Prenatal and postnatal care : a woman-centered approach

Title Page
Copyright Page
Contents
About the Editors
Contributors
Preface
About the Companion Website
Prenatal and Postnatal Care A Woman-Centered Approach
Part I Prenatal and Postnatal Care A Woman-Centered Approach
	Chapter 1 Reproductive Tract Structure and Function
		Anatomy of the Female Reproductive System
			External Genitalia
			Internal Genitalia
		Menstrual Cycle Physiology
			Beginnings
			Onset of Puberty
			The Hypothalamic–Pituitary–Ovarian Axis
			Menstrual Cycle Phases
		Resources for Women
		Resources for Healthcare Providers
		References
	Chapter 2 Conception, Implantation, and Embryonic and Fetal Development
		Introduction
		Conception and Implantation
		The Placenta
			Beginnings and Structure
			Chorionic and Amnionic Membranes
			The Umbilical Cord
			Placental Functions
			Sociocultural Uses of the Placenta
			Placental Transport
			Placental Endocrine Synthesis and Secretion
		The Embryo
			Organogenesis
		The Fetus
		Summary
		Resources for Healthcare Providers
		Resources for Women, Their Families, and Healthcare Providers
		References
	Chapter 3 Maternal Physiological Alterations during Pregnancy
		Introduction
		Hematologic System Adaptations
			Blood Changes
		Cardiovascular System Adaptations
			Anatomical and Functional Cardiac Changes
			Vascular Changes
			Blood Pressure Changes
			Supine Hypotensive Syndrome
		Respiratory System Adaptations
			Anatomical Changes
			Pulmonary Function Changes
		Renal System Adaptations
			Anatomical Changes
			Renal Function Changes
		Gastrointestinal System Adaptations
			Anatomical Adaptations
			Gastrointestinal Function Changes
			Liver and Biliary Changes
		Metabolic System Adaptations
			Basal Metabolic Rate
			Carbohydrate Metabolism
			Protein Metabolism
			Fat Metabolism
			Leptin and Ghrelin
			Insulin
			Skin Changes
			Pigmentation Changes
			Vascular Changes
			Connective Tissue Changes
			Sebaceous and Sweat Gland Changes
			Hair and Nail Changes
		Immune System Adaptations
			Fetus as Allograft
			Disorders Related to Immunologic Changes in Pregnancy
		Neurological System and Sensory Adaptations
		Musculoskeletal System Adaptations
		Endocrine System Adaptations
			Anatomical Changes
			Pituitary Function Changes
			Thyroid Function Changes
			Adrenal Function Changes
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 4 Physiological Alterations during the Postnatal Period
		Introduction
		Uterus
		Lochia
		Cervix
		Vagina
		Labia and Perineum
		Rectal Anatomy
		Additional Maternal Alterations during the Postpartum Period
			Weight Loss
			Hair Growth
			Central Nervous System
			Endocrine Changes
			Immune Response
			Cardiovascular System
			Musculoskeletal System
			Renal System
			Gastrointestinal Tract
		Summary
		Resource for Women
		Resource for Healthcare Providers
		References
Part II Preconception, Prenatal Care, and Postnatal Care
	Chapter 5 Preconception Care
		Introduction
		Challenges to Providing Preconception Care
		Benefits of Preconception Health Care
		Evidence Supporting Preconception Health Care
		Preconception Care
		Risk Assessment and Screening
			Health History
			Physical Examination
			Laboratory Examination
			Mental Health
			Substance Use and Abuse
			Intimate Partner Violence
			Genetics
			Infections
			Exposure to Teratogens
		Preconception Health Care for Women with Chronic Illnesses
			Asthma
			Cancer Survivors
			Cardiovascular Disease and Hypertension
			Diabetes
			Phenylketouria
			Systemic Lupus Erythematosus (SLE)
			Seizure Disorders
			Thrombophilias
			Thyroid Disorders
		Preconception Health Promotion and Counseling
			Conception
			Nutrition
			Dietary Supplements
			Weight
			Physical Activity
			Preparation for Pregnancy and Childbirth
			Reproductive Life Plan
			Vaccinations
		Unique Considerations
			Immigrant and Refugee Women
			Prior Pregnancy Loss
			Women with Disabilities
			Preconception Care for Men
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 6 Prenatal Care: Goals, Structure, and Components
		Introduction
		A Brief History of Prenatal Care
		Current Goals of Prenatal Care
			Initial and Continuing Risk Assessment
			Health Promotion
			Medical and Psychosocial Interventions and Follow‐Up
			Updates to the “Content of Prenatal Care”
		Structure of Prenatal Care
			The Schedule of Prenatal Visits
			How Much Prenatal Care Is Enough?
			What Happens in Prenatal Care?
