Evidence Based Obstetrics

PREPREGNANCY 1 PREPREGNANCY EDUCATION 1.1 Nutritional Preparation for Pregnancy 1.2 Exercise 1.3 Work 2 ORGANIZATION OF PRENATAL CARE 2.1 Organization of Prenatal Care and Identification of Risk 3 GENETIC COUNSELING 3.1 Genetic Counseling 4 SOCIODEMOGRAPHIC FACTORS 4.1 Pregnancy in Adolescence 4.2 Advanced Maternal Age and Pregnancy 4.3 Pregnancy in Women at the Extremes of Parity 4.4 Pregnancy in Women with Poor Socioeconomic Background 4.5 Pregnancy in Women from Different Ethnic Backgrounds 5 MATERNAL WEIGHT AND WEIGHT GAIN 5.1 Pregnancy in Underweight Women 5.2 Pregnancy in Overweight Women 5.3 Abnormal Weight Gain in Pregnancy EARLY PREGNANCY 6 BLEEDING IN EARLY PREGNANCY 6.1 Bleeding in Early Pregnancy 7 RECURRENT MISCARRIAGE 7.1 Recurrent Miscarriage 8 SCREENING FOR FETAL ABNORMALITY 8.1 Serum Alpha-Fetoprotein Screening for Neural Tube Defects 8.2 Serum Screening for Fetal Chromosomal Abnormality 8.3 The Routine Obstetric Ultrasound Scan 9 INVASIVE FETAL PROCEDURES 9.1 Chorion Villus Sampling and Placental Biopsy 9.2 Amniocentisis 9.3 Fetal Blood Sampling Before Labor 9.4 Fetal Tissue Biopsy 9.5 Selective Reduction of Pregnancy FETAL PROBLEMS 10 FETAL HEALTH 10.1 Assessing Fetal Health 11 FETAL GROWTH 11.1 Fetal Growth Restriction 12 ABNORMALITIES OF AMNIOTIC FLUID 12.1 Abnormalities of Amniotic Fluid 13 FETAL DEATH 13.1 Fetal Death 14 FETAL HYDROPS 14.1 Fetal Hydrops 15 FETAL HEMOLYTIC DISEASE 15.1 Fetal Hemolytic Disease 16 FETAL THROMBOCYTOPENIA 16.1 Fetal Thrombocytopenia 17 FETAL CARDIAC PROBLEMS 17.1 Fetal Arrhythmias 17.2 Cardiac Malformations 18 CRANIOSPINAL AND FACIAL ABNORMALITIES 18.1 Open Neural Tube Defects: Anencephaly, Cephalocele and Spina Bifida 18.2 Hydrocephalus 18.3 The Holoprosencephaly Sequence 18.4 Facial Clefts 18.5 Dandy-Walker Malformation 18.6 Aneurysm of the Vein of Galen 18.7 Hydranencephaly 18.8 Microcephaly 18.9 Agenesis of the Corpus Callosum 18.10 Intracranial Hemorrhage and Porencephaly 18.11 Choroid Plexus Cyst 18.12 Cystic Hygroma 18.13 Caudal Regression Syndrome 19 GENITOURINARY MALFORMATIONS 19.1 Gentourinary Malformations 20 GASTROINTESTINAL ABNORMALITIES 20.1 Omphalocele 20.2 Gastroschisis 20.3 Congenital Diaphragmatic Hernia 20.4 Esophageal Atresia (+/- Fistula) 20.5 Duodenal Atresia 20.6 Jejunoileal Atresia 20.7 Large bowel Obstruction, anal Atresia, Imperforate Anus 20.8 Meconium Ileus/Peritonitis 20.9 Intra-Abdominal Echolucent ('cystic') Structures 20.10 Echogenic Bowel and Liver 21 SKELETAL ABNORMALITIES 21.1 Skeletal Abnormalities 22 FETAL ENDOCRINOLOGY 22.1 Fetal Hyperthyroidism 22.2 Fetal Hypothyroidism 22.3 Congenital Adrenal Hyperplasia 23 FETAL TUMORS 23.1 Fetal Tumors INFECTION 24 INFECTION 24.1 Measles (Rubeola) 24.2 Rubella 24.3 Varicella-zoster Virus 24.4 Cytomegalovirus 24.5 Parvovirus B19 24.6 Herpes Simplex Virus (Genital) 24.7 