9781119318347

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Prenatal and Postnatal Care

The second edition of the comprehensive and award-winning text on prenatal and postnatal care

The updated edition of Prenatal and Postnatal Care offers a comprehensive text for the care of the woman during the childbearing year. The expert author team presents information needed to master foundational knowledge in anatomy, physiology, psychology, culture, the structure of preconception, prenatal and postnatal care, as well as the management of common health problems.

This edition has been revised throughout and contains six new chapters on the following topics: prenatal ultrasound, triage of the pregnant woman, assisting women to develop confidence for physiologic birth, pregnancy after infertility, oral health, and issues around diversity and inclusion in prenatal and postnatal care. Additional highlights include new and updated content on pregnant women in the workplace, prenatal genetic testing, trauma-informed care, and transgender pregnancy care. The second edition also includes commonly used complementary therapies and offers more detailed information on shared decision-making and planning for birth.

Prenatal and Postnatal Care:

Provides expanded faculty resources with case studies and test questions for each chapter
Offers a comprehensive text that covers essential aspects of prenatal and postnatal care of the childbearing woman
Builds on the edition that won the Book of the Year award from the American College of Nurse Midwives (ACNM) in 2015.

This revised, authoritative text is an ideal resource for midwifery, nurse practitioner and physician assistant students, and healthcare providers working with pregnant and postpartum women.

About the Editors
The three editors are professionally active with many years of experience in midwifery and women's health clinical practice, education, and scholarship.
Robin G. Jordan, PhD, CNM, FACNM is a certified nurse-midwife and midwifery educator. She is currently Adjunct Faculty in the Nurse-Midwifery/WHNP programs at Georgetown University. She is engaged in local and national political advocacy with a special focus on women's health and health policy.

Cindy L. Farley, PhD, CNM, FACNM is a certified nurse-midwife and midwifery educator. She is currently a full time Associate Professor in the Nurse-Midwifery/WHNP programs at Georgetown University. She serves as a locum tenens midwife to two midwifery practices caring for Amish women in Ohio.

Karen Trister Grace, PhD(c), MSN, CNM is a certified nurse-midwife and midwifery educator. She is currently Adjunct Faculty in the Nurse-Midwifery/WHNP programs at Georgetown University. She is engaged in doctoral studies at the Johns Hopkins University School of Nursing with a research focus in reproductive coercion.