			Integrating Quality into Prenatal Care
		Group Prenatal Care: CenteringPregnancy
			Making Group Prenatal Care Work
		Components of Prenatal Care
			Assessment
			Health History: Initial Visit
			Physical Assessment
			Laboratory Assessment
			Genetic Screening
			Diagnostic Testing
		Preventative Care
			Immunization
			Oral Health
			Mental Health
			Intimate Partner Violence (IPV)
		Health Promotion and Education
			Nutrition
			Substance Abuse
			Exercise
			Working and Pregnancy
			Health Education throughout Pregnancy
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 7 Nutrition during Pregnancy
		Introduction
		Understanding Food Units and Recommendations
			Size of Food Servings
		Prenatal Nutrition and Health Outcomes
			Fetal Origins of Disease
		Nutritional Needs in Pregnancy
			Fluid Intake
			Macronutrients: Total Energy
			Macronutrients: Fats
			Macronutrients: Carbohydrates
			Protein
			Micronutrients
			Overweight and Obesity in Pregnancy
			Underweight in Pregnancy
			Pre- and Postnatal Flavor Learning
		Food Safety during Pregnancy
			Food-Borne Infections
			Alcohol, Caffeine, and Artificial Sweeteners
		Factors Influencing Nutritional Intake
			Resource Availability
			Culture and Family
		Making a Nutritional Assessment
		Using Nutrition Resources
		Counseling for Optimal Prenatal Nutrition
		Special Issues in Prenatal Nutrition
			Adolescent Pregnancy
			Vegetarian and Vegan Diets in Pregnancy
			Pregnancy after Bariatric Surgery
			Eating Disorders
			Pica
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 8 Pregnancy Diagnosis and Gestational Age Assessment
		Introduction
		Benefits of Early Pregnancy Diagnosis and Gestational Age Assessment
		Pregnancy Diagnosis
			Presumptive Signs of Pregnancy
			Probable Signs of Pregnancy
			Positive Signs of Pregnancy
		Gestational Age Assessment
			Terminology Used to Describe Gestational Age
			Devices Used to Calculate the Gestational Age
			Methods of Estimating the  Gestational Age
		Counseling for Pregnancy Diagnosis
			Counseling after a Negative Pregnancy Test
			Counseling after a Positive Pregnancy Test
			Options Counseling for Unintended Pregnancy
			Providing Evidence-Based Information about Pregnancy Options
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 9 Risk Assessment during Pregnancy
		Introduction
		Process and Purpose of Risk Assessment
		Benefits of Risk Assessment
		Limitations of Risk Assessment
			Poor Predictive Value
			Lack of Precision
			Nonmodifiable Risk Factors
		Disadvantages of Risk Assessment and Risk Management
			Unnecessary Interventions
			Normalization of Technology and Illusion of Risk Control
		Labeling Women as High Risk
		Misapplication of Risk Assessment and Risk Management
			Introduction of Actual Risk
			Increase in Financial, Physical, and Emotional Costs
			Birth Fear
		Perspective of Risk and Risk Assessment
		Explaining Risk to Women
			Potential Problems of Risk Miscommunication
		Informed Consent
		Summary
		Resources for Healthcare Providers and Women and Their Families
		References
	Chapter 10 Prenatal Ultrasound
		Introduction
		The Physics and Mechanics of Ultrasound
		Types of Scans
		Use of Prenatal Ultrasound
			First-Trimester Ultrasound
			Second-Trimester Ultrasound
			Third-Trimester Ultrasound
		Interpreting and Communicating Results
		The Woman’s Experience of Ultrasound
			Patient Education
		Safety
		Overuse of Ultrasound
		Recreational Prenatal Ultrasound
		Who Performs Prenatal Ultrasounds
		Adding Ultrasound to Scope of Practice
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 11 Genetic Counseling, Screening, and Diagnosis
		Introduction
		Family History and Risk Evaluation
		Genetic Screening Tests
		Screening for Neural Tube Defects
		Screening for Aneuploidy
			First-Trimester Screening
			Second-Trimester Screening
			Integrated and Sequential Screening
			Noninvasive Prenatal Testing
		Genetic Screening by Ultrasound
		Carrier Screening
			Expanded Carrier Screening
		Diagnostic Prenatal Genetic Testing
			Amniocentesis
			Chorionic Villus Sampling
			Percutaneous Umbilical Blood Sampling
			Chromosomal Microarray Analysis
		The Role of Genetic Counselors
		Psychosocial Considerations in Genetic Testing
			Prenatal Genetic Testing and the Tentative Pregnancy
		Genetic Testing Counseling during Prenatal Care
			Pretest Counseling
			Post-Test Counseling
