Critical Care Obstetrics Fifth Edition PDF


Critical Care Obstetrics Fifth Edition PDF

Critical Care Obstetrics Fifth Edition PDF

Critical Care Obstetrics Fifth Edition  

is the best book that explains everything that need to know in OBSTETRICS AND GYNECOLOGY residency programs let discuss something about the epidemiology successful epidemiologic evaluation of any particular disease or condition has several prerequisites. Two of the most important prerequisites are that the condition should be accurately defined and that there should be measurable outcomes of interest.

Another requirement is that there must be some systematic way of data collection or surveillance that will allow the measurement  the outcomes of interest and associated risk factors. The epidemiologic evaluation of critical illness associated with pregnancy has met with mixed success on all of these counts.

Historically, surveillance of pregnancy – related critical illness has focused on the well  defined outcome of maternal mortality in order to identify illnesses or conditions that might have led to maternal death. Identification of various conditions associated with maternal mortality initially came from observations by  clinicians. One of the best examples is the link described by Semmelweiss between hand – washing habits and puerperal fever. In most industrial and many developing countries, there are now population – based surveillance mechanisms in place to track maternal mortality.

These often are mandated by law. In fact, the World Health Organization uses maternal mortality as one of the measures of the health of a population  
Fortunately, in most industrialized nations the maternal mortality rates have fallen to very low levels. Recent statistics for the United States suggest that overall maternal mortality was 11.5 maternal deaths per 100 000 live births during 1991 – 97
Despite this impressively low rate of maternal mortality, tracking maternal deaths may not be the best way to assess pregnancy  related critical illnesses since the majority of such illnesses do not result in maternal death. As stated by Harmer  “ death represents the tip of the morbidity iceberg, the size of which is unknown.


Unlike mortality, which is an unequivocal endpoint, critical illness in pregnancy as a morbidity outcome is difficult to defi ne and, therefore, difficult to measure and study  precisely.