About the Editors xxi

Contributors xxiii

Preface xxvii

About the Companion Website xxix

Part I Physiological Foundations of Prenatal and Postnatal Care 3

1 Reproductive Tract Structure and Function 5
Patricia W. Caudle

Anatomy of the Female Reproductive System 6

Menstrual Cycle Physiology 11

Resources for Women 17

Resources for Healthcare Providers 17

References 17

2 Conception, Implantation, and Embryonic and Fetal Development 19
Patricia W. Caudle

Introduction 20

Conception and Implantation 20

The Placenta 21

The Embryo 25

The Fetus 30

Summary 31

Resources for Healthcare Providers 31

Resources for Women, Their Families, and Healthcare Providers 32

References 32

3 Maternal Physiological Alterations during Pregnancy 33
Patricia W. Caudle

Introduction 33

Hematologic System Adaptations 33

Cardiovascular System Adaptations 35

Respiratory System Adaptations 37

Renal System Adaptations 38

Gastrointestinal System Adaptations 38

Metabolic System Adaptations 39

Immune System Adaptations 42

Neurological System and Sensory Adaptations 44

Musculoskeletal System Adaptations 44

Endocrine System Adaptations 45

Summary 46

Resources for Women and Their Families 46

Resources for Healthcare Providers 46

References 46

4 Physiological Alterations during the Postnatal Period 49
Kaitlin Wilson and Cindy L. Farley

Introduction 49

Uterus 49

Lochia 50

Cervix 51

Vagina 51

Labia and Perineum 51

Rectal Anatomy 52

Additional Maternal Alterations during the Postpartum Period 52

Summary 55

Resource for Women 55

Resource for Healthcare Providers 55

References 55

Part II Preconception, Prenatal Care, and Postnatal Care 57

5 Preconception Care 59
Cynthia Nypaver

Introduction 59

Challenges to Providing Preconception Care 59

Benefits of Preconception Health Care 60

Evidence Supporting Preconception Health Care 60

Preconception Care 61

Risk Assessment and Screening 61

Preconception Health Care for Women with Chronic Illnesses 67

Unique Considerations 74

Summary 76

Resources for Women and Their Families 76

Resources for Healthcare Providers 77

References 77

6 Prenatal Care: Goals, Structure, and Components 81
Carrie S. Klima

Introduction 82

A Brief History of Prenatal Care 82

Current Goals of Prenatal Care 83

Structure of Prenatal Care 85

Group Prenatal Care: CenteringPregnancy 88

Components of Prenatal Care 89

Preventative Care 95

Health Promotion and Education 96

Summary 99

Resources for Women and Their Families 100

Resources for Healthcare Providers 100

References 100

7 Nutrition during Pregnancy 103
Robin G. Jordan

Introduction 104

Understanding Food Units and Recommendations 104

Prenatal Nutrition and Health Outcomes 104

Nutritional Needs in Pregnancy 106

Food Safety during Pregnancy 113

Factors Influencing Nutritional Intake 116

Making a Nutritional Assessment 117

Using Nutrition Resources 118

Counseling for Optimal Prenatal Nutrition 121

Special Issues in Prenatal Nutrition 121

Summary 126

Resources for Women and Their Families 126

Resources for Healthcare Providers 126

References 126

8 Pregnancy Diagnosis and Gestational Age Assessment 131
Janet L. Engstrom and Joyce D. Cappiello

Introduction 132

Benefits of Early Pregnancy Diagnosis and Gestational Age Assessment 132

Pregnancy Diagnosis 132

Gestational Age Assessment 138

Counseling for Pregnancy Diagnosis 146

Summary 150

Resources for Women and Their Families 151

Resources for Healthcare Providers 151

References 151

9 Risk Assessment during Pregnancy 155
Robin G. Jordan

Introduction 155

Process and Purpose of Risk Assessment 155

Benefits of Risk Assessment 156

Limitations of Risk Assessment 156

Disadvantages of Risk Assessment and Risk Management 156

