de Swiet's Medical Disorders in Obstetric Practice E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 2632

Veröffentlichungsjahr: 2010

Beschreibung

Pregnancy affects the physiology of women as their bodies adapt to the growing life within them; but how does this affect how you manage general, or pre-existing medical complaints? How do you differentiate the effects of pregnancy from genuine medical conditions? What are the effects of the 'standard' treatments on the growing fetus? What about breastfeeding? In this brand-new edition of de Swiet's Medical Disorders in Clinical Practice, expert physicians present the best evidence and practical wisdom to guide you and your patients through their pregnancy and illness, to a successful birth and early motherhood. Using a combination of algorithms, years of experience and an evidence-based approach, this book will help you to: * Diagnose difficult to identify conditions during pregnancy * Effectively prescribe for pregnant and lactating women * Overcome the challenges of imaging, anesthesia and critical care for pregnant women de Swiet's assists you in navigating the many challenges pregnancy presents for both the patient and physician.

Leseprobe

Contents

List of contributors

Preface

Foreword

1. Pulmonary disease in pregnancy

Introduction

Physiologic adapations to pregnancy

Specific conditions

Asthma

Smoking cessation in pregnancy

Respiratory tract infection

Ventilatory support in pregnancy

Amniotic fluid embolism

Pulmonary hypertension

Obstructive sleep apnea

Cystic fibrosis

Chronic obstructive pulmonary disease

Kyphoscoliosis

Erythema nodosum

Sarcoidosis

Wegener’s granulomatosis

Pulmonary lymphangioleiomyomatosis

Idiopathic pulmonary fibrosis

Churg–Strauss syndrome

Lung cancer

Pneumothorax and pneumomediastinum

Pleural effusion

Anesthetic considerations

2. Hematologic disease in pregnancy

Anemia

The hemoglobinopathies and thalassemias

Thrombocytopenia and other platelet disorders in pregnancy

Bleeding disorders

3. Thromboembolic disease in pregnancy

Introduction

Investigation for venous thromboembolism in pregnancy

Acute treatment of venous thromboembolism

Maintenance treatment of venous thromboembolism

Prevention of venous thromboembolism in pregnancy

Anesthetic issues related to venous thromboembolism and anticoagulation

4. Thrombophilias and pregnancy

Physiologic changes of the hemostatic system in pregnancy

Introduction to thrombophilia

Management of thrombophilic pregnancies

Anesthetic concerns related to thrombophilias and thromboembolic disease in pregnancy

