Acknowledgment This chapter is based on a similar chapter by Richard H. Lee, MD, Raymond T. Chung, MD, and Patricia Pringle, MD in the eighth edition. Liver Function in Normal Pregnancy Normal pregnancy often elevates the liver superiorly, particularly as…
Anatomic and physiologic alterations of the gastrointestinal tract result in significant maternal symptoms that are experienced even in uncomplicated gestations. Difficulty arises in differentiating normal pregnancy complaints from those associated with pathology. The workup of suspected gastrointestinal disease is hampered…
Acknowledgments We gratefully acknowledge the contributions in this chapter of Dr. Dalal Al-Ali and Dr. Karel Dandurand, fellows in Metabolic Bone Disease at McMaster University. Hypothalamic-Pituitary Disorders Hypothalamic-pituitary disorders present in one or more of the following ways: an incidental…
Thyroid disorders are among the most common endocrinopathies in women of childbearing age, yet diagnosis and management are often confusing during pregnancy. In large areas of the world, iodine deficiency is the predominant cause of these disorders affecting both maternal…
Acknowledgment The authors would like to acknowledge Dr. Thomas Kelly, MD, for his work on the previous edition of this chapter. Epidemiology Since the 1960s a stunning increase in obesity has plagued the United States. Overall rates of overweight and…
Global Prevalence of Diabetes An epidemic of diabetes continues to sweep the globe in parallel with an epidemic of obesity. In 2019 it was estimated that there were 463 million people with diabetes worldwide, over 4 million deaths attributable to…
Proper functioning of the cardiorespiratory system is imperative to achieve adequate oxygenation of maternal and fetal tissues. The maternal cardiorespiratory system undergoes significant changes during gestation to optimize oxygen delivery to the fetus and maternal tissues. Pulmonary disease is one…
Pregnancy induces many changes to both renal function and physiology. Physiologic adaptations to the renal system that occur in normal pregnancy are the subject of Chapter 9 . The focus of this chapter is to describe the effects of various…
Overview of Cancer in Pregnancy It is estimated that 1 in 1000 pregnancies are complicated by a diagnosis of cancer. Approximately 30% of pregnancy-associated cancers are diagnosed antepartum, with the remainder diagnosed in the postpartum period. Of women with cancer…
Anemia is defined as a hemoglobin (Hb) value less than the lower limit of normal not explained by the state of hydration. This definition has physiologic validity, in that it is the amount of Hb per unit volume of blood…