We celebrate this 25th edition of Williams Obstetrics with greatappreciation for the insight and expertise that the early editorsbrought to this textbook. To pay tribute to the first author, J.Whitridge Williams, we begin each chapter with a passage fromhis 1st edition that complements the topic. During this selectionprocess, we were inspired by the strides that modernobstetrics has made since that edition in 1903. Similarly, wewere humbled by some of the classic challenges that still persist.Preterm labor, preeclampsia, and infections are some examples.That said, many of these advances were derived from rigorous,evidence-based research. And, we acknowledge and support thepower of this academic ideal to further our specialty in thedecades to come.Forthis 25th edition, we continue to present the detailedstaples of basic obstetrics such as maternal anatomy and physiology,preconceptional and prenatal care, labor, delivery, andthe puerperium.These accompany detailed discussions ofobstetrical complications exemplified by preterm labor, hemorrhage,hypertension, and many more. To emphasize the “M” inMaternal–Fetal Medicine,we continue to iterate the manymedical and surgical disorders that can complicate pregnancy.And,our second patient—the fetus—has accrued especialattention with an entire section devoted todiagnosis and treatmentof fetal disorders. For all of these, we once again emphasizethescience-based underpinnings of clinical obstetrics withspecial emphasis on biochemical andphysiological principles.As was the hallmark of previous editions, these dovetail withdescriptionsof evidence-based practices. Expert clinical pearlsadd depth to these discussions and are writtenfor busy practitioners—those “in the trenches.”To accomplish these goals, the text has beenupdated withmore than 3000 new literature citations through 2017. Manyof the nearly 900figures are new, and these graphs, sonograms,magnetic resonance images, photographs,photomicrographs,and data graphs are almost all in vivid color. Much of theoriginal artwork was rendered by our own medical illustrators.Also, as before, we continue to incorporatecontemporaneousguidelines from professional and academic organizationssuch as the AmericanCollege of Obstetricians and Gynecologists,the Society for Maternal–Fetal Medicine, theNationalInstitutes of Health and the National Institute for ChildHealth and Human Development,the Centers for DiseaseControl and Prevention, and other authoritative sources. Manyof thesedata are distilled into nearly 100 tables, in which informationhas been arranged in an easyread-and-use format. Inaddition, several diagnostic and management algorithms areavailable to quickly guide practitioners. Although we strive tocite numerous sources and provide multipleevidence-basedoptions for such management schemes, we also include ourown clinicalexperiences drawn from the large obstetrical serviceat Parkland Hospital. We are convinced thatthese aredisciplined examples of evidence-based obstetrics but quicklyacknowledge that they donot constitute the sole method ofmanagement.
 F. Gary Cunningham
 Kenneth J. Leveno
 Steven L. Bloom
 Jodi S. Dashe
 Barbara L. Hoffman
 Brian M. Casey
 Catherine Y. Spong
 
 
Preface
 Acknowledgments
 SECTION 1:OVERVIEW
 1. Overview of Obstetrics
 SECTION 2:MATERNAL ANATOMY AND PHYSIOLOGY
 2. Maternal Anatomy
 3. Congenital GenitourinaryAbnormalities
 4. Maternal Physiology
 SECTION 3:PLACENTATION, EMBRYOGENESIS, AND FETAL DEVELOPMENT
 5. Implantation and PlacentalDevelopment
 6. Placental Abnormalities
 7. Embryogenesis and FetalDevelopment
 SECTION 4:PRECONCEPTIONAL AND PRENATAL CARE
 8. Preconceptional Care
 9. Prenatal Care
 SECTION 5:THE FETAL PATIENT
 10. Fetal Imaging
 11. Amnionic Fluid
 12. Teratology, Teratogens, andFetotoxic Agents
 13. Genetics
 14. Prenatal Diagnosis
 15. Fetal Disorders
 16. Fetal Therapy
 17. Fetal Assessment
 SECTION 6:EARLY PREGNANCY COMPLICATIONS
 18. Abortion
 19. Ectopic Pregnancy
 20. Gestational Trophoblastic Disease
 SECTION 7:LABOR
 21. Physiology of Labor
 22. Normal Labor
 23. Abnormal Labor
 24. Intrapartum Assessment
 25. Obstetrical Analgesia andAnesthesia
 26. Induction and Augmentationof Labor
 SECTION 8:DELIVERY
 27. Vaginal Delivery
 28. Breech Delivery
 29. Operative Vaginal Delivery
 30. Cesarean Delivery and PeripartumHysterectomy
 31. Prior Cesarean Delivery
 SECTION 9:THE NEWBORN
 32. The Newborn
 33. Diseases and Injuries ofthe Term Newborn
 34. The Preterm Newborn
 35. Stillbirth
 SECTION 10:THE PUERPERIUM
 36. The Puerperium
 37. Puerperal Complications
 38. Contraception
 39. Sterilization
 SECTION 11:OBSTETRICAL COMPLICATIONS
 40. Hypertensive Disorders
 41. Obstetrical Hemorrhage
 42. Preterm Birth
 43. Postterm Pregnancy
 44. Fetal-Growth Disorders
 45. Multifetal Pregnancy
 SECTION 12:MEDICAL AND SURGICAL COMPLICATIONS
 46. General Considerations andMaternal Evaluation
 47. Critical Care and Trauma
 48. Obesity
 49. Cardiovascular Disorders
 50. Chronic Hypertension
 51. Pulmonary Disorders
 52. Thromboembolic Disorders
 53. Renal and Urinary Tract Disorders
 54. Gastrointestinal Disorders
 55. Hepatic, Biliary, and PancreaticDisorders
 56. Hematological Disorders
 57. Diabetes Mellitus
 58. Endocrine Disorders
 59. Connective Tissue Disorders
 60. Neurological Disorders
 61. Psychiatric Disorders
 62. Dermatological Disorders
 63. Neoplastic Disorders
 64. Infectious Diseases
 65. Sexually Transmitted Infections
 APPENDIX
 Serum and Blood Constituents
 Maternal EchocardiographicMeasurements
 Fetal Sonographic Measurements
 Index