Conclusion

5. Heart disease in pregnancy

Introduction

Physiologic changes of pregnancy

Counseling patients

Management: general principles

Specific lesions

Anesthetic concerns for pregnant women with cardiac disease

Acknowledgment

Inspection

Palpation

Auscultation

6. Hypertension in pregnancy

Cardiovascular changes in pregnancy

Hypertension in pregnancy: introduction

Pre-eclampsia

Other causes of hypertension in pregnancy

Secondary hypertension

The fetus in hypertensive pregnancies

Anesthesia concerns for women with pre-eclampsia

Conclusions

7. Renal disease in pregnancy

Introduction

Changes in renal physiology in normal pregnancy

Chronic kidney disease outside pregnancy

Urinary tract infection

Acute renal failure

Renal calculi in pregnancy

Renal transplantation in pregnancy

Anesthetic management of parturients with renal impairment

Models of antenatal care for women with renal disease

8. Rheumatologic disorders in pregnancy

Introduction

Inflammatory arthritis

Systemic lupus erythematosus

Antiphospholipid syndrome

Scleroderma

Vasculitis

Neonatal lupus

Management of rheumatic diseases in pregnancy

Conclusion

9. Disorders of the liver, biliary system and exocrine pancreas in pregnancy

Normal liver physiology in pregnancy

Maternal hyperbilirubinemia and the fetus

Viral hepatitis and pregnancy

Autoimmune hepatitis

Intrahepatic cholestasis of pregnancy

Wilson’s disease

Hemochromatosis

Biliary disease

Gallstones and cholescystitis

Primary biliary cirrhosis, primary sclerosing cholangitis and biliary atresia

Budd–chiari syndrome

Cirrhosis and portal hypertension

Liver transplantation

Acute fatty liver of pregnancy

Pancreatic disease

Anesthetic concerns in patients with liver disease

10. Disorders of the gastrointestinal tract in pregnancy

Physiologic changes in the gastrointestinal system in pregnancy

Disorders of the oral cavity

Gastroesphageal disorders

Disorders of the intestinal tract

Anorectal and perineal disorders

Malignancy

Common nonobstetric causes of abdominal pain

Nutrition in pregnancy

Special considerations in antenatal care, labor and delivery, and puerperal care of patients with stomas

Endoscopy in pregnancy and lactation

Anesthetic considerations when caring for women with gatrointestinal disease in pregnancy

11. Diabetes mellitus in pregnancy

Introduction

Maternal energy metabolism and the role of insulin

Gestational diabetes

Effects of diabetes on the fetus and neonate

Medical management

Diabetic ketoacidosis

Conclusion

12. Thyroid disease in pregnancy

Introduction

Normal physiologic changes in pregnancy

Autoimmune thyroid disease

Hyperthyroidism

Hypothyroidism

Postpartum thyroiditis

13. Pituitary and adrenal disease in pregnancy

Anterior pituitary

Posterior pituitary

Adrenals

14. Calcium metabolism and diseases of the parathyroid glands during pregnancy

Calcium and phosphate homeostasis during pregnancy and lactation

Vitamin D deficiency

Parathyroid disease

Obstetric and perinatal care

Magnesium and calcium interaction

15. Neurologic disorders in obstetric practice

Introduction

Neurologic assessment

Multiple sclerosis

Stroke

Epilepsy

Central nervous system tumors

Mononeuropathies

Myasthenia gravis

Headache

Anesthetic considerations for obstetric patients with neurologic disease

16. Nonviral infectious diseases in pregnancy

Fever and host immune response in pregnancy

Genital infections in pregnancy

Nongenital infections in pregnancy

Puerperal infections

Obstetric anesthesia concerns related to thermoregulation and infection in pregnancy

17. Viral infections in pregnancy other than human immunodeficiency virus

Introduction

Pathogenesis of viral infections during pregnancy

Immune response to viral infections during pregnancy

Diagnosis of viral infections during pregnancy

Viral infections of predominantly maternal impact

Viral infections of predominantly fetal impact

Viral infections that affect both maternal and fetal health

Viral infections that affect both maternal and neonatal health

Viral infections that result in increased neonatal morbidity

Other viral infections in pregnancy

Immunization during pregnancy and breastfeeding

18. Human immunodeficiency virus infection in pregnancy

Introduction

Epidemiology of human immunodeficiency virus infection in women

Screening for human immunodeficiency virus infection in pregnancy

Diagnostic tests for human immunodeficiency virus infection

Pathogenesis of human immunodeficiency virus infection

Preconception counseling

Antepartum management

Management of labor and delivery

Postpartum management

Conclusion

19. Substance misuse in pregnancy

Introduction

Definitions

Prevalence of substance use in young women

Substance use during pregnancy

Mortality

Morbidity

Effect of substance misuse on pregnancy and the neonate (Table 19.3)

