Queenan's Management of High-Risk Pregnancy-An Evidence-Based Approach, 7e (Mar 4, 2024)_(1119636493)_(Wiley-Blackwell)

Cover
Title Page
Copyright Page
Contents
List of Contributors
Foreword
Preface
Acknowledgments
Part 1 Factors of High-Risk Pregnancy
	Chapter 1 Overview of High-Risk Pregnancy
	Chapter 2 Nutrition in Pregnancy
		Fetal growth
		Body mass index, weight gain, and adverse pregnancy outcomes
		Obesity
		Nutrition assessment and counseling
		Food security
		Energy intake during pregnancy
		Healthy dietary pattern in pregnancy
		Multivitamins
		Micronutrients in pregnancy
			Iron
			Folate/folic acid
			Calcium
			Vitamin D
			Iodine
		Vitamin toxicity
		Caffeine consumption in pregnancy
		Seafood consumption in pregnancy
		Multifetal pregnancy
		Nutrition during lactation
		Conclusion
		References
	Chapter 3 Alcohol and Substance Use Disorder
		Introduction
		Screening and testing for substance use disorder
		Alcohol
			Maternal effects
			Effects on the fetus
			Prenatal treatment
		Opioids
			Maternal effects
			Effects on the fetus
			Prenatal treatment
			Intrapartum and postpartum care
		Cannabis
		Stimulants
		Vaping (E-cigarettes)
		Benzodiazepines
		References
	Chapter 4 Environmental Agents and Reproductive Risk
		Background incidence of adverse outcome
		Biologic evidence of toxicity
		General principles
		Specific agents
			Lead
			Mercury
			Pesticides and herbicides
			Polychlorinated biphenyls
			Polybrominated diphenyl ethers
			Organic solvents
			Perfluorochemicals
			Video display terminals
			Bisphenol A
			Phthalates
			Air pollutants
		References
Part 2 Genetics
	Chapter 5 Genetic Screening for Mendelian Disorders
		Family history
		Mendelian inheritance
		Carrier screening
			Carrier screening guidelines
		Hemoglobinopathies
		Cystic fibrosis
		Spinal muscular atrophy
		Fragile X syndrome
		Jewish genetic diseases
		Prenatal diagnosis
		Newborn screening
		References
	Chapter 6 Screening for Congenital Heart Disease
		Introduction
		Screening low-risk populations
		Benefits of cardiac screening
		High-risk populations for fetal echocardiography
		Normal fetal heart anatomy
		Technique
			Two-dimensional cross-sectional imaging
			Four-chamber view
			Ventricular outflow tracts
			Three-vessel and three-vessel trachea views
			Additional cardiac views
		Color Doppler imaging
		Expectations from cardiac screening
			Four-chamber view
			Addition of outflow tract views and three-vessel views
		Conclusion
		References
	Chapter 7 First- and Second-Trimester Screening for Fetal Aneuploidy and Neural Tube Defects
		First-trimester sonographic screening
		Combined first-trimester serum and sonographic screening
		First-trimester cystic hygroma
		Second-trimester sonographic screening
		Second-trimester serum screening
		Combined first- and second-trimester screening
		Screening in multiple gestations
		Screening for neural tube defects
		Cell-free fetal DNA (cffDNA) screening for fetal aneuploidy
			Scientific basis of cffDNA screening
			Limitations of cffDNA screening
			CffDNA screening performance
			Implementation of cffDNA testing in clinical practice
		References
Part 3 Fetal Assessment
	Chapter 8 Sonographic Dating and Standard Fetal Biometry
		Pregnancy dating
		First trimester
		Second and third trimesters
		Estimation of fetal weight
		Macrosomia
		Fetal growth restriction
			Definition
			Symmetric versus asymmetric
			Timing of diagnosis
			Risk factors
			Outcome
			Management
			Fetal arterial Doppler
			Venous Doppler and fetal growth restriction
			Clinical application
		References
	Chapter 9 Antepartum Fetal Monitoring
		Nonstress test
		Biophysical profile
		Modified biophysical profile (NST/amniotic fluid volume)
		Doppler velocimetry
		References
	Chapter 10 Interpreting Intrapartum Fetal Heart Tracings
		Components of EFM documentation
			Baseline FHR
			Baseline FHR variability
			Accelerations
			Decelerations
			Uterine contractions
			Changes and trends in FHR over time
		Interpretation of EFM
			Category I
			Category III
			Category II
		Management of FHR abnormalities in labor
			Placement of internal monitors (intrauterine pressure catheter, fetal scalp electrode)
			Tachysystole with fetal heart rate changes
			Maternal hypotension
			Maternal repositioning
