ||
| Somitogenesis | 54 | ||
| Intermediate and Lateral Plate Mesoderm Patterning | 54 | ||
| Limb Development | 55 | ||
| Endodermal Patterning | 57 | ||
| Organogenesis | 59 | ||
| Conclusion | 59 | ||
| Key Points | 59 | ||
| References | 61.e1 | ||
| 4 Amniotic Fluid Dynamics | 62 | ||
| Volume of Amniotic Fluid | 62 | ||
| Production and Composition of Amniotic Fluid | 62 | ||
| Urine Production | 63 | ||
| Lung Fluid Production | 64 | ||
| Minor Sources of Amniotic Fluid | 64 | ||
| Resorption of Amniotic Fluid | 64 | ||
| Fetal Swallowing | 64 | ||
| Intramembranous Flow | 64 | ||
| Possible Mechanisms to Regulate Amniotic Fluid Volume via Intramembranous Flow | 65 | ||
| Membrane Water Flow | 65 | ||
| Membrane Anatomy | 66 | ||
| Possible Regulation of Intramembranous Flow | 66 | ||
| Key Points | 67 | ||
| References | 67.e1 | ||
| 5 Multiple Gestation | 68 | ||
| Zygosity and Chorionicity | 68 | ||
| Mechanisms Underlying Dizygotic and Monozygotic Twinning | 69 | ||
| Dizygotic Twinning | 69 | ||
| Monozygotic Twinning | 69 | ||
| Twin Placentation Types | 70 | ||
| Dichorionic Placentation | 70 | ||
| Monochorionic Placentation | 70 | ||
| Complications of Monochorionic Twinning and Their Associated Placental Characteristics | 71 | ||
| Twin-to-Twin Transfusion Syndrome | 72 | ||
| Definition | 72 | ||
| Pathogenesis | 72 | ||
| Placental Findings | 72 | ||
| Twin Anemia-Polycythemia Sequence | 73 | ||
| Definition | 73 | ||
| Pathogenesis | 73 | ||
| Placental Findings | 73 | ||
| Twin Reversed Arterial Perfusion Sequence (Acardiac Twinning) | 74 | ||
| Definition | 74 | ||
| Pathogenesis | 74 | ||
| Placental and Fetal Findings | 74 | ||
| Fetal Growth Discordance in Monochorionic Twins | 75 | ||
| Definition | 75 | ||
| Pathogenesis | 75 | ||
| Placental Findings | 75 | ||
| Monoamniotic Twinning | 76 | ||
| 2 Obstetric Imaging | 249 | ||
| Part 2_Section 1 | 251 | ||
| 18 Performing and Documenting the Fetal Anatomy Ultrasound Examination | 252 | ||
| Categorizing Types of Obstetric Ultrasound Examinations | 252 | ||
| The Basic Midtrimester Fetal Anatomy Scan (CPT 76805) | 252 | ||
| Documentation of the Obstetric Ultrasound Examination | 254 | ||
| The Detailed Maternal and Fetal Evaluation Study (CPT 76811) | 254 | ||
| Typical Images Obtained in a CPT 76811 Detailed Obstetric Ultrasound Examination | 255 | ||
| Key Points | 255 | ||
| References | 265.e1 | ||
| 19 Doppler Ultrasound | 266 | ||
| Umbilical Artery | 266 | ||
| Anatomy | 266 | ||
| Technique | 266 | ||
| Number of Vessels | 266 | ||
| Doppler Flow Pattern | 266 | ||
| Clinical Use | 266 | ||
| Fetal Growth Restriction | 266 | ||
| Monochorionic Twin Gestations | 267 | ||
| Twin-Twin Transfusion Syndrome. | 267 | ||
| Selective Intrauterine Growth Restriction. | 267 | ||
| Middle Cerebral Artery | 267 | ||
| Anatomy | 267 | ||
| Technique | 268 | ||
| Clinical Use | 270 | ||
| Fetal Anemia | 270 | ||
| Twin Anemia-Polycythemia Sequence | 270 | ||
| Intrauterine Growth Restriction | 270 | ||
| Ductus Venosus | 270 | ||
| Anatomy | 270 | ||
| Technique | 271 | ||
| 3 Fetal Disorders: Diagnosis and Therapy | 491 | ||
| 32 Prenatal Diagnosis of Congenital Disorders | 493 | ||
| Screening for Fetal Genetic Disorders | 493 | ||
| Likelihood Ratios | 493 | ||
| Maternal Age as a Screening Test | 494 | ||
| First-Trimester Screening for Aneuploidy: First-Trimester Biochemical Screening | 495 | ||
| First-Trimester Ultrasound Screening for Aneuploidy | 495 | ||
| Combined First-Trimester Nuchal Translucency and Biochemistry Screening | 497 | ||
| Additional First-Trimester Markers of Down Syndrome | 497 | ||
| Biochemical Markers | 497 | ||
| Ultrasound Markers | 497 | ||
| Nasal Bone. | 497 | ||
| Tricuspid Regurgitation. | 499 | ||
| Ductus Venosus Waveform. | 499 | ||
| Impact of Spontaneous Miscarriages on First-Trimester Screening | 499 | ||
| Second-Trimester Maternal Serum Screening for Aneuploidy | 499 | ||
| Combined First- and Second-Trimester Screening Tests | 500 | ||
| Integrated Screening | 500 | ||
