Protocols for High-Risk Pregnancies E-Book
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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
Through seven editions, Protocols for High-Risk Pregnancies has helped busy obstetricians keep pace with a constantly evolving field. Providing just-in-time content, its focus on protocols and guidelines helps organize medical thinking, avoid heuristic errors of omission and commission, and optimize maternal and fetal outcomes. As with the prior six editions, the editors have once again assembled some of the world's top obstetrical and medical experts. This seventh edition has also been expanded to include a number of new topics, including: * Protocols on opioid use, misuse and addition in pregnancy and postpartum * Noninvasive prenatal diagnosis of aneuploidy * Periconceptual genetic screening * Expanded protocols on maternal valvular heart disease and cardiomyopathies * Protocols on arboviruses, including Zika and malaria Protocols for High-Risk Pregnancies: An Evidence-Based Approach will be an essential reference for obstetricians, medical students, general practitioners and all medical professionals who are seeking the most up-to-date information and guidance on high-risk pregnancies.
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Seitenzahl: 1057
Veröffentlichungsjahr: 2020
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Table of Contents
Cover
Title Page
Copyright Page
Preface
Reference
List of Contributors
PART 1: Concerns in Pregnancy
PROTOCOL 1: Alcohol Use in Pregnancy and Lactation
Overview
Alcohol use during pregnancy
Alcohol use during lactation
Screening for alcohol use
Intervention and referral to treatment
Conclusion
Suggested reading
PROTOCOL 2: Smoking, Vaping, and Nicotine Exposure
Clinical significance
Pathophysiology
Screening for tobacco, nicotine, and vaping exposure
Interventions
Pharmacotherapy
Complications
Follow‐up and prevention
Suggested reading
PROTOCOL 3: Opioid Use, Misuse, and Addiction in Pregnancy and Postpartum
Overview
Opioid use and misuse
Screening and diagnosis
Management
Labor and delivery
Postpartum
Conclusion
Suggested reading
PROTOCOL 4: Depression
Clinical significance
Pathophysiology
Diagnosis
Management
Follow‐up
Conclusion
Suggested reading
PART 2: Antenatal Testing
PROTOCOL 5: Prenatal Testing for Chromosomal Abnormalities
Overview
Pathophysiology
Diagnosis and screening protocols
Conclusion
Suggested reading
PROTOCOL 6: Fetal Echocardiography
Overview
Pathophysiology
Structural heart disease
Fetal arrhythmias
Suggested reading
PROTOCOL 7: Clinical Use of Doppler
Overview
Pathophysiology
Diagnosis
Management
Summary
Suggested reading
PROTOCOL 8: Antepartum Testing
Nonstress test
Biophysical profile
Modified biophysical profile
Contraction stress test
Umbilical Artery Doppler Velocimetry
Indications for antepartum fetal surveillance
Suggested reading
PROTOCOL 9: Fetal Blood Sampling and Transfusion
Clinical significance
Cytogenetic diagnosis
Fetal infection
Fetal anemia
Procedure‐related risks
Long‐term effects
Technique
Future directions
Suggested reading
PROTOCOL 10: Preconception Genetic Screening
Overview
Cystic fibrosis
Spinal muscular atrophy
Hemoglobinopathies
Fragile X syndrome
Tay–Sachs disease and other disorders more prevalent in individuals of Ashkenazi Jewish descent
Management and follow‐up
Conclusion
Suggested reading
PART 3: Maternal Disease
PROTOCOL 11: Maternal Anemia
Definition
Consequences
Diagnostic work‐up and treatment
Macrocytic anemia
Suggested reading
PROTOCOL 12: Hemoglobinopathies in Pregnancy
Clinical significance
Diagnosis
Role of transfusion therapy
Pregnancy management of sickle cell disease
Pregnancy management of thalassemias
Suggested reading
PROTOCOL 13: Fetal and Neonatal Alloimmune Thrombocytopenia
Introduction
Diagnosis
Management
Conclusion
Suggested reading
PROTOCOL 14: Rheumatological Disorders
Introduction
Systemic lupus erythematosus
Rheumatoid arthritis
Scleroderma
Suggested reading
PROTOCOL 15: Antiphospholipid Syndrome
Overview
Pathophysiology
Diagnosis
Effect on pregnancy
Antepartum management
Conclusion
Suggested reading
PROTOCOL 16: Inherited Thrombophilias
Overview
Mechanisms of hemostasis
Mechanisms of thrombosis
Genetic risk factors for thrombosis
Adverse pregnancy outcome
Evaluation and treatment
Suggested reading
PROTOCOL 17: Valvular Heart Disease in Pregnancy
Introduction
Diagnosis and work‐up
Etiology of VHD
Maternal risk stratification
Stages of progression of valvular heart disease
Cardiac medications in pregnancy
Stenotic versus regurgitant valve lesions
Mixed anomalies
Artificial valves
Cardiac surgery in pregnancy
Preconception and early pregnancy counseling