			Intravenous fluid bolus
			Maternal hyperoxygenation
			Amnioinfusion
			Fetal stimulation
		Future directions
		References
Part 4 Maternal Disease
	Chapter 11 Sickle Cell Anemia
		Hemoglobin SCD
		Hemoglobin S/-thalassemia disease
		Management during pregnancy
			Acute pain
			Chronic pain
			Prophylactic red blood cell transfusions
			Other treatments
		Fetal assessment
		Labor and delivery
		Genetic evaluation
			CASE PRESENTATION
		References
	Chapter 12 Anemia
		Consequences
		Causes of anemia in pregnancy
		Diagnostic workup and treatment
		Macrocytic anemia
		Normocytic anemia
		Microcytic anemia
		Iron supplementation in pregnancy
		Treatment of iron deficiency anemia
		References
	Chapter 13 Thrombocytopenia
		Maternal thrombocytopenia
			Gestational thrombocytopenia
			Autoimmune thrombocytopenia
			HELLP
			Thrombotic thrombocytopenic purpura and atypical hemolytic uremic syndrome
			Other causes
		Fetal thrombocytopenia
			Autoimmune thrombocytopenia
			Alloimmune thrombocytopenia
		References
	Chapter 14 Inherited and Acquired Thrombophilias
		Overview of hemostasis changes during pregnancy
		Inherited thrombophilias
		Factor V Leiden
		Prothrombin gene mutation (G2021A)
		Protein C deficiency
		Protein S deficiency
		Antithrombin deficiency
		Acquired thrombophilia
			Antiphospholipid antibody syndrome
		Management considerations in patients with inherited or acquired thrombophilia
			Inherited thrombophilia
			Antiphospholipid antibody syndrome
		Summary
		References
	Chapter 15 Thromboembolic Disorders
		Physiology of hemostasis
			Platelet plug formation
			The coagulation cascade
			Endogenous anticoagulants
		Pathophysiology of and risk factors for thrombosis in pregnancy
		Diagnosis of venous thromboembolism
			Deep venous thrombosis
			Pulmonary embolus
		Conclusion
		References
	Chapter 16 Cardiac Disease in Pregnancy
		Risk assessment and risk-appropriate care
		Antenatal care and optimization
			First trimester
			Second trimester
			Third trimester
		Multidisciplinary delivery planning
			Mode of delivery
			Analgesia and anesthesia
			Monitoring and emergency preparedness
		Postpartum and interconception care
		Conclusion
		References
	Chapter 17 Renal Disease
		Physiological changes in renal function during pregnancy
		Anatomic changes in the urinary tract during pregnancy
		Renal disease in pregnancy
			Proteinuria
			Chronic kidney disease
			Mild renal insufficiency
			Moderate and severe renal insufficiency
			Hypertensive disorders with renal insufficiency
		Renal dialysis
		Renal transplantation
		Management of pregnancies complicated by renal disease
		Conclusion
		References
	Chapter 18 Pregnancy in Transplant Patients
		Prepregnancy assessment and counseling
		Antepartum care
		Review of common agents for maintenance immunosuppression
		Kidney transplant
		Other organ transplant patients
			Kidney-pancreas
			Liver
			Heart
			Lung
			Other transplant groups
			Uterus
		Intrapartum management
		Obstetric emergencies
		The baby
		References
	Chapter 19 Gestational Diabetes Mellitus
		Risk factors for gestational diabetes
		Therapeutic modalities in gestational diabetes
		Antenatal testing
		Delivery: when and how to deliver
		Postpartum considerations
		References
	Chapter 20 Diabetes Mellitus
		Initial evaluation
		Regulating maternal glycemia
		Management during pregnancy
		Management of insulin during labor
		References
	Chapter 21 Thyroid Disorders
		Diagnosis
			Additional studies
		Hypothyroidism
			Implications for pregnancy
			Treatment
		Hyperthyroidism
			Implications for pregnancy
			Management
		Thyroid storm management [3,4,10]
		References
	Chapter 22 Asthma
		Definition of asthma
		Effect of pregnancy on the course of asthma
			Clinical observations
			Mechanisms
		Effect of asthma on pregnancy
			Clinical observations
			Mechanisms
		Diagnosis of asthma during pregnancy
		Management
		Assessment and monitoring
		Control of factors contributing to severity
		Patient education
		Pharmacologic therapy
		Chronic asthma
		Acute asthma
		Management during labor and delivery
		Conclusion
		References
	Chapter 23 Epilepsy
		Contraception
		Fertility
		Preconception counseling
		Folic acid
		Seizures during pregnancy
		ASM risks: Structural and neurodevelopmental teratogenicity
