BOOK
Practical Obstetrics And Gynaecology Handbook For O&g Clinicians And General Practitioners (2nd Edition)
Tan Thiam Chye | Tan Kim Teng | Tay Eng Hseon
(2014)
Additional Information
Book Details
Abstract
This handbook provides an evidence-based approach to common obstetrics & gynaecological problems faced by O & G clinicians and general practitioners in their daily practice. It is the only book available with current evidence-based recommendations and protocols in O & G.Compiled by experienced experts, this new edition contains 24 new chapters. The existing chapters have been updated using the latest evidence. The authors have included multiple flow charts and detailed practical approaches to various gynaecology and obstetric issues. The book will be a valuable and quick practical guide to everyone — not only to general practitioners and O & G clinicians, but also to medical students and resident doctors. Topics like “Approach to Ectopic Pregnancy” and “Pelvic Inflammatory Disease” will provide invaluable guidance to even emergency medicine doctors.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| CONTENTS | xxi | ||
| Foreword | v | ||
| History of KK Women’s and Children’s Hospital | vii | ||
| Preface | xi | ||
| About the Authors and Chief Editor | xiii | ||
| Acknowledgements | xvii | ||
| PART 1: OBSTETRICS | 1 | ||
| Chapter 1 Pre-Conception Preparation | 3 | ||
| OBJECTIVES: | 3 | ||
| TO IMPROVE PREGNANCY OUTCOME | 3 | ||
| 1. Optimising Medical Conditions Prior to Pregnancy — to Improve the Prognosis for both Mother and Baby | 3 | ||
| 2. Avoid Teratogenic Drugs | 10 | ||
| 3. Screen for Infections and Genetic Blood Disorders — Treat, Immunise and Counsel | 10 | ||
| 4. Encourage Appropriate Counselling Sessions | 12 | ||
| Chapter 2 Routine Antenatal Follow-Up | 17 | ||
| OBJECTIVES OF ANTENATAL VISITS | 17 | ||
| Warning Symptoms in Pregnancy | 20 | ||
| Warning signs in pregnancy | 21 | ||
| Chapter 3 Vaccination in Pregnancy | 23 | ||
| GENERAL PRINCIPLES | 23 | ||
| VACCINATIONS CONTRAINDICATED IN PREGNANCY | 24 | ||
| Chapter 4 Approach to Bleeding in Early Pregnancy | 29 | ||
| Causes | 29 | ||
| Management of Early Pregnancy Bleeding | 30 | ||
| Chapter 5 Approach to Spontaneous Miscarriage | 35 | ||
| Aetiologies | 35 | ||
| Spontaneous Miscarriages | 37 | ||
| Chapter 6 Approach to Recurrent Spontaneous Miscarriage (RSM) | 41 | ||
| Common Aetiologies | 41 | ||
| Chapter 7 Approach to Abdominal Pain in Pregnancy | 45 | ||
| Chapter 8 Obstetric & Gynaecological (O&G) Causes of Abdominal Pain in Early Pregnancy | 49 | ||
| Chapter 9 Obstetric & Gynaecological (O&G) Causes of Abdominal Pain in Late Pregnancy | 55 | ||
| Chapter 10 Non Obstetric & Gynaecological (Non O&G) Causes of Abdominal Pain in Pregnancy: Simple Approach by Site of Pain | 63 | ||
| Chapter 11 Non Obstetric & Gynaecological (Non O&G) Causes of Abdominal Pain in Pregnancy | 67 | ||
| Chapter 12 Approach to Ectopic Pregnancy (EP) | 83 | ||
| Ultrasound Features of Normal Early Gestation | 88 | ||