Antepartum management
Anticoagulation
Delivery planning
Medications on L&D
Delivery and the immediate postpartum period
Prophylactic antibiotics
Anesthesia
Follow‐up
Suggested reading
PROTOCOL 18: Peripartum Cardiomyopathy
Peripartum cardiomyopathy and the obstetric care provider
Clinical presentation and diagnosis
Etiopathogenesis of peripartum and other cardiomyopathies
Stabilization and treatment
Cardiomyopathy pearls for the obstetric care provider
Suggested reading
PROTOCOL 19: Thromboembolism
Introduction
Hemostasis changes during pregnancy
Clinical risk factors for thromboembolism associated with pregnancy
Inherited thrombophilias
Acquired thrombophilia
Diagnosis and management of venous thromboembolism associated with pregnancy
Radiation considerations in pregnancy
Treatment of venous thromboembolism
Anticoagulation management considerations in the peripartum and postpartum periods
Postpartum anticoagulation
Anticoagulation prophylaxis considerations for women at risk for pregnancy‐related venous thromboembolism
Summary
Suggested reading
PROTOCOL 20: Renal Disease
Overview
Pre‐pregnancy counseling
Management
Suggested reading
PROTOCOL 21: Obesity
Clinical significance
Diagnosis
Treatment
Pregnancy and obesity
Prenatal care
Intrapartum care
Postpartum care
Conclusion
Suggested reading
PROTOCOL 22: Diabetes Mellitus
Overview
Pathophysiology
Pregestational diabetes mellitus
Gestational diabetes mellitus
Suggested reading
PROTOCOL 23: Thyroid Disorders
Overview
Diagnosis
Hypothyroidism
Hyperthyroidism
Suggested reading
PROTOCOL 24: Hepatitis in Pregnancy
Hepatitis A in pregnant and breastfeeding women
Hepatitis B in pregnant and breastfeeding women
Hepatitis C in pregnant and breastfeeding women
Hepatitis D in pregnant and breastfeeding women
Hepatitis E in pregnant and breastfeeding women
Suggested reading
PROTOCOL 25: Asthma
Overview
Pathophysiology
Diagnosis
Management
Conclusion
Suggested reading
PROTOCOL 26: Epilepsy
Overview
Pathophysiology and risks
Antiepileptic drugs
Pregnancy management
Suggested reading
PROTOCOL 27: Chronic Hypertension
Definition and diagnosis
Etiology and classification
Maternal–perinatal risks
Treatment
Suggested management
Evaluation and classification
Low‐risk hypertension
High‐risk hypertension
Summary
Suggested reading
PROTOCOL 28: Cytomegalovirus, Genital Herpes, Rubella, and Toxoplasmosis
Cytomegalovirus
Genital herpes simplex virus
Rubella
Toxoplasmosis
Suggested reading
PROTOCOL 29: Syphilis
Epidemiology
Pathophysiology and clinical manifestations
Congenital syphilis
Diagnosis in pregnancy
Management
Suggested reading
PROTOCOL 30: Vector‐Borne Diseases in Pregnancy: Zika, West Nile, and Chagas Disease
Zika virus
West Nile virus
Chagas disease
Suggested reading
PROTOCOL 31: Influenza
Overview
Pathophysiology
Diagnosis
Treatment
Complications
Prevention
Suggested reading
PROTOCOL 32: Malaria
Overview
Life cycle of the parasite
Clinical significance and pathophysiology
Epidemiology
Diagnosis
Prevention
Travel to endemic areas
Conclusion
Suggested reading
PROTOCOL 33: Human Immunodeficiency Virus Infection
Epidemiology
Pathophysiology
Screening in pregnancy
Diagnosis
Initial counseling
Initial laboratory assessment
Treatment
Follow‐up
Intrapartum management
Postpartum management
Conclusion
Suggested reading
PROTOCOL 34: Parvovirus B19
Overview
Epidemiology
Pathophysiology
Clinical features
Diagnosis
Management
Follow‐up
Prevention
Screening
Summary
Suggested reading
PROTOCOL 35: Group B Streptococcus
Clinical significance
Pathophysiology
Diagnosis
Treatment
Preterm labor
Preterm prelabor rupture of the membranes
Bacteriuria
Cesarean delivery
Penicillin allergy
Unknown GBS status
Prevention
Conclusion
Suggested reading
PROTOCOL 36: Biliary, Liver, and Pancreatic Disease
Chronic calculus cholecystitis/biliary dyskinesia
Acute cholecystitis
Choledocholithiasis
Intrahepatic cholestasis of pregnancy
Acute fatty liver of pregnancy
Acute pancreatitis during pregnancy
Suggested reading
PART 4: Obstetric Problems
PROTOCOL 37: Cervical Insufficiency
Overview
Diagnosis
Management in singleton pregnancy
Surgical technique for cerclage placement
Management in twin pregnancy
Suggested reading
PROTOCOL 38: Nausea and Vomiting
Clinical significance
Diagnosis and pathophysiology
Differential diagnosis
Treatment
Complications
Recurrence risk
Conclusion
Suggested reading
PROTOCOL 39: Fetal Death and Stillbirth
Overview
Pathophysiology and etiology
Diagnosis
Treatment
Diagnostic evaluation
Follow‐up
Suggested reading
PROTOCOL 40: Abnormal Amniotic Fluid Volume
Overview
Physiology of normal amniotic fluid volume
Amniotic fluid production
Amniotic fluid removal
Oligohydramnios
Polyhydramnios
