Obstetrics: Evidence-Based Algorithms

Clinical research has produced a continuous stream of evidence-based guidelines to guide practice in obstetrics. The guidelines are often widely scattered: this book brings together the essential guidelines in one comprehensive resource. The primary focus is on the Royal College of Obstetricians and Gynaecologists and other UK national guidelines; however, many chapters contain a 'Guideline Comparator' box carrying information from important international guidelines. Where there are no UK guidelines, information based on international guidelines is provided; where any guidelines do not exist, available evidence and accepted norms of practice based on expert opinion are detailed. Several chapters also contain a 'what not to do' box, which should act as a source of rich debate. To assist those studying for postgraduate examinations - such as MRCOG - the information is presented in schematic flowcharts, representing a step-by-step method of approaching clinical problems and providing an easy-to-use learning resource. An ideal resource for postgraduate examination preparation Information is presented in step-by-step flowcharts to aid problem solving Several chapters include a 'what not to do' section List of abbreviations Part I. Fetal Conditions: 1. Prenatal screening for aneuploidy and neural tube defects 2. Routine fetal ultrasound screening 3. Amniocenteses and chorionic villus sampling 4. Non immune fetal hydrops 5. Late intrauterine fetal death and stillbirth 6. Fetal haemolytic disease 7. Anti-D immunoglobulin for rhesus D prophylaxis 8. Small for gestational age babies (SGA) 9. Reduced fetal movements (RFM) 10. Multiple pregnancy – twin pregnancy 11. Amniotic fluid abnormalities Part II. Infections in Pregnancy: 12. Human immunodeficiency virus 13. Hepatitis 14. Group B streptococcal disease in pregnancy 15. Viral rash in pregnancy 16. Genital herpes in pregnancy 17. Rubella infection in pregnancy 18. CMV infection in pregnancy 19. Toxoplasmosis in pregnancy 20. Parvo-virus infection in pregnancy 21. Chicken pox in pregnancy 22. Measles in pregnancy 23. Malaria in pregnancy 24. Bacterial sepsis in pregnancy Part III. Antenatal Care: 25. Antenatal care 26. Pregnancy induced hypertension (PIH) or gestational HT 27. Pre-eclampsia (PET) and eclampsia 28. Obstetric cholestasis (OC) 29. Gestational diabetes mellitus (GDM) 30. Antepartum haemorrhage (APH) 31. Preterm prelabour rupture of membranes (PPROM) 32. Preterm labour (PTL) 33. Preterm labour – tocolysis and antenatal corticosteroids Part IV. Maternal Medicine: 34. Chronic hypertension 35. Pregnancy in pre-existing type 1 or type 2 diabetes mellitus 36. Cardiac disease and pregnancy 37. Thyroid disorders in pregnancy 38. Renal condition in pregnancy 39. Iron deficiency anaemia in pregnancy 40. Epilepsy in pregnancy 41. Haemoglobinopathies – sickle cell disease in pregnancy 42. Haemoglobinopathies – beta thalassemia in pregnancy 43. Prevention and treatment of thrombosis and embolism during pregnancy and the puerperium 44. Pruritis in pregnancy 45. Antenatal and postnatal mental health Part V. Labour and Delivery: 46. Breech presentation 47. Caesarean section (CS) 48. Induction of labour (IOL) 49. Intra partum care 50. Operative vaginal delivery (OVD) 51. Vaginal birth after previous caesarean section (VBAC) 52. Management of third, and fourth-degree, perineal tears Part VI. Obstetric Emergencies: 53. Shoulder dystocia 54. Prevention and management of postpartum haemorrhage (PPH) 55. Blood transfusion (BT) in obstetrics 56. Maternal collapse in pregnancy and the puerperium 57. Umbilical cord prolapse 58. Neonatal resuscitation Part VII. Postnatal Care: 59. Postnatal care 60. Bacterial sepsis following pregnancy Part VIII. Miscellaneous: 61. Obesity in pregnancy 62. Alcohol consumption in pregnancy 63. Smoking in pregnancy 64. Teenage pregnancy 65. Reproductive ageing 66. Air travel in pregnancy 67. Women with breast cancer in pregnancy 68. Complex social issues and pregnancy Index.