| Ultrasound Features of Tubal Ectopic Gestation | 88 | ||
| 1. Medical Management of Ectopic Pregnancy | 89 | ||
| 2. Surgical Management of Ectopic Pregnancy | 91 | ||
| 3. Expectant Management of Ectopic Pregnancy | 93 | ||
| Other Types of Ectopic Pregnancies (EP) | 94 | ||
| Chapter 13 Approach to Gestational Trophoblastic Disease (GTD) | 99 | ||
| Types of GTD | 99 | ||
| Chapter 14 Termination of Pregnancy (TOP) | 103 | ||
| Management of Asherman Syndrome (Adhesions or Fibrosis within the Uterine Cavity) | 108 | ||
| Chapter 15 Medical Disorders and Potential Risk Factors in Pregnancy | 111 | ||
| Chapter 16 Multiple Pregnancy | 147 | ||
| TWINS | 147 | ||
| Antenatal Care | 148 | ||
| Monochorionic, Monoamniotic Twins | 148 | ||
| Complications of Multiple Pregnancy — Foetal Causes | 148 | ||
| Chapter 17 Infections in Pregnancy | 159 | ||
| Antenatal Screening for Infection | 159 | ||
| Management of Infection in Pregnancy | 159 | ||
| List of Infections in Pregnancy | 160 | ||
| 4. Cytomegalovirus (CMV) Infection | 162 | ||
| 5. Dengue Infection | 164 | ||
| 6. Genital Warts Infection | 165 | ||
| 7. Gonorrhoea | 166 | ||
| 8. Group B Streptococcus | 166 | ||
| 9. Hand-Foot-Mouth Disease (HFMD) Infection | 167 | ||
| 10. Hepatitis B Infection | 168 | ||
| 11. Hepatitis C Infection | 169 | ||
| 12. Hepatitis E Infection | 169 | ||
| 13. Herpes Simplex Virus (HSV) Infection | 170 | ||
| 14. H1N1 Influenza Infection | 171 | ||
| 15. HIV Infection | 172 | ||
| 16. Listeriosis Infection | 173 | ||
| 17. Malaria Infection | 174 | ||
| 18. Parvovirus B19 Infection | 176 | ||
| 19. Rubella Infection | 178 | ||
| 20. Shingles (Herpes/Varicella-Zoster Virus) Infection | 180 | ||
| 21. Syphilis (Treponema pallidum) Infection | 180 | ||
| 22. Toxoplasmosis Infection | 181 | ||
| 23. Trichromoniasis | 182 | ||
| 24. Tuberculosis Infection | 183 | ||
| 25. Varicella Zoster (Chickenpox) Infection | 184 | ||
| Chapter 18 Skin Disorders in Pregnancy | 187 | ||
| 1. Hormone-related Skin Disorders | 187 | ||
| 2. Pre-existing Skin Disorders | 187 | ||
| 3. Pregnancy-specific Skin Disorders | 187 | ||
| Chapter 19 Approach to Depression in Pregnancy | 195 | ||
| Antenatal Depression is associated with | 195 | ||
| Postnatal Depression is associated with | 195 | ||
| Recognition of symptoms is important | 196 | ||
| Screening for Depression | 197 | ||
| Treatment | 198 | ||
| Chapter 20 Medications in Pregnancy and Lactation | 199 | ||
| Food Drug Administration (FDA) Classification for Drugs in Pregnancy | 200 | ||
| Teratogenic Mechanisms Associated with Medication Use | 201 | ||
| Drugs to Avoid in Pregnancy | 202 | ||
| Drugs to Avoid in Pregnancy for G6PD Deficient Individuals | 205 | ||
| Commonly Prescribed Medications during Pregnancy | 207 | ||
| Special Conditions in Pregnancy | 222 | ||
| Hyperthyroidism | 222 | ||
| Depression | 226 | ||
| Indications of Anti-D Immunoglobulin Administration in Pregnancy | 228 | ||
| Indications of Aspirin Use in Pregnancy | 230 | ||
| Dosage of Aspirin | 231 | ||
