The second edition of the comprehensive and award-winning text on prenatal and postnatal care
The updated edition of Prenatal and Postnatal Care offers a comprehensive text for the care of the woman during the childbearing year. The expert author team presents information needed to master foundational knowledge in anatomy, physiology, psychology, culture, the structure of preconception, prenatal and postnatal care, as well as the management of common health problems.
This edition has been revised throughout and contains six new chapters on the following topics: prenatal ultrasound, triage of the pregnant woman, assisting women to develop confidence for physiologic birth, pregnancy after infertility, oral health, and issues around diversity and inclusion in prenatal and postnatal care. Additional highlights include new and updated content on pregnant women in the workplace, prenatal genetic testing, trauma-informed care, and transgender pregnancy care. The second edition also includes commonly used complementary therapies and offers more detailed information on shared decision-making and planning for birth.
Prenatal and Postnatal Care: - Provides expanded faculty resources with case studies and test questions for each chapter - Offers a comprehensive text that covers essential aspects of prenatal and postnatal care of the childbearing woman - Builds on the edition that won the Book of the Year award from the American College of Nurse Midwives (ACNM) in 2015.
This revised, authoritative text is an ideal resource for midwifery, nurse practitioner and physician assistant students, and healthcare providers working with pregnant and postpartum women.
Table of Contents
About the Editors xxi
Contributors xxiii
Preface xxvii
About the Companion Website xxix
Part I Physiological Foundations of Prenatal and Postnatal Care 3
1 Reproductive Tract Structure and Function 5
Patricia W. Caudle
Anatomy of the Female Reproductive System 6
Menstrual Cycle Physiology 11
Resources for Women 17
Resources for Healthcare Providers 17
References 17
2 Conception, Implantation, and Embryonic and Fetal Development 19
Patricia W. Caudle
Introduction 20
Conception and Implantation 20
The Placenta 21
The Embryo 25
The Fetus 30
Summary 31
Resources for Healthcare Providers 31
Resources for Women, Their Families, and Healthcare Providers 32
References 32
3 Maternal Physiological Alterations during Pregnancy 33
Patricia W. Caudle
Introduction 33
Hematologic System Adaptations 33
Cardiovascular System Adaptations 35
Respiratory System Adaptations 37
Renal System Adaptations 38
Gastrointestinal System Adaptations 38
Metabolic System Adaptations 39
Immune System Adaptations 42
Neurological System and Sensory Adaptations 44
Musculoskeletal System Adaptations 44
Endocrine System Adaptations 45
Summary 46
Resources for Women and Their Families 46
Resources for Healthcare Providers 46
References 46
4 Physiological Alterations during the Postnatal Period 49
Kaitlin Wilson and Cindy L. Farley
Introduction 49
Uterus 49
Lochia 50
Cervix 51
Vagina 51
Labia and Perineum 51
Rectal Anatomy 52
Additional Maternal Alterations during the Postpartum Period 52
Summary 55
Resource for Women 55
Resource for Healthcare Providers 55
References 55
Part II Preconception, Prenatal Care, and Postnatal Care 57
5 Preconception Care 59
Cynthia Nypaver
Introduction 59
Challenges to Providing Preconception Care 59
Benefits of Preconception Health Care 60
Evidence Supporting Preconception Health Care 60
Preconception Care 61
Risk Assessment and Screening 61
Preconception Health Care for Women with Chronic Illnesses 67
Unique Considerations 74
Summary 76
Resources for Women and Their Families 76
Resources for Healthcare Providers 77
References 77
6 Prenatal Care: Goals, Structure, and Components 81
Carrie S. Klima
Introduction 82
A Brief History of Prenatal Care 82
Current Goals of Prenatal Care 83
Structure of Prenatal Care 85
Group Prenatal Care: CenteringPregnancy 88
Components of Prenatal Care 89
