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1. Spontaneous abortion is defined as delivery prior to 20 weeks gestation. 2. Recurrent spontaneous abortion is defined as three or more spontaneous abortions prior to 20 weeks gestation.

1. Rh isoimmunization represents a maternal antibody response to immunologically incompatible fetal blood. 2. Rh isoimmunization is a preventable outcome of maternal-fetal Rh incompatibility. 3. Fetal blood should be considered Rh positive unless documented otherwise.

1. Infectious complications in pregnancy include maternal or fetal morbidity, teratogenic or developmental abnormalities, and disruption of the course of pregnancy. 2. Management of infection during pregnancy begins with thorough preconception evaluation. 3. Routine screening of all prenatal patients for common asymptomatic infections is a cornerstone of prenatal care. 4. Women should be screened by history for signs or symptoms that are suggestive of common infectious complications of pregnancy at each prenatal visit.

1. Hypertension in pregnancy is defined as blood pressure (BP) higher than 140 mmHg systolic or 90 mmHg diastolic on two occasions separated by at least 6 hours. 2. Pregnancy-induced hypertension is defined as hypertension diagnosed at or after 20 weeks gestation. 3. Pre-eclampsia is a multisystem disease characterized by hypertension and proteinuria. 4. Pre-eclampsia may lead to fetal complications including preterm delivery, intrauterine growth restriction (IUGR), fetal demise, and perinatal death, as well as maternal complications of seizure, stroke, and death.

1. Diabetes mellitus (DM) is defined as carbohydrate intolerance resulting from either insulin deficiency or insulin insensitivity. 2. Exposure to elevated serum glucose is associated with increased risk for organogenic birth defects, macrosomic infants, shoulder dystocia, and birth trauma. 3. Gestational diabetes is defined as glucose intolerance first recognized during pregnancy.

1. Intervention in pregnancy can greatly reduce the incidence of transmission of HIV from mother to child. 2. HIV treatment is not without risk and should be discussed with the patient. 3. Two-thirds of HIV transmission occur during delivery. 4. The combination of elective cesarean section, antiretroviral therapy, and the avoidance of breastfeeding can reduce maternal to fetal transmission to 2–3%. 5. Women with HIV RNA greater than 1000 copies/mL should receive highly active antiretroviral therapy (HAART) with zidovudine (ZDV) as part of the regime. 6. Women with HIV RNA less than 1000 copies/mL may receive ZDV alone or ZDV +- HAART depending on necessity. 7. ZDV has been found to relatively safe in infants, with the only observed toxicity being a mild, reversible anemia in the first 6 weeks of life.

1. Multigestational pregnancy presents unique management challenges beyond those encountered in singleton pregnancies. 2. Multigestational pregnancy may result from either a single or multiple fertilized ovum (ova). 3. Complications associated with multigestational pregnancies include spontaneous abortion, preterm delivery, pre-eclampsia, postpartum hemorrhage, and increased perinatal mortality.

1. Term pregnancy is defined as 37 to 42 weeks gestation. 2. Accurate pregnancy dating is critical to assessment and management of postdates pregnancy. 3. Timing of delivery should be prior to 42 weeks gestation; earlier if antenatal testing is nonreassuring.

1. Labor is defined as uterine contractions resulting in progressive cervical change. 2. Assessment of labor begins with confirmation of gestational age.

1. Induction is defined as artificial initiation of labor. 2. Augmentation is defined as artificial stimulation of labor. 3. Induction should always be performed for a specific indication.