The impact of parental substance misuse on children

Effect of pregnancy on substance misuse

Overarching principles of treatment

Screening and detection

Management of substance misuse in pregnancy

Postnatal interventions

Special groups

Child protection

Model service development

Cost-effectiveness

Policy recommendations

Obstetric anesthesia concerns in relation to substance misuse

Conclusion

20. Skin diseases in pregnancy

Drug therapy during pregnancy

Physiologic skin changes in pregnancy

Dermatoses specific to pregnancy

The effect of pregnancy on other dermatoses

General recommendations about dermatologic medication use during pregnancy

Skin disorders and neuraxial anesthesia

21. Psychiatric disorders in pregnancy

Introduction

Major depressive disorder

Bipolar disorder

Schizophrenia

Panic disorder and generalized anxiety disorder

Obsessive compulsive disorder

Post-traumatic stress disorder

Eating disorders

Conclusion

22. Cancer in pregnancy

Introduction

Cervical neoplasia complicating pregnancy

Breast cancer in pregnancy

Malignant melanoma in pregnancy

Malignant ovarian masses in pregnancy

Hematologic malignancies in pregnancy

23. Critical care in pregnancy

Introduction

Epidemiology of critical illness in pregnancy

Organization of the intensive care unit

Indications for intensive care unit admission

Obstetric versus medical disorders

Antepartum versus postpartum intensive care unit admissions

Initial assessment of a critically ill patient

Comprehensive maternal and fetal evaluation

Organ dysfunction and failure

Cardiovascular dysfunction

Respiratory failure

Renal failure

Acute hepatic dysfunction

Central nervous system dysfunction

Coagulation failure

Delivery of critically ill patients

Intrapartum management

Prevention of thromboembolic disease

Prognosis and outcomes

Conclusion

24. Embryologic and fetal development

25. Global issues in maternal health

Introduction

Levels and causes of maternal mortality and morbidity

The role of medical disorders in maternal mortality

Global issues in obstetric anesthesia

26. Future health concerns for women who have had a complicated pregnancy

Introduction

Pre-eclampsia (see chapter 6)

Preterm birth and fetal growth restriction

Eclampsia

Pre-eclampsia and future kidney disease

Pre-eclampsia and future cancer

Pregnancy-induced hypertension

Thrombosis during pregnancy (see chapters 3 and 4)

Gestational diabetes mellitus (see chapter 11)

Gestational diabetes insipidus

Thyroid disease (see chapter 12)

Liver disease (see chapter 9)

Peripartum cardiomyopathy (see chapter 5)

Postpartum depression (see chapter 21)

Pregnancy in later life (see chapter 28)

Conclusion

27. Special concerns for the obese patient

Introduction

The obesity epidemic

Risks associated with obesity in pregnancy

Obesity and the risk of cesarean delivery

Additional implications for management

Anesthesia

Weight loss interventions

Conclusion

28. Special concerns for patients with advanced maternal age

Introduction

Preconception evaluation of older women considering pregnancy

Early pregnancy

Late pregnancy

Management of labor and delivery

Maternal mortality

29. Principles of obstetric anesthesia

Introduction

Preanesthetic care

Principles of regional anesthesia for normal labor and delivery

Principles of general anesthesia for cesarean delivery

Aspiration pneumonitis prophylaxis

Principles of regional anesthesia for cesarean delivery

Pain relief following cesarean delivery

Ambulatory/mobile/walking epidurals and combined spinal-epidural for labor and delivery

Successful interdisciplinary team work

Urgent/emergency cesarean delivery

Airway emergencies

Hemorrhagic emergencies (see also chapter 2)

Other specific circumstances

Conclusion

30. Prescribing in pregnancy: a practical approach

Introduction

General approach

Have a plan for drug treatment options

Conclusion

Disclaimer

31. Prescribing during lactation

Introduction

The alveolar subunit

Drug transfer into human milk

Bio-availability

Calculating infant dose

Conclusion

32. Diagnostic imaging in pregnancy

Introduction

Absorbed dose

Ultrasound and magnetic resonance imaging

Fetal absorbed radiation with x-rays and computed tomography

Fetal absorbed radiation with nuclear medicine imaging

Risks of radiation in pregnancy

Timing and fetal effects of radiation

Iodinated contrast

Maternal risks from radiation in pregnancy

Informed consent

33. Contraception for women with medical disorders

34. Effect of pregnancy on common laboratory tests

35. Approach to headaches in pregnancy

Introduction

Primary headaches

Secondary headaches

Evaluation

36. Approach to anemia in pregnancy

Introduction

Definition in pregnancy

Clinical consequences of anemia in pregnancy

Approach to anemia

37. Approach to moderately elevated liver function tests in pregnancy not attributable to pre-eclampsia/HELLP syndrome

Introduction

Diagnosis

Evaluation of elevated transaminases

Conclusion

38. Approach to shortness of breath in pregnancy

Introduction

Physiologic changes

History

Physical examination

Diagnostic testing

39. Approach to hypertensive emergencies in pregnancy

Introduction

What is severe hypertension?