Preventative Care 95
Health Promotion and Education 96
Summary 99
Resources for Women and Their Families 100
Resources for Healthcare Providers 100
References 100
7 Nutrition during Pregnancy 103
Robin G. Jordan
Introduction 104
Understanding Food Units and Recommendations 104
Prenatal Nutrition and Health Outcomes 104
Nutritional Needs in Pregnancy 106
Food Safety during Pregnancy 113
Factors Influencing Nutritional Intake 116
Making a Nutritional Assessment 117
Using Nutrition Resources 118
Counseling for Optimal Prenatal Nutrition 121
Special Issues in Prenatal Nutrition 121
Summary 126
Resources for Women and Their Families 126
Resources for Healthcare Providers 126
References 126
8 Pregnancy Diagnosis and Gestational Age Assessment 131
Janet L. Engstrom and Joyce D. Cappiello
Introduction 132
Benefits of Early Pregnancy Diagnosis and Gestational Age Assessment 132
Pregnancy Diagnosis 132
Gestational Age Assessment 138
Counseling for Pregnancy Diagnosis 146
Summary 150
Resources for Women and Their Families 151
Resources for Healthcare Providers 151
References 151
9 Risk Assessment during Pregnancy 155
Robin G. Jordan
Introduction 155
Process and Purpose of Risk Assessment 155
Benefits of Risk Assessment 156
Limitations of Risk Assessment 156
Disadvantages of Risk Assessment and Risk Management 156
Labeling Women as High Risk 157
Misapplication of Risk Assessment and Risk Management 157
Perspective of Risk and Risk Assessment 159
Explaining Risk to Women 160
Informed Consent 162
Summary 163
Resources for Healthcare Providers and Women and Their Families 163
References 163
10 Prenatal Ultrasound 167
Cynthia Parke and Robin G. Jordan
Introduction 168
The Physics and Mechanics of Ultrasound 168
Types of Scans 169
Use of Prenatal Ultrasound 170
Interpreting and Communicating Results 174
The Woman’s Experience of Ultrasound 175
Safety 176
Overuse of Ultrasound 177
Recreational Prenatal Ultrasound 177
Who Performs Prenatal Ultrasounds 178
Adding Ultrasound to Scope of Practice 178
Resources for Women and Their Families 178
Resources for Healthcare Providers 178
References 178
11 Genetic Counseling, Screening, and Diagnosis 181
Robin G. Jordan
Introduction 182
Family History and Risk Evaluation 182
Genetic Screening Tests 182
Screening for Neural Tube Defects 183
Screening for Aneuploidy 183
Genetic Screening by Ultrasound 186
Carrier Screening 187
Diagnostic Prenatal Genetic Testing 189
The Role of Genetic Counselors 190
Psychosocial Considerations in Genetic Testing 190
Genetic Testing Counseling during Prenatal Care 191
Summary 193
Resources for Women, Their Families, and Healthcare Providers 193
References 194
12 Assessment of Fetal Well‐Being 197
Jenifer Fahey
Introduction 197
Physiologic Principles 198
Indications 199
Interprofessional Care 199
Fetal Testing Methods 200
Education and Counseling 210
Cultural, Personal, and Family Considerations 211
Health Disparities and Vulnerable Populations 211
Legal and Liability Issues 211
Summary 212
Resource for Healthcare Providers 213
References 213
13 Common Discomforts of Pregnancy 215
Robin G. Jordan
Introduction 215
Back Pain and Pelvic Girdle Pain 216
Bleeding Gums 218
Breast Tenderness 219
Carpal Tunnel Syndrome (CTS) 220
Cervical Pain 220
Constipation 220
Dizziness/Syncope 222
Edema 222
Emotional Changes 223
Fatigue 223
Flatulence 224
Headache 225
Heartburn 225
Heart Palpitations 226
Hemorrhoids 227
Increased Warmth and Perspiration 227
Leukorrhea 227
Leg Cramps 228
Nasal Congestion 228
Epistaxis 229
Nausea and Vomiting of Pregnancy (NVP) 230
Ptyalism 233
Restless Leg Syndrome (RLS) 233
Round Ligament Pain 234
Shortness of Breath 235
Skin, Hair, and Nail Changes 235
Hyperpigmentation 236
Vascular Changes 237
Hair and Nail Changes 237
Sleep Disturbances 238
Supine Hypotension Syndrome (SHS) 239
Urinary Frequency and Nocturia 240
Urinary Incontinence 240
Varicosities (Legs/Vulva) 241
Vision Changes 243
Resources for Women and Their Families 243
References 243