| Sequential Screening. | 500 | ||
| Serum Integrated Screen. | 500 | ||
| Abnormal Screening Markers in Pregnancies With a Normal Karyotype | 500 | ||
| Serum Markers | 500 | ||
| First Trimester | 500 | ||
| Unexplained Decreased PAPP-A | 500 | ||
| Ultrasound Markers | 501 | ||
| Increased Nuchal Translucency and Normal Karyotype. | 501 | ||
| Second Trimester | 502 | ||
| Unexplained Elevated Maternal Serum Alpha Fetoprotein | 502 | ||
| Unexplained Elevated Human Chorionic Gonadotropin Levels | 502 | ||
| Unexplained Elevated Inhibin-A Levels | 503 | ||
| Elevated Human Chorionic Gonadotropin and Maternal Serum Alpha Fetoprotein | 503 | ||
| Low Second-Trimester Maternal Serum Estriol | 503 | ||
| Management Strategies for Women With Unexplained Abnormal Serum Markers | 503 | ||
| Second-Trimester Ultrasound Markers of Down Syndrome | 503 | ||
| Use of Second-Trimester Ultrasound in Down Syndrome Screening | 505 | ||
| Second-Trimester Ultrasound Screening for Other Chromosomal Abnormalities | 505 | ||
| Aneuploidy Screening Using Cell-Free Fetal DNA in the Maternal Circulation | 506 | ||
| Characteristics of Cell-Free DNA in the Maternal Circulation | 506 | ||
| Cell-Free DNA Methods Used to Screen for Fetal Aneuploidy | 506 | ||
| Cell-Free DNA Screening Performance Characteristics | 508 | ||
| Failure to Receive Cell-Free DNA Result | 508 | ||
| Cell-Free DNA Screening for Sex Chromosome Aneuploidies | 509 | ||
| Cell-Free DNA Screening for Microdeletions | 510 | ||
| False-Positive Cases | 510 | ||
| Incidental Findings | 510 | ||
| Maternal Chromosomal Abnormalities | 510 | ||
| Maternal Malignancy | 510 | ||
| Current Society Recommendations for Cell-Free DNA Screening | 510 | ||
| Pretest Counseling for Cell-Free DNA Screening for Fetal Aneuploidy | 511 | ||
| Additional Clinical Applications for Cell-Free DNA Screening | 511 | ||
| RhD Blood Group Determination | 511 | ||
| Screening for Single-Gene Disorders | 511 | ||
| Maternal Serum Alpha Fetoprotein Screening for Neural Tube Defects and Other Structural Defects | 511 | ||
| Physiology | 511 | ||
| Screening | 512 | ||
| Evaluation of Elevated Maternal Serum Alpha Fetoprotein | 512 | ||
| Other Fetal Causes of Elevated Maternal Serum Alpha Fetoprotein and Amniotic Fluid Alpha Fetoprotein | 513 | ||
| Screening for Gene Mutations That Lead to Fetal Disease | 514 | ||
| Universal Carrier Screening | 514 | ||
| Cystic Fibrosis Screening | 515 | ||
| Jewish Genetic Disease Testing | 517 | ||
| Tay-Sachs Disease | 517 | ||
| Canavan Disease | 518 | ||
| Familial Dysautonomia | 518 | ||
| Other Diseases With Increased Incidence in the Jewish Population | 518 | ||
| Hemoglobinopathies | 518 | ||
| Sickle Cell Syndromes | 518 | ||
| Hemoglobin Variants. | 519 | ||
| Sickle Thalassemias. | 519 | ||
| β-Thalassemia | 519 | ||
| α-Thalassemia | 520 | ||
| Fragile X Syndrome | 521 | ||
| Spinal Muscular Atrophy | 523 | ||
| Diagnostic Tests | 524 | ||
| Indications for Diagnostic (Invasive) Testing | 524 | ||
| Advanced Maternal Age and Positive Screening | 524 | ||
| Other Indications for Diagnostic Testing | 524 | ||
| Biochemical or DNA Studies | 525 | ||
| Amniocentesis | 525 | ||
| Technique of Amniocentesis | 525 | ||
| Complications of Amniocentesis | 526 | ||
| Pregnancy Loss After Midtrimester Amniocentesis | 526 | ||
| Early Amniocentesis (Performed Before 15 Weeks’ Gestation) | 527 | ||
| Chorionic Villus Sampling | 528 | ||
| Technique of Transcervical Chorionic Villus Sampling | 528 | ||
| Technique of Transabdominal Chorionic Villus Sampling | 528 | ||
| Comparison of Transcervical and Transabdominal Chorionic Villus Sampling | 529 | ||
| Pregnancy Loss After Chorionic Villus Sampling | 529 | ||
| Other Complications of Chorionic Villus Sampling | 529 | ||
| Risk for Fetal Abnormality After Chorionic Villus Sampling | 531 | ||
| Laboratory Analysis of Prenatal Diagnostic Samples | 531 | ||
| Chromosomal Microarray for Prenatal Testing | 531 | ||
| Current Indications for Microarray Analysis in Prenatal Diagnosis | 531 | ||