		Management during pregnancy
			Prenatal screening
			ASM levels
		Peripartum care
			Labor and delivery
			Maternal outcomes
		Postpartum care
			ASM management and seizure risk
			Breastfeeding
			Postpartum depression
		Summary
		References
	Chapter 24 Chronic Hypertension
		Definition
		Diagnosis
		Preconceptional counseling
		Morbidity and mortality
		Diagnosis and evaluation in pregnancy
		Treatment during pregnancy
		Antepartum fetal assessment
		Delivery
		Postpartum care
		References
	Chapter 25 Systemic Lupus Erythematosus
		Epidemiology
		Etiology
		Pathogenesis
		Differential diagnosis
		Morbidity
			General morbidity and mortality
			Effects of pregnancy on systemic lupus erythematosus
			Effects of systemic lupus erythematosus on pregnancy
		Management during pregnancy
		Antiphospholipid antibodies
		References
	Chapter 26 Perinatal Infections
		Parvovirus B19
			Clinical manifestations
			Diagnosis
			Management of parvovirus B19 in pregnancy
		Rubella
			Clinical manifestations
			Diagnosis
			Management and prevention
		Syphilis
			Clinical manifestations
			Diagnosis
			Treatment
		Toxoplasmosis
			Clinical manifestations
			Diagnosis
			Management and prevention
		Herpes simplex infection
			Clinical manifestations
			Diagnosis
			Management and prevention
		Cytomegalovirus
			Clinical manifestations
			Diagnosis
			Management and prevention
		Varicella zoster virus
			Clinical manifestations
			Diagnosis
			Management and prevention
		Group B Streptococcus
			Clinical manifestations
			Diagnosis
			Management and prevention
		References
	Chapter 27 Malaria
		Clinical features
		Diagnosis
		Treatment
		Complications
		Prevention
		References
	Chapter 28 Hepatitis in Pregnancy
		Hepatitis A
		Hepatitis E
		Hepatitis B
			Interaction of HBV with physiology of the pregnant immune system
			Maternal screening
			Prevention of HBV infection
			Treatment of mothers with HBV
			Elective cesarean section vs. vaginal delivery
			Breastfeeding
		Hepatitis D
		Hepatitis C
			Epidemiology
			Screening
			Diagnostic algorithm
			Additional monitoring and management considerations during pregnancy
			Treatment
			Breastfeeding
		Hepatitis G
		References
	Chapter 29 HIV Infection
		Identifying infected patients
		Posttest counseling of pregnant patients with HIV
		Laboratory assessment of the pregnant patient with HIV
		Recommended immunizations for pregnant patients with HIV
		Antiretroviral treatment in pregnancy
		Labor and delivery care for pregnant patients living with HIV
		Postpartum care for pregnant patients living with HIV
		Ethical and legal considerations
		Conclusion
		References
	Chapter 30 Pregnancy in Women with Disabilities
		General considerations
			Demographic disadvantages
			Prepregnancy health and wellness
			Medication use
		Psychosocial risk factors
			Abuse
			Mental health
			Tobacco, alcohol, and substance use and misuse
			Weight gain, mobility, and skin integrity
			Urinary tract function and infections
			Respiratory complications
			Venous thromboembolic disease
			Antepartum consultation
			Barriers to care
		Pregnancy outcomes
			Across disability types
			Cesarean delivery
			Considerations for specific disability types and associated conditions
		Intellectual and developmental disabilities
		Sensory disabilities
		Breastfeeding
		Conclusion
		References
	Chapter 31 COVID-19 in Pregnancy
		Pathophysiology of COVID in pregnancy
		Epidemiology
		Screening and Prevention
		Vaccination
		Clinical course
		Vertical transmission
		Clinical management
		Treatment
		Postpartum care and newborns
		References
Part 5 Obstetric Complications
	Chapter 32 Recurrent Pregnancy Loss
		Factors contributing to recurrent pregnancy loss
			Genetic abnormalities
			Uterine abnormalities
		Immunologic factors
		Hematologic factors
			Antiphospholipid antibody syndrome
		Inherited thrombophilias
			Endocrinopathies
			Vitamin D deficiency
			Polycystic ovary syndrome
			Obesity and other social factors
			Male factor
			Infections
		Evidence-based evaluation of couples experiencing recurrent pregnancy loss
	Chapter 33 Cervical Insufficiency
		Syndrome of spontaneous preterm birth
		How can we make the clinical diagnosis of cervical insufficiency, and how effective is cerclage for a history indication?
