Chapter 8: Obstetrics

Subsequent prenatal visits focus on maternal surveillance through regular monitoring of vital signs, weight progression, fundal height measurement, and fetal cardiac activity, while addressing common gestational complaints. The chapter details first, second, and third trimester screening strategies, including serum markers like pregnancy-associated plasma protein A and human chorionic gonadotropin, ultrasound assessment of nuchal translucency, and antepartum fetal surveillance techniques including nonstress testing and biophysical profiling. High-risk pregnancy management encompasses recognition and care of adolescent pregnancy and multiple gestations, both associated with elevated rates of adverse outcomes. Common obstetric complications receive detailed coverage, including ectopic pregnancy with discussion of medical versus surgical management, spontaneous abortion with classification of severity stages, gestational trophoblastic disease with characteristic imaging findings, and gestational diabetes mellitus screening and treatment protocols. The chapter extensively addresses hypertensive complications including preeclampsia and eclampsia with pharmacologic management strategies, and HELLP syndrome as a severe manifestation. Placental abnormalities such as placenta previa and placental abruption are distinguished by their clinical presentations and bleeding characteristics. Labor and delivery content covers the three stages of labor with emphasis on cervical changes and descent mechanics, intrapartum monitoring of maternal and fetal status, and management of dysfunctional labor patterns through augmentation or operative delivery. The postpartum section describes normal physiological involution of the uterus and lochia characteristics, while reviewing common complications including postpartum hemorrhage with management algorithms and postpartum infection requiring antibiotic intervention.