Labeling Women as High Risk 157

Misapplication of Risk Assessment and Risk Management 157

Perspective of Risk and Risk Assessment 159

Explaining Risk to Women 160

Informed Consent 162

Summary 163

Resources for Healthcare Providers and Women and Their Families 163

References 163

10 Prenatal Ultrasound 167
Cynthia Parke and Robin G. Jordan

Introduction 168

The Physics and Mechanics of Ultrasound 168

Types of Scans 169

Use of Prenatal Ultrasound 170

Interpreting and Communicating Results 174

The Woman’s Experience of Ultrasound 175

Safety 176

Overuse of Ultrasound 177

Recreational Prenatal Ultrasound 177

Who Performs Prenatal Ultrasounds 178

Adding Ultrasound to Scope of Practice 178

Resources for Women and Their Families 178

Resources for Healthcare Providers 178

References 178

11 Genetic Counseling, Screening, and Diagnosis 181
Robin G. Jordan

Introduction 182

Family History and Risk Evaluation 182

Genetic Screening Tests 182

Screening for Neural Tube Defects 183

Screening for Aneuploidy 183

Genetic Screening by Ultrasound 186

Carrier Screening 187

Diagnostic Prenatal Genetic Testing 189

The Role of Genetic Counselors 190

Psychosocial Considerations in Genetic Testing 190

Genetic Testing Counseling during Prenatal Care 191

Summary 193

Resources for Women, Their Families, and Healthcare Providers 193

References 194

12 Assessment of Fetal Well‐Being 197
Jenifer Fahey

Introduction 197

Physiologic Principles 198

Indications 199

Interprofessional Care 199

Fetal Testing Methods 200

Education and Counseling 210

Cultural, Personal, and Family Considerations 211

Health Disparities and Vulnerable Populations 211

Legal and Liability Issues 211

Summary 212

Resource for Healthcare Providers 213

References 213

13 Common Discomforts of Pregnancy 215
Robin G. Jordan

Introduction 215

Back Pain and Pelvic Girdle Pain 216

Bleeding Gums 218

Breast Tenderness 219

Carpal Tunnel Syndrome (CTS) 220

Cervical Pain 220

Constipation 220

Dizziness/Syncope 222

Edema 222

Emotional Changes 223

Fatigue 223

Flatulence 224

Headache 225

Heartburn 225

Heart Palpitations 226

Hemorrhoids 227

Increased Warmth and Perspiration 227

Leukorrhea 227

Leg Cramps 228

Nasal Congestion 228

Epistaxis 229

Nausea and Vomiting of Pregnancy (NVP) 230

Ptyalism 233

Restless Leg Syndrome (RLS) 233

Round Ligament Pain 234

Shortness of Breath 235

Skin, Hair, and Nail Changes 235

Hyperpigmentation 236

Vascular Changes 237

Hair and Nail Changes 237

Sleep Disturbances 238

Supine Hypotension Syndrome (SHS) 239

Urinary Frequency and Nocturia 240

Urinary Incontinence 240

Varicosities (Legs/Vulva) 241

Vision Changes 243

Resources for Women and Their Families 243

References 243

14 Oral Health 247
Julia Lange Kessler

Introduction 247

Anatomy of the Oral Cavity 247

Initial Assessment of the Oral Cavity 248

Influence of Oral Health on Pregnancy Outcomes 249

Conditions Affecting Oral Health 250

Postpartum and Newborn Oral Health 251

Summary 251

Resources for Women and Their Families 251

Resources for Healthcare Providers 251

References 251

15 Medication Use during Pregnancy 253
Mary C. Brucker and Tekoa L. King

Introduction 254

Types of Pharmaceutical Agents 254

Prescriptive Authority 254

Governmental Oversight of Pharmaceutical Agents 254

Pre‐Marketing Drug Testing 255

The Prescription: Essential Components 256

Pharmacokinetics in Pregnancy 261

Common Medications Used During Pregnancy 261

Vaccines during Pregnancy 261

Rational Use of Drugs in Pregnancy 261

Summary 264

Resources for Healthcare Providers 267

Resources for Women and Their Families 267

References 267

16 Substance Use during Pregnancy 271