| Mechanism of Action of Aspirin | 231 | ||
| Chapter 21 Approach to Postnatal Problems | 233 | ||
| Bladder Care After Vaginal Delivery | 235 | ||
| Postnatal Problems | 236 | ||
| Risk factors of sepsis | 240 | ||
| Chapter 22 Lactation and Breastfeeding | 243 | ||
| Introduction | 243 | ||
| Benefits of Breastfeeding | 243 | ||
| CONTRAINDICATIONS OF BREASTFEEDING | 244 | ||
| ANTENATAL PREPARATION | 244 | ||
| Management of Breastfeeding Related Problems | 245 | ||
| Treatment of breast engorgement includes | 247 | ||
| Chapter 23 Frequently Asked Questions on Pregnancy | 253 | ||
| 1. Air Travel in Pregnancy | 253 | ||
| 2. Carrying heavy things in pregnancy | 255 | ||
| 3. Clothing in pregnancy | 255 | ||
| 4. Dental health concerns in pregnancy | 255 | ||
| 5. Does Epidural Cause Backache? | 260 | ||
| 6. Exercise in Pregnancy | 260 | ||
| 7. Facial Treatments in Pregnancy | 260 | ||
| 8. Food, smoking and alcohol in pregnancy | 261 | ||
| 9. Hair-Dyeing, Hair Rebonding and Perming in Pregnancy | 263 | ||
| 10. House Paint in Pregnancy | 263 | ||
| 11. Ideal Weight Gain in Pregnancy | 264 | ||
| 12. Insecticides in Pregnancy | 264 | ||
| 13. Massage/Aromatherapy in Pregnancy | 264 | ||
| 14. Mobile Phones in Pregnancy | 265 | ||
| 15. Sauna/Steam in Pregnancy | 265 | ||
| 16. Sex in Pregnancy | 265 | ||
| 17. Tattoos in Pregnancy | 265 | ||
| 18. Use of Mosquito Repellants containing DEET in Pregnancy | 266 | ||
| 19. Use of Over the Counter (OTC) Slimming Pillsin Pregnancy | 266 | ||
| 20. Working on Computers/ Video Display Terminals/Photocopier/Printerin Pregnancy — Safe? | 266 | ||
| 21. X-rays/Radiation Exposure in Pregnancy | 266 | ||
| 22. Breastfeeding after Breast Augmentation Surgery | 268 | ||
| PART 2: INVESTIGATIONS IN OBSTETRICS | 269 | ||
| Chapter 24 Routine Antenatal Blood Investigations and Infective Screening | 271 | ||
| Routine Antenatal Blood Investigations | 271 | ||
| Routine Antenatal Infective Screening | 273 | ||
| Chapter 25 Approach to Prenatal Screening for Thalassaemia | 279 | ||
| Alpha-Thalassaemia | 280 | ||
| Beta-thalassaemia | 282 | ||
| HbE Trait | 283 | ||
| Alpha-thalassaemia/Beta-thalassaemia Coinheritance | 285 | ||
| Sickle Cell Disease | 286 | ||
| Chapter 26 Miscellaneous Antenatal Blood Investigations | 295 | ||
| Miscellaneous Antenatal Blood Tests | 295 | ||
| Pre-Eclampsia Blood/Urine Investigations | 297 | ||
| Urine Protein: Creatinine Ratio | 298 | ||
| Chapter 27 Screening for Chromosomal Defects | 299 | ||
| Introduction | 299 | ||
| Various Screening Tests for Down Syndrome | 300 | ||
| First Trimester Screening Available in KK Hospital | 303 | ||
| Nuchal Translucency | 305 | ||
| Noninvasive Prenatal Testing (NIPT) for Foetal Aneuploidy | 308 | ||
| Chapter 28 Prenatal Invasive Diagnostic Tests | 311 | ||
| Additional Information | 318 | ||
| Chapter 29 Ultrasonography and Foetal Doppler in Obstetrics | 319 | ||
| 1. Dating Scan | 319 | ||
| 2. Screening Scan | 319 | ||
| 3. Growth Scan | 320 | ||
| 4. Foetal Doppler Studies in Obstetrics | 321 | ||
