Tuberculosis

The diagnosis of tuberculosis in pregnancy is made by history taking, physical examination, and skin testing, with special attention to women from ethnic groups with a high prevalence of the disease (such as women…

Syphilis, Gonorrhea, & Chlamydia trachomatis Infection

These sexually transmitted diseases have significant consequences for mother and child. Untreated syphilis in pregnancy will cause late abortion, stillbirth, transplacental infection, and congenital syphilis.…

Seizure Disorders

Epileptic women contemplating pregnancy who have not had a seizure for 5 years should consider a prepregnancy trial of withdrawal from treatment. Those with recurrent epilepsy should use a single drug with…

Heart Disease

Overall, 5% of maternal deaths are due to heart disease. Most heart disease complicating pregnancy in the United States is congenital heart disease. Normal pregnancy causes a faster pulse, an increase of cardiac…

The effect of pregnancy on asthma is unpredictable. About 50% of patients have no change, 25% improve, and 25% get worse. Management of acute and chronic asthma during pregnancy does not differ significantly from that of…

Urinary Tract Infection

The urinary tract is especially vulnerable to infections during pregnancy because the altered secretions of steroid sex hormones and the pressure exerted by the gravid uterus upon the ureters and…

Thyroid Disease

Thyrotoxicosis during pregnancy may result in fetal anomalies, late abortion, or preterm labor and fetal hyperthyroidism with goiter. Thyroid storm in late pregnancy or labor is a life-threatening emergency.

Radioactive isotope…

Varicella

Commonly known as chickenpox, varicella-zoster virus (VZV) infection has a fairly benign course when incurred during childhood but may result in serious illness in adults, particularly during pregnancy. Infection results in lifelong immunity. Approximately…

Group B Streptococcal Infection

Group B streptococci frequently colonize the lower female genital tract, with an asymptomatic carriage rate in pregnancy of 5-30%. This rate depends on maternal age, gravidity, and geographic…

Acute Fatty Liver of Pregnancy

Acute fatty liver of pregnancy is a disorder limited to the gravid state. It occurs in the third trimester of pregnancy and involves acute hepatic failure.…

Maternal Hepatitis B & C Carrier State

There are an estimated 200 million chronic carriers of hepatitis B virus worldwide. Among these people there is an increased incidence of…

Hypertensive Disease

Hypertensive disease in women of childbearing age is usually essential hypertension, but secondary causes should be considered: coarctation of the aorta, pheochromocytoma, hyperaldosteronism, and renovascular and renal hypertension.

Preeclampsia is superimposed…

Herpes Genitalis

Infection of the lower genital tract by herpes simplex virus type 2 (HSV-2) is a common sexually transmitted disease of potential seriousness to pregnant women and their newborn infants. Although up to…

Peripartum Cardiomyopathy

Cardiac failure that develops during pregnancy or during the first 6 months postpartum in a woman without a history of heart disease and with no cause for heart failure other than pregnancy is…

Diabetes Mellitus

Pregnancy is associated with increased tissue resistance to insulin, resulting in increased levels of blood insulin as well as glucose and triglycerides. These changes are due to placental lactogen and elevated circulating estrogens…

AIDS During Pregnancy

Heterosexual acquisition (51%) and injecting drug use (45%) are the principal modes of HIV infection in women. In 15%, no risk factor is reported or identified. Asymptomatic infection is associated with…

Lupus Anticoagulant-Anticardiolipin-Antiphospholipid Antibody Syndrome

The presence of antibodies to phospholipids and a variety of clinical symptoms, including vascular thromboses, thrombocytopenia, and recurrent pregnancy loss, characterize the lupus anticoagulant-anticardiolipin-antiphospholipid antibody syndrome. Many of these…

Anemia

Plasma volume increases 50% during pregnancy, while red cell volume increases 25%, causing lower hemoglobin and hematocrit values, which are maximally changed around the 24th to 28th weeks. Anemia in pregnancy is often defined as…