Handbook of Obstetric Medicine 2021

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* Same content as the original book
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Women with pre-existing or new-onset medical problems in pregnancy are encountered
in every antenatal clinic and in every delivery suite in every country� The prevalence
of medical disorders in pregnancy is increasing and these conditions are becoming
more important as causes of maternal death� In developed countries, women are
delaying pregnancy until they are older and more likely to have medical disorders;
in addition, advances in medicine and surgery have resulted in women with complex
medical histories now presenting either pregnant or requesting assisted reproductive
therapies� Every clinician caring for pregnant women therefore needs to understand
the interaction between medical disorders and pregnancy and needs to be able to
counsel women about these interactions as well as about the safety of investigations
and drug therapy during pregnancy and while breastfeeding� The explosion in the
numbers of multidisciplinary, joint antenatal medical clinics is a welcome advance in
care but this is only one aspect� All obstetricians need to be confident in the diagnosis
of new-onset medical problems that may face them with increasing frequency�
This Handbook is designed as a pragmatic, easy-to-use, ready reference guide�
In the sixth edition, I have again retained the same basic format of two sections�
Section A is divided into chapters by systems, and each chapter describes the
incidence, clinical features, pathogenesis, diagnosis and the effect of pregnancy
and management of each condition� ‘Points to remember’ boxes serve as summaries
and revision� Section B describes the differential diagnosis of common symptoms,
signs and abnormal investigations encountered in pregnancy� All the chapters
have been updated and revised to reflect current understanding and evidence to
support management strategies for medical disorders in pregnancy� I have added
an appendix on contraception in pregnancy� The suggestions for further reading
include relevant guidelines where appropriate� Readers are also reminded about
other resources such as the website of the International Society of Obstetric
Medicine at http://www�isomnet�org and the journal of the Society, Obstetric
Medicine: The Medicine of Pregnancy also available online at https://journals�sagepub�
com/home/obm� In the UK, the Royal College of Physicians and The Society of
Acute Medicine have produced a toolkit on managing acute medical problems
in pregnancy, available at https://www�rcplondon�ac�uk/guidelines-policy/
acute-care-toolkit-15-managing-acute-medical-problems-pregnancy�
I am delighted that this Handbook continues to be used by trainees to help them
revise for and pass examinations, but more importantly that it fuels an interest and
thirst for knowledge in the exciting field of obstetric medicine� I am hugely grateful to
all those doctors and midwives that have provided such useful feedback and comments
about the Handbook over the years� For this edition I would particularly like to thank
Dr Oier Ateka� I am also indebted to my many colleagues and patients who have taught
me so much� To practise obstetric medicine remains an enormous privilege