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Medical Disorders in Pregnancy - a Manual for Midwives 2E


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Table of Contents

Companion Website details viii Contributors ix Acknowledgements xi Acronyms, Abbreviations and Cardiac Terms xiii Foreword xvii Foreword to the First Edition xix Preface xxi 1 Midwifery Care and Medical Disorders 1 S. Elizabeth Robson Pre-conception Care 2 Antenatal Care 2 Intrapartum Care 5 Postnatal Care 6 General Considerations 7 Emergency Management 9 Preventing Maternal Mortality 9 Back to Basics Campaign 12 Patient Organisations and Essential Reading 13 References 14 Appendix 1.1 UK Maternal Deaths ? Causes and Risk Factors 15 Appendix 1.2 Daily Vitamin and Mineral Dietary Intake for Pregnancy and Lactation 16 2 Skin Disorders 17 Catherine Gittins and Rhoda Cowell 2.1 Physiological Skin Changes in Pregnancy 18 2.2 Dermatoses Specifi c to Pregnancy 19 2.3 Eczema 20 2.4 Psoriasis 22 Patient Organisations and Essential Reading 24 References 25 Appendix 2.2.1 Emollients and Steroid Creams 26 3 Hypertensive Disorders 27 Sophia Webster, Claire Dodd and Jason Waugh 3.1 Chronic Hypertension 28 3.2 Pre-eclampsia 34 3.3 Severe Pre-eclampsia and Eclampsia 36 3.4 HELLP Syndrome 38 Patient Organisations and Essential Reading 40 References 41 4 Heart Disease 43 Moira McLean, Frances A. Bu?Lock and S. Elizabeth Robson 4.1 Mild Structural Heart Disease 44 4.2 Moderate Structural Heart Disease 48 4.3 Severe Structural Heart Disease 51 4.4 Rheumatic and Valvular Heart Disease 54 4.5 Marfan?s Syndrome 56 4.6 Functional Heart Disease: Cardiomyopathy 58 4.7 Functional Heart Disease: Arrhythmias 60 4.8 Ischaemic Heart Disease: Angina and Myocardial Infarction 62 4.9 Pulmonary Hypertension and Eisenmenger?s Syndrome 64 4.10 Heart Transplant 66 Patient Organisations and Essential Reading 68 References 69 Appendix 4.3.1 Drugs for Cardiac Disease ? An Overview for Midwives 74 5 Respiratory Disorders 75 Jane Scullion, Christopher Brightling and Michelle Goldie 5.1 The Breathless Pregnant Woman 76 5.2 Asthma 78 5.3 Pneumonia and Chest Infections 80 5.4 Tuberculosis 82 5.5 Cystic Fibrosis 84 5.6 Sarcoidosis 86 Patient Organisations and Essential Reading 88 References 89 Appendix 5.2.1 Asthma in Pregnancy:An Information Leaflet for Pregnant Women 90 6 Renal Disorders 91 Nigel J. Brunskill and Andrea Goodlife 6.1 Urinary Tract Infections 92 6.2 Chronic Kidney Disease 94 6.3 Dialysis in Pregnancy 96 6.4 Renal Transplantation 98 6.5 Nephrotic Syndrome 100 Patient Organisations and Essential Reading 102 References 103 Appendix 6.3.1 Replacement of Renal Function by Dialysis 104 7 Endocrine Disorders 105 Robert Gregory and Diane Todd 7.1 Hypothyroidism 106 7.2 Thyrotoxicosis 108 7.3 Type 1 Diabetes Mellitus 110 7.4 Type 2 Diabetes Mellitus 113 7.5 Gestational Diabetes Mellitus 115 7.6 Addison?s Disease (Adrenal Insuffi ciency) 118 7.7 Prolactinoma 120 Patient Organisations and Essential Reading 122 References 123 Appendix 7.3.1 Diabetes Mellitus 124 8 Neurological Disorders 125 Fionnuala McAuliffe, Eleanor Burns-Kent, Deborah Frost and Edmund S. Howarth 8.1 Migraine and Headaches 126 8.2 Epilepsy 128 8.3 Cerebrovascular Disease and Stroke 132 8.4 Bell?s Palsy 137 8.5 Carpal Tunnel Syndrome 140 8.6 Myasthenia Gravis 142 8.7 Multiple Sclerosis 144 Patient Organisations and Essential Reading 147 References 148 Appendix 8.2.1 Drugs Used for Neurological Conditions 152 9 Musculoskeletal Disorders 153 S. Elizabeth Robson, Marie C. Smith, Edmund S. Howarth and Javed Iqbal 9.1 Back and Pelvic Pain 154 9.2 Diastasis Recti Abdominis 156 9.3 Pregnancy Related Pelvic Girdle Pain 158 9.4 Hypovitaminosis D 160 9.5 Osteoporosis 163 Patient Organisations and Essential Reading 165 