Suggested reading
PROTOCOL 41: Fetal Growth Restriction
Definition and clinical significance
Etiology
Screening
Surveillance
Management
Outcome
Prevention
Conclusion
Suggested reading
PROTOCOL 42: Rh and Other Blood Group Alloimmunizations
Overview
Pathophysiology
Management of the first alloimmunized pregnancy (Figure 42.1)
Management of a subsequent alloimmunized pregnancy
Treatment
Outcome and follow‐up
Prevention
Conclusion
Suggested reading
PROTOCOL 43: Preterm Labor
Clinical significance
Pathophysiology
Diagnosis
Treatment
Complications
Follow‐up
Conclusion
Suggested reading
PROTOCOL 44: Prevention of Preterm Birth
Clinical significance
Pathophysiology and antecedents of preterm birth
Management
Conclusion
Suggested reading
PROTOCOL 45: Premature Rupture of the Membranes
Overview
Pathophysiology
Clinical implications
Diagnosis
Evaluation
Management
Special circumstances
Prevention of recurrent preterm PROM
Suggested reading
PROTOCOL 46: Indicated Late‐Preterm and Early‐Term Deliveries
Clinical significance
Pathophysiology
Diagnosis
Management
Complications
Follow‐up and prevention
Conclusion
Suggested reading
PROTOCOL 47: Chorioamnionitis
Overview
Definitions and clinical presentation
Epidemiology
Pathophysiology
Risk factors
Management
Fever of unknown origin
Isolated intrapartum maternal fever
Complications
Prevention
Conclusion
Suggested reading
PROTOCOL 48: Third‐Trimester Bleeding
Introduction
Etiology
Work‐up of third‐trimester bleeding
General management considerations
Potential complications
Conclusion
Suggested reading
PROTOCOL 49: Amniotic Fluid Embolism
Overview
Pathogenesis
Clinical presentation
Management
Published guidelines
Conclusion
Suggested reading
PROTOCOL 50: Preeclampsia
Overview
Pathophysiology
Diagnosis
Management
Initial evaluation
Gestational hypertension and preeclampsia without severe features
Preeclampsia with severe features
Complications of preeclampsia and HELLP
Follow‐up and maternal counseling
Suggested reading
PART 5: Labor and Delivery
PROTOCOL 51: Elective Induction of Labor
Overview
Cervical ripening agents
Labor‐inducing procedures and agents
Failed induction
Conclusion
Suggested reading
PROTOCOL 52: Electronic Fetal Heart Rate Monitoring
Overview
Physiology of fetal heart rate patterns
Fetal oxygenation and its interruption
A simplified, standardized approach to management
Conclusion
Suggested reading
PROTOCOL 53: Breech Delivery
Overview
Diagnosis
Management
Breech delivery at cesarean
Conclusion
Suggested reading
PROTOCOL 54: Vaginal Birth After Cesarean
Overview
Prelabor counseling
Management of labor and delivery
Uterine rupture
Conclusion
Suggested reading
PROTOCOL 55: Placenta Accreta Spectrum
Overview and clinical significance
Pathophysiology and risk factors
Diagnosis
Complications
Management
Prevention
Follow‐up
Conclusion
Suggested reading
PROTOCOL 56: Shoulder Dystocia
Overview
Pathophysiology and diagnosis
Management
Extraordinary maneuvers
Documentation
Suggested reading
PROTOCOL 57: Twins, Triplets, and Beyond
Clinical significance
Pathophysiology
Placentation
Diagnosis
Management
Delivery
Complications
Multifetal pregnancy reduction
Selective termination
Conclusion
Suggested reading
PROTOCOL 58: Postpartum Hemorrhage
Clinical significance
Definition
Pathophysiology
Diagnosis
Management
Complications
Follow‐up
Reporting
Prevention
Conclusion
Suggested reading
Appendix A: Evaluation of Fetal Health and Defects
Index
End User License Agreement
List of Tables
Chapter 1
Table 1.1 Four components of brief intervention
Chapter 3
Table 3.1 Medication choice for treatment of opioid use disorder in pregnancy...
Table 3.2 Buprenorphine initiation protocol example
Table 3.3 Risks and protective factors for neonatal abstinence syndrome (NAS)
Chapter 5
Table 5.1 Nuchal translucency (NT) measurement criteria of the Nuchal Translu...
Table 5.2 Sonographic findings associated with trisomies 21, 18, and 13
Chapter 6
Table 6.1 Indications for fetal echocardiography
Table 6.2 Standard fetal echocardiographic views and what to see
Table 6.3 AIUM recommended components of detailed fetal echocardiographic exa...
Chapter 8
Table 8.1 Fetal biophysical profile
Chapter 10
Table 10.1 Recommended carrier screening for individuals of Ashkenazi Jewish ...
Chapter 11
Table 11.1 Changes in laboratory values in pregnancy
Table 11.2 Oral preparations for therapy of iron deficiency anemia
Table 11.3 Intravenous preparations for therapy of iron deficiency anemia
Chapter 14
Table 14.1 2019 SLE Criteria from the European League against Rheumatism and ...
Table 14.2 Differentiating a lupus flare from preeclampsia
Chapter 16
Table 16.1 Inherited thrombophilia and the risk of venous thromboembolism (VT...
