Clinical Obstetrics and Gynaecology by Magowan, Brian A. -- Read -- Imperial Library of Trantor

Index

Title page Table of Contents Copyright page Dedication Foreword Preface Contributors SECTION 1: Fundamentals

1. Clinical pelvic anatomy

Introduction Obstetric anatomy The pelvic organs during pregnancy Anatomical points for obstetric analgesia Gynaecological anatomy Anatomy of the lower urinary tract

2. Human embryogenesis

Introduction Nomenclature Fertilization to implantation (0–6 GD) Implantation and formation of the germ layers (7–18 GD) Organogenesis (19–56 + GD)

3. History and examination

Introduction Gynaecological history Gynaecological examination Obstetrical history Obstetrical examination

4. Imaging in obstetrics and gynaecology

Introduction Obstetrics Gynaecology

SECTION 2: Gynaecology

5. Paediatric gynaecology

Introduction Normal puberty Delayed puberty Precocious puberty Abnormal genital tract development Sexual abuse Paediatric vaginal discharge

6. Disorders of sex development (DSD)

Introduction Definitions Some fundamental principles Normal sex differentiation Genital differentiation Incidence of DSD Classification of DSD Summary Management and prospects

7. The normal menstrual cycle

Introduction Endocrine control of the menstrual cycle The ovarian cycle The uterine cycle Other cyclical changes

8. Amenorrhoea

Introduction Primary amenorrhoea Secondary amenorrhoea Summary of clinical management

9. Infertility

Introduction Definitions Age and fertility Causes of infertility Diagnosis History and examination Investigations and their interpretation Treatment Assisted conception The UK Human Fertilisation and Embryology Act

10. Early pregnancy care

Miscarriage Sepsis Recurrent miscarriage Conclusion

11. Heavy menstrual bleeding and dysmenorrhoea

Heavy menstrual bleeding Dysmenorrhoea

12. Pelvic pain

Introduction History Examination Acute pelvic pain Chronic pelvic pain (CPP)

13. Endometriosis

Introduction Incidence Aetiology Clinical presentation Examination Endometriosis and infertility Investigation Management Fertility treatment Complications, prognosis and long-term sequelae

14. Premenstrual syndrome

Introduction Aetiology Clinical presentation Differential diagnosis Management

15. The menopause

Introduction Physiology Signs and symptoms (Table 15.1) Long-term effects Osteoporosis Diagnosis Hormonal therapy Non-hormonal treatment

16. Genital prolapse

Introduction Aetiology Classification Symptoms Signs Management

17. Urinary incontinence

Introduction Types of urinary incontinence The mechanism of continence Aetiology Clinical presentation Diagnostic evaluation Treatment

18. Ovarian neoplasms

Introduction Natural history Aetiology Pathology Spread Presentation Investigation and staging Tumour markers Treatment Survival

19. Uterine neoplasia

Introduction Incidence Aetiology Clinical features and diagnosis Pathology Prognostic factors Treatment Recurrence Summary

20. Cervical neoplasia

Introduction Cervical intraepithelial and cervical cancer screening Cervical cancer

21. Gestational trophoblastic disease

Introduction Trophoblast cells in health and disease Premalignant GTD Malignant GTD (Table 21.1) Management of molar pregnancies Follow-up after a molar pregnancy Management of malignant GTD

22. Disorders of the vulva

Introduction Examination of the vulva Simple vulval conditions Infection Dermatoses Pruritus Vulvodynia Vulval intraepithelial neoplasia (VIN) Vulval carcinoma

23. Gynaecological surgery

Introduction Preoperative counselling Common gynaecological operations Surgical anatomy Laparoscopic surgery Postoperative management Postoperative complications

SECTION 3: Reproductive health

24. Sexually transmitted infections

Introduction Principles of STI management Sexual history Examination for genital infections Taking samples for genital infections Symptoms associated with genital infections Specific infections Systemic presentations of sexually transmitted infections

25. Sexual problems

Introduction Normal sexual response The effect of age The functions of sex History-taking Female sexual dysfunction Male sexual dysfunction Treatment of sexual problems Conclusion

26. Termination of pregnancy

Introduction Worldwide perspectives UK perspectives Legal and ethical aspects Counselling before abortion Pre-abortion investigations Methods of abortion Complications of abortion Abortion aftercare Conclusion

27. Contraception

Introduction Methods of contraception Non-hormonal contraception Natural family planning Emergency contraception Sterilization