References 166 Appendix 9.1.1 Pain Therapy Ladder for Pregnancy 169 10 Gastrointestinal Disorders 171 Rosemary Lydall, Manjiri Khare, Caroline Farrar and S. Elizabeth Robson 10.1 Gastro-oesophageal Reflux and Hiatus Hernia 172 10.2 Coeliac Disease 176 10.3 Ulcerative Colitis 178 10.4 Crohn?s Disease 180 10.5 Irritable Bowel Syndrome 182 10.6 Haemorrhoids 184 10.7 Anal Sphincter Disorders 186 10.8 Obstetric Cholestasis 188 10.9 Gall Bladder and Pancreatic Disease 190 Patient Organisations and Essential Reading 192 References 193 Appendix 10.3.1 Care of a Stoma 197 Appendix 10.5.1 Management Algorithm of Irritable Bowel Syndrome 198 11 Autoimmune Disorders 199 S. Elizabeth Robson and Julie Goddard 11.1 Rheumatoid Arthritis 200 11.2 Raynaud?s Phenomenon 202 11.3 Systemic Lupus Erythematosus 204 11.4 Antiphospholipid (Hughes) Syndrome 206 Patient Organisations and Essential Reading 209 References 210 Appendix 11.1.1 Drugs for Autoimmune Disease ? An Overview for Midwives 213 12 Infectious Conditions 215 Karen Watkins, Veronica Johnson-Roffey, Juliet Houghton and S. Elizabeth Robson 12.1 Viral Hepatitis 216 12.2 Human Immunodefi ciency Virus 218 12.3 Malaria 220 12.4 Chickenpox 223 12.5 Toxoplasmosis 226 12.6 Listeriosis 228 12.7 Herpes Simplex Virus 230 12.8 Streptococcal Sepsis 232 Patient Organisations and Essential Reading 234 References 235 Appendix 12.1.1 The ABC of Hepatitis 238 Appendix 12.2.1 Other Infectious Viral Diseases 239 Appendix 12.2.2 Other Infectious Bacterial Diseases 240 13 Metabolic Disorders 241 Rowena Doughty and Jason Waugh 13.1 Obesity 242 13.2 Phenylketonuria 244 13.3 Hyperemesis Gravidarum 246 13.4 Acute Fatty Liver of Pregnancy 248 Patient Organisations and Essential Reading 250 References 251 Appendix 13.1.1 Body Mass Index 253 14 Haematological Disorders 255 Abena Addo, Christina Oppenheimer and S. Elizabeth Robson 14.1 Iron Deficiency Anaemia 256 14.2 Megaloblastic Anaemia 260 14.3 Disseminated Intravascular Coagulation 262 14.4 Von Willebrand?s Disease and Other Bleeding Disorders 264 14.5 Thrombocytopenia in Pregnancy 266 14.6 Thalassaemia 268 14.7 Sickle Cell Disorders 270 Patient Organisations and Essential Reading 273 References 274 Appendix 14.1.1 Blood and Blood Products Overview 277 15 Thrombo-embolic Disorders 279 Daksha Elliott and Sue Pavord 15.1 Thrombophilia and Inherited Clotting Disorders 280 15.2 Deep Vein Thrombosis 282 15.3 Pulmonary Embolism 287 15.4 Thromboprophylaxis 290 Patient Organisations and Essential Reading 294 References 295 Appendix 15.4.1 Thrombo-embolic Disease Stockings 297 16 Addictive Disorders 299 Paul Moran and Madeleine Findlay 16.1 Substance Misuse 300 16.2 Alcohol Addiction 302 16.3 Tobacco and Cannabis Use 304 16.4 Cocaine Addiction 306 16.5 Opiate Addiction 308 16.6 Stimulant Addiction 310 Patient Organisations and Essential Reading 312 References 313 Appendix 16.1.1 Applying a Formal Assessment Framework 315 Appendix 16.3.1 Preventing SIDS: Advice to Parents 316 Appendix 16.4.1 Care of the Baby who Experiences Withdrawal 317 17 Psychiatric Disorders 319 Renuka Lazarus and Kathryn Gutteridge 17.1 Antenatal Psychiatric Disorders 320 17.2 Postnatal Psychiatric Disorders 322 17.3 Eating Disorders 324 17.4 Post-Traumatic Stress Disorder 326 Patient Organisations and Essential Reading 328 References 329 Appendix 17.1 Treatment Guidance for Depression 331 18 Neoplasia 333 Caroline Farrar and Francis J. E. Gardner 18.1 Gestational Trophoblastic Disease (Hydatidiform Mole and Choriocarcinoma) 334 18.2 Cervical Cancer 336 18.3 Cervical Screening 340 18.4 Breast Cancer 342 18.5 Non-Hodgkin?s Lymphoma 344 18.6 Hodgkin?s Lymphoma 346 18.7 Ovarian Neoplasia 348 18.8 Malignant Melanoma 351 Patient Organisations and Essential Reading 354 References 355 Index 357