How should patients with severe hypertension be assessed?

How urgent is it to treat severe hypertension?

Which antihypertensive agents should be used to treat severe hypertension?

What other monitoring or treatment is advised?

Anesthetic considerations

40. Approach to palpitations in pregnancy

Introduction

History

Physical examination

Investigations

Conclusion

41. Approach to proteinuria identified remote from term

Introduction

Physiology of proteinuria

Types of proteinuria

Measurement of proteinuria

Differential diagnosis of proteinuria

Evaluation of proteinuria

Evaluation of proteinuria based on clinical presentation

Nephritic renal disease

Nephrotic renal disease

Conclusion

42. Approach to new-onset hypertension remote from term

Introduction

Screening for secondary causes of hypertension

Evaluation for end-organ damage

Assessment of cardiovascular risk factors

Evaluation of hypertension

Conclusion

43. Approach to presyncope and syncope in pregnancy

Introduction

Causes of syncope

Investigations

Treatment of neurally mediated (vasovagal) presyncope and syncope (Box 43.1)

Conclusion

44. Approach to chest pain in pregnancy

Introduction

45. New-onset seizures in pregnancy

Physiologic changes

General introduction

Diagnosis

Management

Conclusion

46. Approach to prosthetic heart valves in pregnancy

Introduction

Pregnant women with prosthetic heart valves

Approach to pregnant women with mechanical heart valves (Table 46.1) [32]

47. Approach to the use of glucocorticoids in pregnancy for nonobstetric indications

Introduction

Safety of glucocorticoids in pregnancy

Use of stress-dose glucocorticoids at time of labor and delivery

48. Approach to hyperemesis gravidarum

Background and epidemiology

Pathophysiology

Clinical presentation

Diagnosis

Complications

Management

49. Approach to fetal assessment, optimization of neonatal outcome, mode of delivery and timing for nonobstetric readers

Introduction

Assessment of fetal well-being in utero

Optimization of fetal outcome

Mode of delivery

Timing of delivery

50. Promoting safe care for women with medical problems during pregnancy

Introduction

Increasing the medical safety of pregnant women

Conclusion

Appendix: Medications and their relative risk to breastfeeding infants

Index

Color plate

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List of contributors

Brenna Anderson

Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI, USA

Teresa Baker

Department of Obstetrics and Gynecology, Texas Tech University of Medicine, Amarillo, TX, USA

Mrinalini Balki

Department of Anesthesia, Mount Sinai Hospital, Toronto, Ontario, Canada

Emma Barber

Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA

Marianne Berwick

Department of Internal Medicine and the Cancer Research and Treatment Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA

David Birnbach

Department of Anesthesia, University of Miami and Jackson Memorial Hospital, Miami, FL, USA

Ghada Bourjeily

Department of Medicine, Warren Alpert Medical School of Brown University, Women & Infants’ Hospital of Rhode Island, Providence, RI, USA

Brian Brost

Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA

Mark A. Brown

Department of Renal Medicine, St George Hospital and University of New South Wales, Sydney, Australia

Brenda Bucklin

Department of Anesthesiology, University of Colorado Health Sciences Center, Denver, CO, USA

William Camann

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, USA

Michael P. Carson

UMDNJ-Robert Wood Johnson Medical Scholl, Departments of Medicine and Obstetrics/Gynecology, Jersey Shore University Medical Center, Neptune, NJ, USA

Brian M. Casey

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA

Eliana Castillo

Department of Medicine, University of British Columbia; Women’s Health Research Institute, British Columbia Women’s Hospital, Vancouver, BC, Canada

Wee Shian Chan

Department of Medicine, University of Toronto, Sunnybrooke and Women’s Health Sciences Center, Toronto, Canada

Kenneth K. Chen

Department of Medicine, Warren Alpert Medical School of Brown University, Women & Infants’ Hospital of Rhode Island, Providence, RI, USA

Edward K.S. Chien

Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women & Infants’ Hospital of Rhode Island, Providence, RI, USA