| Evaluation of Ultrasound Structural Anomalies. | 531 | ||
| Interpretation of Uncertain Karyotype Findings. | 531 | ||
| Marker Chromosomes. | 531 | ||
| Apparently Balanced De Novo Reciprocal Translocation. | 531 | ||
| Evaluation of a Stillborn Fetus. | 532 | ||
| First-Tier Test for Advanced Maternal Age and Positive Down Syndrome Screening. | 532 | ||
| Prenatal Diagnosis and Multifetal Gestations | 532 | ||
| Risk for Fetal Aneuploidy in Multifetal Gestations | 532 | ||
| Assisted Reproductive Technology and Aneuploidy Risk | 532 | ||
| Aneuploidy Screening Tests in Twins | 533 | ||
| First Trimester | 533 | ||
| Nuchal Translucency and Maternal Age. | 533 | ||
| Conventional Screening With Nuchal Translucency and Maternal Serum Markers | 533 | ||
| Nasal Bone Screening in Twins | 533 | ||
| Second Trimester. | 534 | ||
| Integrated Screening in Twins | 535 | ||
| Aneuploidy Screening in Higher Order Multiples. | 535 | ||
| Screening for Neural Tube Defects. | 535 | ||
| Mendelian Disorders and Multifetal Gestations. | 535 | ||
| Cell-Free DNA Screening for Aneuploidy in Twins | 535 | ||
| Amniocentesis in Multifetal Gestations | 535 | ||
| Complications of Amniocentesis in Multifetal Gestations. | 536 | ||
| Chorionic Villus Sampling in Multifetal Gestations | 537 | ||
| Complications of Chorionic Villus Sampling in Multifetal Gestations. | 537 | ||
| Which Procedure to Perform? | 537 | ||
| Percutaneous Umbilical Blood Sampling | 537 | ||
| Technique of Percutaneous Umbilical Blood Sampling | 537 | ||
| Other Invasive Diagnostic Procedures | 538 | ||
| Key Points | 538 | ||
| References | 538.e1 | ||
| 33 Teratogenesis and Environmental Exposure | 539 | ||
| Historical Perspective | 539 | ||
| Principles of Teratology | 540 | ||
| Sources of Data on Safety and Risks of Exposures in Pregnancy | 541 | ||
| Case Reports of Adverse Events | 541 | ||
| Case Series | 541 | ||
| Pregnancy Registries | 541 | ||
| Exposure Cohort Studies | 541 | ||
| Database Cohort Studies | 542 | ||
| Case-Control Studies | 542 | ||
| Summary of Data Sources | 542 | ||
| Risk Assessments and Resources | 542 | ||
| Selected Human Teratogenic Exposures | 543 | ||
| Antiepileptic Drugs | 543 | ||
| Treatment of Pregnant Women With Antiepileptic Drugs | 543 | ||
| Valproic Acid | 543 | ||
| Carbamazepine | 543 | ||
| Lamotrigine | 543 | ||
| Levetiracetam | 543 | ||
| Risk-Benefit Considerations | 543 | ||
| Immunosuppressive Agents | 544 | ||
| Mycophenolate | 544 | ||
| Adrenal Corticosteroids | 544 | ||
| Methotrexate | 544 | ||
| Vitamin K Antagonists (Coumarins) | 544 | ||
| Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Antagonists | 544 | ||
| Antidepressants | 545 | ||
| Lithium | 545 | ||
| Selective Serotonin Reuptake Inhibitors | 545 | ||
| Opioids | 545 | ||
| Retinoids | 545 | ||
| Isotretinoin and Other Oral Synthetic Retinoids | 545 | ||
| Vitamin A | 546 | ||
| Ionizing Radiation | 546 | ||
| Environmental Agents | 546 | ||
| General Considerations | 546 | ||
| Methyl Mercury | 546 | ||
| Lead | 546 | ||
| Recreational Drugs | 546 | ||
| Ethanol | 546 | ||
| Tobacco | 547 | ||
| Marijuana | 548 | ||
| Cocaine | 548 | ||
| Methamphetamine | 548 | ||
| Acknowledgment | 548 | ||
| Key Points | 548 | ||
| References | 548.e1 | ||
| 34 Assessment of Fetal Health | 549 | ||
| Principles of Ideal Fetal Monitoring | 549 | ||
| Assessment of Normal Fetal Physiology | 549 | ||
| Fetal Heart Rate Changes During Development | 549 | ||
| Fetal Behavior | 550 | ||
| Methods of Monitoring Fetal Health | 550 | ||
| Fetal Heart Rate Monitoring | 550 | ||
| Biophysical Profile | 551 | ||
| Biophysical Profile Score Variables | 552 | ||
| Amniotic Fluid Measurement. | 552 | ||
| Amniotic Fluid Volume. | 552 | ||
| Diagnosis of Oligohydramnios. | 552 | ||
| Fetal Breathing Movements. | 552 | ||
| Fetal Movement and Tone. | 552 | ||
| Biophysical Profile Technique | 553 | ||
| Score of 10/10, 8/8, or 8/10 With Normal Fluid Volume. | 553 | ||
| Oligohydramnios With a Score of 8/10. | 553 | ||
