By Karen Rosene-Montella

This protocol-based booklet makes use of algorithms to debate preconception care, care while pregnant, hard work and supply, and the hyperlink among postpartum and ongoing basic care. the necessity for an informed supplier group to deal with pregnant sufferers is gigantic, and Medical administration of the Pregnant sufferer provides a pragmatic instruction manual that addresses all features of this subject. a quick review of body structure, its impression on being pregnant and diagnostics, and therapy suggestions are integrated. each one part covers either ailments which could exist autonomous of being pregnant and illnesses particular to being pregnant. also, symptom-based court cases are included into every one part and cross-referenced correctly. inner medication physicians, obstetricians, kin practitioners and gynecologists alike will enjoy the sensible scientific instructions provided during this ebook.

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Extra resources for Medical Management of the Pregnant Patient: A Clinician's Handbook

Sample text

While these data are helpful, they are limited by the fact that cardiovascular physiology is different depending on the type of shock. Therefore, we may not be able to extrapolate data related to regional anesthesia to sepsis, for instance, or cardiogenic shock. Dopamine is a dopaminergic, alpha-1 and beta-1 agonist. The action of this drug on these receptors is dose dependent. Multiple animal studies show that dopamine reduces uterine artery blood flow in pregnant baboons and sheep [28–30]. No studies looked at the possibility of fetal toxicity in humans, but cardiac abnormalities were reported in some animal studies [31, 32].

Estradiol treatment may decrease breast milk production in the immediate postpartum period, and it carries health risks and need for progestin use with long-term administration [17]. Antidepressants and Breast-Feeding The antidepressant exposure risk with breast-feeding is much lower than during pregnancy. Antidepressant levels in the infant are influenced by the infant’s age and capacity to metabolize the drug through the hepatic enzymes, and premature infants may be more vulnerable to adverse effects [18].

As discussed above, in the second trimester and beyond, the gravid uterus can hinder venous return and up to 25 % reduction in cardiac output by means of aortocaval compression. Hence, the first steps in the management of pregnant women with circulatory collapse should start by placing gravidas in a left lateral decubitus position which has been shown to improve cardiac output significantly [17]. Although fluid resuscitation is the first step in managing hemodynamic instability, the lower 28 E.

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