We celebrate this 25th edition of Williams Obstetrics with great appreciation for the insight and expertise that the early editors brought to this textbook. To pay tribute to the first author, J. Whitridge Williams, we begin each chapter with a passage from his 1st edition that complements the topic. During this selection process, we were inspired by the strides that modern obstetrics has made since that edition in 1903. Similarly, we were 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 the power of this academic ideal to further our specialty in the decades to come.
For this 25th edition, we continue to present the detailed staples of basic obstetrics such as maternal anatomy and physiology, preconceptional and prenatal care, labor, delivery, and the puerperium. These accompany detailed discussions of obstetrical complications exemplified by preterm labor, hemorrhage, hypertension, and many more. To emphasize the “M” in Maternal–Fetal Medicine, we continue to iterate the many medical and surgical disorders that can complicate pregnancy. And, our second patient—the fetus—has accrued especial attention with an entire section devoted to diagnosis and treatment of fetal disorders. For all of these, we once again emphasize the science-based underpinnings of clinical obstetrics with special emphasis on biochemical and physiological principles. As was the hallmark of previous editions, these dovetail with descriptions of evidence-based practices. Expert clinical pearls add depth to these discussions and are written for busy practitioners—those “in the trenches.”
To accomplish these goals, the text has been updated with more than 3000 new literature citations through 2017. Many of the nearly 900 figures are new, and these graphs, sonograms, magnetic resonance images, photographs, photomicrographs, and data graphs are almost all in vivid color. Much of the original artwork was rendered by our own medical illustrators.
Also, as before, we continue to incorporate contemporaneous guidelines from professional and academic organizations such as the American College of Obstetricians and Gynecologists, the Society for Maternal–Fetal Medicine, the National Institutes of Health and the National Institute for Child Health and Human Development, the Centers for Disease Control and Prevention, and other authoritative sources. Many of these data are distilled into nearly 100 tables, in which information has been arranged in an easy read-and-use format. In addition, several diagnostic and management algorithms are available to quickly guide practitioners. Although we strive to cite numerous sources and provide multiple evidence-based options for such management schemes, we also include our own clinical experiences drawn from the large obstetrical service at Parkland Hospital. We are convinced that these are disciplined examples of evidence-based obstetrics but quickly acknowledge that they do not constitute the sole method of management.