| Equivocal or Abnormal Scores. | 553 | ||
| Vibroacoustic Stimulation | 554 | ||
| Contraction Stress Test and Oxytocin Challenge Test | 555 | ||
| Doppler Ultrasound | 556 | ||
| Fetal Doppler Velocimetry | 556 | ||
| Umbilical Artery | 556 | ||
| Hemodynamics. | 556 | ||
| Measurement. | 556 | ||
| Clinical Significance. | 557 | ||
| Middle Cerebral Artery | 558 | ||
| Hemodynamics. | 558 | ||
| Measurement. | 558 | ||
| Clinical Significance. | 559 | ||
| Fetal Venous Doppler Studies | 559 | ||
| Ductus Venosus. | 559 | ||
| Umbilical Vein. | 560 | ||
| Other Veins. | 560 | ||
| Clinical Significance. | 560 | ||
| Patterns of Deterioration | 560 | ||
| Practical Aspects of Fetal Testing | 561 | ||
| Who, When, and How to Test | 561 | ||
| Impacts of Monitoring on Perinatal Mortality and Long-Term Outcomes | 562 | ||
| Summary | 562 | ||
| Acknowledgment | 562 | ||
| Key Points | 562 | ||
| References | 563.e1 | ||
| 35 Intrapartum Fetal Surveillance | 564 | ||
| Factors Controlling Fetal Heart Rate | 564 | ||
| Parasympathetic Nervous System | 564 | ||
| Sympathetic Nervous System | 564 | ||
| Chemoreceptors | 564 | ||
| Baroreceptors | 565 | ||
| Central Nervous System | 565 | ||
| Hormonal Regulation | 565 | ||
| Adrenal Medulla | 565 | ||
| Renin-Angiotensin System | 565 | ||
| Prostaglandins | 565 | ||
| Other Hormones | 565 | ||
| Blood Volume Control | 565 | ||
| Capillary Fluid Shift | 565 | ||
| Intraplacental Pressures | 565 | ||
| Frank-Starling Mechanism | 565 | ||
| Umbilical Blood Flow | 566 | ||
| Monitoring Fetal Heart Rate | 566 | ||
| Fetal Heart Rate Detection | 566 | ||
| Fetal Electrode | 566 | ||
| Doppler Ultrasound Transducer | 566 | ||
| Uterine Activity Detection | 566 | ||
| Intraamniotic Catheter | 566 | ||
| Tocodynamometer | 566 | ||
| Fetal Responses to Hypoxia or Acidemia | 566 | ||
| Fetal Acid-Base Balance | 567 | ||
| Physiology | 567 | ||
| Carbonic Acid | 567 | ||
| Nonvolatile Acids | 567 | ||
| Buffers | 567 | ||
| pH Determination | 567 | ||
| Terminology | 568 | ||
| Factors Affecting Acid-Base Balance | 568 | ||
| Respiratory Factors | 568 | ||
| Metabolic Factors | 568 | ||
| Effects of Labor | 569 | ||
| Umbilical Cord Blood Acid-Base Analysis | 569 | ||
| Technique | 569 | ||
| Normal Values | 569 | ||
| Pathologic Fetal Acidemia | 570 | ||
| Acute Neurologic Injury | 571 | ||
| Other Clinical Events and Umbilical Blood Acid-Base Status | 571 | ||
| Acute Chorioamnionitis. | 571 | ||
| Nuchal Cords. | 571 | ||
| Meconium-Stained Amniotic Fluid. | 571 | ||
| Prolonged Pregnancy. | 571 | ||
| Fetal Heart Rate Abnormalities. | 572 | ||
| Method of Delivery. | 572 | ||
| Shoulder Dystocia. | 572 | ||
| Effect of Oxytocin. | 572 | ||
| Measuring Acid-Base Status | 572 | ||
| Characteristics of Fetal Heart Rate Patterns | 572 | ||
| Basic Patterns | 572 | ||
| Baseline Features | 572 | ||
| Baseline Rate. | 573 | ||
| Fetal Heart Rate Variability. | 573 | ||
| Periodic Heart Rate Patterns | 573 | ||
| Late Decelerations. | 573 | ||
| Early Decelerations. | 573 | ||
| Variable Decelerations. | 573 | ||
| Accelerations. | 573 | ||
| Quantification. | 573 | ||
| Normal and Abnormal Heart Rate Patterns | 573 | ||
| Baseline Rate | 574 | ||
| Bradycardia. | 574 | ||
| Tachycardia. | 574 | ||
| Classification and Significance of Baseline Variability | 575 | ||
| Periodic Changes in Fetal Heart Rate | 576 | ||
| Late Decelerations. | 576 | ||
| Variable Decelerations. | 577 | ||
| Classification of Fetal Heart Rate Tracings. | 577 | ||
| Effect of in Utero Treatment. | 577 | ||
| Other Heart Rate Patterns | 577 | ||
| Sinusoidal Pattern. | 577 | ||
| Saltatory Pattern. | 579 | ||
| Congenital Anomalies | 579 | ||
| Efficacy, Risks, and Recommendations for Monitoring | 579 | ||
| Electronic Monitoring Versus Auscultation | 579 | ||
| Adjuncts to Electronic Fetal Heart Rate Monitoring | 580 | ||
| Key Points | 582 | ||
| Acknowledgments | 582 | ||
| References | 582.e1 | ||
| 36 Assessment and Induction of Fetal Pulmonary Maturity | 583 | ||
