An estimated 1% to 3% (40,000 to 120,000) of pregnant women require critical care services in the United States each year. Most admissions are related to hemorrhage, hypertension, or cardiac disease. , When a woman requires any of the following…
The physical and hormonal alterations induced by pregnancy, childbirth, and the puerperium are associated with numerous cutaneous changes. Some occur so frequently that they are not considered abnormal and vary only in degree. This chapter discusses these physiologic changes, the…
Substance use, substance misuse, and substance use disorder (SUD) or addiction are among the most complex clinical and public health challenges that affect individuals, families, and society. Most people in the United States have used a substance, but only some…
Epidemiology Approximately one in five women experiences a major depressive episode (MDE) over the course of her lifetime. Chronic psychotic disorders are less common, affecting about 1% of women. The risk for developing any type of depressive, bipolar, or chronic…
Women are as susceptible to neurologic disorders during gestation as at other times, and certain disorders may be aggravated or influenced by pregnancy. Investigation and management of many neurologic disorders may be complicated by the pregnancy and by concern about…
Systemic Lupus Erythematosus Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with multiorgan involvement characterized by periods of remission and relapse. The clinical presentation varies considerably, but the disease tends to affect the joints, skin, kidneys, serous membranes, hematologic…
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…