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