| Assessment of Fetal Pulmonary Maturity | 583 | ||
| Direct Evaluation of Amniotic Fluid | 583 | ||
| Noninvasive Assessment of Fetal Pulmonary Maturity | 585 | ||
| Assessment of Fetal Pulmonary Maturity in Special Groups | 585 | ||
| Impact of Contaminants on Fetal Pulmonary Testing Results | 586 | ||
| Assessment of Fetal Pulmonary Maturity From Vaginal Fluid Specimens | 587 | ||
| Induction of Fetal Pulmonary Maturity | 587 | ||
| Perinatal and Long-Term Outcomes After Antenatal Corticosteroids | 587 | ||
| Other Fetal and Neonatal Effects of Antenatal Corticosteroids | 588 | ||
| Maternal Effects of Antenatal Corticosteroids | 588 | ||
| Impact of Corticosteroid Type and Route of Administration | 589 | ||
| Impact of Special Circumstances on Antenatal Corticosteroid Effects | 589 | ||
| Periviable Birth | 589 | ||
| Late Preterm Birth | 589 | ||
| Planned Term Delivery | 590 | ||
| Preterm PROM | 590 | ||
| Twin Pregnancy | 591 | ||
| Impact of Timing of Antenatal Corticosteroids | 591 | ||
| Incomplete Course of Treatment | 591 | ||
| Remote Course of Treatment | 592 | ||
| Repeated Courses. | 592 | ||
| Rescue Antenatal Corticosteroids. | 592 | ||
| Summary | 593 | ||
| Key Points | 593 | ||
| References | 593.e1 | ||
| 37 Invasive Fetal Therapy | 594 | ||
| Open Fetal Surgery | 594 | ||
| Ex Utero Intrapartum Treatment Procedure | 594 | ||
| Fetoscopy | 597 | ||
| Prevention of Preterm Premature Rupture of the Membranes | 597 | ||
| Amniopatch. | 597 | ||
| Cerclage as an Adjunct to Fetal Therapy. | 598 | ||
| Anesthetic Considerations | 598 | ||
| Maternal Anesthetic Considerations | 598 | ||
| Fetal Anesthetic Considerations | 598 | ||
| Teratogenic Concerns. | 598 | ||
| Fetal Pain. | 599 | ||
| Complicated Monochorionic Twin Pregnancies | 599 | ||
| Twin-Twin Transfusion Syndrome | 599 | ||
| Diagnosis of Twin-Twin Transfusion Syndrome | 599 | ||
| Prediction of Monochorionic Pregnancies at Risk for Twin-Twin Transfusion Syndrome | 600 | ||
| Staging of Twin-Twin Transfusion Syndrome | 600 | ||
| Treatment of Twin-Twin Transfusion Syndrome | 600 | ||
| Amnioreduction | 601 | ||
| Septostomy | 601 | ||
| Selective Feticide | 601 | ||
| Fetoscopic Laser Coagulation | 601 | ||
| Complications | 603 | ||
| Amnioreduction Versus Laser Coagulation | 604 | ||
| Measures to Improve Outcome of Twin-Twin Transfusion Syndrome | 605 | ||
| Selective Feticide for Other Complications | 606 | ||
| Results of Selective Feticide in Monochorionic Twins | 607 | ||
| Indications for Selective Feticide in Monochorionic Twins | 607 | ||
| Twin Reversed Arterial Perfusion Sequence | 609 | ||
| Amniotic Band Syndrome | 610 | ||
| Isolated Congenital Diaphragmatic Hernia | 610 | ||
| Etiology and Consequences of Congenital Diaphragmatic Hernia | 610 | ||
| Prenatal Assessment of Congenital Diaphragmatic Hernia | 611 | ||
| Prenatal Prediction of Congenital Diaphragmatic Hernia Outcome | 612 | ||
| Ultrasonography | 612 | ||
| Three-Dimensional Techniques | 613 | ||
| Prenatal Intervention for Congenital Diaphragmatic Hernia | 613 | ||
| Congenital Thoracic Malformations | 615 | ||
| Congenital Pulmonary Airway Malformation | 615 | ||
| Bronchopulmonary Sequestration | 617 | ||
| Prenatal Management of Congenital Pulmonary Airway Malformation and Bronchopulmonary Sequestration | 617 | ||
| Other Thoracic Lesions | 618 | ||
| Lower Urinary Tract Obstruction | 618 | ||
| Pathophysiology | 618 | ||
| Lower Urinary Tract Obstruction Good Prognosis Features for Shunt Consideration | 619 | ||
| Outcomes After Antenatal Interventions for Lower Urinary Tract Obstruction | 619 | ||
| Congenital Heart Defects | 619 | ||
| Prenatal Intervention for Congenital Heart Defects | 620 | ||
| Atrial Septostomy | 622 | ||
| Balloon Valvuloplasty for Hypoplastic Left Heart Syndrome and Pulmonary Atresia | 622 | ||
| Myelomeningocele Repair | 623 | ||
| Prenatal Diagnosis | 623 | ||
| Fetal Surgery: Experimental Basis and Early Experience | 623 | ||
| Results of Fetal Surgery for Myelomeningocele | 625 | ||
| Fetoscopic Surgery | 626 | ||