			Ethical Responsibilities in Genetic Testing
			Prenatal Genetic Counseling and the Healthcare Provider
		Summary
		Resources for Women, Their Families, and Healthcare Providers
		References
	Chapter 12 Assessment of Fetal Well-Being
		Introduction
		Physiologic Principles
		Indications
		Interprofessional Care
		Fetal Testing Methods
			Fetal Movement Counting (FMC)
			Care of a Woman Reporting Decreased Fetal Movement
			Nonstress Test
			Contraction Stress Test
			Amniotic Fluid Volume Assessment
			The Biophysical Profile (BPP) and Modified BPP
			Doppler Ultrasonography
		Education and Counseling
		Cultural, Personal, and Family Considerations
		Health Disparities and Vulnerable Populations
		Legal and Liability Issues
		Summary
		Resource for Healthcare Providers
		References
	Chapter 13 Common Discomforts of Pregnancy
		Introduction
		Back Pain and Pelvic Girdle Pain
			Assessment
			Relief and Preventative Measures
		Bleeding Gums
			Assessment
			Relief and Preventative Measures
		Breast Tenderness
			Assessment
			Relief and Preventative Measures
		Carpal Tunnel Syndrome (CTS)
			Assessment
			Relief and Preventative Measures
		Cervical Pain
		Constipation
			Assessment
			Relief and Preventative Measures
		Dizziness/Syncope
			Assessment
			Relief and Preventative Measures
		Edema
			Assessment
			Relief and Preventative Measures
		Emotional Changes
			Assessment
			Relief and Preventative Measures
		Fatigue
			Assessment
			Relief and Preventative Measures
		Flatulence
			Assessment
			Relief and Preventative Measures
		Headache
			Assessment
			Relief and Preventative Measures
		Heartburn
			Assessment
			Relief and Preventative Measures
		Heart Palpitations
			Assessment
			Relief and Preventative Measures
		Hemorrhoids
			Assessment
			Relief and Preventative Measures
		Increased Warmth and Perspiration
		Leukorrhea
			Assessment
			Relief and Preventative Measures
		Leg Cramps
			Assessment
			Relief and Preventative Measures
		Nasal Congestion
			Assessment
			Relief and Preventative Measures
		Epistaxis
			Assessment
			Relief and Preventative Measures
		Nausea and Vomiting of Pregnancy (NVP)
			Assessment
			Relief and Preventative Measures
		Ptyalism
			Assessment
			Relief and Preventative Measures
		Restless Leg Syndrome (RLS)
			Assessment
			Relief and Preventative Measures
		Round Ligament Pain
			Assessment
			Relief and Preventative Measures
		Shortness of Breath
			Assessment
			Relief and Preventative Measures
		Skin, Hair, and Nail Changes
			Hyperpigmentation
			Vascular Changes
			Hair and Nail Changes
			Relief and Preventative Measures
		Sleep Disturbances
			Assessment
			Relief and Preventative Measures
		Supine Hypotension Syndrome (SHS)
			Assessment
			Relief and Preventative Measures
		Urinary Frequency and Nocturia
			Assessment
			Relief and Preventative Measures
		Urinary Incontinence
			Assessment
			Relief and Preventative Measures
		Varicosities (Legs/Vulva)
			Leg Varicosities
			Relief and Preventative Measures
			Vulvar Varicosities
			Relief and Preventative Measures
		Vision Changes
			Assessment
			Relief and Preventative Measures
		Resources for Women and Their Families
		References
	Chapter 14 Oral Health
		Introduction
		Anatomy of the Oral Cavity
		Initial Assessment of the Oral Cavity
			Oral Health History
			Physical Exam
		Influence of Oral Health on Pregnancy Outcomes
			Gingivitis
			Periodontitis
			Pregnancy (Pyogenic) Granuloma
		Conditions Affecting Oral Health
		Postpartum and Newborn Oral Health
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 15 Medication Use during Pregnancy
		Introduction
		Types of Pharmaceutical Agents
		Prescriptive Authority
		Governmental Oversight of Pharmaceutical Agents
		Pre-Marketing Drug Testing
		The Prescription: Essential Components
			FDA Categories for Drugs in Pregnancy
			Etiology of Birth Defects
			Mechanisms of Teratogenic Drugs
			Identification of a Teratogen
			Selected Teratogens
		Pharmacokinetics in Pregnancy
		Common Medications Used During Pregnancy
		Vaccines during Pregnancy
		Rational Use of Drugs in Pregnancy
		Summary
		Resources for Healthcare Providers
		Resources for Women and Their Families
		References
	Chapter 16 Substance Use during Pregnancy
		Relevant Terms
		Introduction
		Prevalence of Prenatal Substance Use
		Terminology
		Historical Approaches to Prenatal Substance Use