| Common Indications for Doppler Flow Velocimetry Studies Include | 322 | ||
| Chapter 30 Approach to Screening Scan Foetal Abnormalities | 325 | ||
| 1. Head, Neck & Spine Abnormalities | 326 | ||
| 2. Abnormalities in the Chest | 329 | ||
| 3. Abnormalities in the Abdomen | 331 | ||
| 4. Abnormalities in the Pelvis | 333 | ||
| 5. Other Ultrasound Scan Abnormalities | 334 | ||
| Chapter 31 Laboratory Values in Normal Pregnancy | 337 | ||
| Endocrine Values | 344 | ||
| Lipids | 347 | ||
| Chapter 32 An Overview of Serum Human Chorionic Gonadotrophin (HCG) | 349 | ||
| Sources | 349 | ||
| hcg Level in Pregnancy | 351 | ||
| hcg Level in Relation to Spontaneous Miscarriage | 352 | ||
| hcg Level in Relation to Gestational Trophoblastic Disease (GTD) | 352 | ||
| hcg Level in Relation to Ectopic Pregancy | 353 | ||
| PART 3: GYNAECOLOGY | 357 | ||
| Chapter 33 Amenorrhoea | 359 | ||
| Primary Amenorrhoea | 359 | ||
| Management of Primary Amenorrhoea | 361 | ||
| Secondary Amenorrhoea | 361 | ||
| Chapter 34 Abnormal Uterine Bleeding (AUB) | 365 | ||
| Definition of AUB | 365 | ||
| Classification of AUB-FIGO | 366 | ||
| Approach to Management of AUB | 368 | ||
| Treatment for AUB | 370 | ||
| Medications Used for AUB | 372 | ||
| Chapter 35 Adolescent Abnormal Uterine Bleeding (AUB) | 381 | ||
| Incidence and Facts | 381 | ||
| Investigations of Adolescent AUB | 383 | ||
| Management of Adolescent AUB | 384 | ||
| Chapter 36 Premenstrual Syndrome (PMS) | 385 | ||
| Definition of Different Types of Premenstrual Syndrome | 385 | ||
| Epidemiology | 386 | ||
| Risk Factors | 386 | ||
| Clinical Features of PMS | 386 | ||
| Diagnosis of PMS | 387 | ||
| Assessment of PMS | 387 | ||
| Treatment of PMS | 389 | ||
| GnRH Analogues | 390 | ||
| Chapter 37 Dysmenorrhoea | 391 | ||
| Causes | 391 | ||
| 1. Typical Symptoms of Primary Dysmenorrhoea | 392 | ||
| 2. Typical Symptoms of Secondary Dysmenorrhoea | 392 | ||
| 3. Findings Suggestive of Pelvic Pathology Consistent with Secondary Dysmenorrhoea include | 392 | ||
| Management of Dysmenorrhoea | 393 | ||
| Chapter 38 Chronic Pelvic Pain (CPP) | 395 | ||
| Investigations for Chronic Pelvic Pain | 397 | ||
| Management of Chronic Pelvic Pain | 398 | ||
| Other Treatments | 399 | ||
| Chapter 39 Polycystic Ovarian Syndrome (PCOS) | 401 | ||
| Epidemiology | 402 | ||
| High Risk Groups | 402 | ||
| Assessment of PCOS | 402 | ||
| Management of PCOS | 404 | ||
| Chapter 40 Approach to Gynaecological Cancers | 411 | ||
| Special Considerations | 411 | ||
| 1. Carcinoma of the Cervix | 413 | ||
| 2. Carcinoma of the Fallopian Tube | 415 | ||
| 3. Carcinoma of the Ovary | 417 | ||
| 4. Carcinoma of the Uterus (endometrium) | 420 | ||
| 5. Carcinoma of the Vulva/Vagina | 422 | ||
| Chapter 41 Pap Smear Screening and Management of Abnormal Pap Smears | 425 | ||
| Cervical Screening Singapore programme | 428 | ||
| Bethesda 2001 Cervical Cytology Classification — Negative for Squamous Intraepithelial Lesion or Malignancy | 429 | ||
