Vaginal Delivery, as the Obstetrician Would Say

This book aims to describe in-depth decisions about maternal care with up-to-date and practical knowledge that improves obstetric and perinatal outcomes of the mother-baby binomial. Developed in seven chapters, with dozens of figures, it begins by describing the physiological, hormonal, immunological, and enzymatic events produced in mother-fetus communication between the onset of regular uterine contractions, through labor, birth, and delivery, until the puerperium. In this context, the Friedman curve and the new studies and definitions established by Dr. Zhang and his group are compared. It is explained how the partograph must be filled out properly, relating to the alterations of labor known as dystocia, and recommendations are given for timely diagnosis and relevant interventions. A chapter on electronic fetal monitoring is included, emphasizing antepartum and intrapartum interpretation and its clinical utility. Multiple examples are presented with recording graphs and correlated with fetal acid-base status. Postpartum hemorrhage is addressed. It is a foreseeable event secondary to childbirth, whose mortality is almost always avoidable. For this reason the authors develop the topic including pathophysiology, etiology, risk factors, prevention, diagnosis, and diagnostic aids, medical and surgical interventions according to the cause. For the authors, this book could not fail to include a chapter on labor induction. Bearing in mind that a properly carried out practice can reduce the number of cesarean sections and maternal and fetal morbidity and mortality, the indications, contraindications, risks, and different methods to end the pregnancy by vaginal delivery are presented. The last chapter deals with the normal puerperium and the pathologies frequently found in women after childbirth and ends with the protocol of the postpartum control appointment. This book has been created after the simple observation of three professors from the Universidad del Valle who, from their day-to-day work, mainly at the Hospital Universitario del Valle "Evaristo García," concluded that students and professionals from different health careers involved in maternal care could improve their knowledge regarding labor, delivery and the puerperium; and that although there are texts available in the literature on obstetrics in general, and that most of them are of good academic quality, none of them is dedicated exclusively to addressing physiological processes and their alterations during labor, delivery, and the puerperium as in the book Vaginal Delivery, as the Obstetrician Would Say.