		Harm Reduction Approaches to Prenatal Substance Use
		Common Comorbid Conditions
			Mental Health Disorders
			Social Issues
			Medical Conditions
		Prenatal Screening
			Screening Tools
			Brief Intervention
		Treatment Types
		Commonly Used Substances, Pregnancy Implications, and Recommended Treatment
			Alcohol
			Nicotine
			Cocaine
			Marijuana
			Amphetamines/Methamphetamines
			Designer Drugs
			Opioids
		Perinatal Care of Women with Substance Use Disorders
			Pregnancy Dating
			Prenatal Laboratory Testing
			Psychosocial Assessment
			Screening for Social Determinants
			Concurrent Medications
			Fetal Assessment
			Anticipatory Guidance
			Barriers to Treatment
			Communication and Coordination of Care
			Neonatal Abstinence Syndrome
			Postpartum Care
			Breastfeeding and Substance Use
			Interprofessional Care
		Summary
		Resources for Healthcare Providers
		References
	Chapter 17 Health Disparities and Social Issues in Pregnancy
		Introduction
		Poverty
			Food Insecurity
			Housing Insecurity
			Financial Insecurity
			Interdisciplinary Care
		Incarceration during Pregnancy
		Intimate Partner Violence during Pregnancy
		Reproductive Coercion
		Human Trafficking
		Pregnancy and a History of Childhood Sexual Abuse
			Assessing for Childhood Sexual Abuse
			Providing Care
		Summary
		Resources for Healthcare Providers
		Resources for Women and Their Families
		References
	Chapter 18 Diversity and Inclusiveness in the Childbearing Year
		Introduction
		Inequities in Perinatal Care and Outcomes
		Contributors to Perinatal Health Disparities
			Socioeconomic Conditions
			Physiologic Effects of Discrimination
			Medical Mistrust
		Developing Cultural Competence
		Communication
		Selected Cultural Traditions in the Childbearing Year
			Pregnancy
			Labor and Birth Care
			Postpartum
			Infant Care
		Summary
		Resources for Healthcare Providers
		Resources for Women
		References
	Chapter 19 Exercise, and Sexual, Occupational, and Environmental Health in Pregnancy
		Introduction
		Exercise
			Benefits of Exercise in Pregnancy
			Physiologic Changes during Pregnancy and Exercise
			Motivation to Exercise
			Measuring Exercise Activities
			Exercise Activities
			General Advice for Exercising in Pregnancy
			Exercise during the Postpartum Period
		Environmental Exposures
			Making an Environmental Exposure Assessment
			Metals and Metalloids
			Organic Solvents
			Pesticides
			Endocrine-Disrupting Chemicals
			Reducing Exposures
		Sexuality
			Pregnancy Influences on Sexuality
			Sexual Activity during Pregnancy
			Sexual History
		The Workplace and Pregnancy
			Shift Work
			Heavy Lifting and Long Work Hours
			Noise Exposure
			Psychosocial Stress and Employment
			Pregnancy Discrimination in the Workplace
			Assessing Occupational Conditions
			Supporting Pregnancy Health in the Workplace
		Resources on Pregnancy and Environmental Exposure for Women
		Resources on Pregnancy and Environmental Exposure for Healthcare Providers
		Resource on Work during Pregnancy for Women
		References
	Chapter 20 Psychosocial Adaptations in Pregnancy
		Introduction
		Developing Relationship: A Trauma‐Informed Approach
		Maternal-Newborn Attachment and Adaptation
			Bowlby and Ainsworth
			Kennell and Klaus
			Brazelton
			Long-Term Effects of Disorganized Attachment
		Maternal Role Development
			Rubin
			Lederman
		Body Image
		Sibling Preparation
		Partner Adaptation and Attachment
			Male Partners
			Female Partners
		Pregnancy in Transgender Men
			Caring for a Pregnant Transman
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 21 Health Education during Pregnancy
		Introduction
		Sources and Quality of Consumer Childbirth Education
		Prenatal Visit Approach to Individual Childbirth Education
		Class Education and Group Prenatal Care
		Developmental Considerations
			Adolescents
			Adult Education Principles
		Issues Integral to Prenatal Education
			Literacy, Health Literacy, Written Materials, and Reading Level
			Prioritizing Prenatal Education Needs
			Trimester Based Approaches to Prenatal Education
			Cultural Considerations
			Health Disparities and Vulnerable Populations
			Documentation of Teaching
		Summary
		Resources for Women and Their Families (Government Websites)
		Resources for Women and Their Families (Nongovernment Websites)
		References
	Chapter 22 Preparing for Birth
		Introduction
		What Is Physiologic Birth?