| Sampling Devices for Pap Smear | 431 | ||
| How to Obtain Samples | 433 | ||
| Follow Up Management of Pap Smears | 436 | ||
| Referral Criteria for Colposcopy | 440 | ||
| What is Colposcopy? How to explain to our patients? | 441 | ||
| Summary of Treatment for Pre-Invasive Cervical Lesions | 444 | ||
| Cone Biopsy | 445 | ||
| Atypical Glandular Cells | 447 | ||
| Adenocarcinoma in situ (AIS) | 448 | ||
| Chapter 42 Postcoital Bleeding (PCB) | 449 | ||
| Causes of PCB | 449 | ||
| Chapter 43 Human Papilloma (HPV) Vaccines and HPV Testing — Salient Facts for Clinical Practice | 453 | ||
| Facts about Cervical Cancer | 453 | ||
| Human Papilloma Virus and Cervical Cancers and Other Cancers | 453 | ||
| Human Papilloma Virus and Genital Warts | 454 | ||
| Clinical Manifestations | 454 | ||
| Natural History of hr-HPV Infection and pathogenesis of Cervical Cancer | 454 | ||
| The Cervical Epithelium and Cervical Cancers | 455 | ||
| Cervical Intraepithelial Neoplasia (CIN) and Squamous Cell Carcinoma (SCC) | 455 | ||
| Adenocarcinoma In situ (AIS) and Adenocarcinoma — Why does it Need Special Attention? | 456 | ||
| Overview of Treatment for Cervical Pre-Cancers | 456 | ||
| Pap Smear Screening | 457 | ||
| High-Risk(hr-) HPV Testing | 457 | ||
| Self-Sampling for Cervical Screening | 458 | ||
| HPV Vaccination | 459 | ||
| Chapter 44 Vulvar and Vaginal Lesions | 463 | ||
| Vulvar Disorders | 463 | ||
| 1. Normal anatomical variants. No treatment required | 471 | ||
| 2. Vulvar Pigmented Lesions | 472 | ||
| 3. Vulvar Ulcers | 474 | ||
| 4. Vulvar Nodules, Cysts or Tumours | 479 | ||
| 5. Vulvar Dermatoses | 481 | ||
| Chapter 45 Postmenopausal Bleeding (PMB) | 497 | ||
| Causes of PMB | 497 | ||
| Management of Postmenopausal Bleeding (PMB) | 498 | ||
| Chapter 46 Thickened Endometrium | 501 | ||
| Chapter 47 Polyps (Cervical/Endometrial) | 511 | ||
| Cervical Polyps | 511 | ||
| Endometrial Polyps | 513 | ||
| Chapter 48 Fibroids | 517 | ||
| Exact Aetiology | 517 | ||
| Location of Fibroids | 517 | ||
| Risk Factors | 518 | ||
| Physical Examination | 520 | ||
| Investigations | 521 | ||
| Management of fibroids | 522 | ||
| Fertility and Fibroids | 527 | ||
| Pregnancy and Fibroids | 527 | ||
| Chapter 49 Endometriosis and Adenomyosis | 531 | ||
| Investigations for Endometriosis | 533 | ||
| Differential diagnosis of endometriosis | 534 | ||
| 1. Endometriosis Associated Pain | 535 | ||
| 2. Endometriosis Associated Subfertility | 536 | ||
| Definition of Adenomyosis | 538 | ||
| Differential Diagnosis of Adenomyosis | 538 | ||
| Investigations of Adenomyosis | 539 | ||
| Chapter 50 Ovarian Cyst | 541 | ||
| Types of Adnexal Masses and Management of Ovarian Cysts in Women | 541 | ||
| Pregnancy with Adnexal Mass | 545 | ||
| Chapter 51 Pelvic Organ Prolapse (POP) | 549 | ||
| Chapter 52 Voiding and Urinary Disorders | 553 | ||
| Urinary Incontinence | 554 | ||
| Detrusor Overactivity (DO) | 555 | ||
| Frequency/Urgency Syndrome | 556 | ||
| Simple Urinary Tract Infection (UTI) | 557 | ||