SECTION 4: Pregnancy and the puerperium

28. The physiology of pregnancy

Introduction Respiratory system Cardiovascular system Blood, plasma and extracellular fluid volume Blood constituents and anaemia Haemostasis in pregnancy Renal system Endocrine system Gastrointestinal system Liver and bile ducts Skin and appendages Metabolic changes Calcium homeostasis Placental transfer Immunology Summary

29. Strategies to improve global maternal and neonatal health

Estimates of global maternal and neonatal mortality Obstetric causes of maternal mortality Medical conditions contributing to maternal mortality and morbidity Strategies to improve global maternal and newborn health Availability and quality of care

30. Antenatal care

Introduction The booking visit Antenatal surveillance Prolonged pregnancy Antenatal assessment of fetal well-being Common antenatal problems Patient education Drug misuse

31. Postnatal care

Introduction Normal puerperium Postnatal problems

32. Medical disorders in pregnancy

Introduction Diabetes mellitus Venous thromboembolic disease Cardiac disease Connective tissue disease Epilepsy Hepatic disorders Renal disorders Respiratory disorders Thrombocytopenia Thyroid disorders

33. Prenatal diagnosis

Introduction Non-directive counselling The spectrum of congenital abnormality Assessing the risk Screening for fetal abnormalities Structural and chromosomal abnormalities Prenatal congenital infection Termination of pregnancy for fetal abnormality

34. Obstetric haemorrhage

Introduction Definitions Antepartum haemorrhage (APH) Intrapartum haemorrhage Postpartum haemorrhage (PPH)

35. Small babies

Introduction Accuracy of dating Small-for-gestational-age (SGA) Fetal growth restriction (FGR) Aetiology Screening and diagnosis Management Long-term implications of FGR

36. Hypertensive disorders in pregnancy

Introduction The scale of the problem Definitions Chronic hypertension Gestational hypertension, pre-eclampsia and eclampsia HELLP syndrome

37. Prematurity

Introduction Definitions Aetiology and predisposing factors Identifying women at increased risk of pre-term birth Prevention of the onset of pre-term labour Diagnosis and management of pre-term labour Inhibition of pre-term labour Pre-term pre-labour rupture of the membranes (PPROM) Delivery and optimizing neonatal outcome

38. Multiple pregnancy

Introduction The nature of twinning and chorionicity Maternal complications Fetal complications Antenatal problems specific to monochorionic twin pregnancies Management of pregnancy Management of twin delivery Triplets and higher multiples

39. Fetal haemolytic disease

Introduction The blood group system Pathophysiology of haemolytic disease Incidence Aetiology and predisposing factors Prevention of haemolytic disease Prediction of at-risk pregnancies Fetal assessment and therapy Delivery Prognosis

40. Labour

Introduction Primigravid compared with multigravid labour The uterus during pregnancy The initiation of labour The mechanism of normal labour and delivery Diagnosis of labour Rupture of the membranes Clinical progress in labour Episiotomies and perineal tears

41. Monitoring of the fetus in labour

Introduction Fetal physiology Risk assessment Fetal heart rate recording Fetal blood sampling (FBS) Clinical examples of fetal monitoring scenarios with corresponding CTGs Long-term prognosis following delivery

42. Induction of labour

Introduction Unfavourable cervix Favourable cervix Other methods of induction Failed induction

43. Pain relief in labour

Introduction Factors influencing pain Physiology of labour pain Psychology of labour pain Methods of pain relief

44. Precipitate labour and slow labour

Introduction Precipitate labour Slow labour

45. Malpresentations and malpositions

Introduction Malpresentation Malposition

46. Obstetric emergencies

Introduction Principles of management Resuscitation Amniotic fluid embolism Prolapsed umbilical cord Retained placenta Sepsis Shoulder dystocia Uterine inversion Uterine rupture

47. Operative delivery

Introduction Instrumental vaginal delivery Caesarean section

48. When a baby dies: stillbirth and neonatal death

Introduction Statistics of adverse perinatal outcomes Stillbirth Neonatal mortality Conclusions

49. Neonatal resuscitation

Physiology Practical aspects of neonatal resuscitation Discontinuation of resuscitation

50. Neonatal care

Introduction The transition at birth Routine care at birth Preventing haemorrhagic disease of the newborn Perinatal asphyxia Neonatal examination Physical birth injury Congenital abnormalities Feeding Signs of illness Jaundice Low birth weight infants Infection

Index

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