14 Oral Health 247
Julia Lange Kessler
Introduction 247
Anatomy of the Oral Cavity 247
Initial Assessment of the Oral Cavity 248
Influence of Oral Health on Pregnancy Outcomes 249
Conditions Affecting Oral Health 250
Postpartum and Newborn Oral Health 251
Summary 251
Resources for Women and Their Families 251
Resources for Healthcare Providers 251
References 251
15 Medication Use during Pregnancy 253
Mary C. Brucker and Tekoa L. King
Introduction 254
Types of Pharmaceutical Agents 254
Prescriptive Authority 254
Governmental Oversight of Pharmaceutical Agents 254
Pre‐Marketing Drug Testing 255
The Prescription: Essential Components 256
Pharmacokinetics in Pregnancy 261
Common Medications Used During Pregnancy 261
Vaccines during Pregnancy 261
Rational Use of Drugs in Pregnancy 261
Summary 264
Resources for Healthcare Providers 267
Resources for Women and Their Families 267
References 267
16 Substance Use during Pregnancy 271
Daisy J. Goodman, Kelley A. Bowden,and Alane B. O’Connor
Introduction 271
Prevalence of Prenatal Substance Use 272
Terminology 272
Historical Approaches to Prenatal Substance Use 273
Harm Reduction Approaches to Prenatal Substance Use 274
Common Comorbid Conditions 275
Prenatal Screening 275
Treatment Types 278
Commonly Used Substances, Pregnancy Implications, and Recommended Treatment 279
Perinatal Care of Women with Substance Use Disorders 285
Summary 290
Resources for Healthcare Providers 291
References 291
17 Health Disparities and Social Issues in Pregnancy 297
Nena R. Harris
Introduction 297
Poverty 298
Incarceration during Pregnancy 300
Intimate Partner Violence during Pregnancy 302
Reproductive Coercion 303
Human Trafficking 303
Pregnancy and a History of Childhood Sexual Abuse 305
Summary 307
Resources for Healthcare Providers 307
Resources for Women and Their Families 308
References 308
18 Diversity and Inclusiveness in the Childbearing Year 313
Cindy L. Farley and Michal J. Wright
Introduction 314
Inequities in Perinatal Care and Outcomes 314
Contributors to Perinatal Health Disparities 314
Developing Cultural Competence 316
Communication 317
Selected Cultural Traditions in the Childbearing Year 317
Summary 320
Resources for Healthcare Providers 320
Resources for Women 320
References 320
19 Exercise, and Sexual, Occupational, and Environmental Health in Pregnancy 323
Meghan Garland
Introduction 323
Exercise 323
Environmental Exposures 329
Sexuality 333
The Workplace and Pregnancy 335
Resources on Pregnancy and Environmental Exposure for Women 337
Resources on Pregnancy and Environmental Exposure for Healthcare Providers 337
Resource on Work during Pregnancy for Women 338
References 338
20 Psychosocial Adaptations in Pregnancy 341
Cindy L. Farley, Eva M. Fried, and Amy R. Chavez
Introduction 342
Developing Relationship: A Trauma‐Informed Approach 342
Maternal‐Newborn Attachment and Adaptation 343
Maternal Role Development 346
Body Image 352
Sibling Preparation 354
Partner Adaptation and Attachment 354
Pregnancy in Transgender Men 358
Summary 359
Resources for Women and Their Families 359
Resources for Healthcare Providers 359
References 359
21 Health Education during Pregnancy 363
Lisa Hanson, Karen Robinson, Leona VandeVusse, and Kathryn Harrod
Introduction 363
Sources and Quality of Consumer Childbirth Education 363
Prenatal Visit Approach to Individual Childbirth Education 365
Class Education and Group Prenatal Care 366
Developmental Considerations 366
Issues Integral to Prenatal Education 367
Summary 369
Resources for Women and Their Families (Government Websites) 373
Resources for Women and Their Families (Nongovernment Websites) 373
References 373
22 Preparing for Birth 375
Melissa D. Avery, Carrie E. Neerland, and Melissa A. Saftner
Introduction 375
What Is Physiologic Birth? 375
Benefits of Physiologic Birth 376
Fear of Childbirth 376
Maternal Confidence for Physiologic Birth 376
Evidence Related to Women’s Prenatal Confidence for Physiologic Birth 378
Individual Strategies 380
