22q11.2 deletion syndrome (22q11.2DS) is the most common chromosomal microdeletion syndrome with an incidence of 1/3,000-1/4,000 live births. Common manifestations of 22q11.2DS include congenital heart defects, hypocalcemia, immune deficiency, cleft palate, cognitive deficits, and psychiatric disturbances. As childhood management of 22q11.2DS has improved, these individuals are living into adulthood and may have children of their own. Thus, it is imperative for the clinician to have an understanding of both the physical and psychiatric complications that may be seen in the adult with 22q11.2DS and how this may affect a pregnancy. Here we review the common features of 22q11.2DS in the adult and pregnancy management recommendations for the obstetrician. This review contains 4 figures, 1 tables, and 27 references. Keywords: 22q11.2 Deletion Syndrome; DiGeorge Syndrome; Velocardiofacial Syndrome; 22q11.2 Deletion Syndrome Adult; 22q11.2 Deletion Syndrome pregnancy; DiGeorge Syndrome pregnancy; DiGeorge Syndrome adult.
{"title":"Common Maternal Genetic Syndromes VI: 22q11.2 Deletion Syndrome","authors":"Megan Boothe, N. Robin","doi":"10.2310/OBG.19147","DOIUrl":"https://doi.org/10.2310/OBG.19147","url":null,"abstract":"22q11.2 deletion syndrome (22q11.2DS) is the most common chromosomal microdeletion syndrome with an incidence of 1/3,000-1/4,000 live births. Common manifestations of 22q11.2DS include congenital heart defects, hypocalcemia, immune deficiency, cleft palate, cognitive deficits, and psychiatric disturbances. As childhood management of 22q11.2DS has improved, these individuals are living into adulthood and may have children of their own. Thus, it is imperative for the clinician to have an understanding of both the physical and psychiatric complications that may be seen in the adult with 22q11.2DS and how this may affect a pregnancy. Here we review the common features of 22q11.2DS in the adult and pregnancy management recommendations for the obstetrician. \u0000This review contains 4 figures, 1 tables, and 27 references.\u0000Keywords: 22q11.2 Deletion Syndrome; DiGeorge Syndrome; Velocardiofacial Syndrome; 22q11.2 Deletion Syndrome Adult; 22q11.2 Deletion Syndrome pregnancy; DiGeorge Syndrome pregnancy; DiGeorge Syndrome adult.","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117293805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The prevalence of maternal obesity has increased significantly in the United States and throughout the world over the last several decades. In the United States, where obesity has reached epidemic proportions, it is estimated that more than two-thirds of reproductive aged women are overweight or obese. Obesity poses a challenge for the obstetrician, given its association with significant increases in maternal morbidity before, during, and after pregnancy. Obesity is associated with an increased risk for diabetes, preeclampsia, cesarean delivery, and venous thromboembolic disease, among other complications. Poor pregnancy outcomes, including miscarriage and stillbirth, are more common in the setting of maternal obesity. Maternal obesity also appears to impact both fetal brain and metabolic development, in ways that may have critical implications for long-term health outcomes of future generations. This review contains 5 figures, 1 table, and 127 references. Keywords: Pregnancy, obesity, congenital anomaly, cesarean delivery, wound complications, stillbirth, hypertensive disorders, bariatric surgery, diabetes, neurodevelopment
{"title":"Obesity in Pregnancy","authors":"A. Peterson, A. Edlow","doi":"10.2310/OBG.19043","DOIUrl":"https://doi.org/10.2310/OBG.19043","url":null,"abstract":"The prevalence of maternal obesity has increased significantly in the United States and throughout the world over the last several decades. In the United States, where obesity has reached epidemic proportions, it is estimated that more than two-thirds of reproductive aged women are overweight or obese. Obesity poses a challenge for the obstetrician, given its association with significant increases in maternal morbidity before, during, and after pregnancy. Obesity is associated with an increased risk for diabetes, preeclampsia, cesarean delivery, and venous thromboembolic disease, among other complications. Poor pregnancy outcomes, including miscarriage and stillbirth, are more common in the setting of maternal obesity. Maternal obesity also appears to impact both fetal brain and metabolic development, in ways that may have critical implications for long-term health outcomes of future generations.\u0000This review contains 5 figures, 1 table, and 127 references.