Table 16.2 Testing for inherited thrombophilia
Table 16.3 Guidelines for the prevention of VTE during pregnancy in women wit...
Table 16.4 Protocols for anticoagulation
Chapter 17
Table 17.1 Physiological cardiac changes in pregnancy
Table 17.2 Etiology of valvular heart disease
Table 17.3 Risk stratification schema for maternal heart disease in pregnancy
Table 17.4 Modified WHO pregnancy risk classification system by cardiac condi...
Table 17.5 Stages of progression of VHD
Table 17.6 Pregnancy‐associated maternal mortality in valvular heart disease
Table 17.7 Select cardiac medications with obstetric implications
Table 17.8 Hemodynamic effects of VHD, effects of pregnancy, and management o...
Table 17.9 New York Heart Association (NYHA) risk stratification
Table 17.10 Select obstetric medications with cardiac implications
Table 17.11 Special populations requiring antibiotic prophylaxis during labor...
Table 17.12 Infective endocarditis prophylactic antibiotic regimens in pregna...
Chapter 18
Table 18.1 Clinical and echocardiographic features of variants of cardiomyopa...
Chapter 19
Table 19.1 Inherited thrombophilia, personal history of VTE and pregnancy VTE...
Table 19.2 Fetal radiation exposure of various ionizing modalities in rads
Table 19.3 Timing of neuraxial anesthesia in relation to pharmacological anti...
Table 19.4 Antepartum anticoagulation
Table 19.5 Postpartum anticoagulation
Table 19.6 Anticoagulation regimen definitions
Chapter 20
Table 20.1 Classification of chronic kidney disease
Table 20.2 Classification of CKD
Table 20.3 Pregnancy‐related outcomes by CKD stage
Table 20.4 Specific kidney diseases and pregnancy
Chapter 21
Table 21.1 Institute of Medicine recommendations for total and rate of weight...
Table 21.2 Obesity‐related maternal/fetal risks
Table 21.3 Management considerations for the obese gravida
Chapter 22
Table 22.1 Glycosylated hemoglobin levels
Table 22.2 National Academy of Medicine weight gain recommendations for pregn...
Table 22.3 Glucose control during first stage of labor
Table 22.4 Venous plasma concentrations for positive diagnosis of diabetes me...
Table 22.5 Values for venous plasma glucose
Chapter 23
Table 23.1 Diagnosis of thyroid disorders
Chapter 24
Table 24.1 Nucleos(t)ide analogues recommended for treatment of chronic hepat...
Chapter 25
Table 25.1 Long‐term control medications for asthma during pregnancy
Table 25.2 Estimated comparative daily adult dosages for inhaled corticostero...
Table 25.3 Recommendations for preferred step therapy for asthma during pregn...
Table 25.4 Classification of asthma control during pregnancy
a
Table 25.5 Asthma biologics
Table 25.6 Pharmacological management of acute asthma during pregnancy
Chapter 27
Table 27.1 Rates of adverse pregnancy outcome in observational studies descri...
Table 27.2 Drugs used to treat hypertension in pregnancy
Chapter 29
Table 29.1 Clinical manifestations of syphilis in the adult
Chapter 32
Table 32.1 Presentation of malaria in pregnancy by underlying endemicity
Table 32.2 Recommendations for travel to a malarious area during pregnancy
Chapter 33
Table 33.1 Baseline laboratory studies for pregnant women living with HIV
Chapter 34
Table 34.1 Results of maternal serological testing for parvovirus B19 infecti...
Chapter 35
Table 35.1 Rate of early‐onset neonatal GBS sepsis in the presence of materna...
Table 35.2 Recommended regimens for intrapartum antibiotic prophylaxis
a
Chapter 37
Table 37.1 Summary of evidence for management of cervical insufficiency by di...
Table 37.2 Use of cerclage in singleton gestations
Chapter 38
Table 38.1 Pregnancy‐Unique Quantification of Emesis (PUQE) index
Table 38.2 Differential diagnosis of nausea and vomiting
Table 38.3 Initial laboratory evaluation
Table 38.4 Pharmacological agents for use in nausea and vomiting in pregnancy
Chapter 40
Table 40.1 Association of oligohydramnios and adverse perinatal outcome
Table 40.2 Comparison of use of amniotic fluid index or mean vertical pocket ...
Table 40.3 Etiologies of polyhydramnios
Table 40.4 Outcomes of polyhydramnios based on severity
Chapter 41
Table 41.1 Selected FGR etiologies and associations
Chapter 42
Table 42.1 Non‐RhD antibodies and associated hemolytic disease of the fetus o...
Table 42.2 Other indications for Rhesus immune globulin administration
Chapter 43
Table 43.1 Survival and major morbidities by gestational age at birth in 2008
Chapter 44
Table 44.1 Risk factors for preterm birth
Chapter 46
Table 46.1 Timing of indicated deliveries in the late‐preterm and early‐term ...
Chapter 47
Table 47.1 Abnormal amniotic fluid results confirmatory of intraamniotic infe...
Chapter 48
Table 48.1 Blood product replacements
Table 48.2 Causes of third‐trimester bleeding
Chapter 49
Table 49.1 Proposed diagnostic criteria for the case definition of AFE
Table 49.2 Differential diagnosis of AFE
Table 49.3 Agents used in cardiovascular resuscitation and right‐sided heart ...