| Recurrent Urinary Tract Infection (UTI) | 558 | ||
| Acute Retention of Urine | 559 | ||
| Microscopic Haematuria (MH) | 560 | ||
| Chapter 53 Vaginal Discharge and Recurrent Vulvovaginal Candidiasis | 561 | ||
| Causes of Vaginal Discharge | 561 | ||
| Management of Vaginal Discharge | 562 | ||
| Treatment of Vaginal Discharge | 563 | ||
| Treatment of Uncomplicated Acute Vulvovaginal Candidiasis (VVC) | 564 | ||
| Treatment of Recurrent Vulvovaginal Candidiasis (VVC) | 565 | ||
| Treatment of Bacterial Vaginosis | 566 | ||
| Treatment of Bacterial Vaginosis in Pregnancy | 566 | ||
| Treatment of Atrophic Vaginitis | 567 | ||
| Treatment of Chlamydia Trachomatis | 568 | ||
| Treatment of Chlamydia Trachomatis Infection in Pregnancy | 568 | ||
| Treatment of Neisseria Gonorrhoea | 569 | ||
| Treatment of Gonococcal Infection in Pregnancy | 569 | ||
| Chapter 54 Pelvic Inflammatory Disease (PID) | 571 | ||
| Chapter 55 Sexually Transmitted Infection (STI) | 583 | ||
| Risk Factors for STI | 584 | ||
| Screening Approach for (STI) | 584 | ||
| Approach to Management of STI | 585 | ||
| Physical Examination | 585 | ||
| STI-related Genital Ulcers | 587 | ||
| Laboratory Investigations for STI | 589 | ||
| Specific STI Investigations and Management | 589 | ||
| 1. Genital herpes | 589 | ||
| 2. Syphilis | 592 | ||
| 3. Chancroid | 598 | ||
| 4. Granuloma Inguinale (GI) — Rare | 599 | ||
| 5. Lymphogranuloma venerum (LGV) — Rare | 600 | ||
| 6. Genital warts | 601 | ||
| 7. Human Immunodeficiency Virus (HIV) infection | 606 | ||
| Chapter 56 Oral Hormonal Contraception | 613 | ||
| Combined Oral Contraceptive (COC) Pill | 613 | ||
| Management of Missed Pills for 21-day Regimen — COC | 619 | ||
| Advice to patients for missed pills | 620 | ||
| Progestin Only Pill (POP) | 621 | ||
| Chapter 57 Non-Oral Contraception/Contraception For Lactating Mothers | 625 | ||
| Barrier Method | 625 | ||
| Depot Provera (Progestin-Only Injectables) | 626 | ||
| Evra Patch | 627 | ||
| Implanon Nxt Implants | 628 | ||
| Intrauterine Contraceptive Device (IUCD) | 630 | ||
| Levonorgestrel Intrauterine System (Mirena IUCD) | 631 | ||
| Mesigyna/Norigynon (Monthly Combined Injectables) | 633 | ||
| Nuva Ring | 633 | ||
| Permanent Sterilisation | 634 | ||
| Chapter 58 Choice of Contraception | 639 | ||
| Contraceptive Choice Based on Personal Characteristics and Reproductive History | 640 | ||
| Chapter 59 Contraception in Patients with Medical Conditions and Drug Interactions | 647 | ||
| Combined Hormonal Contraception (CHC) is not recommended in | 663 | ||
| Contraceptive Advice for Women Using Enzyme-inducing Drugs | 664 | ||
| Drugs that increase Contraceptive Hormone Levels | 667 | ||
| Drugs that are affected by Contraceptive Hormones | 669 | ||
| Chapter 60 Intrauterine Contraceptive Device (IUCD) and Associated Dilemmas | 673 | ||
| Missing IUCD Threads | 673 | ||
| Management of Missing IUCD (Intrauterine Contraceptive Device) | 675 | ||
| Other IUCD dilemmas | 677 | ||
| Chapter 61 Emergency Contraception | 679 | ||