Summary 381
Resources for Healthcare Providers 381
Resources for Women and Their Families 382
References 382
23 Triage during Pregnancy 385
Cathy Ruhl
Introduction 385
Objectives and Goals of Triage Care and Evaluation 385
Obstetric Triage in the Hospital Setting 386
Primary Responsibilities of Professionals during Triage and Evaluation 386
Common Reasons Women Seek Urgent/ Emergent Care during Pregnancy 386
Collaboration Between Obstetric and Emergency Departments 387
Obstetric Triage Unit Organization 387
Elements of Triage 387
Elements of Healthcare Provider Evaluation 388
Best Practices in Triage Units 388
Liability Issues in Obstetric Triage and Evaluation 390
Quality Measures in Triage 391
Anticipatory Guidance about Triage during Prenatal Care 391
Summary 391
Resources for Women and Their Families 391
Resources for Healthcare Providers 391
References 391
24 Assessment and Care at the Onset of Labor 393
Amy Marowitz
Introduction 393
Determining the Onset of Labor 393
Timing of Admission to the Birth Setting 394
Reframing “False Labor” 394
Determining Active Labor 395
Anticipatory Guidance during the Prenatal Period 395
Assessment of the Woman with Report of Labor Onset 396
Plan of Care 397
Summary 398
References 398
25 Components of Postnatal Care 401
Tia P. Andrighetti and Deborah Brandt Karsnitz
Introduction 401
Fourth-Trimester Tasks 402
Immediate Postpartum Care 402
Later Postpartum Care 402
Assessment of Maternal Physical and Emotional Adjustment 404
Maternal Role Development 407
Infant Feeding 407
Activity and Exercise 407
Diet and Nutrition 408
Lochia 408
Afterbirth Pain 409
Perineal Discomfort 410
Diureseis and Diaphoresis 410
Constipation and Hemorrhoids 410
Sleep 410
Sexuality 411
Resumption of Menses and Ovulation 411
Contraception 412
Postpartum Physical Examination 412
Postpartum Depression and Intimate Partner Violence Screening 414
Postpartum Warning Signs 415
Cultural Considerations 415
Health Disparities and Vulnerable Populations 416
Interprofessional Care 417
Recovery and Employment 417
Summary 418
Resources for Women 418
Resources for Healthcare Providers 418
References 418
26 Lactation and Breastfeeding 423
Marsha Walker
Introduction 423
Benefits of Breastfeeding 423
Breastfeeding as a Public Health Issue 426
Promoting and Supporting Breastfeeding 427
Maternal and Infant Anatomy and Physiology of Lactation and Breastfeeding 428
Basics of Breastfeeding Support and Assessment 432
Care of the Breastfeeding Mother 436
Summary 440
Resources for Women and Healthcare Providers 440
References 440
27 Contraception in the Postnatal Period 445
Leah N. Torres
Introduction 445
Postpartum Care and Return to Fertility after Childbirth 445
Selecting a Postpartum Contraceptive Method 446
Contraceptive Methods 448
Tier One Methods 448
Tier Two Methods 451
Tier Three Methods 455
Emergency Contraception 457
Summary 457
Resources for Women and Healthcare Providers 458
References 458
Part III Complex Prenatal and Postnatal Conditions 461
28 Bleeding during Pregnancy 463
Robin G. Jordan
Introduction 463
Early Pregnancy Bleeding 464
Subchorionic Hemorrhage 466
Leiomyomas 466
Spontaneous Pregnancy Loss 466
Ectopic Pregnancy 470
Gestational Trophoblastic Disease 472
Bleeding during the Second Half of Pregnancy 474
Placenta Previa 474
Placental Abruption 476
Vasa Previa 477
Diagnosis and Management of Bleeding in the Second Half of Pregnancy 478
Resources for Women and Their Families 478
References 479
29 Amniotic Fluid and Fetal Growth Disorders 481
Victoria H. Burslem and Cindy L. Farley
Introduction 482
Amniotic Fluid Dynamics 482
Placentation and Perinatal Outcomes 483
Amniotic Fluid Disorders 484
Fetal Growth Disorders 488
Summary 492
Resources for Women and Their Families 492
Resources for Healthcare Providers 492
References 492
30 Preterm Labor and Birth 495
Robin G. Jordan and Nancy Jo Reedy
Introduction 495
Social and Racial Disparities 496
Pathophysiology of Preterm Birth 497
Perinatal Morbidity Related to Prematurity 497
