Overview of High-Risk Pregnancy

Obstetrics has seen extraordinary changes in practice with enormous gains in molecular genetics, imaging, and evidence-based management of both common and uncommon conditions. In this chapter, the authors provide new insights into the management of maternal substance use and simplify approaches to prenatal screening and diagnosis of fetal genetic abnormalities. They provide indications for fetal surgery and cover the range of established perinatal pathogens such as group B beta-hemolytic streptococcus, malaria, hepatitis, and HIV and emerging infections such as Zika and COVID-19. The latest in diagnosis and treatment of serious maternal pre-existing medical conditions including cardiac and renal disease, systemic lupus erythematosus, chronic hypertension, diabetes, thrombo-embolism, thrombocytopenia, and anemia are described. Indications, risks, and techniques for a full range of obstetrical procedures are also explored from operative vaginal delivery to induction of labor, fetal monitoring, and fetal diagnostic procedures.