Daisy J. Goodman, Kelley A. Bowden,and Alane B. O’Connor

Introduction 271

Prevalence of Prenatal Substance Use 272

Terminology 272

Historical Approaches to Prenatal Substance Use 273

Harm Reduction Approaches to Prenatal Substance Use 274

Common Comorbid Conditions 275

Prenatal Screening 275

Treatment Types 278

Commonly Used Substances, Pregnancy Implications, and Recommended Treatment 279

Perinatal Care of Women with Substance Use Disorders 285

Summary 290

Resources for Healthcare Providers 291

References 291

17 Health Disparities and Social Issues in Pregnancy 297
Nena R. Harris

Introduction 297

Poverty 298

Incarceration during Pregnancy 300

Intimate Partner Violence during Pregnancy 302

Reproductive Coercion 303

Human Trafficking 303

Pregnancy and a History of Childhood Sexual Abuse 305

Summary 307

Resources for Healthcare Providers 307

Resources for Women and Their Families 308

References 308

18 Diversity and Inclusiveness in the Childbearing Year 313
Cindy L. Farley and Michal J. Wright

Introduction 314

Inequities in Perinatal Care and Outcomes 314

Contributors to Perinatal Health Disparities 314

Developing Cultural Competence 316

Communication 317

Selected Cultural Traditions in the Childbearing Year 317

Summary 320

Resources for Healthcare Providers 320

Resources for Women 320

References 320

19 Exercise, and Sexual, Occupational, and Environmental Health in Pregnancy 323
Meghan Garland

Introduction 323

Exercise 323

Environmental Exposures 329

Sexuality 333

The Workplace and Pregnancy 335

Resources on Pregnancy and Environmental Exposure for Women 337

Resources on Pregnancy and Environmental Exposure for Healthcare Providers 337

Resource on Work during Pregnancy for Women 338

References 338

20 Psychosocial Adaptations in Pregnancy 341
Cindy L. Farley, Eva M. Fried, and Amy R. Chavez

Introduction 342

Developing Relationship: A Trauma‐Informed Approach 342

Maternal‐Newborn Attachment and Adaptation 343

Maternal Role Development 346

Body Image 352

Sibling Preparation 354

Partner Adaptation and Attachment 354

Pregnancy in Transgender Men 358

Summary 359

Resources for Women and Their Families 359

Resources for Healthcare Providers 359

References 359

21 Health Education during Pregnancy 363
Lisa Hanson, Karen Robinson, Leona VandeVusse, and Kathryn Harrod

Introduction 363

Sources and Quality of Consumer Childbirth Education 363

Prenatal Visit Approach to Individual Childbirth Education 365

Class Education and Group Prenatal Care 366

Developmental Considerations 366

Issues Integral to Prenatal Education 367

Summary 369

Resources for Women and Their Families (Government Websites) 373

Resources for Women and Their Families (Nongovernment Websites) 373

References 373

22 Preparing for Birth 375
Melissa D. Avery, Carrie E. Neerland, and Melissa A. Saftner

Introduction 375

What Is Physiologic Birth? 375

Benefits of Physiologic Birth 376

Fear of Childbirth 376

Maternal Confidence for Physiologic Birth 376

Evidence Related to Women’s Prenatal Confidence for Physiologic Birth 378

Individual Strategies 380

Summary 381

Resources for Healthcare Providers 381

Resources for Women and Their Families 382

References 382

23 Triage during Pregnancy 385
Cathy Ruhl

Introduction 385

Objectives and Goals of Triage Care and Evaluation 385

Obstetric Triage in the Hospital Setting 386

Primary Responsibilities of Professionals during Triage and Evaluation 386

Common Reasons Women Seek Urgent/ Emergent Care during Pregnancy 386

Collaboration Between Obstetric and Emergency Departments 387

Obstetric Triage Unit Organization 387

Elements of Triage 387

Elements of Healthcare Provider Evaluation 388

Best Practices in Triage Units 388

