Midwifery is a medico-biological science that studies:

fertilization, the pregnancy, birth and postpartum period in normal, in conditions of increased risk and in realized risk - pathology. It is part of the unified clinical discipline of obstetrics and gynecology - a major specialty in humanitarian medicine education.
Modern advances in medicine in various fields continue to have a significant impact on midwifery theory and practice. The simultaneous, human rights-based requirement for the active participation of the pregnant woman in the treatment-diagnostic process through informed consent or refusal modifies to some extent the accepted behavior based on long-term experience and medical evidence.

In the present textbook we have tried to preserve the view of midwifery characteristic of the Bulgarian school, by keeping all the chapters from the previous textbooks. We have tried to update the data in accordance with the modern achievements of science and technology. This made it necessary to expand the chapters on "prenatal screening" and diagnosis of congenital anomalies, monitoring the development of pregnancy using the ultrasound method in various conditions, monitoring the condition of the fetus using cardiography, pulse measurement, micro blood analysis, etc.

 

Modern obstetrics is faced with the problems of a rising childbearing age. The socio-economic conditions requiring career development of women and the wide penetration of assisted reproductive techniques have increased the fertile age to previously unthinkable limits. The older age of women is accompanied by an increased frequency and severity of diseases accompanying pregnancy, which requires a multi-disciplinary approach in pregnancy monitoring. In order to respond to this phenomenon, the volume of the chapter "Risk pregnancy" has been increased.

World statistics shows that about 1/3 of births are by caesarean section. The pandemic of Caesarean sections that occurred in recent decades necessitated the creation of a new chapter "Abdominal birth". Analysis of the causes shows that they are mainly due to socio-economic and to a lesser extent to medical reasons. The fight against "Caesarism" has turned out to be unsuccessful in the world, and this made it necessary to pay attention to the place of Caesarean section in modern practice and to direct attention to the safety of the operation.
When building the textbook, we tried to present generally accepted facts, our experience and avoid those of a discussion nature. We believe that this approach facilitates students and interns in understanding the basic issues of midwifery. We are far from thinking that the truth in medicine is one, but an obstetrician in the process of his additional qualification and practice will be able to build his approach and understanding in solving problems in obstetrics.

CONTENTS:
PART I: NORMAL PREGNANCY

1. Fertilization

2. Development of pregnancy

3. Diagnosis of pregnancy

4. Duration of pregnancy

5. Changes in the mother's body during pregnancy

6. Pregnancy hygiene

7. Nutrition during pregnancy

8. Prehospital monitoring of pregnancy

9. Monitoring the condition of the fetus during pregnancy

PART II: HIGH-RISK PREGNANCY

10. Definition of the concept of high-risk pregnancy

11. Diseases accompanying pregnancy

12. Pregnancy and childbirth in case of multiple pregnancy

13. Pregnancy and birth in breech presentation

14. Pregnancy and childbirth in an adult virgin

15. Pregnancy and childbirth in adolescent pregnancy

16. Pregnancy and childbirth with high multiparity

17. Occupational hazards and pregnancy

PART III: PATHOLOGY OF PREGNANCY

18. Vomiting during early pregnancy

19. Pregnancy-induced hypertension

20. Abortions

21. Premature birth

22. Premature rupture of the amniotic sac

23. Premature fetus

24. Transferred pregnancy

25. Ectopic pregnancy

26. Bleeding during pregnancy, not directly related to it

PART IV: PATHOLOGY OF THE FRUIT AND ITS APPENDAGES

27. Fetal pathology

28. Pathology of the placenta

29. Pathology of the umbilical cord

30. Pathology of the amniotic fluid

PART V: PROBLEMS OF VAGINAL BIRTH

31. Infectious pathology of the fetus and its appendages

32. Normal vaginal birth

33. Labor management

34. Induction of labor

35. Monitoring the state of the fetus during childbirth

36. Ante- and intranatal asphyxia of the fetus

37. Analgesia of childbirth

38. Difficulties in vaginal delivery

39. Operations during vaginal delivery

40. Operations to complete vaginal delivery

41. Complications of the woman as a result of vaginal birth

42. Injuries to the fetus during vaginal delivery

43. Shock in obstetrics

PART VI: ABDOMINAL BIRTH - CAESAREAN SECTION

44. Frequency

45. Indications

46. Types of CS

47. Cesarean section technique

48. Complications of cesarean section

49. Operations during caesarean section

50. Perioperative care for caesarean section

51. Pregnancy and childbirth after caesarean section

52. Pros and cons of abdominal delivery

53. Maternal and perinatal morbidity and mortality

PART VII: POSTPARTUM PERIOD (PUERPERIUM)

54. Physiological postpartum period

55. Complicated postpartum period

56. Pathology of the mammary glands in the postpartum period

VIEW C OBSTETRICS