Hepatitis B Virus 24.8 Human Immunodeficiency Virus 24.9 Listeriosis 24.10 Toxoplasmosis 24.11 Urinary Tract Infections 24.12 Intra-amniotic Infections (Chorioamnionitis) 24.13 Sexually Transmitted Diseases 24.14 Candidiasis 24.15 Group B Streptococcal Infection 24.16 Tuberculosis 24.17 Malaria 24.18 Lyme disease MATERNAL PROBLEMS 25 SMOKING AND DRUGS 25.1 Cigarette Smoking 25.2 Alcohol 25.3 Drug Abuse: General 25.4 Drug Abuse: Specific - heroin, cocaine, barbiturates etc. 25.5 Medication During Pregnancy 26 HYPERTENSION, PREECLAMPSIA AND ECLAMPSIA 26.1 Chronic hypertension 26.2 Preeclampsia 26.3 Severe/Acute Hypertension 26.4 Eclampsia 27 DIABETES 27.1 Diabetes 28 CARDIAC DISEASE 28.1 Cardiac disease: General 28.2 Cardiac disease: Specific 29 THYROID DISEASE 29.1 Hyperthyroidism 29.2 Hypothyroidism 29.3 Thyroid Nodule in Pregnancy 30 PITUITARY AND ADRENAL DISEASE 30.1 Pituitary Disorders 30.2 Adrenal Disease 31 HEMATOLOGICAL DISEASE 31.1 Iron- and Folate-Deficiency Anemia 31.2 Sickle-cell Anemia 31.3 Thrombocytopenia 31.4 Abnormalities in neutrophil count 31.5 Coagulation Disorders: Congenital 31.6 Coagulation Disorders: Acquired 31.7 Nonleukemic Myeloproliferative Disorders 31.8 Hematological Malignancies 32 RESPIRATORY DISEASE 32.1 Breathlessness 32.2 Asthma 32.3 Sarcoid 32.4 Tuberculosis 32.5 Kyphoscoliosis 32.6 Cystic Fibrosis (maternal) 32.7 Pneumonia 33 HEPATIC AND GASTROINTESTINAL DISEASE 33.1 Obstetric Cholestasis 33.2 Acute Fatty Liver of Pregnancy 33.3 Hyperemesis Gravidarum 33.4 The liver in severe Preeclampsia 33.5 Peptic Ulceration in Pregnancy 33.6 Celiac Disease in Pregnancy 33.7 Inflammatory Bowel Disease in Pregnancy 34 NEUROMUSCULAR DISEASE 34.1 Seizures 34.2 Cerebrovascular Disease 34.3 Headache 34.4 Mononeuropathies 34.5 Polyneuropathies 34.6 Myotonic Dystrophy 34.7 Multiple Sclerosis 34.8 Cerebral Tumors 34.9 Movement Disorders 34.10 Cerebral Abscess 35 RENAL DISEASE 35.1 Chronic Renal Insufficiency 35.2 Chronic Hemodialysis 35.3 Renal Transplantation 35.4 Acute Renal Failure 35.5 Nephrolithiasis 36 AUTOIMMUNE DISEASE 36.1 Systemic Lupus Erythematosus 36.2 Antiphospholipid Syndrome 36.3 Rheumatoid Arthritis 36.4 Systemic Sclerosis 36.5 Myasthenia Gravis 37 ORTHOPEDIC, BACK AND JOINT PROBLEMS 37.1 General Evaluation of Back and Pelvic Pain 37.2 Management of Back and Pelvic Pain during Pregnancy 37.3 Scoliosis 37.4 Pelvic Arthropathy 37.5 Rupture of the Pubic Symphysis 37.6 Hip Problems 38 THROMBOEMBOLIC DISEASE 38.1 Thromboembolic Disease 39 DERMATOLOGICAL PROBLEMS 39.1 Preexisting Skin Disorders 39.2 Pruritus in Pregnancy 39.3 Rashes in Pregnancy 40 BENIGN GYNECOLOGICAL DISEASE 40.1 Subfertility 40.2 Ovarian Cysts 40.3 Fibroids 40.4 Prolapse 40.5 Other Gynecological Diseases and Problems 41 MALIGNANT DISEASE (NONHEMATOLOGICAL) 41.1 Cervical Cancer 41.2 Ovarian Cancer 41.3 Other Gynecological