Normal and Problem Pregnancies Handbook: Evidence-Based Principles of Maternal-Fetal Medicine, Labor Management, & Postpartum Care for OB/GYN Residents

Pregnancy raises the heart rate, lowers the blood pressure and creatinine, doubles the alkaline phosphatase and thins the platelet count, so early preeclampsia, hemorrhage, sepsis and thromboembolism can hide inside values that look physiologic. This handbook teaches obstetrics around that boundary. Eighteen chapters move from maternal physiology, prenatal care, genetic screening and early pregnancy through normal labor, fetal heart rate interpretation, induction, operative birth, emergencies and postpartum hemorrhage, then into hypertension, diabetes, preterm birth, placental disorders, fetal growth, twins, alloimmunization, infection, and the cardiac, endocrine, neurologic, trauma, substance use and mental health conditions that complicate pregnancy. It is written for OB/GYN residents, family physicians who deliver, certified nurse-midwives and labor and delivery hospitalists.

Fifty-four Crossover Point Library entries each state the expected change, the exact point where it becomes a problem, the response it triggers, the condition that masquerades as it, and one rule to carry to the bedside, all gathered in an indexed Master Register.

What You Will Be Able to Do on the Labor Floor and in Clinic

•  Interpret creatinine, platelets, liver tests, thyroid values and vital signs against pregnancy-specific norms

•  Date pregnancies, schedule prenatal screening, and act on cell-free DNA, nuchal translucency and anatomy findings

•  Classify fetal heart rate tracings with the NICHD three-tier system and apply intrauterine resuscitation

•  Manage labor arrest, operative vaginal birth, trial of labor after cesarean, shoulder dystocia and cord prolapse

•  Treat severe-range blood pressure within the hour, dose magnesium sulfate safely, and time delivery in preeclampsia and HELLP syndrome

•  Recognize postpartum hemorrhage early with quantitative blood loss and shock index, and escalate through uterotonics, tranexamic acid and tamponade

•  Plan delivery timing for growth restriction, previa, accreta spectrum, twins, cholestasis and gestational diabetes

Keep this handbook on the unit and act at the boundary, before the crisis becomes obvious.