REFERENCE: 1. Stewart A, Webb J, Giles D, Hewitt D. Malignant disease <strong>in</strong> childhood and diagnostic irradiation <strong>in</strong> utero. Lancet 1956; 2: 447. 2. Hammer-Jacobsen E. Therapeutic abortion on account <strong>of</strong> x-ray exam<strong>in</strong>ation dur<strong>in</strong>g pregnancy. Danish Med Bull 1959; 6: 113-122. 3. United Nations Scientific Committee on the Effects <strong>of</strong> Atomic Radiation. Ioniz<strong>in</strong>g radiation: levels and effects. 1972 Report to the General Assembly, with annexes. Vol II. Effects. New York, United Nations, 1972. 4. Nelson JA, Liv<strong>in</strong>gston JC, Moon RG. Mutagenic evaluation <strong>of</strong> radiographic contrast media. Invest Radiol 1982; 17: 183-185. 5. Benjam<strong>in</strong> SA, Lee AC, Angleton GM, et al. Neoplasms <strong>in</strong> young dogs after per<strong>in</strong>atal irradiation. J Natl Cancer Inst 1986; 77: 563-571. 6. Wagner LK, Archer BR, Zeck OF. Conceptus dose from two state-<strong>of</strong>-theart CT scanners. Radiology 1986; 159: 787-792. 7. Gilman EA, Kneale GW, Knox EG, Stewart AM. <strong>Pregnancy</strong> X-rays and childhood cancers: effects <strong>of</strong> exposure age and radiation dose. J Radiol Prot 1988; 8: 3-8. 8. G<strong>in</strong>sberg JS, Hirsh J, Ra<strong>in</strong>bow AJ, Coates G. Risks to the fetus <strong>of</strong> radiologic procedures used <strong>in</strong> the diagnosis <strong>of</strong> maternal venous thromboembolic disease. Thrombosis and Haemostasis 1989; 61: 189-196. 9. Mole RH. Childhood cancer after prenatal exposure to diagnostic x-ray exam<strong>in</strong>ations <strong>in</strong> Brita<strong>in</strong>. Br J Cancer 1990; 62: 152-168. 10. Roberts PJ, Given-Wilson R, Gifford D, Bryan G. <strong>Pregnancy</strong> and work <strong>in</strong> diagnostic imag<strong>in</strong>g. Report <strong>of</strong> a jo<strong>in</strong>t work<strong>in</strong>g party <strong>of</strong> the Royal College <strong>of</strong> Radiologists and British Institute <strong>of</strong> Radiology. British Institute <strong>of</strong> Radiology, London, 1992. 227 11. Muirhead CR, Cox R, Stather JW, et al. Estimates <strong>of</strong> late radiation risks to the UK population. Documents <strong>of</strong> the NRPB 4[4]. Chilton: National Radiological Protection Board, 1993: 15-157. 12. Hall EJ. Radiobiology for the radiologist, 4th ed. Philadelphia: Lipp<strong>in</strong>cott; 1994: 363-452. 13. Bushberg JT, Seibert JA, Leidholdt EM, Boone JM. The essential physics <strong>of</strong> medical imag<strong>in</strong>g. Williams and Wilk<strong>in</strong>s, Baltimore, 1994; 694. 14. Berl<strong>in</strong> L. Radiation exposure and the pregnant patient. AJR 1996; 167: 1377- 1379. 15. Damilakis J, Prassopoulos P, Peris<strong>in</strong>akis K, Faflia C, Gourtsoyiannis N. CT <strong>of</strong> the sacroiliac jo<strong>in</strong>ts: Dosimetry and optimal sett<strong>in</strong>gs for a high-resolution technique. Acta Radiol 1997; 38: 870-875. 16. Damilakis J, Peris<strong>in</strong>akis K, Voloudaki A, Gourtsoyiannis N. Estimation <strong>of</strong> fetal radiation dose from computed tomography scann<strong>in</strong>g <strong>in</strong> late pregnancy: depth-dose data from rout<strong>in</strong>e exam<strong>in</strong>ations. Investigative Radiology 2000; 35: 527-533. 17. Doll R, Wakeford R. Risk <strong>of</strong> childhood cancer from fetal irradiation. Br J Radiol 1997; 70: 130-139. 18. Accessed 3/14/06. ACOG Committee on Obstetric Practice. ACOG ommittee Op<strong>in</strong>ion. Number 299, September 2004. 19. Guidel<strong>in</strong>es for diagnostic imag<strong>in</strong>g ur<strong>in</strong>g pregnancy. Obstet Gynecol. 2004; 104: 647-651.