| Sacrococcygeal Teratoma | 628 | ||
| Prognostic Factors | 628 | ||
| Perinatal Treatment | 630 | ||
| Outcomes | 631 | ||
| Chorioangioma | 631 | ||
| Key Points | 631 | ||
| Acknowledgment | 631 | ||
| References | 631.e1 | ||
| 38 Hemolytic Disease of the Fetus and Newborn | 632 | ||
| History | 632.e1 | ||
| Red Cell Alloimmunization | 632 | ||
| Epidemiology | 632 | ||
| Pathogenesis | 632 | ||
| Genetics | 632 | ||
| Diagnosis | 634 | ||
| Maternal Antibody Determination | 634 | ||
| Paternal Zygosity | 634 | ||
| Fetal Genotype Testing | 634 | ||
| Middle Cerebral Artery Doppler | 635 | ||
| Clinical Management | 636 | ||
| First Affected Pregnancy | 636 | ||
| Previously Affected Fetus or Infant | 637 | ||
| Treatment | 638 | ||
| Experience | 638 | ||
| Access Site for Intrauterine Transfusion | 638 | ||
| Method of Intrauterine Transfusion | 638 | ||
| Intrauterine Transfusion Technique | 639 | ||
| Severely Anemic Early-Second-Trimester Fetus in a Previous Pregnancy | 639 | ||
| Timing of Delivery | 640 | ||
| Outcome | 640 | ||
| Prevention | 640 | ||
| Formulations | 640 | ||
| Administration | 641 | ||
| The “Weak D” Dilemma | 641 | ||
| Mass Screening of RhD-Negative Women With cffDNA | 642 | ||
| Hemolytic Disease of the Fetus and Newborn Caused by Non-RhD Antibodies | 642 | ||
| Anti-Rhc | 642 | ||
| Anti-RhC, -RhE, and -Rhe | 642 | ||
| Anti-RhG | 642 | ||
| Anti-K (K1) | 642 | ||
| Anti-k (K2) | 642 | ||
| Anti-M and Anti-N | 642 | ||
| Anti-Duffy | 644 | ||
| Anti-Kidd | 644 | ||
| Future Therapy | 644 | ||
| Key Points | 644 | ||
| References | 644.e1 | ||
| 39 Nonimmune Hydrops | 645 | ||
| Diagnosis | 645 | ||
| Initial Signs and Symptoms | 645 | ||
| Ultrasonography | 645 | ||
| Fetal Fluid Accumulation | 646 | ||
| Etiology | 647 | ||
| Cardiovascular Causes | 647 | ||
| Chromosomal Abnormalities | 649 | ||
| Thoracic Abnormalities | 649 | ||
| Twinning | 650 | ||
| Fetal Anemia | 650 | ||
| Infection | 650 | ||
| Cytomegalovirus | 650 | ||
| Parvovirus | 651 | ||
| Other Infections | 651 | ||
| Metabolic Disease | 651 | ||
| Other Malformations | 651 | ||
| Other Causes | 651 | ||
| Experimental Management of Idiopathic Cases | 651 | ||
| Diagnostic Approach to the Fetus With Hydrops | 652 | ||
| Management | 652 | ||
| Prevention | 653 | ||
| Recurrence Risks | 653 | ||
| Delivery Considerations | 653 | ||
| Summary | 653 | ||
| Key Points | 653 | ||
| References | 653.e1 | ||
| 40 Multiple Gestation | 654 | ||
| Perinatal Mortality and Morbidity | 654 | ||
| Maternal Mortality and Morbidity | 655 | ||
| Maternal Adaptations | 655 | ||
| Ultrasonography in Multiple Gestation | 656 | ||
| Diagnosis of Multiple Gestation | 656 | ||
| Chorionicity | 656 | ||
| Detection of Fetal Anomalies | 657 | ||
| Evaluation of Fetal Growth | 657 | ||
| Measurement of Cervical Length | 658 | ||
| Confirmation of Fetal Well-Being | 658 | ||
| Prenatal Diagnosis | 659 | ||
| Risks of Chromosomal Abnormalities | 659 | ||
| First-Trimester Screening for Aneuploidy | 659 | ||
| Second-Trimester Serum Screening for Aneuploidy | 660 | ||
| Screening for Neural Tube Defects | 660 | ||
| Genetic Amniocentesis | 660 | ||
| Chorionic Villus Sampling | 661 | ||
| Antepartum Management | 661 | ||
| Preterm Labor and Delivery | 661 | ||
| Preeclampsia | 662 | ||
| Other Maternal Complications | 663 | ||
| Fetal Surveillance | 663 | ||
| Intrapartum Management | 663 | ||
| Timing of Delivery | 663 | ||
| Preparations | 664 | ||
| Vertex-Vertex Twins | 664 | ||
| Vertex-Nonvertex Twins | 664 | ||
| Nonvertex First Twin | 665 | ||
| Higher Order Multiple Gestations | 665 | ||
| Asynchronous Delivery | 666 | ||
| Special Considerations in Management | 666 | ||
| Twin-Twin Transfusion Syndrome | 666 | ||
| Background and Pathogenesis | 666 | ||
| Clinical and Sonographic Features | 667 | ||
| Management | 667 | ||
| Laser Therapy for Severe TWIN-TWIN TRANSFUSION SYNDROME | 668 | ||
| Monoamniotic Twins | 669 | ||
| Twin Reversed Arterial Perfusion Sequence | 670 | ||