Chapter 50
Table 50.1 Drugs used to treat hypertension in pregnancy
Table 50.2 Protocols for treatment of severe hypertension (systolic blood pre...
Chapter 51
Table 51.1 Elective induction of labor checklist among low‐risk women with ve...
Table 51.2 Bishop pelvic scoring system
Table 51.3 Examples of low‐ and high‐dose oxytocin infusion protocols for lab...
Table 51.4 Clinical pearls for the diagnosis of failed labor induction
Table 51.5 Elective induction of labor: a framework for shared decision makin...
Chapter 52
Table 52.1 Standardized fetal heart rate (FHR) definitions
Table 52.2 Fetal heart rate (FHR) categories
Table 52.3 Potential causes of prolonged deceleration
Table 52.4 Intrapartum FHR monitoring “ABCD” checklist
Chapter 56
Table 56.1 Risk (%) for shoulder dystocia based on fetal weight, diabetic sta...
Chapter 57
Table 57.1 Frequency of presentation
Table 57.2 Maternal complications inmultifetal pregnancies
Table 57.3 Fetal complications in multifetal pregnancies
Table 57.4 Staging of twin‐to‐twin transfusion syndrome
Chapter 58
Table 58.1 Risk factors for postpartum hemorrhage
Table 58.2 Medical treatment for uterine atony
Appendix A
Table A.1 Relationship between nuchal translucency thickness and pregnancy outco...
Table A.2 Estimated rates of karyotypic abnormalities related to maternal age at...
Table A.3 Performance of cell‐free DNA screening for common aneuploidies
Table A.4 Significance of chromosomal microarray in fetuses with normal karyotyp...
Table A.5 Frequency of chromosome aberrations in newborns (modified from a summa...
Table A.6 Common conditions that can be screened for using cell‐free DNA
Table A.7 Common disorders that can be diagnosed prenatally by invasive genetic ...
Table A.8 Relative timing and developmental pathology of certain malformations...
Table A.9 Performance of first‐trimester ultrasound in detection of fetal anomal...
Table A.10 Expected detection rates of fetal malformations in the first trimeste...
Table A.11 Expected detection rates of fetal malformations in the second trimest...
Table A.12 Prevalence of major cardiac defects by nuchal translucency thickness ...
Table A.13 Screening for congenital heart disease: performance of current strate...
Table A.14 Increased risk for neural tube defect (NTD)
Table A.15 Serial sonographic surveillance for twin pregnancies
Table A.16 Staging criteria for twin–twin transfusion syndrome
Table A.17 Drugs associated with congenital malformations in humans
Table A.18 Hemolytic disease resulting from irregular antibodies
Table A.19 Fetal blood sampling
List of Illustrations
Chapter 5
Figure 5.1 Nuchal translucency (NT) ultrasound measurement at 13 weeks’ gest...
Figure 5.2 Increased nuchal translucency measurement at 13 weeks’ gestation ...
Figure 5.3 Nasal bone image of a euploid fetus at 13 weeks. Various features...
Chapter 7
Figure 7.1 Schematic representing zero angle of insonation between the Doppl...
Figure 7.2 Flow velocity waveform of the umbilical artery and definitions fo...
Chapter 9
Figure 9.1 A typical procedure tray set‐up for cordocentesis, with 22 gauge ...
Figure 9.2 A typical OR procedure table set‐up for fetal blood transfusion.
Chapter 11
Figure 11.1 Causes of maternal anemia, classified by mean corpuscular volume...
Figure 11.2 Algorithm for evaluation of normocytic anemia.
Figure 11.3 Algorithm for evaluation of microcytic anemia.
Chapter 17
Figure 17.1 Cardiovascular adaptation to pregnancy. HR, heart rate; MAP, mea...
Chapter 18
Figure 18.1 Diagnostic approach to the patient presenting with cardiopulmona...
Figure 18.2 Differential diagnosis for heart failure with reduced ejection f...
Figure 18.3 Contemporary understanding of the pathophysiology of peripartum ...
Figure 18.4 Framework and clinical pearls for stabilization and ongoing mana...
Chapter 19
Figure 19.1 Exponential increase in venous thromboembolism risk during pregn...
Figure 19.2 Coagulation pathway.
Figure 19.3 Coagulation factor changes in pregnancy.
Figure 19.4 Virchow’s triad associated with pregnancy.
Figure 19.5 Pregnancy‐adapted YEARS algorithm for diagnosis of suspected pul...
Figure 19.6 Algorithm for diagnosis and management of suspected pulmonary em...
Chapter 22
Figure 22.1 Initation of insulin treatment in a GDM 75 kg patient at 28 week...
Chapter 24
Figure 24.1 CDC‐recommended treatment initiation algorithm for HBV infection...
Figure 24.2 CDC‐recommended diagnostic algorithm for identifying current HCV...
Chapter 27
Figure 27.1 Initial evaluation of women with chronic hypertension.
Figure 27.2 Antepartum management of chronic hypertension.
Chapter 29
Figure 29.1 Clinical algorithm for diagnosis and management of syphilis in p...
Chapter 30
Figure 30.1 The diagnostic approach for
symptomatic pregnant women
with pote...