INDEX A abdomen 14, 50, 118, 211, 216, 225-6 Abnormal hemoglob<strong>in</strong>s 13 abortion 21, 35-6, 38, 81, 126, 133, 155-6, 160, 169-70, 172, 174, 189, 191, 213-14, 219 abruptio placentae 96 the risk <strong>of</strong> 52, 93 acid, glutamic 12-13 acoustic damage 221-2 Acute fatty liver <strong>of</strong> pregnancy 112, 119, 121- 3, 114, 116, 119-20, 122-3 adult hemoglob<strong>in</strong>s 12, 15 Adverse Effects <strong>of</strong> Antiretrovirals <strong>in</strong> HIV- Infected Pregnant Women 163 AFP 196-7 album<strong>in</strong> 26, 61, 77, 89, 109-10, 125-6, 196 alcohol 61, 110, 179-81, 183 aldosterone levels 46 ALT 114, 116, 119 am<strong>in</strong>o acids 10, 13, 29, 109, 194, 199 amniocentesis 55, 126-8, 135, 163, 189, 194, 196-7, 199, 216 amniotic fluid 42, 127-8, 135, 190, 193-7, 222, 225 amniotic fluid analysis 27, 126-8 amount 3-4, 12, 31, 47, 64, 93, 110-11, 125, 128, 132, 190, 193, 197, 199, 204 amphetam<strong>in</strong>es 182-3 ampicill<strong>in</strong> 78, 92, 102, 191 anaemia 1-3, 5-6, 8, 10-12, 14, 17, 124, 130, 138-9, 153, 157, 161 iron deficiency 2-3, 17, 160 megaloblastic 10-11, 155 sickle cell 8, 13-14 severe 2, 132, 156, 159, 161 anti-coagulant therapy 143, 145 antibiotic prophylaxis 84-5 antibiotics 16, 73, 75, 92, 102, 145, 150-1, 186 antibodies 107, 110, 115-16, 124-6, 130, 132, 151, 157, 166, 168, 170 antibody production 125, 166 antibody titre 126, 129, 170 anticoagulants 78-9, 137, 142, 144 anticoagulation 85-6 antigen 115, 124, 126-7 Antihypertensive medications 63-5 anuria 42, 45, 96-7 aorta 41, 46, 49-50, 52, 67, 69-71, 74, 80, 84, 225 aortic valves 67, 69-70 aortography 49-50 apnoea 175-6 ap<strong>of</strong>errit<strong>in</strong> 3, 5 appendicitis 223-4, 226 arrhythmias 84-7 asthma 10, 103-4 asymptomatic bacteriuria 24, 91, 99 B bacteremia 78, 180 bacteria 90-2, 148-51 barbiturates 180, 183 bed rest 36, 43, 47-8, 54-5, 80 benzodiazep<strong>in</strong>es 180-1, 183 bile 6, 110-11, 123, 125, 191 bilirub<strong>in</strong> 109-14, 125, 127, 129-34, 195-6 conjugated 110-11 unconjugated 110, 133-4 bilirub<strong>in</strong> encephalopathy 130-1 bilirub<strong>in</strong> glucuronide 125, 130 bilirub<strong>in</strong> levels 117-19, 131-3, 195 <strong>in</strong>direct 129-30 biparietal diameter 27, 207, 210, 215 birth 4, 32, 35, 37, 77, 115, 121, 124-5, 127, 130, 156, 166, 168-9, 172, 194-5 Birth Defects and Drugs <strong>in</strong> <strong>Pregnancy</strong> 186 bladder 62, 89, 91, 215-16, 225 block, left bundle branch 70, 76-7 blood 3-6, 10, 13, 16, 25, 61-2, 67-8, 96, 111, 124-5, 131-2, 136-9, 142-4, 154-5, 170 cord 16, 129, 155 mother's 134, 196 blood constituents 137 blood flow 13, 42-3, 57, 70-1, 111, 137, 139 blood glucose levels 21, 24, 29-30 Blood glucose tests 29-30 Blood <strong>of</strong> Pregnant Women 204 blood picture 10-12, 14-15 blood pressure 10, 26-7, 40-1, 48, 50, 52-5, 58-60, 62, 64-5, 67, 72, 88-9, 93, 119, 144 diastolic 41, 53, 58, 67, 72 blood sugar 22, 24, 26, 29, 46, 64 blood transfusion 15, 116, 154, 156 blood vessels 50, 68, 136-7, 157, 211 blood volume 43, 67-9, 71-2, 75, 109 bone marrow 2, 4, 10, 12, 14-15, 109 bones, long 14, 203-4 bradycardia 58, 175-6 breast milk 64, 79, 102, 175-8, 183, 223 breastfeed<strong>in</strong>g 17, 32-3, 175-9, 222-3 breathlessness 103-4 BUN 88, 90, 93, 97 C caffe<strong>in</strong>e 110, 125, 185 calories 28, 54 candida 149-50, 180 1
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MEDICAL DISORDERS IN PREGNANCY M. S
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PREFACE Almost all medical disorder
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Dedication This manuscript is dedic
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Uri. Elkayam MD Professor of Cardio
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Chapter No: 1 Anaemia in pregnancy:
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performance. Tiredness, listlessnes
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pregnancy and labour. The monthly b
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Fig 1.3: Shows developmental stages
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Prophylactic this includes routine
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granulocytes and thrombocyte is als
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or because the hemoglobin A is repl
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iron. Decrease in the number of gra
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Labor/delivery: Expedite for normal
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Risk factors: The risk of GDM incre
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to a large extent on the measure of
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vomiting, or through intercurrent i
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largely related to the problems of
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femoral epiphyses can help in asses
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in a randomized design the efficacy
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of the previous day’s dose of ins
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women with vascular disease are awa
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Chapter No 3 THYROID DISEASE IN PRE
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such as phenobarbitone 30 mg given
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REFERENCES: 1. Hawe, P. and Francis
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Incidence - Its incidence varies ac
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cerning the disturbance in the Reni
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Renal function: In normal pregnant