Risk Factors for Preterm Birth 497
Predicting Preterm Birth 499
Primary Prevention of Preterm Birth 500
Prenatal Education on Signs and Symptoms of Preterm Labor 504
Diagnosis and Management of Women with Preterm Labor 505
Interprofessional Care 505
Summary 505
Resources for Women and Healthcare Providers 506
References 506
31 Hypertensive Disorders of Pregnancy 511
Robin G. Jordan and Elizabeth Gabzdyl
Introduction 511
Classification of Hypertensive Disorders in Pregnancy 512
Screening for Hypertensive Disorders 512
Preeclampsia-Eclampsia 513
Chronic Hypertension 519
Chronic Hypertension with Superimposed Preeclampsia 520
Gestational Hypertension 521
HELLP Syndrome 521
Interprofessional Care 523
Summary 523
Resources for Women and Their Families 523
Resources for Healthcare Providers 523
References 523
32 Gestational Diabetes 527
Kimberly K. Trout
Introduction 527
Pathophysiology and Potential Problems 527
Prenatal Screening and Diagnosis 528
Management 531
Pharmacologic Treatments 533
Social Considerations 534
Fetal Surveillance and Timing of Birth 534
Postpartum Follow‐Up 535
Interprofessional Care 536
Perspective on GDM Risk 536
Care of the Pregnant Woman with
Pregestational Diabetes 537
Resources for Women and Their Families 537
Resources for Healthcare Providers 537
References 537
33 Multifetal Gestation 541
Heather M. Bradford and Cindy L. Farley
Incidence 541
Embryology 541
Diagnosis 543
Potential Problems 543
Prenatal Care 545
Psychosocial Aspects 547
Resources for Healthcare Providers 548
Resources for Women and Their Families 548
References 548
34 Post‐Term Pregnancy 551
Heather M. Bradford
Introduction 551
Potential Problems 552
Prevention, Intervention, and Management Options 552
Resources for Healthcare Providers 555
Resources for Women and Their Families 555
References 555
35 Hyperemesis Gravidarum 557
Karen Trister Grace
Introduction 557
Etiology and Risk Factors 557
Potential Problems 558
Evaluation 558
Care and Management 558
Resource for Healthcare Providers 560
Resources for Women and Their Families 560
References 560
36 Abdominal Pain 561
Karen Trister Grace
Introduction 561
Evaluation 561
Appendicitis 562
Gall Bladder Disease 562
Abdominal Trauma 563
CPR in Pregnancy 564
Pancreatitis 564
Resources for Healthcare Providers 564
Resources for Women and Their Families 564
References 564
37 Pregnancy after Infertility 567
Melicia Escobar
Introduction 567
Prevalence of Infertility 567
Context and Course of Infertility 568
Preexisting Conditions and Perinatal Issues 569
Pharmacologic Considerations 569
Lifestyle Considerations 569
Psychological Impacts of Infertility Treatment and Transition to Pregnancy 573
Summary 574
Resources for Women and Their Families 574
Resources for Healthcare Providers 574
References 574
38 Common Complications during the Postnatal Period 577
Deborah Brandt Karsnitz
Introduction 577
Postpartum Morbidity and Mortality 578
Postpartum Cultural Considerations 579
Postpartum Disorders 579
Summary 593
Resources for Women and Their Families 594
Resources for Healthcare Providers 594
References 594
39 Common Breastfeeding Problems 597
Marsha Walker
Introduction 597
Common Infant‐Related Breastfeeding Problems 597
Common Maternal Breastfeeding Problems 602
Low Milk Supply 607
Summary 610
Resources for Women and Their Families 610
Resources for Healthcare Providers 610
References 610
40 Perinatal Loss and Grief 613
Robin G. Jordan
Introduction 613
Stillbirth 613
Care and Management of Women with Stillbirth 614
Grieving and Emotional Care after Perinatal Loss 615
Physical Care after Stillbirth 617
Follow‐Up Care 618
Interconception and Subsequent Pregnancy Care 618
Summary 619
Resources for Women and Their Families 619
Resources for Healthcare Providers 619
References 620
Part IV Common Primary Care Health Conditions during the Prenatal and Postnatal Periods 623
41 Obesity 625
Cecilia M. Jevitt
Introduction 625
Prevalence 626
Health Disparities and Cultural Considerations 626