\u0000Keywords: Pregnancy, obesity, congenital anomaly, cesarean delivery, wound complications, stillbirth, hypertensive disorders, bariatric surgery, diabetes, neurodevelopment","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123399769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karyotype analysis of cells has been in use for many years and has led to the causative genetic change in numerous clinical syndromes, including trisomy 21, Klinefelter, Turner, Prader-Willi and Angelman syndromes. The resolution of the test depends on the degree of condensation of the chromosomes in the karyotype, but even at high resolution (> 800 bands per haploid set) the changes identified are in the order of 5 Mb of DNA. Fluorescence in situ hybridization (FISH) bridges the gap between the relatively low resolution of karyotype analysis and the very high resolution of DNA analysis. With FISH it is possible to identify smaller changes in individual cells. The size of the change identified correlates with the size of the probe, which vary from 120 kb to 600 kb in size. FISH is widely used to confirm deletions or duplications identified by newer methods, such as array analysis. This review contains 8 figures, 3 tables, and 25 references. Keywords: Cytogenetics, chromosome, karyotype, chromosomal resolution, tissue culture, fluorescence, hybridization, probe
{"title":"Conventional Karyotype and Fluorescence in situ Hybridization (FISH) Technology","authors":"J. Cowan","doi":"10.2310/obg.19136","DOIUrl":"https://doi.org/10.2310/obg.19136","url":null,"abstract":"Karyotype analysis of cells has been in use for many years and has led to the causative genetic change in numerous clinical syndromes, including trisomy 21, Klinefelter, Turner, Prader-Willi and Angelman syndromes. The resolution of the test depends on the degree of condensation of the chromosomes in the karyotype, but even at high resolution (> 800 bands per haploid set) the changes identified are in the order of 5 Mb of DNA. Fluorescence in situ hybridization (FISH) bridges the gap between the relatively low resolution of karyotype analysis and the very high resolution of DNA analysis. With FISH it is possible to identify smaller changes in individual cells. The size of the change identified correlates with the size of the probe, which vary from 120 kb to 600 kb in size. FISH is widely used to confirm deletions or duplications identified by newer methods, such as array analysis. \u0000This review contains 8 figures, 3 tables, and 25 references.\u0000Keywords: Cytogenetics, chromosome, karyotype, chromosomal resolution, tissue culture, fluorescence, hybridization, probe","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"93 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125974523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Many women with skeletal dysplasias, such as achondroplasia and hypochondroplasia, choose to become pregnant. These women and their partners should receive pre-conception genetic counseling. Once the woman becomes pregnant, a multidisciplinary team at a tertiary care hospital should mange her antepartum care and birth process. An anesthesia plan should be in place that addressed kyphosis, weight based medications and the possibility of a Cesarean Section. Patients should be monitored for respiratory compromise from the gravid uterus on a smaller body frame. Neonatology must be available to help care for the infant. With a supportive antepartum and postpartum care plan, most women with skeletal dysplasia do well and resume routine OBGYN care after birth. This review contains 5 figures, and 21 references. Keywords: Maternal Achondroplasia, Maternal Hypochondroplasia, Inheritance patterns, short limb dwarfism, high risk pregnancy, autosomal dominant inheritance
{"title":"Achondroplasia and Hypochondroplasia","authors":"C. Gooch, A. Subramaniam, N. Robin","doi":"10.2310/obg.19145","DOIUrl":"https://doi.org/10.2310/obg.19145","url":null,"abstract":"Many women with skeletal dysplasias, such as achondroplasia and hypochondroplasia, choose to become pregnant. These women and their partners should receive pre-conception genetic counseling. Once the woman becomes pregnant, a multidisciplinary team at a tertiary care hospital should mange her antepartum care and birth process. An anesthesia plan should be in place that addressed kyphosis, weight based medications and the possibility of a Cesarean Section. Patients should be monitored for respiratory compromise from the gravid uterus on a smaller body frame. Neonatology must be available to help care for the infant. With a supportive antepartum and postpartum care plan, most women with skeletal dysplasia do well and resume routine OBGYN care after birth.\u0000This review contains 5 figures, and 21 references.