Malignant Disease 41.4 Breast Cancer 41.5 Malignant Melanoma 41.6 Colorectal Carcinoma 41.7 Thyroid Cancer 42 TRAUMA 42.1 General Management Options 42.2 Blunt Trauma 42.3 Penetrating Trauma 42.4 Burns 42.5 Electrical Injury 42.6 Perimortem Cesarean Section 43 ABDOMINAL PAIN 43.1 Round Ligament Pain 43.2 Severe Uterine Torsion 43.3 Heartburn, Excess Vomiting and Constipation 43.4 Uterine Fibroids 43.5 Uterine Rupture 43.6 Torsion or Adnexa 43.7 Appendicitis 43.8 Intestinal Obstruction 43.9 Cholecystitis 43.10 Acute Pancreatitis 43.11 Abdominal Pregnancy LATE PREGNANCY 44 BLEEDING IN LATE PREGNANCY 44.1 Bleeding in Late Pregnancy 45 MULTIPLE PREGNANCY 45.1 Multiple Pregnancy: General problems 45.2 Multiple Pregnancy: Specific problems 46 PREMATURITY 46.1 Threatened and Actual Preterm Labor 46.2 Premature Rupture of the Membranes LABOR AND DELIVERY 47 LABOR AMD DELIVERY PROBLEMS 47.1 Breech Presentation 47.2 Unstable Lie 47.3 Prolonged Pregnancy 47.4 Induction of Labor and Termination for Fetal Abnormality 47.5 Poor progress in Labor 47.6 Fetal Distress in Labor 47.7 Pain During Parturition 47.8 Assisted Vaginal Delivery 47.9 Previous Cesarean Section 47.10 Cesarean Section POSTNATAL 48 POSTNATAL PROBLEMS 48.1 Postpartum Hemorrhage 48.2 Other Problems of the Third Stage 48.3 Resuscitation and Immediate Care of the Newborn 48.4 Counseling about Neonatal Problems 48.5 Puerperal Problems 48.6 Postnatal Contraception and Sterilization PREPREGNANCY 1 PREPREGNANCY EDUCATION 1.1 Nutritional Preparation for Pregnancy 1.2 Exercise 1.3 Work 2 ORGANIZATION OF PRENATAL CARE 2.1 Organization of Prenatal Care and Identification of Risk 3 GENETIC COUNSELING 3.1 Genetic Counseling 4 SOCIODEMOGRAPHIC FACTORS 4.1 Pregnancy in Adolescence 4.2 Advanced Maternal Age and Pregnancy 4.3 Pregnancy in Women at the Extremes of Parity 4.4 Pregnancy in Women with Poor Socioeconomic Background 4.5 Pregnancy in Women from Different Ethnic Backgrounds 5 MATERNAL WEIGHT AND WEIGHT GAIN 5.1 Pregnancy in Underweight Women 5.2 Pregnancy in Overweight Women 5.3 Abnormal Weight Gain in Pregnancy EARLY PREGNANCY 6 BLEEDING IN EARLY PREGNANCY 6.1 Bleeding in Early Pregnancy 7 RECURRENT MISCARRIAGE 7.1 Recurrent Miscarriage 8 SCREENING FOR FETAL ABNORMALITY 8.1 Serum Alpha-Fetoprotein Screening for Neural Tube Defects 8.2 Serum Screening for Fetal Chromosomal Abnormality 8.3 The Routine Obstetric Ultrasound Scan 9 INVASIVE FETAL PROCEDURES 9.1 Chorion Villus Sampling and Placental Biopsy 9.2 Amniocentisis 9.3 Fetal Blood Sampling Before Labor 9.4 Fetal Tissue Biopsy 9.5 Selective Reduction of Pregnancy FETAL PROBLEMS 10 FETAL HEALTH 10.1 Assessing Fetal Health 11 FETAL GROWTH 11.1 Fetal Growth Restriction 12 ABNORMALITIES OF AMNIOTIC FLUID 12.1 Abnormalities of Amniotic Fluid 13 FETAL DEATH 13.1 Fetal Death 14 FETAL HYDROPS 14.1 Fetal Hydrops 15 FETAL HEMOLYTIC