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severe pre eclampsia and eclampsia
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Epipastic pain: It is also a late s
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arely occurs. However, if pregnancy
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differentiating between chronic hyp
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fetuses. Recent studies indicate th
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to procrastinate all available meth
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cases are said to occur up to 1 wee
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has been carried out. There can be
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intensive care room for the next 48
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Severe pre eclampsia at or remote f
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Chapter No: 5 HEART DISEASE IN PREG
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pregnancy. The increase in volume i
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Fourth Heart sound - This is rarely
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Class III - With cardiac disease pr
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differentiate from hemodynamically
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dominant). Jervell + Lange Nielson
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striking of which is stippling seen
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increase venous pressure and burden
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determine whether she will be safe
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supplemental 02. Fetal surveillance
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11. Percutaneous transluminal angio
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ureter at the pelvic brim may play
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Fig6.3: Shows location of kidney in
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A clear cut history of streptococca
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(a) Polycystic renal disease - Fort
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with patients in this category. In
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2. Beard, R.W.and Roberts, A.P. (19
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increases slightly. Arterial blood
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scan, 0.004 Gy; pulmonary angiograp
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CD4 + cell count (200/ml) should re
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embark upon a pregnancy. Severe air
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Chapter No: 8 LIVER DISEASE IN PREG
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owel, but conjugated bilirubin is n
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Hepatic causes - Viral hepatitis bo
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Immunoprophylaxis at birth followed
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highest reported rate of vertical t
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curs in 60 to 70 percent of subsequ
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Chronic liver disease: An increased
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22. Riely CA. Hepatic disease in pr
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ilirubin is transported across the
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when the titre is greater than 1: 3
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Induction of labour: When screening
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Blood brain barrier and bilirubin e
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place if the infant develops jaundi
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REFERENCES 1. UpToDate a. “Pathog
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of embolus formation is far less in
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Unfortunately this faculty is not a
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hours. The maximal effect takes 36
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may complain of constricting type o
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When the embolus is small and non f
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3. Sukal S, Geronemus R. "Deep Veno
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damage specific cells in the tissue
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is capable of breaking off and deve
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Chapter No: 12 PARASITIC INFECTIONS
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sporozoite stage. The main characte
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insect repellents and insecticide s
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is 2 tablets i.e. (400 mgs) thrice
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Cardiac failure resulting from seve
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dysmenorrhea, dysuria, and even obs
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Chapter No: 13 VIRAL DISEASES IN PR
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after exposure favors but does not
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Fig13.4: shows CMV infection rash o
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three quarters of HYH strains isola
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where 'T' stands for toxoplasmosis
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Chapter No: 14 Introduction: The dr
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