		Should insufficiency be a sonographic diagnosis?
		Can ultrasound replace the history indication?
		What is acute cervical insufficiency and how effective is a physical exam-indicated cerclage?
		Can acute cervical insufficiency be predicted and managed?
		When should cerclage be placed in a twin gestation?
		How should women with a prior failed vaginal cerclage be managed?
		Do cervical procedures cause insufficiency?
		What surgical techniques are used for history or ultrasound-indicated vaginal cerclage?
		Should postcerclage activity restrictions be recommended?
		When should a cerclage be removed?
		Cerclage complications
		Adjunctive management strategies for cervical insufficiency
		Conclusion
		References
	Chapter 34 Gestational Hypertension, Preeclampsia, and Eclampsia
		Pathophysiology
		Diagnosis
			Gestational hypertension
			Severe gestational hypertension
			Proteinuria
			Edema
			Preeclampsia
			Preeclampsia with severe features
			Eclampsia
			HELLP
		Management
			Initial evaluation
			Gestational hypertension and preeclampsia without severe features
			37 weeks or more
			Less than 37 weeks
			Preeclampsia with severe features or severe gestational hypertension
			Management of preeclampsia with severe features or severe gestational hypertension
			HELLP
			Eclampsia
			Complications of preeclampsia and HELLP
			Intrapartum management of preeclampsia with severe features
		Postpartum management
		Follow up and maternal counseling
		References
	Chapter 35 Postpartum Hemorrhage
		Hematologic parameters
		Defining excessive blood loss
		Prevention
		Risk factors and etiologies
			Uterine atony
			Methylergonovine/ergometrine
			Prostaglandins
			Misoprostol
			Mechanical and surgical control of bleeding
			Uterine tamponade
			Uterine compression sutures
			Uterine devascularization
			Arterial embolization
			Hysterectomy
			Pelvic packing
			Uterine inversion
			Management
			Genital tract lacerations
			Uterine rupture
			Retained placenta
			Placenta accreta spectrum disorder
		Treatment
		Complications
		Conclusion
		References
	Chapter 36 Emergency Care
		Timely and dynamic assessment of trauma
			Primary survey
			Secondary survey
			Diagnostic studies
		Cardiac arrest in pregnancy
			Circulation
			Airway and breathing
			Postarrest care
		Stabilization and resuscitation
			Principles of resuscitation in hemorrhagic shock
			Principles of resuscitation in septic shock
		Optimizing resource use in emergency care
		Suggested readings
	Chapter 37 Rh and Other Blood Group Alloimmunizations
		Prophylaxis
		Methods of surveillance
			Antibody titer
			Ultrasound
			Fetal blood typing through DNA analysis
		Overall clinical management
			First sensitized pregnancy
			Previous severely affected fetus or infant (previous child requiring intrauterine or neonatal transfusion)
			Intrauterine transfusion
		Outcome
			Immunomodulation
			Hemolytic disease of the fetus and newborn caused by non-RhD antibodies
		References
	Chapter 38 Multiple Gestations
		Impact on perinatal outcomes
		Zygosity and chorionicity
			Embryology
			Ultrasound diagnosis of chorionicity
		Fetal complications and multiple gestations
			Intrauterine growth restriction and growth discordance
			Fetal loss
			Discordant congenital anomalies
		Complications unique to monochorionicity
			Monoamnionicity
			Twin–twin transfusion syndrome
		Maternal obstetric complications
		Antepartum management of multiple gestations
			Multifetal pregnancy reduction
			Prenatal diagnosis
			Screening for fetal aneuploidy
			Diagnostic testing for fetal aneuploidy
			Screening for neural tube defects in multiples
			Screening for anatomic abnormalities
			Prevention of preterm delivery
			Antenatal surveillance
		Intrapartum period
		Conclusion
		References
	Chapter 39 Polyhydramnios and Oligohydramnios
		Normal amniotic fluid composition and volume
		Dynamics of amniotic fluid turnover
		Fetal urine
		Fetal lung fluid
		Fetal swallowing
		Intramembranous flow
		Amniotic fluid turnover
		Clinical measurement of amniotic fluid
		Polyhydramnios
			Definition
			Diagnosis
			Associations
			Evaluation
			Management
			Future therapies