DISEASE 15.1 Fetal Hemolytic Disease 16 FETAL THROMBOCYTOPENIA 16.1 Fetal Thrombocytopenia 17 FETAL CARDIAC PROBLEMS 17.1 Fetal Arrhythmias 17.2 Cardiac Malformations 18 CRANIOSPINAL AND FACIAL ABNORMALITIES 18.1 Open Neural Tube Defects: Anencephaly, Cephalocele and Spina Bifida 18.2 Hydrocephalus 18.3 The Holoprosencephaly Sequence 18.4 Facial Clefts 18.5 Dandy-Walker Malformation 18.6 Aneurysm of the Vein of Galen 18.7 Hydranencephaly 18.8 Microcephaly 18.9 Agenesis of the Corpus Callosum 18.10 Intracranial Hemorrhage and Porencephaly 18.11 Choroid Plexus Cyst 18.12 Cystic Hygroma 18.13 Caudal Regression Syndrome 19 GENITOURINARY MALFORMATIONS 19.1 Gentourinary Malformations 20 GASTROINTESTINAL ABNORMALITIES 20.1 Omphalocele 20.2 Gastroschisis 20.3 Congenital Diaphragmatic Hernia 20.4 Esophageal Atresia (+/- Fistula) 20.5 Duodenal Atresia 20.6 Jejunoileal Atresia 20.7 Large bowel Obstruction, anal Atresia, Imperforate Anus 20.8 Meconium Ileus/Peritonitis 20.9 Intra-Abdominal Echolucent ('cystic') Structures 20.10 Echogenic Bowel and Liver 21 SKELETAL ABNORMALITIES 21.1 Skeletal Abnormalities 22 FETAL ENDOCRINOLOGY 22.1 Fetal Hyperthyroidism 22.2 Fetal Hypothyroidism 22.3 Congenital Adrenal Hyperplasia 23 FETAL TUMORS 23.1 Fetal Tumors INFECTION 24 INFECTION 24.1 Measles (Rubeola) 24.2 Rubella 24.3 Varicella-zoster Virus 24.4 Cytomegalovirus 24.5 Parvovirus B19 24.6 Herpes Simplex Virus (Genital) 24.7 Hepatitis B Virus 24.8 Human Immunodeficiency Virus 24.9 Listeriosis 24.10 Toxoplasmosis 24.11 Urinary Tract Infections 24.12 Intra-amniotic Infections (Chorioamnionitis) 24.13 Sexually Transmitted Diseases 24.14 Candidiasis 24.15 Group B Streptococcal Infection 24.16 Tuberculosis 24.17 Malaria 24.18 Lyme disease MATERNAL PROBLEMS 25 SMOKING AND DRUGS 25.1 Cigarette Smoking 25.2 Alcohol 25.3 Drug Abuse: General 25.4 Drug Abuse: Specific - heroin, cocaine, barbiturates etc. 25.5 Medication During Pregnancy 26 HYPERTENSION, PREECLAMPSIA AND ECLAMPSIA 26.1 Chronic hypertension 26.2 Preeclampsia 26.3 Severe/Acute Hypertension 26.4 Eclampsia 27 DIABETES 27.1 Diabetes 28 CARDIAC DISEASE 28.1 Cardiac disease: General 28.2 Cardiac disease: Specific 29 THYROID DISEASE 29.1 Hyperthyroidism 29.2 Hypothyroidism 29.3 Thyroid Nodule in Pregnancy 30 PITUITARY AND ADRENAL DISEASE 30.1 Pituitary Disorders 30.2 Adrenal Disease 31 HEMATOLOGICAL DISEASE 31.1 Iron- and Folate-Deficiency Anemia 31.2 Sickle-cell Anemia 31.3 Thrombocytopenia 31.4 Abnormalities in neutrophil count 31.5 Coagulation Disorders: Congenital 31.6 Coagulation Disorders: Acquired 31.7 Nonleukemic Myeloproliferative Disorders 31.8 Hematological Malignancies 32 RESPIRATORY DISEASE 32.1 Breathlessness 32.2 Asthma 32.3 Sarcoid 32.4 Tuberculosis 32.5 Kyphoscoliosis 32.6 Cystic Fibrosis (maternal) 32.7 Pneumonia 33 HEPATIC AND GASTROINTESTINAL DISEASE 33.1 Obstetric Cholestasis 