\u0000Keywords: Maternal Achondroplasia, Maternal Hypochondroplasia, Inheritance patterns, short limb dwarfism, high risk pregnancy, autosomal dominant inheritance ","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"131 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114861741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Inborn errors of metabolism are a group of inherited disorders that are generally due to a block in an enzymatic pathway. In the past, individuals with inborn errors of metabolism were mainly isolated to the pediatric population. However, with the advent of newborn screening and improved treatment strategies, these patients are now reaching childbearing age. Many successful pregnancies in females with various inborn errors of metabolism have been reported. It is pertinent that obstetrician gynecologists are aware of these conditions and their management guidelines. This review will discuss three main categories of inborn errors of metabolism including protein metabolism disorders, carbohydrate metabolism disorders, and lipid metabolism disorders. This review contains 5 tables, and 30 references. Keywords: Inborn errors of metabolism, phenylketonuria, maternal PKU syndrome, ornithine transcarbamylase deficiency, galactosemia, fatty acid oxidation disorders
{"title":"Inborn Errors of Metabolism","authors":"S. J. Dean","doi":"10.2310/obg.19140","DOIUrl":"https://doi.org/10.2310/obg.19140","url":null,"abstract":"Inborn errors of metabolism are a group of inherited disorders that are generally due to a block in an enzymatic pathway. In the past, individuals with inborn errors of metabolism were mainly isolated to the pediatric population. However, with the advent of newborn screening and improved treatment strategies, these patients are now reaching childbearing age. Many successful pregnancies in females with various inborn errors of metabolism have been reported. It is pertinent that obstetrician gynecologists are aware of these conditions and their management guidelines. This review will discuss three main categories of inborn errors of metabolism including protein metabolism disorders, carbohydrate metabolism disorders, and lipid metabolism disorders.\u0000This review contains 5 tables, and 30 references.\u0000Keywords: Inborn errors of metabolism, phenylketonuria, maternal PKU syndrome, ornithine transcarbamylase deficiency, galactosemia, fatty acid oxidation disorders","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126834562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Non-invasive prenatal testing (NIPT) is a screening test that can determine if a pregnancy is at high risk for the common aneuploidies by analyzing cell-free fetal DNA in the maternal bloodstream. The screening includes trisomy 21, trisomy 18, and trisomy 13, with the option of screening for sex chromosome aneuploidy and fetal sex. Traditionally this testing is offered to women that are at high risk for these aneuploidies, most commonly women of advanced maternal age. Individuals that receive a high risk result on NIPT should be offered diagnostic testing to confirm the result. New forms of NIPT have recently emerged, however the use of this technology as a screening test for other genetic conditions is not currently recommended by national professional society guidelines. Patients should be counseled and consented for NIPT, as this is an optional screening test. This review contains 2 tables, and 39 references. Keywords: NIPT, non-invasive prenatal testing, aneuploidy, Down syndrome, trisomy 18, trisomy 13, Turner syndrome, microdeletions, diagnostic testing
{"title":"Non-invasive Prenatal Testing (NIPT)","authors":"Courtney Manning, M. Abbott","doi":"10.2310/obg.19129","DOIUrl":"https://doi.org/10.2310/obg.19129","url":null,"abstract":"Non-invasive prenatal testing (NIPT) is a screening test that can determine if a pregnancy is at high risk for the common aneuploidies by analyzing cell-free fetal DNA in the maternal bloodstream. The screening includes trisomy 21, trisomy 18, and trisomy 13, with the option of screening for sex chromosome aneuploidy and fetal sex. Traditionally this testing is offered to women that are at high risk for these aneuploidies, most commonly women of advanced maternal age. Individuals that receive a high risk result on NIPT should be offered diagnostic testing to confirm the result. New forms of NIPT have recently emerged, however the use of this technology as a screening test for other genetic conditions is not currently recommended by national professional society guidelines. Patients should be counseled and consented for NIPT, as this is an optional screening test.\u0000This review contains 2 tables, and 39 references.