		Benefits of Physiologic Birth
		Fear of Childbirth
		Maternal Confidence for Physiologic Birth
		Evidence Related to Women’s Prenatal Confidence for Physiologic Birth
			Interviews with Women and Prenatal Care Providers
			Healthcare System Supports
			Prenatal Care Strategies
		Individual Strategies
		Summary
		Resources for Healthcare Providers
		Resources for Women and their Families
		References
	Chapter 23 Triage during Pregnancy
		Introduction
		Objectives and Goals of Triage Care and Evaluation
		Obstetric Triage in the Hospital Setting
		Primary Responsibilities of Professionals during Triage and Evaluation
		Common Reasons Women Seek Urgent/Emergent Care during Pregnancy
		Collaboration Between Obstetric and Emergency Departments
		Obstetric Triage Unit Organization
		Elements of Triage
		Elements of Healthcare Provider Evaluation
		Best Practices in Triage Units
			Triage Acuity Tools
			The Maternal Fetal Triage Index
			Assessment of Pain and Coping in the MFTI
			Relevance of the MFTI for Providers
			Clinical Decision Tools for Triage and Evaluation
			Emergency Medical Treatment and Labor Act
		Liability Issues in Obstetric Triage and Evaluation
		Quality Measures in Triage
		Anticipatory Guidance about Triage during Prenatal Care
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 24 Assessment and Care at the Onset of Labor
		Introduction
		Determining the Onset of Labor
		Timing of Admission to the Birth Setting
		Reframing “False Labor”
		Determining Active Labor
		Anticipatory Guidance during the Prenatal Period
		Assessment of the Woman with Report of Labor Onset
			Subjective Data
			Objective Data for a Face-to-Face Labor Onset Assessment
		Plan of Care
			Self-Care
			Sleep and Rest
			Coping Strategies and Comfort Measures for Early Labor
			Ambulation in Early Labor
		Summary
		References
	Chapter 25 Components of Postnatal Care
		Introduction
		Fourth-Trimester Tasks
		Immediate Postpartum Care
		Later Postpartum Care
			Placental Encapsulation
		Assessment of Maternal Physical and Emotional Adjustment
			Review of Birth Experience
			Family Adaptation
			Sibling Adjustment
		Maternal Role Development
		Infant Feeding
		Activity and Exercise
		Diet and Nutrition
			Weight Loss
		Lochia
		Afterbirth Pain
		Perineal Discomfort
		Diureseis and Diaphoresis
		Constipation and Hemorrhoids
		Sleep
		Sexuality
		Resumption of Menses and Ovulation
		Contraception
		Postpartum Physical Examination
			Breast Exam
			Abdominal Exam
			Costovertebral Angle Tenderness (CVAT)
			Perineal Exam
			Vaginal and Uterine Exam
			Rectal Exam
			Leg Exam
		Postpartum Depression and Intimate Partner Violence Screening
		Postpartum Warning Signs
		Cultural Considerations
		Health Disparities and Vulnerable Populations
		Interprofessional Care
		Recovery and Employment
		Summary
		Resources for Women
		Resources for Healthcare Providers
		References
	Chapter 26 Lactation and Breastfeeding
		Introduction
		Benefits of Breastfeeding
			Unique Properties of Human Milk
			Nutritional Properties of Human Milk
			Defense Agents in Human Milk
		Breastfeeding as a Public Health Issue
		Promoting and Supporting Breastfeeding
		Maternal and Infant Anatomy and Physiology of Lactation and Breastfeeding
		Basics of Breastfeeding Support and Assessment
			Position
			Latch
			Milk Production
			Breastfeeding Patterns
			Assessing Intake
		Care of the Breastfeeding Mother
			Nutrition for Nursing Mothers
			Contraception
			Smoking
			Alcohol and Illicit Drugs
			Medications and Breastfeeding
			Employed Nursing Mothers
		Summary
		Resources for Women and Healthcare Providers
		References
	Chapter 27 Contraception in the Postnatal Period
		Introduction
		Postpartum Care and Return to Fertility after Childbirth
		Selecting a Postpartum Contraceptive Method
		Contraceptive Methods
		Tier One Methods
			Permanent Methods
			Long-Acting Reversible Contraceptive (LARC) Methods
		Tier Two Methods
			Combined Hormonal Contraceptives (CHCs)
			Progestin-Only Contraceptives
			Lactational Amenorrhea Method (LAM)
		Tier Three Methods
			Barrier Methods
			Other Methods
		Emergency Contraception
		Summary
		Resources for Women and Healthcare Providers
		References
Part III Complex Prenatal and Postnatal Conditions
	Chapter 28 Bleeding during Pregnancy
		Introduction
		Early Pregnancy Bleeding
			Differential Diagnosis for Bleeding in the First Half of Pregnancy
			Evaluation
			Problem-Focused History
			Physical Exam
			Laboratory Evaluation
			Diagnostic Testing
		Subchorionic Hemorrhage
		Leiomyomas
		Spontaneous Pregnancy Loss
			Signs and Symptoms
			Diagnosis and Management
			Early Pregnancy Loss Follow-Up Care
			Early Pregnancy Loss and Grief
			Recurrent Pregnancy Loss
			Potential Problems Related to Unexplained Early Pregnancy Bleeding
		Ectopic Pregnancy
			Clinical Presentation