Kue Chung Choi

Department of Anesthesiology, Women & Infants’ Hospital of Rhode Island, Providence, RI, USA

Megan E. B. Clowse

Division of Rheumatology and Immunology, Duke University Medical Center, Durham, NC, USA

Anne-Marie Côté

Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada

Ilana B. Crome

Academic Psychiatry Unit, Keele University Medical School, St George’s Hospital, Stafford, UK

Judith S. Currier

Division of Infectious Diseases, Center for Clinical AIDS Research and Education, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

Peter von Dadelszen

Department of Obstetrics and Gynecology, University of British Columbia, British Columbia Women’s Hospital, Vancouver, BC, Canada

Mark Davis

Department of Dermatology, Mayo Clinic, Rochester, MN, USA

Joanne Douglas

Department of Anesthesia, British Columbia Women’s Hospital, Vancouver, BC, Canada

Hugh M. Ehrenberg

Division of Maternal Fetal Medicine, Ohio State University Medical Center, Columbus, OH, USA

Chris Elton

Department of Anaesthesia, Leicester Royal Infirmary, Leicester, UK

Silvia Degli Esposti

Department of Medicine, Warren Alpert Medical School of Brown University, Women & Infants’ Hospital of Rhode Island, Providence, RI, USA

Roshan Fernando

Department of Anaesthesia, Royal Free Hospital, London, UK

Véronique Filippi

Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK

Melissa Gaitanis

Department of Medicine/Infectious Diseases, Warren Alpert Medical School of Brown University, Providence, RI, USA

Stephen Gatt

Division of Anaesthesia and Intensive Care, Prince of Wales and Sydney Children’s Hospitals and Royal Hospital for Women, Randwick, New South Wales, Australia

Paul S. Gibson

Departments of Medicine and Obstetrics and Gynecology, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada

T. Murphy Goodwin

Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

Dorothy Graham

Obstetric Medicine, University of Western Australia and King Edward Memorial Hospital, Perth, Australia

Michael F. Greene

Vincent Memorial Obstetrics and Gynecology Department, Massachusetts General Hospital, Boston, MA, USA

Ian Greer

Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK

Kalpalatha K. Guntupalli

Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX, USA

Thomas W. Hale

Department of Pediatrics, Texas Tech University of Medicine, Amarillo, TX, USA

Dominic C. Heaney

UCL Institute of Neurology, University College London and UCL Hospitals NHS Foundation Trust, London, UK

Linda Heffner

Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA, USA

Timothy Hurley

Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA

Jessica Illuzzi

Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA

Khaled M.K. Ismail

Keele University Medical School and The Maternity Centre, University Hospital of North Staffordshire, Stoke-on-Trent, UK

Sig-Linda Jacobson

Department of Obstetrics and Gynecology, Oregon Health and Science University, Division of Maternal-Fetal Medicine, Portland, OR, USA

Andra H. James

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA

Dilip R. Karnad

Seth G S Medical College and Medical Intensive Care Unit, KEM Hospital, Mumbai, India, and Baylor College of Medicine, Houston, TX, USA

Warwick D. Ngan Kee

Department of Anesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China

Erin Keely

Department of Endocrinology and Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada

Hanan Khalil

Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Providence, RI, USA

Rshmi Khurana

Departments of Medicine and Obstetrics and Gynecology, University of Alberta, Royal Alexandra Hospital, Edmonton, Alberta, Canada

Sailesh Kumar

Centre for Fetal and Maternal Medicine, Queen Charlotte’s and Chelsea Hospital, Imperial College London, London, UK

Sandra L. Kweder

Department of Medicine, Uniformed Services University, Bethesda, MD, USA

Lucia Larson

Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women & Infants’ Hospital of Rhode Island, Providence, RI, USA

Men-Jean Lee

Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, NY, USA

Stephanie L. Lee

Section of Endocrinology, Diabetes, and Nutrition, Boston Medical Center, Boston, MA, USA

Kimberly K. Leslie

Department of Obstetrics and Gynecology, and the Cancer Research and Treatment Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA

Sandra A. Lowe

Department of Medicine, Royal Hospital For Women and School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia

Cynthia Maxwell

Obstetrics and Maternal Fetal Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada

Elizabeth McGrady

Department of Anesthesia, Princess Royal Maternity Unit, Glasgow Royal Infirmary, Glasgow, Scotland, UK

Claire McLintock

National Women’s Health, Auckland City Hospital, Auckland, New Zealand

Laura A. Magee

Department of Medicine, University of British Columbia, British Columbia Women’s Hospital, Vancouver, BC, Canada

Moke Magoma

Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK

George J. Mangos

Department of Renal Medicine, St George Hospital and University of New South Wales, Sydney, Australia

Niharika Mehta

Department of Medicine, Warren Alpert Medical School of Brown University, Women & Infants’ Hospital of Rhode Island, Providence, RI, USA

Margaret A. Miller

Department of Medicine, Warren Alpert Medical School of Brown University, Women & Infants’ Hospital of Rhode Island, Providence, RI, USA

Mark E. Molitch

Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

Deborah M. Money

Department of Obstetrics and Gynecology, University of British Columbia; Women’s Health Research Institute, British Columbia Women’s Hospital, Vancouver, BC, Canada

Martin N. Montoro

Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

Carolyn Muller

Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA

Uma Munnur

Department of Anesthesiology, Baylor College of Medicine, Houston, TX, USA

Catherine Nelson-Piercy

Guy’s & St Thomas’ Foundation Trust and Queen Charlotte’s & Chelsea Hospital, London, UK

James A. O’Brien

Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women & Infants’ Hospital of Rhode Island, Providence, RI, USA

Patrick O’Brien

UCL Institute of Women’s Health, University College London and UCL Hospitals NHS Foundation Trust, London, UK

Nollag O’Rourke

Department of Anesthesia, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

Medge D. Owen

Department of Anesthesia, Wake Forest University, Winston-Salem, NC, USA

Elvis R. Pagan

Virginia Tech Carilion School of Medicine, Department of Medicine, Carilion Clinic, Roanoke, VA, USA

Michael J. Paglia

Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women & Infants’ Hospital of Rhode Island, Providence, RI, USA

Michael Paidas

Department of Obstetrics, Gynecology and Reproductive Sciences, Yale Women and Children’s Center for Blood Disorders, Yale-New Haven Hospital, New Haven, CT, USA

Alan Peaceman

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

Teri Pearlstein

Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University and Women’s Behavioral Health Program, Women & Infants’ Hospital of Rhode Island, Providence, RI, USA

Michael Peek

Department of Obstetrics and Gynaecology, University of Sydney and Nepean Hospital, Sydney, Australia

Robert A. Peterfreund

Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA

Michelle Petri

Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

Rudiger Pittrof

Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK

Felicity Plaat

Department of Anaesthesia, Queen Charlotte’s and Hammersmith Hospitals, London, UK

Athena Poppas

Division of Cardiology, Department of Medicine, Warren Alpert Medical School of Brown University and Echocardiography Laboratory, Rhode Island Hospital, Providence, RI, USA

Raymond O. Powrie

Department of Medicine, Warren Alpert Medical School of Brown University, Women & Infants’ Hospital of Rhode Island, Providence, RI, USA

Christopher W.G. Redman

Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK

John T. Repke

Penn State Milton S. Hershey Medical Center, MSHMC Maternal Fetal Medicine, Hershey, PA, USA

Marc A. Rodger

Division of Hematology, The Ottawa Hospital, University of Ottawa; Clinical Epeidemiology Program, Ottawa Health Research Institute, Ottawa, Ontario, Canada

Robin Russell

Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, UK

Sunanda Sadanandan

Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA

Sumona Saha

Department of Medicine, Warren Alpert Medical School of Brown University, Women & Infants’ Hospital of Rhode Island, Providence, RI, USA

Scott Segal

Department of Anesthesia, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA

Mathew Sermer

Department of Obstetrics and Gynecology, University of Toronto, and Obstetrics and Maternal Fetal Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada

Daniel I. Sessler

Department of Outcomes Research, Cleveland Clinic, Cleveland, OH, USA

Winnie W. Sia

Departments of Medicine and Obstetrics and Gynecology, University of Alberta, Royal Alexandra Hospital, Edmonton, Alberta, Canada

Caren G. Solomon

Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

Jami Star

Department of Obstetrics and Gynecology, University of Massachusetts Medical School, University of Massachusetts Memorial Medical Center, Worcester, MA, USA

Iris Tong

Department of Medicine, Warren Alpert Medical School of Brown University, Women & Infants’ Hospital of Rhode Island, Providence, RI, USA

Lawrence Tsen

Department of Anesthesiology, Center for Reproductive Medicine, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, USA

Ruth E. Tuomala

Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA, USA

Susan Cu-Uvin

Departments of Medicine and Obstetrics and Gynecology, Brown University; The Immunology Center, The Miriam Hospital, Providence, RI, USA

Claire Verschraegen

Department of Internal Medicine and the Cancer Research and Treatment Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA

Mark C. Walker

Ottawa Health Research Institute and Department of Obstetrics and Gynecology, University of Ottawa, Ontario, Canada

Charles L. Wiggins

Department of Internal Medicine and the Cancer Research and Treatment Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA

David J. Williams

UCL Institute of Women’s Health, University College London and UCL Hospitals NHS Foundation Trust, London, UK

Catherine Williamson

Institute of Reproductive and Developmental Biology, Imperial College London, London, UK

Richard N. Wissler

Department of Anesthesiology, Obstetrics and Gynecology, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA

David Wlody

Department of Anesthesiology, State University of New York Downstate Medical Center, Brooklyn, NY, USA

Edward R. Yeomans

Department of Obstetrics and Gynecology, University of Texas Medical School at Houston and Texas Tech University Health Sciences Center, Lubbock, TX, USA

Preface

Professor Michael de Swiet’s ground breaking first edition of Medical Disorders in Obstetric Practice was published more than 35 years ago and was one of the first international textbooks to focus exclusively on providing expert guidance to obstetricians, medical specialists and anesthesiologists for the care of medical illness during pregnancy. It has remained one of the foremost books in the field with each subsequent edition. We have been privileged to serve as the new multidisciplinary editorial team for this fifth edition. We have entirely revised and updated the last edition while striving to maintain Professor de Swiet’s high standards of scholarship. This edition introduces several innovations that we hope will assist care providers in ensuring that women with medical disorders have the best possible outcomes for themselves and their pregnancies.

Each chapter is now co-written and co-edited by an expert team of practicing clinicians including a high-risk obstetrician, a medical subspecialist and, where appropriate, an obstetric anesthesiologist. This team approach provides a uniquely broad interdisciplinary, practical perspective to the care of medical illness in pregnancy that expertly addresses the entire period from preconception through to postpartum follow up.An entirely new section has been added that provides brief, practical, evidence-based advice from highly experienced clinicians about how to properly investigate and safely manage many of the most common medical problems that present to obstetricians. Topics covered include syncope, palpitations, headaches and abnormal liver function tests.Additional chapters have been added on a wide range of topics including cancer, critical care, obesity, advanced maternal age and prescribing in pregnancy and lactation.The text makes much greater use of tables, algorithms, text boxes and figures to summarize and illustrate key points for busy clinicians.A special section of each major chapter now addresses issues related to the provision of anesthesia care to obstetric patients with medical illness to help obstetricians and medical specialists understand the concerns of their obstetric anesthesiology colleagues.

As doctors caring for medical illness in pregnancy, and building on the foundation of the four prior editions of his textbook, each of the editors feels much in debt to Professor de Swiet. We also gratefully acknowledge our debts to our wonderful partners and families (Harvey Makadon, Laurie, Jonathan and Rebecca Greene and Rhonda, Zac and Andy Camann for the time and attention that was taken from each of them while we worked on this book); our expert authors (for taking time they likely did not have to provide their excellent contributions); and the critical daily assistance from Linda J. Hunt, Lynne Mottola-Doherty and our remarkable publishing team at Wiley-Blackwell.

Raymond O. Powrie

Michael F. Greene

William Camann