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Obstetrics

• Editor's Note
• List of Articles

List of Articles

• Amniotic Fluid Disorders
  Amniotic fluid is seldom considered important until polyhydramnios or oligohydramnios occurs, either of which may significantly impact perinatal survival. Amniotic fluid is dynamic, with large volume flows into and out of the amniotic compartment each day. This document explores what is known about the normal mechanisms affecting the formation and removal of amniotic fluid, including fetal urination, swallowing, lung liquid and intramembranous absorption. In addition, the changes in amniotic fluid volume and composition across gestation, in order to help us understand its normal regulation are examined. The various treatment options available for amniotic fluid volume abnormalities are discussed. The goal of this review is to offer the reader a complete understanding of the known mechanisms and functioning of amniotic fluid volume regulation, and their connection with disease states.
  
  
• Genetic Counseling and Genetic Screening
  The review discusses the principles of genetic counseling and genetic screening. Disorders amenable to genetic screening and prenatal diagnosis are also enumerated. Salient principles of the genetic counseling process are described. A variety of molecular diagnostic tests are available to determine whether an individual or fetus has inherited a disease-causing gene mutation. It can identify other family members or relatives at risk for the disorder or at risk for being a carrier. The gift of life can be "perfect" even in the presence of serious problems.
  
  
• HELLP Syndrome - Diagnosis and Management
  Intravascular hemolysis, elevated liver function tests and low platelets counts (thrombocytopenia) also known as HELLP syndrome has been recognized as a complication of severe preeclampsia and eclampsia for many decades. The purpose of this document is to describe the pathogenesis, diagnosis and management of this syndrome. The presence of this syndrome is associated with increased risk of adverse outcome for both mother and fetus. This review will explain the controversies surrounding the diagnosis and management of this syndrome. Recommendations for the counseling of these women are also provided based on the results of recent studies.
  
  
• Normal Values in Pregnancy
  The physiologic, biochemical, and anatomic changes that occur during pregnancy are extensive and may be systemic or local. However, most systems return to pre-pregnancy status between the time of delivery and 6 weeks postpartum. Major adaptation in maternal anatomy, physiology, and metabolism are required for a successful pregnancy. Hormonal changes, initiated before conception, significantly alter maternal physiology, and persist through both pregnancy and initial postpartum period. A full understanding of physiologic changes is necessary to differentiate between normal alterations and those that are abnormal. This document describes maternal adaptations in pregnancy. An understanding of the normal physiologic changes and values induced by pregnancy is essential in understanding coincidental disease processes. Many laboratory values are dramatically altered from non-pregnant values. We hope this provides a valuable tool to manage your patients effectively.
  
  

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