Acknowledgments xiii

List of Contributors xv

1 Ethical Issues in the Treatment of the Pregnant Patient 1
Christos A. Skouteris

References 3

Further Reading 3

2 Physiologic Changes and Their Sequelae in Pregnancy 5
Christos A. Skouteris

Cardiovascular 5

Respiratory 6

Hematologic 8

Gastrointestinal 10

Genitourinary 12

Endocrine 14

Immunologic 15

Dermatologic 16

Musculoskeletal 17

Psychologic and Behavioral Changes 17

References 18

Further Reading 19

3 Implications of Physiologic Changes in the Dental Management of the Pregnant Patient 25
Christos A. Skouteris

Cardiovascular Changes: Management Considerations 25

Respiratory Changes: Management Considerations 25

Hematologic Changes: Management Considerations 26

Gastrointestinal Changes: Management Considerations 27

Genitourinary Changes: Management Considerations 28

Endocrine Changes: Management Considerations 28

Immunologic Changes: Management Considerations 29

Dermatologic Changes: Management Considerations 29

Musculoskeletal Changes: Management Considerations 30

Psychologic and Behavioral Changes: Management Considerations 31

Reference 31

Further Reading 31

4 General Principles for the Comprehensive Treatment of the Pregnant Patient 33
Christos A. Skouteris

Recording of Pregnancy Status before Treatment 33

Diagnostic Imaging Modalities in Pregnancy 34

Medications, Substance Abuse, and Their Implications in the Dental

Management of the Pregnant Patient 38

Procedural Sedation (Oral, N2O, Intravenous) 57

General Anesthesia 60

References 64

Further Reading 65

5 Dental and Oral Diseases in Pregnancy 71
Christos A. Skouteris

Prenatal Counseling and Prevention 71

Further Reading 73

6 Dental, Oral, and Maxillofacial Diseases and Conditions and Their Treatment 75

Treatment of Dental Disease 75
Benjamin Craig Cornwall

Odontogenic Oral and Maxillofacial Infections in Pregnancy 85
Kyriaki C. Marti

Benign Diseases and Conditions 90
Christos A. Skouteris

Management of Oral and Maxillofacial Malignancy in Pregnancy 93
James Murphy and Brent B. Ward

Management of Oral and Maxillofacial Trauma in Pregnancy 100
Igor Makovey and Sean P. Edwards

References 106

Further Reading 106

7 Postnatal Considerations 113
Kyriaki C. Marti

Medical Contraindications to Breastfeeding 113

Breastfeeding and Infant Oral Health 113

Procedures and Medications During Breastfeeding 115

References 121

Further Reading 122

8 Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) in Pregnancy 125
Kyriaki C. Marti

Cardiac Arrest in Pregnancy 125

BLS 125

ACLS 126

Further

Reading 128

9 Obstetric]Gynecologic Emergencies 129
Christos A. Skouteris

Hypertensive Disorders of Pregnancy 129

Abdominal Pain in Pregnancy 131

Vaginal

Bleeding in Pregnancy 134

Labor and On]Scene Delivery 135

Further Reading 142

Appendices 143

Appendix 1 Cardiovascular Changes 145

Appendix 2 Cardiovascular Changes 146

Appendix 3 Respiratory Changes 147

Appendix 4 Hematologic Changes 148

Appendix 5 Gastrointestinal Changes 149

Appendix 6 Genitourinary Changes 150

Appendix 7 Endocrine Changes: Insulin Gestational Activity 151

Appendix 8 OB-GYN Emergencies 152

Appendix 9 OB-GYN Emergencies 153

Appendix 10 OB-GYN Emergencies 154

Appendix 11 Most Important Physiologic Changes Per Trimester of Pregnancy 155

Appendix 12 Management of Oral Squamous Cell Carcinoma in Pregnancy 156

Appendix 13 Management of Oral and Maxillofacial Trauma in Pregnancy 159

Reader’s Self]Assessment Quiz 161

Index 169