| Conjoined Twins | 671 | ||
| Intrauterine Demise of One Fetus | 672 | ||
| Selective Termination of an Anomalous Fetus | 673 | ||
| Multifetal Pregnancy Reduction | 674 | ||
| Prevention of Higher Order Multifetal Gestation | 675 | ||
| Key Points | 675 | ||
| References | 675.e1 | ||
| 4 Disorders at the Maternal-Fetal Interface | 677 | ||
| 41 Prevention and Management of Preterm Parturition | 679 | ||
| The Problem of Preterm Birth | 679 | ||
| Definitions | 679 | ||
| Incidence of Preterm Birth | 680 | ||
| Ascertainment of Preterm Birth and Low Birth Weight | 680 | ||
| Changes in the Incidence of Preterm Birth | 681 | ||
| Clinical Presentations of Preterm Birth | 681 | ||
| Consequences of Preterm Birth | 681 | ||
| Perinatal and Infant Mortality | 681 | ||
| Factors Affecting Perinatal, Infant, and Childhood Mortality and Morbidity | 682 | ||
| Data Collection. | 682 | ||
| Gestational Age. | 683 | ||
| Birth Weight. | 683 | ||
| Very-Low-Birth-Weight Infants. | 683 | ||
| Extremely-Low-Birth-Weight Infants. | 683 | ||
| Maternal Race. | 684 | ||
| Other Factors. | 684 | ||
| Perinatal Morbidity | 684 | ||
| Long-Term Outcomes | 684 | ||
| Epidemiology and Risk Factors for Preterm Birth | 684 | ||
| Maternal Characteristics | 684 | ||
| Familial Risk | 684 | ||
| Education and Economic Status, Age, and Marital Status | 685 | ||
| Race and Ethnic Background | 685 | ||
| Maternal Behaviors and Environment | 685 | ||
| Stress and Depression | 686 | ||
| Maternal Physical Activity | 686 | ||
| Nutritional Status | 686 | ||
| Infections | 686 | ||
| Genital Tract Infection and Colonization. | 686 | ||
| Specific Infections. | 687 | ||
| Periodontal Disease. | 687 | ||
| Uterine Abnormalities | 687 | ||
| Uterine Anomalies. | 687 | ||
| Cervical Surgery. | 688 | ||
| Reproductive History | 688 | ||
| Prior Preterm Birth | 688 | ||
| Prior Spontaneous Preterm Birth. | 688 | ||
| Prior Twin Preterm Birth. | 689 | ||
| Prior Indicated Preterm Birth. | 689 | ||
| Prior Stillbirth. | 689 | ||
| Pregnancy Termination. | 689 | ||
| Current Pregnancy Characteristics | 689 | ||
| Bleeding | 689 | ||
| Assisted Reproductive Technologies | 690 | ||
| Multiple Gestation | 690 | ||
| Uterine Factors | 690 | ||
| Uterine Volume. | 690 | ||
| Uterine Contractions. | 690 | ||
| Cervical Factors | 690 | ||
| Cervical Length. | 690 | ||
| Cervical Trauma. | 691 | ||
| Interventional Strategies for Preterm Labor | 692 | ||
| Diagnosis of Preterm Labor | 692 | ||
| Symptoms and Signs | 692 | ||
| Tests for Preterm Labor | 693 | ||
| Management of Preterm Labor | 693 | ||
| Regionalized Care. | 693 | ||
| Strategies to Reduce Morbidity and Mortality | 693 | ||
| Antenatal Corticosteroids. | 693 | ||
| Antibiotics. | 694 | ||
| Neuroprotectants. | 694 | ||
| Hydration. | 695 | ||
| Tocolytic Therapy | 695 | ||
| Goals of Tocolysis | 695 | ||
| Contraindications to Arrest of Labor | 695 | ||
| Choosing a Tocolytic Agent | 695 | ||
| Calcium Channel Blockers | 695 | ||
| Pharmacology. | 695 | ||
| Effectiveness. | 695 | ||
| 5 Maternal Complications | 839 | ||
| 49 Patient Safety and Quality Improvement in Obstetrics | 841 | ||
| The Patient Safety Movement | 841 | ||
| Safety Challenges in Obstetrics | 841 | ||
| Potential Strategies to Improve Patient Safety | 843 | ||
| Outside Expert Review | 843 | ||
| Protocols, Guidelines, and Bundles | 844 | ||
| Checklists | 845 | ||
| Checklists in Medicine and Surgery | 845 | ||
| Checklists in Obstetrics | 845 | ||
| Areas in Which Checklists May Have an Impact | 845 | ||
| Oxytocin Use. | 845 | ||
| Acute Clinical Emergencies. | 846 | ||
| Perinatal Patient Safety Nurse | 846 | ||
| Event Reporting Tools | 846 | ||
| The Obstetric Hospitalist | 846 | ||
| Obstetric Patient Safety Committee | 847 | ||
| Safety Culture Surveys and Questionnaires | 847 | ||
| Team Training | 847 | ||
| Electronic Fetal Monitoring Certification | 848 | ||
| Simulation | 848 | ||
| Evaluation of Progress: Outcomes and Measures | 849 | ||
| Economics of Patient Safety | 850 | ||
