Family Medicine Obstetrics


  • Stephen Ratcliffe, MD, MSPH, Professor and Family Practice Program Director, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT

Whether you offer comprehensive pregnancy care in your primary care facility, or provide prenatal and postpartum care, this book delivers the guidance you need to optimize health for both mothers and their babies. It covers all aspects of birth care, from preconception counseling and prenatal care, through labor and delivery (both low-risk and complicated), to postpartum care and the first month of life. The completely revised third edition includes the most up-to- date, evidence-based standards of care. It offers information that is patient centered, prevention oriented, educational, and sensitive to the care of the whole woman and her family.
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Family Practitioners, Internists, Nurse Practitioners, and Physician Assistants


Book information

  • Published: January 2008
  • Imprint: MOSBY
  • ISBN: 978-0-323-04306-9

Table of Contents

1. Improving Safety and Quality in Maternity Care

2. Preconception Care: Improving Birth Outcomes through Care before Pregnancy

3. Content of Prenatal Care
A. History of Prenatal Care
B. Diagnosis and Dating of Pregnancy
C. Prenatal Visits
D. Initial Assessment
E. Monitoring the Progress of Pregnancy
F. Screening in Pregnancy and Predictive Value
G. Medications in Pregnancy
H. Immunizations in Pregnancy
I. Complementary and Alternative Medicine in Maternity Care
J. Diagnostic Ultrasound in Pregnancy

4. Patient and Family Education
A. Nutrition in Pregnancy and Lactation
B. Childbirth Education 65
C. Preparation for Parenting and Family Issues
D. Breastfeeding Promotion
E. Physiologic Changes and Common Discomforts of Pregnancy
F. Exercise and Pregnancy

5. Pregnancy Interventions
A. Psychosocial Interventions
B. Adolescent Pregnancy Interventions
C. Substance Abuse in Pregnancy
D. Smoking in Pregnancy
E. Group Prenatal Care: Centering Pregnancy®

6. Diagnosis and Management of First-Trimester Complications
A. Diagnosis
B. Management of Ectopic Pregnancy
C. Management of Miscarriage

7. Complications of Pregnancy
A. Gestational Diabetes Mellitus
B. Multiple Gestation
C. Vaginal Bleeding in the Second and Third Trimester
D. Vaginal Birth after Cesarean
E. Small-for-Dates Pregnancy
F. Large-for-Dates Pregnancy including Macrosomia
G. Disorders of Amniotic Fluid including Oligohydramnios and Polyhydramnios
H. Possible Indicators of Fetal Abnormalities

8. Chronic Medical Conditions in Pregnancy
A. Pulmonary Problems in Pregnancy
B. Cardiovascular Conditions
C. Chronic Hypertension
D. Thromboembolic Disease and Chronic Anticoagulation
E. Hematologic Conditions in Pregnancy
F. Gastrointestinal Conditions
G. Neurologic Conditions
H. Renal Disease
I. Endocrine Conditions
J. Autoimmune Conditions

9. Commonly Encountered Medical Problems in Pregnancy
A. Infections in Pregnancy
B. Abdominal Pain and Gastrointestinal Illness
C. Trauma in Pregnancy
D. Dermatoses of Pregnancy
E. Acute Neurologic Conditions
F. Cervical Dysplasia in Pregnancy

10. Treatment of Psychiatric Disorders in Pregnancy
A. Affective Disorders
B. Anxiety Disorders
C. Schizophrenia

11. Antenatal Fetal Surveillance and Management of the Postterm Pregnancy
A. Overview of Antenatal Testing
B. Types of Antenatal Testing
C. Management of the Postterm Pregnancy

12. Preterm Labor
A. Risk Factors for Preterm Labor
B. Antenatal Interventions for Prevention of Preterm Delivery
C. Diagnosis of Preterm Labor
D. Pharmacologic Management of Preterm Labor
E. Incompetent Cervix
F. Management of Preterm Delivery
G. Programs Aimed at Identifying Patients at Risk for Preterm Labor and Subsequent Patient Care
H. Preterm Premature Rupture of the Membranes
I. Conclusion

13. Birth Crisis: Caring for the Family Experiencing Perinatal Death or the Birth of a Child with Medical Complications

14. Management of Labor 359
A. Normal Labor
B. Ambulation and Positions in Labor
C. Intrapartum Pain Management
D. Support in Labor
E. Intrapartum Fetal Heart Rate Monitoring
F. Normal Delivery and Birthing Positions
G. Management of the Second Stage
H. Management of the Perineum
I. Management of Third-Stage Birth

15. Management of Labor Abnormalities
A. Dystocia in the Nulliparous Patient
B. Term Premature Rupture of the Membranes
C. Induction of Labor

16. Intrapartum Complications
A. Fetal Intolerance of Labor
B. Shoulder Dystocia
C. Chorioamnionitis
D. Intrapartum Bleeding
E. Postpartum Hemorrhage
F. Retained Placenta
G. Preeclampsia and Eclampsia
H. Medical Emergencies in Pregnancy

17. Malpresentations and Malpositions
A. Diagnosis
B. Face Presentation
C. Brow Presentation
D. Transverse Lie
E. Transverse Arrest
F. Occiput Posterior Position
G. Breech Presentation
H. External Cephalic Version
I. Twin Gestation

18. Intrapartum Procedures
A. Use of Ultrasound in Labor and Delivery
B. Pudendal and Paracervical Blocks
C. Amnioinfusion and Use of Intrauterine Pressure Catheter
D. Assisted Deliveries
E. Episiotomy and Repair of Perineal Lacerations and Episiotomies
F. Amniocentesis during the Third Trimester of Pregnancy
G. Cesarean Delivery

19. The First Month of Life
A. Initial Management of the Normal Newborn
B. Neonatal Resuscitation
C. Neonatal Circumcision
D. Neonatal Jaundice
E. Evaluation and Management of Infection in the Newborn
F. Infant Feeding and Nutrition
G. Bonding and Family Adaptation
H. General Care of the Neonate

20. Postpartum Biomedical Concerns - Breastfeeding
A. Delayed Postpartum Hemorrhage
B. Postpartum Endometritis
C. Breastfeeding
D. Mastitis

E. Thyroiditis
F. Septic Pelvic Thrombophlebitis
G. Post Partum Contraception

21. Postpartum Psychosocial Concerns
A. Maternal Adjustment
B. Paternal Adjustment
C. Marital Adjustment
D. Sibling Adjustment
E. Specific Family Situations
F. Return to Work
A Interpretation of Summary Tables
B Analysis of Risking Instruments
C Summary of Recommendations for Immunization during Pregnancy
D Measuring Clinical Effectiveness