			Diagnosis and Management
		Gestational Trophoblastic Disease
			Potential Problems
			Presentation
			Diagnosis and Management
			Interprofessional Care
		Bleeding during the Second Half of Pregnancy
			Differential Diagnoses
		Placenta Previa
			Potential Problems
			Presentation
			Birth Planning
		Placental Abruption
			Potential Problems
			Presentation
		Vasa Previa
		Diagnosis and Management of Bleeding in the Second Half of Pregnancy
		Resources for Women and Their Families
		References
	Chapter 29 Amniotic Fluid and Fetal Growth Disorders
		Introduction
		Amniotic Fluid Dynamics
		Placentation and Perinatal Outcomes
		Amniotic Fluid Disorders
			Oligohydramnios
			Polyhydramnios
			Chorioamnionitis
		Fetal Growth Disorders
			Determination of Growth Disorders
			Fetal Growth Restriction
			Macrosomia
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 30 Preterm Labor and Birth
		Introduction
		Social and Racial Disparities
		Pathophysiology of Preterm Birth
		Perinatal Morbidity Related to Prematurity
		Risk Factors for Preterm Birth
		Predicting Preterm Birth
			Fetal Fibronectin Testing
			Cervical Length Measurement
		Primary Prevention of Preterm Birth
			Smoking and Substance Use Cessation
			Nutrition and Weight Gain
			Interpregnancy Interval
			Progesterone Therapy
			Cerclage
			Treating Infections
			Prenatal Stress, Depression, and Anxiety
			Disturbed Sleep and Fatigue
			Occupational Activity
			Pessary
		Prenatal Education on Signs and Symptoms of Preterm Labor
		Diagnosis and Management of Women with Preterm Labor
		Interprofessional Care
		Summary
		Resources for Women and Healthcare Providers
		References
	Chapter 31 Hypertensive Disorders of Pregnancy
		Introduction
		Classification of Hypertensive Disorders in Pregnancy
		Screening for Hypertensive Disorders
			Blood Pressure Measurement
			History
			Proteinuria
			Physical Examination
		Preeclampsia-Eclampsia
			Pathophysiology of Preeclampsia-Eclampsia Syndrome
			Potential Problems Due to Preeclampsia
			Risk Factors for Developing Preeclampsia
			Evaluation of Pregnant Women with New-Onset Hypertension
			Management of Women with Preeclampsia
			Prediction of Preeclampsia
			Prevention of Preeclampsia
			Long-Term Sequelae of Preeclampsia
			Risk Management Issues in the Office Setting
		Chronic Hypertension
			Management of Women with Chronic Hypertension in Pregnancy
		Chronic Hypertension with Superimposed Preeclampsia
			Management of Women with Chronic Hypertension with Superimposed Preeclampsia
		Gestational Hypertension
		HELLP Syndrome
			Pathophysiology and Potential Problems
			Diagnosis
		Interprofessional Care
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 32 Gestational Diabetes
		Introduction
		Pathophysiology and Potential Problems
		Prenatal Screening and Diagnosis
			Screening for Women at High Risk for Gestational Diabetes
			Screening and Diagnostic Methods
		Management
			Dietary Intervention
			Exercise Therapy
			Blood Glucose Monitoring
		Pharmacologic Treatments
			Insulin Therapy
			Oral Medications
		Social Considerations
		Fetal Surveillance and Timing of Birth
			Labor and Birth
		Postpartum Follow-Up
		Interprofessional Care
		Perspective on GDM Risk
		Care of the Pregnant Woman with Pregestational Diabetes
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 33 Multifetal Gestation
		Incidence
		Embryology
		Diagnosis
		Potential Problems
			Risks to the Fetuses/Neonates
			Risks to the Woman
		Prenatal Care
			Nutritional Counseling
			Genetic Screening
			Anticipatory Guidance
			Assessing Fetal Growth
			Fetal Surveillance
			Birth Planning
		Psychosocial Aspects
		Resources for Healthcare Providers
		Resources for Women and Their Families
		References
	Chapter 34 Post-Term Pregnancy
		Introduction
		Potential Problems
		Prevention, Intervention, and Management Options
			Fetal Surveillance
			Expectant Management
			Labor-Stimulating Activities
			Labor Induction
		Resources for Healthcare Providers
		Resources for Women and Their Families
		References
	Chapter 35 Hyperemesis Gravidarum
		Relevant Terms
		Introduction
		Etiology and Risk Factors
		Potential Problems
		Evaluation
		Care and Management
		Resource for Healthcare Providers
		Resources for Women and Their Families
		References
	Chapter 36 Abdominal Pain
		Introduction
		Evaluation
		Appendicitis
		Gall Bladder Disease
		Abdominal Trauma
		CPR in Pregnancy
		Pancreatitis
		Resources for Healthcare Providers
		Resources for Women and Their Families
		References
	Chapter 37 Pregnancy after Infertility
		Introduction
		Prevalence of Infertility
		Context and Course of Infertility
			Prior Fertility Treatments
		Preexisting Conditions and Perinatal Issues
		Pharmacologic Considerations
		Lifestyle Considerations
		Psychological Impacts of Infertility Treatment and Transition to Pregnancy
