Key Points About 50% to 70% of conceptions are lost, most in the first trimester. Losses in preimplantation embryos are especially high: 25% to 50% of morphologically normal and 50% to 75% of morphologically abnormal embryos. Sporadic pregnancy loss is…
Key Points Maternal trauma is the most frequent cause of nonobstetric maternal death. In cases of significant trauma, such as motor vehicle accidents, maternal stabilization and evaluation in the emergency department should occur prior to transfer to labor and delivery.…
Key Points Care of the pregnant surgical patient requires a multidisciplinary approach with an understanding of the physiologic changes that accompany normal pregnancy. Expansion of maternal blood volume during pregnancy may mask signs of maternal hemorrhage, and clinically significant blood…
Key Points The WHO, the U.S. Surgeon General, the American Academy of Pediatrics, the American Academy of Family Practice, ACOG, and the Academy of Breastfeeding Medicine endorse breastfeeding as the gold standard for infant feeding. Breastfeeding accrues many health benefits…
Key Points By 6 weeks postpartum, only 28% of women have returned to their prepregnant weight. About 50% of parturients experience diminished sexual desire during the 3 months that follow delivery. Postpartum uterine bleeding of sufficient quantity to require medical…
Key Points Surfactant maintains lung expansion on expiration by lowering surface tension at the air-liquid interface in the alveolus. Antenatal corticosteroids accelerate fetal lung maturation and decrease neonatal mortality and RDS in preterm infants. In addition, corticosteroids are associated with…
Key Points Prior CD is the most important factor associated with PA, and the risk of PA increases with the number of prior CDs. Suspected PA on prenatal imaging allows planned management of the condition and has been associated with…
Key Points VBAC rates have plummeted from a peak of approximately 30% in 1996 to 5% in 2010. Two-thirds of women with a prior low transverse CD are candidates for TOLAC and should be counseled about and offered this option.…
Key Points In 1970, the CD rate was about 5%. By 2008, it had reached 32.8%, the highest rate ever recorded in the United States. The rates of vaginal births after cesarean delivery have plummeted, from a peak of 28.3%…
Key Points Understanding the hemodynamic changes of pregnancy and the physiologic responses that occur with hemorrhage assists in appropriate management. Clinicians should recognize the four classes of hemorrhage to allow for rapid intervention. Placental abruption is diagnosed primarily by clinical…