About the Author

S. Elizabeth Robson is Principal Lecturer in Midwifery atDe Montfort University, Leicester, UK. With 25 years of experienceas a midwifery lecturer, she leads a module on medical disordersfor student midwives with a particular interest in immunology. Herlink lecturer areas comprise a high-risk maternity ward andcommunity team. She has presented nationally, and has a number ofpublications. Jason Waugh is Consultant in Obstetrics and MaternalMedicine at the Royal Victoria Infirmary, Newcastle Upon Tyne, UK.He has published extensively in the fields of hypertension andrenal and cardiovascular disease in pregnancy as well as producingnational guidelines for the management of pre-eclampsia and renaldisease. He is President of the UK s Macdonald ObstetricMedicine Society.


Reviews of 1st edition:"The important facts are laid out concisely, primarily focusing onmanagement and using evidence-based guidelines for best midwiferypractice." ( The Obstetrician & Gynaecologist, 2010) "A strength of this book is that it has an unashamedly simpleat-a-glance format, easy to get used to. The chapters are based onthe traditional systems approach with sections dealing withdisorders and diseases...the important facts are laid outconcisely, primarily focusing on management, using evidence basedguidelines for best midwifery practice." (RCGP Journal,April 2010) This is an excellent book for use in the clinical arenaby nurse midwives, nurses, and other healthcare practitionerscaring for women with preexisting medical problems. (Doody's Reviews, June 2009) "The editors highlight recognition of deviation from the normalas an essential component of midwifery and have provided a manualthat will be appreciated by midwives in all areas of practice andwill be of great value to students studying high-risk modules."(Midwives, April/May 2009) "This book is a must have for any midwife, particularly thoseworking in the community, clinics and in high-risk areas... Thisbook is an extremely useful reference tool. For students midwivesit is an essential read when undertaking the 'complications' moduleof their course." (MIDIRS Midwifery Digest, January2009) I am currently a final year student midwife and can confidentlysay that this book has a simple with easy to read definitions ofeach disorder. It has clear details on the management in pregnancy,labour and following birth from a midwifery perspective - a mustfor any student midwife and a fantastic reference for all qualifiedmidwives. (5 Amazon Review ) "This book is a long awaited text providing a comprehensive lookat many of the medical conditions encountered by women duringchildbirth. Other texts with similar content have been recentlyproduced but this text has the advantage of the information beingpresented in tabular format, thus making it easy to follow and anideal reference tool. The care for each condition is broken downinto pregnancy, labour and postnatal aspects and then presentsexpected care from the medical and midwifery perspective, althoughthe reader will naturally have to apply any local policy for morespecific care. The conditions are divided under logical headingsand have been written by experienced professionals who havespecialist knowledge in the field they are covering. There is alsoa welcome addition of a chapter covering addictive disorders andpsychiatric disorders, both currently high on the agenda." Alison Edwards, Senior Midwifery Lecturer, BirminghamCity University. "Comprehensive coverage - systematic layout - extremelyinformative - simple and easy to understand language." Aine Kothari, Senior Lecturer, Anglia RuskinUniversity "Easy to use and informative. Content relevant and up to date.Covers more topics than standard textbooks for midwives. Highlyrecommended." Lesley Daniels, Midwifery Lecturer, LeedsUniversity "A long-awaited text, providing succinct outlines of corerequired for wide range of commonly occurring conditions." Alison Edwards, Midwifery Lecturer, Birmingham CityUniversity "Excellent book - contemporary, well organized and informativechapters well supported by tables. An excellent resource formidwives and students." Alison James, Midwifery Lecturer, PlymouthUniversity

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