Figure 30.2 The diagnostic approach for
asymptomatic pregnant women
with pos...
Chapter 31
Figure 31.1 Sample influenza inpatient versus outpatient protocol.
Chapter 32
Figure 32.1 Management of malaria during pregnancy.
Chapter 33
Figure 33.1 Algorithm for diagnosis and management of HIV in pregnancy.
Chapter 34
Figure 34.1 Work‐up and management of parvovirus B19 infection in pregnancy....
Chapter 35
Figure 35.1 Algorithm for GBS testing at term. In women with a history of GB...
Figure 35.2 Algorithm for GBS screening and prophylaxis in the setting of pr...
Figure 35.3 Algorithm for GBS screening and prophylaxis in the setting of pr...
Chapter 36
Figure 36.1 Diagnosis of biliary disease in pregnancy.
Figure 36.2 Diagnosis of intrahepatic cholestasis of pregnancy.
Figure 36.3 Work‐up and management of acute fatty liver of pregnancy.
Figure 36.4 Work‐up and management of pancreatitis in pregnancy
Chapter 38
Figure 38.1 Treatment algorithm for nausea and vomiting in pregnancy.
Chapter 41
Figure 41.1 Management of fetal growth restriction.
Chapter 42
Figure 42.1 Algorithm for the management of the red cell alloimmunized pregn...
Chapter 43
Figure 43.1 A proposed algorithm for combined cervical length (CL) and fetal...
Chapter 44
Figure 44.1 Care pathways to reduce risk of preterm birth.
Chapter 46
Figure 46.1 Proposed approach for determination of gestational age.
Chapter 47
Figure 47.1 Isolated maternal fever.
Figure 47.2 Diagnosis of triple I.
Chapter 48
Figure 48.1 Management of third‐trimester bleeding due to placenta previa.
Figure 48.2 Types of vasa previa.
Figure 48.3 Ultrasound diagnosis of vasa previa via transvaginal imaging and...
Figure 48.4 Management of third‐trimester bleeding.
Chapter 49
Figure 49.1 Acute management of AFE.
Chapter 50
Figure 50.1 Signs and symptoms of preeclampsia and organ dysfunction.
Figure 50.2 Recommended management of gestational hypertension or preeclamps...
Figure 50.3 Recommended management of preeclampsia with severe features <34w...
Chapter 52
Figure 52.1 Moderate variability.
Figure 52.2 Late decelerations.
Figure 52.3 Variable decelerations.
Figure 52.4 Sinusoidal pattern.
Figure 52.5 Fetal oxygenation.
Figure 52.6 Two central principles of electronic intrapartum fetal heart rat...
Figure 52.7 Intrapartum FHR monitoring management decision algorithm.
Chapter 54
Figure 54.1 Odds ratio graph comparing morbidity of trial of labor with elec...
Figure 54.2 Flow chart showing one management scheme for vaginal birth after...
Chapter 58
Figure 58.1 Algorithm for postpartum hemorrhage. BP, blood pressure; CS, ces...
Appendix A
Figure A.1 Timeline of prenatal genetic screening and diagnostic testing opt...
Figure A.2 Nuchal translucency measurements between 11 and 14 weeks of gesta...
Figure A.3 Prevalence of trisomies 21, 18, and 13 according to maternal age ...
Figure A.4 Amniotic fluid ΔOD
450
management zones.
Figure A.5 Middle cerebral artery (MCA) Doppler peak velocities. Peak MCA Do...
Guide
Cover Page
Title Page
Copyright
Preface
List of Contributors
Table of Contents
Begin Reading
Appendix A Evaluation of Fetal Health and Defects
Index
WILEY END USER LICENSE AGREEMENT
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Protocols for High‐Risk Pregnancies
An Evidence‐Based Approach
SEVENTH EDITION
EDITED BY
John T. Queenan, MD
Professor and Chair Emeritus
Department of Obstetrics and Gynecology
Georgetown University School of Medicine
Washington, DC, USA
Catherine Y. Spong, MD
Professor and Vice ChairDepartment of Obstetrics and GynecologyChief, Division of Maternal‐Fetal MedicineGillette Professorship of Obstetrics and GynecologyUniversity of Texas Southwestern Medical Center, Dallas, TX, USA
Charles J. Lockwood, MD, MHCM
Senior Vice President, USF Health
Dean of the Morsani College of Medicine
Professor of Obstetrics and Gynecology, and Public Health
University of South Florida, Tampa, FL, USA
This edition first published 2021© 2021 John Wiley & Sons Ltd.