\u0000Keywords: NIPT, non-invasive prenatal testing, aneuploidy, Down syndrome, trisomy 18, trisomy 13, Turner syndrome, microdeletions, diagnostic testing","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116498178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fetal head and neck abnormalities can be reliably assessed using a combination of 2D and 3D ultrasound. The accuracy of imaging depends to a large extent on gestational age. Magnetic resonance imaging (MRI) has evolved as a useful adjunct to ultrasound particularly for prenatal diagnosis of fetal head and neck anomalies. Intrauterine MRI improves diagnostic accuracy for fetal brain abnormalities and often leads to changes in management. MRI can be used to refine diagnoses in complex cases where ultrasound imaging is unclear or cannot determine the precise diagnosis. Some fetal neck masses can result in neonatal respiratory compromise. An ex utero intrapartum treatment (EXIT) procedure may be required if a neck mass is causing tracheal occlusion. Polyhydramnios can occur if there is oesophageal compression. When a fetal head and neck abnormality is detected, appropriate counselling regarding diagnosis, prognosis, and treatment options is crucial in allowing the patient to make an informed and timely decision in relation to pregnancy management. This review contains 14 figures, 3 tables, and 68 references. Key words: Intracranial abnormality, anencephaly, encephalocele, cystic hygroma, fetal neck mass, ventriculomegaly, fetal goiter, Craniosynostosis, Agenesis of the corpus callosum, Holoprosencephaly, EXIT
{"title":"Abnormalities of the Fetal Head and Neck","authors":"A. McHugh, F. Malone","doi":"10.2310/obg.19084","DOIUrl":"https://doi.org/10.2310/obg.19084","url":null,"abstract":"Fetal head and neck abnormalities can be reliably assessed using a combination of 2D and 3D ultrasound. The accuracy of imaging depends to a large extent on gestational age. Magnetic resonance imaging (MRI) has evolved as a useful adjunct to ultrasound particularly for prenatal diagnosis of fetal head and neck anomalies. Intrauterine MRI improves diagnostic accuracy for fetal brain abnormalities and often leads to changes in management. MRI can be used to refine diagnoses in complex cases where ultrasound imaging is unclear or cannot determine the precise diagnosis. Some fetal neck masses can result in neonatal respiratory compromise. An ex utero intrapartum treatment (EXIT) procedure may be required if a neck mass is causing tracheal occlusion. Polyhydramnios can occur if there is oesophageal compression. When a fetal head and neck abnormality is detected, appropriate counselling regarding diagnosis, prognosis, and treatment options is crucial in allowing the patient to make an informed and timely decision in relation to pregnancy management.\u0000This review contains 14 figures, 3 tables, and 68 references.\u0000Key words: Intracranial abnormality, anencephaly, encephalocele, cystic hygroma, fetal neck mass, ventriculomegaly, fetal goiter, Craniosynostosis, Agenesis of the corpus callosum, Holoprosencephaly, EXIT","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133425088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mounting evidence underscoring serious maternal complications such as hemorrhage, emergent hysterectomy, thromboembolic disease and even death from multiple cesarean deliveries has refocused attention upon trial of labor after cesarean birth. Research over the last thirty years has provided insight into some of the clinical and demographic factors associated with uterine rupture and successful trial of labor after cesarean delivery. Clinical application of these strategies has the potential to mitigate the dilemma for physicians in the trenches caused by fear of uterine rupture during a trial of labor after cesarean. Individual risk stratification of candidates that optimizes success and minimizes uterine rupture during a trial of labor after cesarean shows promise for implementation of best practices leading to favorable maternal and neonatal outcomes. This review contains 4 figures, 6 tables, and 97 references. Key Words: Vaginal birth after cesarean (VBAC), Trial of labor after cesarean (TOLAC), uterine rupture, uterine scar, lower uterine segment, repeat cesarean, placenta accreta, uterine dehiscence
{"title":"Vaginal Birth After Cesarean: Contemporary Update and Ongoing Controversies for the Clinician in the Trenches","authors":"M. Rosner, C. Zelop","doi":"10.2310/obg.19059","DOIUrl":"https://doi.org/10.2310/obg.19059","url":null,"abstract":"Mounting evidence underscoring serious maternal complications such as hemorrhage, emergent hysterectomy, thromboembolic disease and even death from multiple cesarean deliveries has refocused attention upon trial of labor after cesarean birth. Research over the last thirty years has provided insight into some of the clinical and demographic factors associated with uterine rupture and successful trial of labor after cesarean delivery. Clinical application of these strategies has the potential to mitigate the dilemma for physicians in the trenches caused by fear of uterine rupture during a trial of labor after cesarean. Individual risk stratification of candidates that optimizes success and minimizes uterine rupture during a trial of labor after cesarean shows promise for implementation of best practices leading to favorable maternal and neonatal outcomes.\u0000This review contains 4 figures, 6 tables, and 97 references.