		Oligohydramnios
			Definition
			Diagnosis
			Clinical significance
			Premature rupture of membranes
			Congenital malformation
			Intrauterine growth restriction
			Postdate pregnancy
			Twin pregnancy
			Management
		Conclusion
		References
	Chapter 40 Pathogenesis and Prediction of Preterm Delivery
		Etiology and pathogenesis of spontaneous preterm delivery
		Idiopathic and stress-associated premature activation of the maternal-placental–fetal hypothalamic–pituitary–adrenal axis
			Placental corticotropin-releasing hormone (CRH) and accelerated HPA activation
			FK506-binding protein 51 and intracellular functional progesterone (P4) withdrawal
		Decidual-amnion-chorion inflammation
			The vaginal microbiome and preterm delivery
			Maternal genital tract inflammation and preterm delivery
		Abruption-associated preterm delivery
		Mechanical stretching of the uterus
		Final common pathway of preterm delivery
		Prediction of preterm delivery: interpretation of test results
		Pathway-specific markers
			Inflammatory biomarkers
		Biomarkers of decidual hemorrhage and dysregulation in coagulation pathways
			Markers of the final preterm delivery common pathway
		References
	Chapter 41 Preterm (Prelabor) Premature Rupture of Membranes
		Mechanisms
		Prediction and prevention
		Diagnosis
		Clinical course
		Evaluation
		Management
		Preterm premature rupture of membranes at 32 to 36 weeks of gestation
		Premature rupture of membranes before 32 weeks of gestation
		Previable premature rupture of membranes before the limit of viability
		Special circumstances
			Cerclage
			Herpes simplex virus
			Human immunodeficiency virus (HIV)
			Resealing of the membranes
		References
	Chapter 42 Management of Preterm Labor
		Evaluation: history, physical exam, and screening tests
		Initial assessment
			Diagnosis of preterm labor
			Fetal fibronectin and cervical length
		Management
			Prophylaxis to prevent neonatal morbidity/mortality from preterm birth (fetal maturation)
			Neuroprotection
		Nontocolytic interventions
			Bed rest
			Hydration
			Prophylactic antibiotics
			Group B streptococcus prophylaxis
			Progesterone
		Tocolysis
			Primary tocolysis – single agent
			Additional tocolysis and antibiotics used simultaneously
			Refractory tocolysis – primary agent is failing
			Maintenance tocolysis – after successful primary tocolysis
		Mode of delivery
		References
	Chapter 43 Placenta Previa and Related Disorders
		Placenta previa
			Definitions
			Clinical significance
			Incidence, pathophysiology, and risk factors
			Clinical presentation
			Diagnosis
			Management
			Timing and mode of delivery
		Vasa previa
			Pathophysiology
			Incidence and risk factors
			Diagnosis
			Management
			Mode and timing of delivery
		Placenta accreta spectrum
			Clinical significance
			Pathophysiology
			Incidence and risk factors
			Diagnosis
			Management
			Timing and mode of delivery
		Conclusion
		References
	Chapter 44 Fetal Growth Restriction
		Definition of fetal growth restriction
		Epidemiology
		Perinatal morbidity and mortality
		Etiologies
		Diagnosis
		Management of FGR
		Antenatal surveillance
		Timing of delivery in FGR
		References
Part 6 Complications of Labor and Delivery
	Chapter 45 Induction of Labor
		Indications and contraindications to labor induction
		Medically indicated delivery timing
		Elective induction of labor
		Predicting a successful induction
		Defining failed induction
		Preinduction considerations
		Cervical ripening
		Risks associated with labor induction
			Uterine tachysystole
			Hyponatremia
			Hypotension
		Additional considerations
			Immediate vs. delayed pushing
			Induction of labor in women with prior cesarean delivery
		Conclusion
		References
	Chapter 46 Cesarean Delivery
		Maternal and perinatal morbidity and mortality
		Evidence-based operative considerations
		Preoperative considerations
		Intraoperative considerations
			Antibiotic prophylaxis
			Vaginal antiseptic prophylaxis
			Abdominal surgical incision
			Manual removal of the placenta
			Extraabdominal vs. intraabdominal repair of the uterine incision
			Single-layer vs. two-layer hysterotomy closure