Edition HistoryJohn Wiley & Sons, Ltd (6e, 2015)
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Library of Congress Cataloging‐in‐Publication Data
Names: Queenan, John T., editor. | Spong, Catherine Y., editor. | Lockwood, Charles J., editor.Title: Protocols for high‐risk pregnancies : an evidence‐based approach / edited by John T. Queenan, Catherine Y. Spong, Charles J. Lockwood.Description: Seventh edition. | Hoboken, NJ : Wiley‐Blackwell, 2021. | Includes bibliographical references and index.Identifiers: LCCN 2020024021 (print) | LCCN 2020024022 (ebook) | ISBN 9781119635260 (paperback) | ISBN 9781119635284 (adobe pdf) | ISBN 9781119635291 (epub)Subjects: MESH: Pregnancy, High‐Risk | Pregnancy Complications | Evidence‐Based MedicineClassification: LCC RG571 (print) | LCC RG571 (ebook) | NLM WQ 240 | DDC 618.3–dc23LC record available at https://lccn.loc.gov/2020024021LC ebook record available at https://lccn.loc.gov/2020024022
Cover Design: WileyCover Image: © Universal Images Group North America LLC/Alamy Stock Photo
Preface
The current acceleration in medical discoveries parallels Moore’s law for computer chips. In the 1950s, medical knowledge doubled every 50 years, by the 1980s it doubled every seven years, and now medical knowledge is estimated to double about every two months (Densen 2011). How can busy obstetricians keep pace? Through seven editions, Protocols for High‐Risk Pregnancies has helped address this exact challenge. Providing just‐in‐time content, its focus on protocols and guidelines helps organize medical thinking, avoid heuristic errors of omission and commission, and optimize maternal and fetal outcomes.
As with the prior six editions, we have once again assembled some of the world’s top obstetrical and medical experts. Concomitantly, the seventh edition adds a number of new features including protocols on opioid use, misuse and addiction in pregnancy and postpartum, noninvasive prenatal diagnosis of aneuploidy, periconceptional genetic screening, and expanded protocols on maternal valvular heart disease and cardiomyopathies; we have also added protocols on arboviruses including Zika, and malaria, to reflect new technologies, changing clinical disease patterns, and emerging global pathogens.
As in prior editions, our focus has been on conducting a comprehensive survey of recent relevant literature to extract the most current evidence‐based practices and then presenting them with concise, focused text and crystal‐clear clinical paradigms. In areas where there are reasonable clinical alternatives, where no single compelling randomized clinical trial or a clear metaanalytical preference is available, we have again asked the authors to use their best judgment to make recommendations.
We are deeply indebted to our common mentor, Dr John T. Queenan, who conceived of this text to help “clinicians in the trenches” and hope we have been faithful to his vision. We also appreciate the help of our editorial team at John Wiley & Sons, Deirdre Barry and Anupama Sreekanth.
Catherine Y. Spong, MD
Charles J. Lockwood, MD, MHCM
Reference
Densen P. Challenges and opportunities facing medical education.
Trans Am Clin Climatol Assoc
2011; 122:48–58.
List of Contributors
Christina M. AckermanDepartment of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal Fetal Medicine, Yale School of Medicine, New Haven, CT, USA
Emily H. AdhikariDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
Anne M. AmbíaDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
Michal Fishel BartalDepartment of Obstetrics and Gynecology and Reproductive Sciences, The University of Texas Medical School at Houston, Houston, TX, USA
Michael A. BelfortDepartment of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
Vincenzo BerghellaDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
Richard BerkowitzDepartment of Obstetrics and Gynecology, Columbia University Medical Center, New York, USA
Bonnie L. BermasDivision of Rheumatic Diseases, University of Texas, Southwestern Medical Center, Dallas, TX, USA
Rupsa C. BoeligDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
Christian BrechotDepartment of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
Haywood L. BrownDepartment of Obstetrics and Gynecology, University of South Florida, Tampa, FL, USA
Catalin S. BuhimschiDepartment of Obstetrics and Gynecology, University of Illinois College of Medicine at Chicago, Chicago, IL, USA
Irina A. BuhimschiDepartment of Obstetrics and Gynecology, University of Illinois College of Medicine at Chicago, Chicago, IL, USA
Elizabeth O. BuschurDepartment of Internal Medicine, Division of Endocrinology, Metabolism, and Diabetes, The Ohio State University Wexner Medical Center, Columbus, OH, USA
John ByrneDepartment of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
Joshua A. CopelDepartments of Obstetrics, Gynecology and Reproductive Sciences, and Pediatrics, Yale School of Medicine, New Haven, CT, USA
Mary E. D’AltonDepartment of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, USA
Jodi S. DasheDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
Mara J. DinsmoorDepartment of Obstetrics and Gynecology, NorthShore University Health System, Evanston, IL, USADepartment of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
Kerry E. DruryDepartment of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
Elaine DuryeaMaternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
Sarah Rae EasterDepartments of Obstetrics and Gynecology, and Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
Jerome J. FederspielDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, Duke University Medical Center, Durham, NC, USA
Steven G. GabbeDepartment of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, USA Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA
Henry L. GalanDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, University of Colorado School of Medicine, Colorado Fetal Care Center, Aurora, CO, USA
Robert B. GhermanDivision of Maternal Fetal Medicine, WellSpan Health System, York, PA, USA
Afshan B. HameedDivision of Obstetrics and Gynecology, Irvine School of Medicine, University of California, Irvine, CA, USA
Christina S. HanDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA Center for Fetal Medicine and Women's Ultrasound, Los Angeles, CA, USA
G. Justus HofmeyrEffective Care Research Unit, Universities of the Witwatersrand and Fort Hare, Bhisho, South AfricaDepartment of Obstetrics and Gynecology, University of Botswana, Gaborone, Botswana