Liability Issues in Obstetric Triage and Evaluation 390

Quality Measures in Triage 391

Anticipatory Guidance about Triage during Prenatal Care 391

Summary 391

Resources for Women and Their Families 391

Resources for Healthcare Providers 391

References 391

24 Assessment and Care at the Onset of Labor 393
Amy Marowitz

Introduction 393

Determining the Onset of Labor 393

Timing of Admission to the Birth Setting 394

Reframing “False Labor” 394

Determining Active Labor 395

Anticipatory Guidance during the Prenatal Period 395

Assessment of the Woman with Report of Labor Onset 396

Plan of Care 397

Summary 398

References 398

25 Components of Postnatal Care 401
Tia P. Andrighetti and Deborah Brandt Karsnitz

Introduction 401

Fourth-Trimester Tasks 402

Immediate Postpartum Care 402

Later Postpartum Care 402

Assessment of Maternal Physical and Emotional Adjustment 404

Maternal Role Development 407

Infant Feeding 407

Activity and Exercise 407

Diet and Nutrition 408

Lochia 408

Afterbirth Pain 409

Perineal Discomfort 410

Diureseis and Diaphoresis 410

Constipation and Hemorrhoids 410

Sleep 410

Sexuality 411

Resumption of Menses and Ovulation 411

Contraception 412

Postpartum Physical Examination 412

Postpartum Depression and Intimate Partner Violence Screening 414

Postpartum Warning Signs 415

Cultural Considerations 415

Health Disparities and Vulnerable Populations 416

Interprofessional Care 417

Recovery and Employment 417

Summary 418

Resources for Women 418

Resources for Healthcare Providers 418

References 418

26 Lactation and Breastfeeding 423
Marsha Walker

Introduction 423

Benefits of Breastfeeding 423

Breastfeeding as a Public Health Issue 426

Promoting and Supporting Breastfeeding 427

Maternal and Infant Anatomy and Physiology of Lactation and Breastfeeding 428

Basics of Breastfeeding Support and Assessment 432

Care of the Breastfeeding Mother 436

Summary 440

Resources for Women and Healthcare Providers 440

References 440

27 Contraception in the Postnatal Period 445
Leah N. Torres

Introduction 445

Postpartum Care and Return to Fertility after Childbirth 445

Selecting a Postpartum Contraceptive Method 446

Contraceptive Methods 448

Tier One Methods 448

Tier Two Methods 451

Tier Three Methods 455

Emergency Contraception 457

Summary 457

Resources for Women and Healthcare Providers 458

References 458

Part III Complex Prenatal and Postnatal Conditions 461

28 Bleeding during Pregnancy 463
Robin G. Jordan

Introduction 463

Early Pregnancy Bleeding 464

Subchorionic Hemorrhage 466

Leiomyomas 466

Spontaneous Pregnancy Loss 466

Ectopic Pregnancy 470

Gestational Trophoblastic Disease 472

Bleeding during the Second Half of Pregnancy 474

Placenta Previa 474

Placental Abruption 476

Vasa Previa 477

Diagnosis and Management of Bleeding in the Second Half of Pregnancy 478

Resources for Women and Their Families 478

References 479

29 Amniotic Fluid and Fetal Growth Disorders 481
Victoria H. Burslem and Cindy L. Farley

Introduction 482

Amniotic Fluid Dynamics 482

Placentation and Perinatal Outcomes 483

Amniotic Fluid Disorders 484

Fetal Growth Disorders 488

Summary 492

Resources for Women and Their Families 492

Resources for Healthcare Providers 492

References 492

30 Preterm Labor and Birth 495
Robin G. Jordan and Nancy Jo Reedy

Introduction 495

Social and Racial Disparities 496

Pathophysiology of Preterm Birth 497

Perinatal Morbidity Related to Prematurity 497

Risk Factors for Preterm Birth 497

Predicting Preterm Birth 499

Primary Prevention of Preterm Birth 500

Prenatal Education on Signs and Symptoms of Preterm Labor 504

Diagnosis and Management of Women with Preterm Labor 505

Interprofessional Care 505