			Peritoneal closure
			Abdominal wall closure techniques
		Postoperative considerations
			Pain regimens
			Thromboprophylaxis
		Potential risks of repeat cesarean delivery
		Current indications for cesarean delivery
			Failure to progress in labor
			Fetal distress
			Malpresentation
		Repeat cesarean
		References
	Chapter 47 Vaginal Birth after Cesarean Delivery
		Trends in vaginal birth after cesarean-trial of labor
		Candidates for trial of labor
		Factors affecting the success rates for trial of labor
			Maternal demographics
			Prior indication for cesarean delivery
			Prior vaginal delivery
			Birthweight
			Labor status and cervical examination
			Previous incision type
			Multiple prior cesarean deliveries
		Risks of vaginal birth after cesarean-trial of labor
			Uterine rupture
			Number of prior cesarean deliveries
			Prior vaginal delivery
			Uterine closure technique
			Interpregnancy interval
			Labor induction
			Labor augmentation
			Sonographic evaluation of the uterine scar
		Management of vaginal birth after cesarean-trial of labor
		Counseling for vaginal birth after cesarean-trial of labor
		References
	Chapter 48 Breech Delivery
		Types of breech
		Diagnosis
		Prevention
		Complications of vaginal breech delivery
		Approach to management
		External cephalic version at or near term
		Planned mode of delivery
		Delivery planning
		Vaginal breech delivery
			Criteria for vaginal beech delivery
			Induction and augmentation of labor
			Care during labor
			Conduct of vaginal breech delivery
		Cesarean breech delivery
		Complications to anticipate
		Twin pregnancy with leading breech presentation
		Noncephalic second twin
		Internal podalic version and total breech extraction for cephalic second twins
		Preterm breech birth
		Training
		Conclusion
		Acknowledgments
		References
	Chapter 49 Operative Vaginal Delivery
		Prerequisites and indications
		Classification
		Instrument selection
		Site of delivery
		Technique
			Forceps
			Vacuum extraction
		Outcomes
			Maternal
			Neonatal
		Training
		Conclusion
		References
	Chapter 50 Obstetric Analgesia and Anesthesia
		Labor and vaginal delivery
			Consequences of unrelieved pain
			Multimodal regional analgesia
			Epidural, spinal, and combined spinal–epidural analgesia
			Patient-controlled epidural analgesia
			Timing of regional pain relief
		Cesarean delivery
			Postoperative analgesia
			Opioid crisis
		Compromised coagulation and neuraxial regional analgesia and anesthesia
		References
	Chapter 51 Quality and Patient Safety
		Patient safety in obstetrics
		How to measure safety
			Outcome measures
			Process measures
			Structure and culture measures
		Tools to improve patient safety
		Evidence to support improvement tools
		Beyond safety and quality
		References
Part 7 Procedures
	Chapter 52 Genetic Amniocentesis, Chorionic Villus Sampling, Intrauterine Transfusion, and Shunts
		Prenatal diagnosis
		Chorionic villus sampling
			Transcervical chorionic villus sampling
			Transabdominal chorionic villus sampling
			Complications of chorionic villus sampling
		Amniocentesis
			Traditional amniocentesis (15 weeks gestation)
			Early amniocentesis (<14 weeks gestation)
			Multiple gestations
			Complications of amniocentesis
		Diagnostic studies
			Fluorescence in Situ Hybridization
			Karyotype
			Chromosomal microarray
			Next generation sequencing
		Intrauterine Transfusion
			Intraperitoneal approach to IUT
			Intravascular access for fetal transfusion
			Technique for IUT
			Complications
		Fetal shunts
			Vesicoamniotic shunt
			Thoracoamniotic shunts
			Technique for shunt placement
			Complications of shunts
		References
	Chapter 53 Fetal Surgery
		Different fetal techniques
			Open fetal surgery (hysterotomy)
			Fetoscopic surgery
			Ultrasound-guided percutaneous fetal therapy
		Specific diseases
			Myelomeningocele
			Congenital lung lesions
			Sacrococcygeal teratoma
			Congenital diaphragmatic hernia
			Twin–twin transfusion syndrome, twin anemia-polycythemia sequence
			Fetal obstructive uropathies and renal diseases
		Fetal molecular therapies
		Conclusion
		References
Index
Supplemental Images
EULA