			Psychosocial and Emotional Care and Support
			Supporting the Partner
			Supporting Gestational Carriers
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 38 Common Complications during the Postnatal Period
		Introduction
		Postpartum Morbidity and Mortality
		Postpartum Cultural Considerations
		Postpartum Disorders
			Puerperal Fever (Pyrexia)
			Puerperal Infection (Postpartum Infection)
			Wound Infection
			Secondary (Delayed) Postpartum Hemorrhage
			Postpartum Hematoma
			Postpartum Urinary Retention
			Subinvolution
			Postpartum Preeclampsia–Eclampsia
			Postpartum Venous Thromboembolism (VTE)
			Postpartum Thyroiditis
			Postpartum Mood and Anxiety Disorders
			Postpartum Blues
			Postpartum Depression
			Postpartum Psychosis
			Generalized Anxiety Disorder
			Obsessive-Compulsive Disorder
			Panic Disorder
			Post-Traumatic Stress Disorder
			Mood and Anxiety Disorder Assessment/Screening
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 39 Common Breastfeeding Problems
		Introduction
		Common Infant-Related Breastfeeding Problems
			Difficulty or Failure to Latch
			Fussy Baby
			Sleepy Baby
			Slow Weight Gain
			Preterm and Late Preterm Infants
		Common Maternal Breastfeeding Problems
			Sore Nipples
			Management of Sore Nipples
			Breast Engorgement
			Plugged Ducts
			Mastitis
			Abscess
		Low Milk Supply
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 40 Perinatal Loss and Grief
		Introduction
		Stillbirth
			Breaking the News
		Care and Management of Women with Stillbirth
		Grieving and Emotional Care after Perinatal Loss
			Cultural Considerations
		Physical Care after Stillbirth
		Follow-Up Care
		Interconception and Subsequent Pregnancy Care
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
Part IV Part IV Common Primary Care Health Conditions during the Prenatal and Postnatal Periods
	Chapter 41 Obesity
		Introduction
		Prevalence
		Health Disparities and Cultural Considerations
		Personal and Family Considerations
		Obesity Physiology
		Potential Problems
		Management of Pregestational Obesity
			Nondiscriminatory Language
			Assessment of the Pregnant Woman with Obesity
			Management Principles
			Nutrition
			Pregnancy Weight Gain and Management Issues
			Low Weight Gain, Weight Loss, and Pregnancy Concerns
			Physical Activity
			Comfort Measures
		Bariatric Surgery and Pregnancy Issues
		Prolonged Pregnancy
		Intrapartum and Postpartum Issues
		Interprofessional Care
		Legal and Liability Issues
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 42 Mood and Anxiety Disorders
		Introduction
		Depression during Pregnancy
			Potential Problems of Perinatal Depression
			Screening for Perinatal Depression
			Management of Perinatal Depression
			Starting Medications
			Pregnant Women Currently Taking Antidepressants
			Complementary and Alternative Therapies
		Bipolar Disorder in Pregnancy
			Signs and Symptoms of Bipolar Disorder
			Screening for Bipolar Disorder
			Management of Pregnant Women with Bipolar Disorder
		Anxiety and Trauma‐Related Disorders
			Post-Traumatic Stress Disorder (PTSD)
			Generalized Anxiety Disorder (GAD)
		Interprofessional Care
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 43 Hematologic and Thromboembolic Disorders
		Introduction
		Anemia
			Physiologic Hematologic Changes in Pregnancy
			Iron-Deficiency Anemia
		Alloimmunization of Pregnancy
			Rh Blood Group System
			Atypical Blood Group Incompatibilities
			Anti-D Immunoglobulin for Prevention of Alloimmunization
			Identification and Management of Alloimmunization
		Hemoglobinopathies
			Sickle Cell Hemoglobinopathies
			Thalassemia
		Folate Deficiency
		Vitamin B12 Deficiency
		Bleeding Disorders
			Thrombocytopenia
			Inherited Bleeding Disorders
		Thromboembolic Disorders
			Inherited or Acquired Thrombophilias
			Signs, Symptoms, and Management
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 44 Respiratory Disorders
		Introduction
		Respiratory Physiology and Pregnancy
		Asthma
			Potential Problems
			Differential Diagnosis
			Common Clinical Presentation and Data Gathering
			Management of Asthma during Pregnancy
		Smoking Cessation
		Patient Education
			Interprofessional Care
		Influenza
		Upper Respiratory Infection
		Pneumonia
		Summary
		Resource for Healthcare Providers
		References
	Chapter 45 Urinary Tract Disorders
		Introduction
		Urinary Tract Infection
			Prevalence and Risk Factors
			Pathophysiology
			Common Pathogens
			Asymptomatic Bacteriuria
			Acute Cystitis
			Acute Pyelonephritis
		Evaluation
			Health History
			Physical Examination
			Laboratory Testing
		Care of Women with Urinary Tract Infections
		Recurrent UTI
		Care of Women with Suspected Acute Pyelonephritis
		Nephrolithiasis
			Evaluation
			Care of Women with Suspected Nephrolithiasis
		Summary
		Resources for Women and Their Families