33.2 Acute Fatty Liver of Pregnancy 33.3 Hyperemesis Gravidarum 33.4 The liver in severe Preeclampsia 33.5 Peptic Ulceration in Pregnancy 33.6 Celiac Disease in Pregnancy 33.7 Inflammatory Bowel Disease in Pregnancy 34 NEUROMUSCULAR DISEASE 34.1 Seizures 34.2 Cerebrovascular Disease 34.3 Headache 34.4 Mononeuropathies 34.5 Polyneuropathies 34.6 Myotonic Dystrophy 34.7 Multiple Sclerosis 34.8 Cerebral Tumors 34.9 Movement Disorders 34.10 Cerebral Abscess 35 RENAL DISEASE 35.1 Chronic Renal Insufficiency 35.2 Chronic Hemodialysis 35.3 Renal Transplantation 35.4 Acute Renal Failure 35.5 Nephrolithiasis 36 AUTOIMMUNE DISEASE 36.1 Systemic Lupus Erythematosus 36.2 Antiphospholipid Syndrome 36.3 Rheumatoid Arthritis 36.4 Systemic Sclerosis 36.5 Myasthenia Gravis 37 ORTHOPEDIC, BACK AND JOINT PROBLEMS 37.1 General Evaluation of Back and Pelvic Pain 37.2 Management of Back and Pelvic Pain during Pregnancy 37.3 Scoliosis 37.4 Pelvic Arthropathy 37.5 Rupture of the Pubic Symphysis 37.6 Hip Problems 38 THROMBOEMBOLIC DISEASE 38.1 Thromboembolic Disease 39 DERMATOLOGICAL PROBLEMS 39.1 Preexisting Skin Disorders 39.2 Pruritus in Pregnancy 39.3 Rashes in Pregnancy 40 BENIGN GYNECOLOGICAL DISEASE 40.1 Subfertility 40.2 Ovarian Cysts 40.3 Fibroids 40.4 Prolapse 40.5 Other Gynecological Diseases and Problems 41 MALIGNANT DISEASE (NONHEMATOLOGICAL) 41.1 Cervical Cancer 41.2 Ovarian Cancer 41.3 Other Gynecological Malignant Disease 41.4 Breast Cancer 41.5 Malignant Melanoma 41.6 Colorectal Carcinoma 41.7 Thyroid Cancer 42 TRAUMA 42.1 General Management Options 42.2 Blunt Trauma 42.3 Penetrating Trauma 42.4 Burns 42.5 Electrical Injury 42.6 Perimortem Cesarean Section 43 ABDOMINAL PAIN 43.1 Round Ligament Pain 43.2 Severe Uterine Torsion 43.3 Heartburn, Excess Vomiting and Constipation 43.4 Uterine Fibroids 43.5 Uterine Rupture 43.6 Torsion or Adnexa 43.7 Appendicitis 43.8 Intestinal Obstruction 43.9 Cholecystitis 43.10 Acute Pancreatitis 43.11 Abdominal Pregnancy LATE PREGNANCY 44 BLEEDING IN LATE PREGNANCY 44.1 Bleeding in Late Pregnancy 45 MULTIPLE PREGNANCY 45.1 Multiple Pregnancy: General problems 45.2 Multiple Pregnancy: Specific problems 46 PREMATURITY 46.1 Threatened and Actual Preterm Labor 46.2 Premature Rupture of the Membranes LABOR AND DELIVERY 47 LABOR AMD DELIVERY PROBLEMS 47.1 Breech Presentation 47.2 Unstable Lie 47.3 Prolonged Pregnancy 47.4 Induction of Labor and Termination for Fetal Abnormality 47.5 Poor progress in Labor 47.6 Fetal Distress in Labor 47.7 Pain During Parturition 47.8 Assisted Vaginal Delivery 47.9 Previous Cesarean Section 47.10 Cesarean Section POSTNATAL 48 POSTNATAL PROBLEMS 48.1 Postpartum Hemorrhage 48.2 Other Problems of the Third Stage 48.3 Resuscitation and Immediate Care of the Newborn 48.4 Counseling about Neonatal Problems 48.5 Puerperal Problems 48.6 Postnatal Contraception and Sterilization