Summary 505

Resources for Women and Healthcare Providers 506

References 506

31 Hypertensive Disorders of Pregnancy 511
Robin G. Jordan and Elizabeth Gabzdyl

Introduction 511

Classification of Hypertensive Disorders in Pregnancy 512

Screening for Hypertensive Disorders 512

Preeclampsia-Eclampsia 513

Chronic Hypertension 519

Chronic Hypertension with Superimposed Preeclampsia 520

Gestational Hypertension 521

HELLP Syndrome 521

Interprofessional Care 523

Summary 523

Resources for Women and Their Families 523

Resources for Healthcare Providers 523

References 523

32 Gestational Diabetes 527
Kimberly K. Trout

Introduction 527

Pathophysiology and Potential Problems 527

Prenatal Screening and Diagnosis 528

Management 531

Pharmacologic Treatments 533

Social Considerations 534

Fetal Surveillance and Timing of Birth 534

Postpartum Follow‐Up 535

Interprofessional Care 536

Perspective on GDM Risk 536

Care of the Pregnant Woman with

Pregestational Diabetes 537

Resources for Women and Their Families 537

Resources for Healthcare Providers 537

References 537

33 Multifetal Gestation 541
Heather M. Bradford and Cindy L. Farley

Incidence 541

Embryology 541

Diagnosis 543

Potential Problems 543

Prenatal Care 545

Psychosocial Aspects 547

Resources for Healthcare Providers 548

Resources for Women and Their Families 548

References 548

34 Post‐Term Pregnancy 551
Heather M. Bradford

Introduction 551

Potential Problems 552

Prevention, Intervention, and Management Options 552

Resources for Healthcare Providers 555

Resources for Women and Their Families 555

References 555

35 Hyperemesis Gravidarum 557
Karen Trister Grace

Introduction 557

Etiology and Risk Factors 557

Potential Problems 558

Evaluation 558

Care and Management 558

Resource for Healthcare Providers 560

Resources for Women and Their Families 560

References 560

36 Abdominal Pain 561
Karen Trister Grace

Introduction 561

Evaluation 561

Appendicitis 562

Gall Bladder Disease 562

Abdominal Trauma 563

CPR in Pregnancy 564

Pancreatitis 564

Resources for Healthcare Providers 564

Resources for Women and Their Families 564

References 564

37 Pregnancy after Infertility 567
Melicia Escobar

Introduction 567

Prevalence of Infertility 567

Context and Course of Infertility 568

Preexisting Conditions and Perinatal Issues 569

Pharmacologic Considerations 569

Lifestyle Considerations 569

Psychological Impacts of Infertility Treatment and Transition to Pregnancy 573

Summary 574

Resources for Women and Their Families 574

Resources for Healthcare Providers 574

References 574

38 Common Complications during the Postnatal Period 577
Deborah Brandt Karsnitz

Introduction 577

Postpartum Morbidity and Mortality 578

Postpartum Cultural Considerations 579

Postpartum Disorders 579

Summary 593

Resources for Women and Their Families 594

Resources for Healthcare Providers 594

References 594

39 Common Breastfeeding Problems 597
Marsha Walker

Introduction 597

Common Infant‐Related Breastfeeding Problems 597

Common Maternal Breastfeeding Problems 602

Low Milk Supply 607

Summary 610

Resources for Women and Their Families 610

Resources for Healthcare Providers 610

References 610

40 Perinatal Loss and Grief 613
Robin G. Jordan

Introduction 613

Stillbirth 613

Care and Management of Women with Stillbirth 614

Grieving and Emotional Care after Perinatal Loss 615

Physical Care after Stillbirth 617

Follow‐Up Care 618

Interconception and Subsequent Pregnancy Care 618

Summary 619

Resources for Women and Their Families 619

Resources for Healthcare Providers 619

References 620

Part IV Common Primary Care Health Conditions during the Prenatal and Postnatal Periods 623

