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…
Key Points Hypertension is the most common medical complication during pregnancy. Preeclampsia is a leading cause of maternal mortality and morbidity worldwide. The pathophysiologic abnormalities of preeclampsia are numerous, but the etiology is unknown. At present, there is no proven…
Key Points PROM complicates about 8% to 10% of pregnancies and is a significant cause of gestational age–dependent and infectious perinatal morbidity and mortality. Latency from membrane rupture to delivery is typically brief and decreases with increasing gestational age at…
Key Points More than 70% of fetal, neonatal, and infant morbidity and mortality occurs in infants born preterm. The rate of PTB peaked in 2006 as the result of the increased use of assisted reproductive technology, ultrasound dating, and indicated…
Key Points Cervical insufficiency is primarily a clinical diagnosis characterized by recurrent painless dilatation and spontaneous midtrimester loss. Cervical insufficiency is rarely a distinct and well-defined clinical entity, but only one component of the larger and more complex spontaneous preterm…