Key Points Behavioral modification of diet or diet plus exercise can decrease excessive gestational weight gain in obese women. Weight gain in pregnancy should be based on pregravid BMI and should follow the Institute of Medicine recommendations. Obese women should…
Key Points Pregnancy has been characterized as a diabetogenic state because of increased postprandial glucose levels in late gestation. Both hepatic and peripheral (tissue) insulin sensitivity are reduced in normal pregnancy. As a result, a progressive increase in insulin secretion…
Key Points Asymptomatic bacteriuria complicates 5% to 7% of pregnancies. If left untreated, it will result in symptomatic urinary tract infections in 40% of women. Pyelonephritis complicates 1% to 2% of pregnancies and generally requires inpatient treatment. Women with glomerular…
Key Points Pneumonia is the most common nonobstetric infectious cause of maternal mortality, and more than 40% of pneumonia cases are complicated by preterm delivery. Streptococcus pneumoniae is the most common bacterial pathogen associated with pneumonia during pregnancy. To treat…
Key Points Hemodynamic changes in pregnancy may adversely affect maternal cardiac performance. Intercurrent events (e.g., infection) in pregnancy are usually the cause of decompensation. Women with heart disease in pregnancy frequently have unique psychosocial needs. Labor, delivery, and postpartum are…
Key Points Ultrasonography, preferably done in the first trimester, is the most accurate method with which to establish the EDD. No gestational cutoff has been established by which to define a prolonged pregnancy in multiple gestations. The risk for stillbirth…
Key Points AF is dynamic, with large volume flows into and out of the amniotic compartment each day. Clinical estimates of actual AFV based on ultrasound measurements of the AFI or MVP are not accurate in predicting true volume. In…
Key Points Alloimmunization to the RhD, Kell (K1), and Rhc red cell antigens is the main cause of HDFN. Despite the widespread use of rhesus immune globulin (RhIG), approximately six cases of RhD alloimmunization occur annually per 1000 live births…
Key Points Although the terms intrauterine growth restriction (IUGR), fetal growth restriction (FGR), and small for gestational age (SGA) are used interchangeably, IUGR and FGR identify pathologically small fetuses, whereas SGA indicates a fetus below a specific cutoff without designation…
Key Points Twinning is one of the most common high-risk conditions in all of obstetrics with a reported rate of 33.1 per 1000 births in 2012. Both maternal and perinatal morbidity and mortality are significantly higher in multifetal gestations than…