Personal and Family Considerations 626
Obesity Physiology 626
Potential Problems 627
Management of Pregestational Obesity 628
Bariatric Surgery and Pregnancy Issues 632
Prolonged Pregnancy 632
Intrapartum and Postpartum Issues 632
Interprofessional Care 633
Legal and Liability Issues 633
Summary 633
Resources for Women and Their Families 634
Resources for Healthcare Providers 634
References 634
42 Mood and Anxiety Disorders 637
Heather Shlosser
Introduction 637
Depression during Pregnancy 637
Bipolar Disorder in Pregnancy 642
Anxiety and Trauma‐Related Disorders 645
Interprofessional Care 647
Summary 647
Resources for Women and Their Families 648
Resources for Healthcare Providers 648
References 648
43 Hematologic and Thromboembolic Disorders 651
Jalana Lazar, Karen Trister Grace and Robin G. Jordan
Introduction 652
Anemia 652
Alloimmunization of Pregnancy 654
Hemoglobinopathies 658
Folate Deficiency 659
Vitamin B12 Deficiency 660
Bleeding Disorders 660
Thromboembolic Disorders 661
Summary 663
Resources for Women and Their Families 663
Resources for Healthcare Providers 663
References 663
44 Respiratory Disorders 665
Janyce Cagan Agruss
Introduction 665
Respiratory Physiology and Pregnancy 665
Asthma 665
Influenza 668
Upper Respiratory Infection 670
Pneumonia 671
Summary 671
Resource for Healthcare Providers 671
References 671
45 Urinary Tract Disorders 673
Rhonda Arthur and Nancy Pesta Walsh
Introduction 673
Urinary Tract Infection 673
Evaluation 675
Care of Women with Urinary Tract Infections 677
Recurrent UTI 678
Care of Women with Suspected Acute Pyelonephritis 678
Nephrolithiasis 678
Summary 679
Resources for Women and Their Families 679
Resource for Healthcare Providers 679
References 679
46 Gastrointestinal Disorders 681
Debora M. Dole
Introduction 681
Initial Evaluation 681
Gastroenteritis 681
Intraheptic Cholestasis of Pregnancy 683
Cholecystitis and Cholelithiasis 684
Acute Appendicitis 685
Summary 686
Resources for Healthcare Providers 686
Resource for Women and Their Families 686
References 686
47 Endocrine Disorders 687
Elizabeth Gabzdyl
Introduction 687
Thyroid Disorders in Pregnancy 687
Overt Hypothyroidism 689
Hyperthyroidism 691
Postpartum Thyroiditis 692
Iodine in Pregnancy 692
Pregestational Diabetes Mellitus 693
Summary 695
Resources for Women and Healthcare Providers 695
References 695
48 Neurological Disorders 697
Lise Hauser
Introduction 697
Seizure Disorders 697
Headache 701
Multiple Sclerosis 704
Restless Legs Syndrome/Willis‐Eckbom Disease 705
Carpal Tunnel Syndrome 706
Central Nervous System Imaging in Pregnancy and Lactation 706
Interprofessional Care 706
Resources for Women and Their Families 706
Resources for Healthcare Providers 706
References 706
49 Dermatological Disorders 709
Nell L. Tharpe
Introduction 709
Atopic Eruption of Pregnancy 710
Pruritic Urticarial Papules and Plaques of Pregnancy 712
Pruritic Folliculitis of Pregnancy 713
Pemphigoid Gestationis 714
Pustular Psoriasis of Pregnancy 716
Intrahepatic Cholestasis of Pregnancy 717
Summary 718
Resources for Healthcare Providers 718
References 719
50 Infectious Diseases 721
Elizabeth A. Parr
Introduction 721
Cytomegalovirus (CMV) 722
Group B Streptococcus (GBS) 724
Hepatitis A 725
Hepatitis B 726
Hepatitis C 728
Parvovirus B19 729
Rubella 730
Toxoplasmosis 731
Varicella 734
Emerging Infectious Diseases 735
Ebola 736
Zika 736
Summary 737
Resources for Women and Their Families 737
Resources for Healthcare Providers 738
References 738
51 Sexually Transmitted Infections and Vaginitis 741
Eva M. Fried and Cindy L. Farley
Introduction 741
Sexually Transmitted Bacterial Infections 742
Sexually Transmitted Viral Infections 744
Sexually Transmitted Parasitic Infection 748
Fungal Vaginitis 749
Bacterial Vaginitis 749
Partner STI Treatment 751
Legal Requirements for Reporting STI Diagnosis 752
Psychosocial Impact of STI Diagnosis 752
Summary 753
Resources for Healthcare Providers 753
Resource for Women and Partners 754
References 754
Index 757
