Care of the pregnant patient with medical illness

Care of the pregnant woman who has a medical illness requires careful coordination between the consulting general internist, subspecialist, and obstetrician. When possible, this care should be initiated prior to conception to optimize medical management and, when appropriate, initiate genetic counseling. Many diagnostic and therapeutic choices must be made without good scientific data. Yet, most of the time, outcomes are favorable. Few disciplines within internal medicine provide such a rich, yet demanding, challenge to the consulting internist.