\u0000Key Words: Vaginal birth after cesarean (VBAC), Trial of labor after cesarean (TOLAC), uterine rupture, uterine scar, lower uterine segment, repeat cesarean, placenta accreta, uterine dehiscence","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130567692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vulvar cancer is one of the least common gynecologic cancers. In 2018, vulvar cancer accounted for approximately 6,190 (0.4%) of new cancer diagnoses and approximately 1,200 (0.2%) of cancer deaths in the United States.1 The median age at diagnosis is 68.1 At time of diagnosis, 59% of patients have local disease, 30% have regional disease, and 6% present with metastatic disease.1 The incidence of vulvar cancer per 100,000 women is 1.8 in white women, 1.3 in black women, and 1.3 in Hispanic women.2 Vulvar cancer typically presents as a pruritic lesion, noted by the patient or a provider on exam. Ninety percent of vulvar cancers are of squamous cell histopathology,3 and have risk factors similar to cervical squamous cell carcinoma. Vulvar cancer is staged surgically. The mainstay of vulvar cancer treatment is surgery, however later stages may be treated with chemotherapy and/or radiation. This review contains 2 figures, 2 tables, and 40 references. Keywords: vulvar cancer, chemoradiation, sentinel lymph nodes, inguinal lymphadenectomy, chemotherapy, lymphedema
{"title":"Vulvar Cancer","authors":"K. Hicks-Courant, D. Roque","doi":"10.2310/obg.19172","DOIUrl":"https://doi.org/10.2310/obg.19172","url":null,"abstract":"Vulvar cancer is one of the least common gynecologic cancers. In 2018, vulvar cancer accounted for approximately 6,190 (0.4%) of new cancer diagnoses and approximately 1,200 (0.2%) of cancer deaths in the United States.1 The median age at diagnosis is 68.1 At time of diagnosis, 59% of patients have local disease, 30% have regional disease, and 6% present with metastatic disease.1 The incidence of vulvar cancer per 100,000 women is 1.8 in white women, 1.3 in black women, and 1.3 in Hispanic women.2 Vulvar cancer typically presents as a pruritic lesion, noted by the patient or a provider on exam. Ninety percent of vulvar cancers are of squamous cell histopathology,3 and have risk factors similar to cervical squamous cell carcinoma. Vulvar cancer is staged surgically. The mainstay of vulvar cancer treatment is surgery, however later stages may be treated with chemotherapy and/or radiation.\u0000This review contains 2 figures, 2 tables, and 40 references.\u0000Keywords: vulvar cancer, chemoradiation, sentinel lymph nodes, inguinal lymphadenectomy, chemotherapy, lymphedema","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"821 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120883065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Intrapartum care encompasses the treatment of pregnancy during labor and delivery. Knowledge of the normal labor process is essential to effectively recognize and treat abnormalities, and thus optimize maternal and fetal health. This review aims to outline the physiology of labor and discuss contemporary features of spontaneous labor, prolonged labor, and arrest of labor. It addresses management of group B streptoccocous colonization and electronic fetal monitoring practices. Additionally, issues associated with term labor such as prelabor rupture of membranes, abruption, intrapartum intraamniotic infection, and persistent occiput posterior position are discussed. The review concludes with a brief overview of delivery methods. This review contains 7 figures, 14 tables, and 49 references. Keywords: term labor, intrapartum monitoring, induction of labor, Group B Streptococcous prophylaxis, prelabor rupture of membranes, intraamniotic infection, mode of delivery
{"title":"Intrapartum Care","authors":"J. M. Hart, B. Young","doi":"10.2310/obg.19022","DOIUrl":"https://doi.org/10.2310/obg.19022","url":null,"abstract":"Intrapartum care encompasses the treatment of pregnancy during labor and delivery. Knowledge of the normal labor process is essential to effectively recognize and treat abnormalities, and thus optimize maternal and fetal health. This review aims to outline the physiology of labor and discuss contemporary features of spontaneous labor, prolonged labor, and arrest of labor. It addresses management of group B streptoccocous colonization and electronic fetal monitoring practices. Additionally, issues associated with term labor such as prelabor rupture of membranes, abruption, intrapartum intraamniotic infection, and persistent occiput posterior position are discussed. The review concludes with a brief overview of delivery methods. \u0000This review contains 7 figures, 14 tables, and 49 references.\u0000Keywords: term labor, intrapartum monitoring, induction of labor, Group B Streptococcous prophylaxis, prelabor rupture of membranes, intraamniotic infection, mode of delivery","PeriodicalId":120074,"journal":{"name":"DeckerMed Obstetrics and Gynecology","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129317347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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