		Resource for Healthcare Providers
		References
	Chapter 46 Gastrointestinal Disorders
		Introduction
		Initial Evaluation
		Gastroenteritis
			Evaluation
			Diagnostic Testing
			Treatment
			Interprofessional Care
		Intraheptic Cholestasis of Pregnancy
			Evaluation
			Diagnostic Testing
			Treatment
			Interprofessional Care
		Cholecystitis and Cholelithiasis
			Evaluation
			Diagnostic Testing
			Treatment
			Interprofessional Care
		Acute Appendicitis
			Evaluation
			Diagnostic Testing
			Interprofessional Care
		Summary
		Resources for Healthcare Providers
		Resource for Women and Their Families
		References
	Chapter 47 Endocrine Disorders
		Introduction
		Thyroid Disorders in Pregnancy
			Thyroid Physiology in Pregnancy
			Screening for Thyroid Disorders in Pregnancy
			Diagnosing Thyroid Disorders
		Overt Hypothyroidism
			Maternal and Fetal Risks
			Clinical Presentation
			Laboratory Testing, Diagnosis, and Management
			Subclinical Hypothyroidism
			Screening for Hypothyroidism in Pregnancy
			Preconception Care of a Woman with Hypothyroidism
		Hyperthyroidism
			Maternal and Fetal Risks
			Clinical Presentation
			Laboratory Testing, Diagnosis, and Management
			Interprofessional Care
			Subclinical Hyperthyroidism
			Thyroid Storm
		Postpartum Thyroiditis
			Laboratory Evaluation, Diagnosis, and Management
		Iodine in Pregnancy
		Pregestational Diabetes Mellitus
			Classifications
			Perinatal Risks
			Preconception Counseling and Care
		Summary
		Resources for Women and Healthcare Providers
		References
	Chapter 48 Neurological Disorders
		Introduction
		Seizure Disorders
			Potential Pregnancy Problems
			Antiepileptic Drugs (AEDs) during Pregnancy
		Headache
			Primary Headaches: Tension Type
			Primary Headaches: Migraines
			Secondary Headaches: Trauma
			Nonpharmacological Headache Management
			Pharmacologic Treatment of Migraine Headaches
			Postpartum Headaches
			Cluster Headaches
		Multiple Sclerosis
		Restless Legs Syndrome/ Willis-Eckbom Disease
		Carpal Tunnel Syndrome
		Central Nervous System Imaging in Pregnancy and Lactation
		Interprofessional Care
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 49 Dermatological Disorders
		Introduction
		Atopic Eruption of Pregnancy
			Assessment and Diagnosis
			Differential Diagnoses
			Treatment and Management
		Pruritic Urticarial Papules and Plaques of Pregnancy
			Assessment
			Differential Diagnoses
			Treatment and Management
		Pruritic Folliculitis of Pregnancy
			Assessment and Diagnosis
			Differential Diagnosis
			Treatment and Management
		Pemphigoid Gestationis
			Assessment
			Differential Diagnosis
			Treatment and Management
			Interprofessional Care
		Pustular Psoriasis of Pregnancy
			Assessment
			Differential Diagnosis
			Treatment and Management
			Interprofessional Care
		Intrahepatic Cholestasis of Pregnancy
			Assessment
			Differential Diagnoses
			Treatment and Management
			Interprofessional Care
		Summary
		Resources for Healthcare Providers
		References
	Chapter 50 Infectious Diseases
		Introduction
		Cytomegalovirus (CMV)
			Potential Problems
			Clinical Presentation and Assessment
			Management
			Prevention
		Group B Streptococcus (GBS)
			Potential Problems
			Assessment
			Management
		Hepatitis A
			Potential Problems
			Assessment
			Management
			Prevention
		Hepatitis B
			Potential Problems
			Assessment
			Management
			Prevention
		Hepatitis C
			Potential Problems
			Assessment
			Management
		Parvovirus B19
			Potential Problems
			Assessment
			Management
		Rubella
			Presentation and Assessment
			Management
			Prevention of Rubella and CRS
		Toxoplasmosis
			Potential Problems
			Clinical Presentation and Assessment
			Management
			Prevention
		Varicella
			Potential Problems
			Clinical Presentation and Assessment
			Management
		Emerging Infectious Diseases
		Ebola
		Zika
			Potential Problems
			Clinical Presentation and Assessment
			Management
			Prevention
		Summary
		Resources for Women and Their Families
		Resources for Healthcare Providers
		References
	Chapter 51 Sexually Transmitted Infections and Vaginitis
		Introduction
		Sexually Transmitted Bacterial Infections
			Chlamydia Trachomatis
			Neisseria Gonorrhoeae
			Syphilis
		Sexually Transmitted Viral Infections
			Herpes Simplex
			Human Immunodeficiency Virus (HIV)
			Human Papillomavirus (HPV)
			Hepatitis B
			Zika Virus
		Sexually Transmitted Parasitic Infection
			Trichomoniasis
		Fungal Vaginitis
			Vulvovaginal Candidiasis (VVC)
		Bacterial Vaginitis
			Bacterial Vaginosis (BV)
		Partner STI Treatment
		Legal Requirements for Reporting STI Diagnosis
		Psychosocial Impact of STI Diagnosis
			Effects on the Individual
			STI Prevention within Relationships
		Summary
		Resources for Healthcare Providers
		Resource for Women and Partners
		References
Index
EULA