| Chapter 62 Menopause | 683 | ||
| Definition | 683 | ||
| Factors Affecting Age of Menopause | 684 | ||
| Clinical Features in Perimenopausal Period | 684 | ||
| Menopausal Transition | 685 | ||
| Long-term Implications | 686 | ||
| Assessment of Menopause | 686 | ||
| Management of Menopause | 686 | ||
| Chapter 63 Osteoporosis | 689 | ||
| Definition | 689 | ||
| Risk Factors for Fractures | 690 | ||
| Screening Assessment Tools | 691 | ||
| OSTA CHART | 693 | ||
| BMD Measurement | 694 | ||
| When to Repeat BMD | 695 | ||
| Management of Osteoporosis | 695 | ||
| Chapter 64 Hormone Replacement Therapy (HRT) | 699 | ||
| WHO to Give? | 699 | ||
| How to Give? | 700 | ||
| Benefits of HRT? | 700 | ||
| Risks of HRT? | 700 | ||
| Contraindications of HRT | 701 | ||
| Selective Oestrogen Receptor Modulators (SERMs) | 701 | ||
| Chapter 65 Subfertility, Semen Analysis and Management of Azoospermia | 709 | ||
| Definition | 709 | ||
| Management of Subfertility | 710 | ||
| Ovarian Hyperstimulation Syndrome (OHSS) | 714 | ||
| Symptoms of OHSS | 715 | ||
| Approach to Azoospermia | 724 | ||
| Chapter 66 Approach to Hyperprolactinaemia | 725 | ||
| Management of Pituitary Adenomas/ Prolactinomas in Pregnancy | 729 | ||
| Chapter 67 Approach to Galactorrhoea | 731 | ||
| History | 732 | ||
| Examination | 733 | ||
| Chapter 68 Sexual Dysfunctional Problems | 735 | ||
| Introduction | 735 | ||
| How to Help Dissatisfied Women with their Sexual Response? | 736 | ||
| History of sexual problem | 737 | ||
| Types of problems encountered | 738 | ||
| The Psychosexual Dysfunction | 738 | ||
| Assessing Categories of Aetiology | 740 | ||
| Physical Examination | 740 | ||
| Investigations | 741 | ||
| Management of Sexual Dysfunction Problems | 741 | ||
| To Treat or to Refer? | 742 | ||
| Intervention | 742 | ||
| Vaginismus | 744 | ||
| Chapter 69 Mammogram, Breast Ultrasound Scan and Breast Biopsy | 747 | ||
| Introduction | 747 | ||
| Mammogram | 747 | ||
| Breast Ultrasound Scan | 748 | ||
| Breast Biopsy | 749 | ||
| Chapter 70 Breast Cancer Screening | 751 | ||
| Screening Mammogram Schedule | 751 | ||
| PART 4: INVESTIGATIONS IN GYNAECOLOGY | 753 | ||
| Chapter 71 Ovarian Tumour Markers | 755 | ||
| Chapter 72 Female Hormonal Profile | 759 | ||
| Chapter 73 Imaging Modalities in Gynaecology | 763 | ||
| Indications for Ultrasound in Gynaecology | 763 | ||
| Indications for Transabdominal Ultrasound Scan | 764 | ||
| 1. Transvaginal Ultrasound Scan (TVUS) | 764 | ||
| 2. Hysterosalpingography (HSG) | 764 | ||
| 3. Saline Infusion Sonohysterography (SIS) | 765 | ||
| 4. CT Scan | 766 | ||
| 5. MRI Scan | 766 | ||
| Chapter 74 Role of Interventional Radiology (IR) in Obstetrics and Gynaecology | 767 | ||
| Modalities | 767 | ||
| 1. Ultrasound Scan (US) | 767 | ||
| 2. Computed Tomography (CT Scan) | 768 | ||
| 3. Magnetic Resonance Imaging (MRI) Scan | 769 | ||
| General Risks of Procedures | 769 | ||
| Common Procedures Performed at KK Hospital | 770 | ||
| References | 793 | ||
| Index | 809 |