Key Points Labor results in significant pain for many women that is individualized, dynamic, and unpredictable. Although the effects of obstetric analgesia and anesthesia on the fetus and neonate are typically benign, there is potential for adverse neonatal effects. During…
Key Points Cesarean section occurs in approximately one-third of all births in the United States, with substantial variation among hospitals that cannot be entirely accounted for by preexisting maternal or fetal comorbidities. Multidisciplinary team training can reduce infant morbidity after…
Key Points Fetal assessment demands a view into the somewhat inaccessible intrauterine environment; the primary tools are ultrasound and fetal heart rate monitoring. It is important to make the distinction between intrapartum (during labor) and antepartum (before labor) fetal assessment;…
Key Points Substance use remains at epidemic proportions, both nationally and globally. Increasing legalization of marijuana has resulted in new concerns for fetal and infant exposure, with limited understanding of the short- and long-term effects in this population. The recent…
Key Points Hypertensive disorders of pregnancy are classified as chronic hypertension, gestational hypertension, preeclampsia with and without severe features, and chronic hypertension with superimposed preeclampsia. Pharmacologic management of chronic hypertension should be reserved for women with sustained elevations in blood…
Key Points Diagnostic imaging carries a risk of fetal radiation exposure. However, in most cases the actual fetal dose is low. While x-ray and computed tomography imaging should be avoided during pregnancy if possible, these studies are not contraindicated if…
Key Points The incidence of diabetes in pregnancy is steadily rising, likely in parallel with the rising incidence of obesity among pregnant patients. Pregnant patients with diabetes are at increased risk for fetal complications (such as congenital malformations, fetal growth…
Key Points Nonimmune hydrops fetalis results from many etiologies. Management involves correcting the underlying cause. The condition is associated with significant morbidity and mortality. Some etiologies are amenable to treatment in utero. A newborn with hydrops has an abnormal accumulation…
Key Points Preterm birth, defined as birth prior to 37 weeks gestation, is the leading cause of under-five child mortality worldwide. Preterm birth can be spontaneous or medically indicated, in which cesarean delivery or induction of labor is performed to…
Key Points The multiple birth rate has increased by 76% in the past three decades; however, it has recently started to stabilize or even decline. Increased utilization of assisted reproductive technologies and women delaying childbearing are the main contributors to…