Elizabeth HooverDepartment of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
Brenna L. HughesDepartment of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
Andra H. JamesDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, Duke University Medical Center, Durham, NC, USA
Tara KerinDepartment of Pediatrics, David Geffen School of Medicine at UCLA/UCLA Mattel Children’s Hospital, Los Angeles, CA, USA
Anna KingDepartment of Obstetrics and Gynaecology, Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK
Jeffrey A. KullerDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, Duke University School of Medicine, Durham, NC, USA
Mark B. LandonDepartment of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA
Heather S. LipkindDepartment of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal Fetal Medicine, Yale School of Medicine, New Haven, CT, USA
Judette LouisDepartment of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
Deirdre J. LyellDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, Stanford University Medical Center, Stanford, CA, USA
Caitlin A. MacGregorDepartment of Obstetrics and Gynecology, NorthShore University Health System, Evanston, IL, USADepartment of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
George A. MaconesDivision of Maternal Fetal Medicine, Dell Medical School‐University of Texas at Austin, Austin, TX, USA
Kathy C. MatthewsNew York Presbyterian–Weill Cornell Medicine, New York, USA
Thomas McElrathDivision of Maternal‐Fetal Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
Brian M. MercerDepartment of Obstetrics and Gynecology, Case Western University–MetroHealth Medical Center, Cleveland, OH, USA
David A. MillerDepartment of Obstetrics, Gynecology and Pediatrics, Keck School of Medicine, University of Southern California, Children’s Hospital Los Angeles, Los Angeles, CA, USA
Russell MillerDepartment of Obstetrics and Gynecology, Columbia University Medical Center, New York, USA
Kenneth J. Moise JrDepartments of Obstetrics, Gynecology and Reproductive Sciences, and Pediatric Surgery, McGovern School of Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
Thomas R. MooreDepartment of Obstetrics, Gynecology and Reproductive Sciences, Division of Perinatal Medicine, University of California San Diego, San Diego, CA, USA
Andrew MyersDepartment of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
Michael P. NageotteMiller Children’s and Women’s Hospital, Long Beach, CA, USADepartment of Obstetrics and Gynecology, University of California, Irvine, CA, USA
Mercy‐Nkuba NassaliDepartment of Obstetrics and Gynecology, University of Botswana, Gaborone, Botswana
David B. NelsonDepartment of Maternal‐Fetal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
Karin Nielsen‐SainesDepartment of Pediatrics, David Geffen School of Medicine at UCLA/UCLA Mattel Children’s Hospital, Los Angeles, CA, USA
Ruta M. NonacsDepartment of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
Mary E. NortonDepartment of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, CA, USA
Asa OxnerDepartment of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
Michael J. PaidasDepartment of Obstetrics, Gynecology and Reproductive Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
Shivani PatelDepartment of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
Ilina D. PluymDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
Patrick S. RamseyDepartment of Obstetrics and Gynecology, Center for Pregnancy and Newborn Research, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
Laura E. RileyDepartment of Clinical Obstetrics and Gynecology, Weill Cornell Medicine, New York, USA
Jared T. RoecknerDepartment of Obstetrics and Gynecology, University of South Florida, Tampa, FL, USA
Vanessa RogersDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
Stephanie RosDepartment of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampla, FL, USA
George SaadeDepartment of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Texas Medical Branch, Galveston, TX, USA
Lisa R. SammaritanoDivision of Rheumatology, Hospital for Special Surgery – Weill Cornell Medicine, New York, NY, USA
Patricia Santiago‐MunozDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, University of Texas Medical Center, Dallas, TX, USA
Alexander M. SaucedoDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
Lauren SayresDivision of Maternal Fetal Medicine, University of Colorado, Aurora, CO, USA
Michael SchatzDepartment of Allergy, Kaiser Permanente Medical Center, San Diego, CA, USADepartment of Medicine, University of California San Diego School of Medicine, San Diego, CA, USA
James R. ScottDepartment of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
Baha M. SibaiDepartment of Obstetrics and Gynecology and Reproductive Sciences, The University of Texas Medical School at Houston, Houston, TX, USA
Robert M. SilverDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, University of Utah Health Sciences Center, Salt Lake City, UT, USA
Hyagriv N. SimhanDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
Lynn L. SimpsonDepartment of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, USA
Rachel G. SinkeyDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
John SinnottDepartment of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
Bradley SipeDepartment of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
Catherine Y. SpongDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
Irene A. StaffordDepartment of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
Sarah J.E. StockDepartment of Maternal and Fetal Medicine, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
Mishka TerplanFriends Research Institute, Adjunct Faculty, Clinical Consultation Center, University of California, San Francisco, CA, USA
Stephen F. ThungDepartment of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA
Emilie L. Vander HaarNew York Presbyterian–Weill Cornell Medicine, New York, USA
Vic VelanovichDepartment of Surgery, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
Blair J. WylieDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
Kimberly YonkersDepartments of Psychiatry, Obstetrics, Gynecology and Reproductive Sciences and School of Public Health, Yale University School of Medicine, New Haven, CT, USA
Carolyn M. ZelopDepartment of Obstetrics and Gynecology, NYU School of Medicine, New York, USA
Amanda C. ZofkieDepartment of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
Blake ZwerlingDivision of Obstetrics and Gynecology, Irvine School of Medicine, University of California, Irvine, CA, USA