41 Obesity 625
Cecilia M. Jevitt

Introduction 625

Prevalence 626

Health Disparities and Cultural Considerations 626

Personal and Family Considerations 626

Obesity Physiology 626

Potential Problems 627

Management of Pregestational Obesity 628

Bariatric Surgery and Pregnancy Issues 632

Prolonged Pregnancy 632

Intrapartum and Postpartum Issues 632

Interprofessional Care 633

Legal and Liability Issues 633

Summary 633

Resources for Women and Their Families 634

Resources for Healthcare Providers 634

References 634

42 Mood and Anxiety Disorders 637
Heather Shlosser

Introduction 637

Depression during Pregnancy 637

Bipolar Disorder in Pregnancy 642

Anxiety and Trauma‐Related Disorders 645

Interprofessional Care 647

Summary 647

Resources for Women and Their Families 648

Resources for Healthcare Providers 648

References 648

43 Hematologic and Thromboembolic Disorders 651
Jalana Lazar, Karen Trister Grace and Robin G. Jordan

Introduction 652

Anemia 652

Alloimmunization of Pregnancy 654

Hemoglobinopathies 658

Folate Deficiency 659

Vitamin B12 Deficiency 660

Bleeding Disorders 660

Thromboembolic Disorders 661

Summary 663

Resources for Women and Their Families 663

Resources for Healthcare Providers 663

References 663

44 Respiratory Disorders 665
Janyce Cagan Agruss

Introduction 665

Respiratory Physiology and Pregnancy 665

Asthma 665

Influenza 668

Upper Respiratory Infection 670

Pneumonia 671

Summary 671

Resource for Healthcare Providers 671

References 671

45 Urinary Tract Disorders 673
Rhonda Arthur and Nancy Pesta Walsh

Introduction 673

Urinary Tract Infection 673

Evaluation 675

Care of Women with Urinary Tract Infections 677

Recurrent UTI 678

Care of Women with Suspected Acute Pyelonephritis 678

Nephrolithiasis 678

Summary 679

Resources for Women and Their Families 679

Resource for Healthcare Providers 679

References 679

46 Gastrointestinal Disorders 681
Debora M. Dole

Introduction 681

Initial Evaluation 681

Gastroenteritis 681

Intraheptic Cholestasis of Pregnancy 683

Cholecystitis and Cholelithiasis 684

Acute Appendicitis 685

Summary 686

Resources for Healthcare Providers 686

Resource for Women and Their Families 686

References 686

47 Endocrine Disorders 687
Elizabeth Gabzdyl

Introduction 687

Thyroid Disorders in Pregnancy 687

Overt Hypothyroidism 689

Hyperthyroidism 691

Postpartum Thyroiditis 692

Iodine in Pregnancy 692

Pregestational Diabetes Mellitus 693

Summary 695

Resources for Women and Healthcare Providers 695

References 695

48 Neurological Disorders 697
Lise Hauser

Introduction 697

Seizure Disorders 697

Headache 701

Multiple Sclerosis 704

Restless Legs Syndrome/Willis‐Eckbom Disease 705

Carpal Tunnel Syndrome 706

Central Nervous System Imaging in Pregnancy and Lactation 706

Interprofessional Care 706

Resources for Women and Their Families 706

Resources for Healthcare Providers 706

References 706

49 Dermatological Disorders 709
Nell L. Tharpe

Introduction 709

Atopic Eruption of Pregnancy 710

Pruritic Urticarial Papules and Plaques of Pregnancy 712

Pruritic Folliculitis of Pregnancy 713

Pemphigoid Gestationis 714

Pustular Psoriasis of Pregnancy 716

Intrahepatic Cholestasis of Pregnancy 717

Summary 718

Resources for Healthcare Providers 718

References 719

50 Infectious Diseases 721
Elizabeth A. Parr

Introduction 721

Cytomegalovirus (CMV) 722

Group B Streptococcus (GBS) 724

Hepatitis A 725

Hepatitis B 726

Hepatitis C 728

Parvovirus B19 729

Rubella 730

Toxoplasmosis 731

Varicella 734

Emerging Infectious Diseases 735

Ebola 736

Zika 736

Summary 737

Resources for Women and Their Families 737

Resources for Healthcare Providers 738

References 738

51 Sexually Transmitted Infections and Vaginitis 741
Eva M. Fried and Cindy L. Farley

Introduction 741

Sexually Transmitted Bacterial Infections 742

Sexually Transmitted Viral Infections 744

Sexually Transmitted Parasitic Infection 748

Fungal Vaginitis 749

Bacterial Vaginitis 749

Partner STI Treatment 751

Legal Requirements for Reporting STI Diagnosis 752

Psychosocial Impact of STI Diagnosis 752

Summary 753

Resources for Healthcare Providers 753

Resource for Women and Partners 754

References 754

Index 757

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Prenatal and Postnatal Care

Prenatal and Postnatal Care

1119318343

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