| Coping With the Aftermath of Adverse Events | 850 | ||
| Key Points | 851 | ||
| References | 851.e1 | ||
| 50 Maternal Mortality | 852 | ||
| Measurement/Definitions | 852 | ||
| Epidemiology | 853 | ||
| Demographics | 854 | ||
| Role of State Maternal Mortality Review Committees | 855 | ||
| Causes and Preventability of Maternal Mortality | 855 | ||
| Improvement Opportunities | 856 | ||
| Obstetric Hemorrhage | 857 | ||
| Amniotic Fluid Embolism | 857 | ||
| Venous Thromboembolic Events | 857 | ||
| Preeclampsia and Eclampsia | 858 | ||
| Cardiovascular Disease | 859 | ||
| Sepsis | 859 | ||
| Suicides and Homicides | 860 | ||
| African-American Maternal Mortality Rates | 861 | ||
| “Near Miss” or Severe Maternal Morbidity | 861 | ||
| Role of Obstetrics Leaders in Reducing Maternal Mortality | 861 | ||
| Key Points | 861 | ||
| Acknowledgment | 861 | ||
| References | 861.e1 | ||
| 51 Maternal and Fetal Infections | 862 | ||
| Genital Infections | 862 | ||
| Candidiasis (Monilial Vaginitis) | 862 | ||
| Pathogenesis | 862 | ||
| 6 The Neonate | 1307 | ||
| 73 Neonatal Morbidities of Prenatal and Perinatal Origin | 1309 | ||
| Obstetric Decisions and Neonatal Outcomes | 1309 | ||
| The Perinatal Consultation and the Role of the Neonatologist | 1309 | ||
| Common Morbidities of Pregnancy and Neonatal Outcome | 1309 | ||
| Prematurity | 1311 | ||
| Complications of Prematurity | 1311 | ||
| Decisions at the Threshold of Viability | 1313 | ||
| Planning for Delivery at the Limits of Viability | 1314 | ||
| Neonatal Resuscitation at the Limits of Viability | 1314 | ||
| Prenatal and Perinatal Morbidities | 1314 | ||
| Respiratory Problems in the Neonatal Period | 1314 | ||
| Transient Tachypnea of the Newborn | 1314 | ||
| Definition. | 1314 | ||
| Pathophysiology. | 1314 | ||
| Risk Factors. | 1314 | ||
| Clinical Presentation. | 1315 | ||
| Diagnosis. | 1315 | ||
| Management. | 1315 | ||
| Neonatal Implications. | 1315 | ||
| Pulmonary Hypoplasia | 1315 | ||
| Respiratory Distress Syndrome | 1315 | ||
| Perinatal Risk Factors. | 1315 | ||
| Clinical Presentation and Diagnosis. | 1316 | ||
| Management Principles | 1316 | ||
| General Measures. | 1316 | ||
| Surfactant Therapy. | 1316 | ||
| Continuous Positive Airway Pressure. | 1317 | ||
| Mechanical Ventilation. | 1317 | ||
| Other Treatments. | 1317 | ||
| Complications of Respiratory Distress Syndrome. | 1317 | ||
| Bronchopulmonary Dysplasia | 1317 | ||
| Pathophysiology. | 1317 | ||
| Long-Term Complications. | 1318 | ||
| Prevention Strategies. | 1318 | ||
| Meconium-Stained Amniotic Fluid and Meconium Aspiration Syndrome | 1318 | ||
| Pulmonary Hypertension | 1320 | ||
| Gastrointestinal Problems in the Neonatal Period | 1320 | ||
| Necrotizing Enterocolitis | 1320 | ||
| Hyperbilirubinemia | 1321 | ||
| Feeding Problems | 1322 | ||
| Neonatal Management of Neurologic Problems | 1323 | ||
| Hypoxic-Ischemic Encephalopathy | 1323 | ||
| Definition of “Asphyxia.” | 1323 | ||
| Clinical Markers. | 1323 | ||
| Neonatal Encephalopathy. | 1323 | ||
| Multiorgan Injury. | 1323 | ||
| Neuropathology. | 1323 | ||
| Neuroimaging. | 1323 | ||
| Neuroprotection Strategies. | 1324 | ||
| Summary. | 1324 | ||
| Intraventricular Hemorrhage | 1324 | ||
| Incidence. | 1324 | ||
| Pathogenesis. | 1324 | ||
| Outcomes. | 1324 | ||
| Antenatal Prevention. | 1324 | ||
| Postnatal Prevention. | 1325 | ||
| Posthemorrhagic Hydrocephalus. | 1325 | ||
| Summary. | 1325 | ||
| Periventricular Leukomalacia | 1325 | ||
| Neuropathology. | 1325 | ||
| Pathogenesis. | 1325 | ||
| Clinical Outcomes. | 1325 | ||
| Index | 1335 | ||
| A | 1335 | ||
| B | 1340 | ||
| C | 1342 | ||
| D | 1347 | ||
| E | 1349 | ||
| F | 1351 | ||
| G | 1354 | ||
| H | 1355 | ||
| I | 1358 | ||
| J | 1360 | ||
| K | 1360 | ||
| L | 1360 | ||
| M | 1362 | ||
| N | 1366 | ||
| O | 1368 | ||
| P | 1369 | ||
| Q | 1376 | ||
| R | 1376 | ||
| S | 1378 | ||
| T | 1382 | ||
| U | 1385 | ||
| V | 1386 | ||
| W | 1388 | ||
| X | 1388 | ||
| Y | 1388 | ||
| Z | 1388 | ||
| Endsheet 7 | IBC3 |