Additional Information
Book Details
Abstract
The aim of the book is to help students to understand the importance of history taking, physical
examination and its relevance in making a provisional diagnosis.
This book also deals with relevant investigations based on provisional diagnosis. Presentation is
kept very simple and concise. This book deals with common clinical conditions and is designed in such
a way as to help students to prepare for their clinical and practical exams.
This book deals with common clinical conditions and is designed in such
a way as to help students to prepare for their clinical and practical exams.
Photos of clinical importance, specimens, instruments and USG are incorporated in this book.
Case discussions and key points in each cases will help students to understand the subject easily.
Frequently asked questions are also included after each chapter.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Cover | Cover | ||
| Title page | iii | ||
| Copyright page | iv | ||
| Dedication | v | ||
| About the Book | vii | ||
| Table of Content | ix | ||
| Foreword | xi | ||
| Preface | xiii | ||
| Abbreviations | xv | ||
| Part 1 - Obstetric cases | 1 | ||
| Case 1 - Obstetric history taking and examination | 3 | ||
| Introduction | 3 | ||
| Guidelines for obstetric history taking | 3 | ||
| Patient’s details | 3 | ||
| History | 3 | ||
| Discussion on patient details and it’s importance | 4 | ||
| Terminology | 6 | ||
| History | 8 | ||
| Chief complaints to be noted in chronological order | 8 | ||
| History of present illness | 8 | ||
| History of present pregnancy | 8 | ||
| Menstrual history | 9 | ||
| Marital history | 12 | ||
| Past obstetric history | 12 | ||
| Past medical history | 14 | ||
| Past surgical history | 14 | ||
| Family history | 14 | ||
| Personal history | 14 | ||
| Physical examination | 14 | ||
| General examination | 15 | ||
| Obstetric examination | 22 | ||
| Inspection | 22 | ||
| Palpation | 23 | ||
| Auscultation | 28 | ||
| Percussion | 28 | ||
| Per vaginal examination | 31 | ||
| Summary | 32 | ||
| Diagnosis | 32 | ||
| Investigations | 32 | ||
| Key points | 34 | ||
| Frequently asked questions | 34 | ||
| Case 2 - Normal pregnancy | 37 | ||
| Patient’s details | 37 | ||
| Present complaints | 37 | ||
| History | 37 | ||
| History of present illness | 37 | ||
| Menstrual history, marital history, past obstetric history, past medical and surgical history, family history, personal history | 37 | ||
| Examination | 37 | ||
| General examination and obstetric examination | 37 | ||
| Summary | 38 | ||
| Diagnosis | 38 | ||
| Investigations | 38 | ||
| Case discussion | 38 | ||
| Mechanism of labour | 38 | ||
| Causes for first trimester bleeding | 39 | ||
| AMTSL—active management of third stage of labour | 39 | ||
| Episiotomy | 40 | ||
| Lacerated perineum | 41 | ||
| Key points | 42 | ||
| Frequently asked questions | 42 | ||
| Case 3 - A case of anaemia complicating pregnancy  | 43 | ||
| Patient’s details | 43 | ||
| Present complaints | 43 | ||
| History | 43 | ||
| Present history | 43 | ||
| Menstrual history | 43 | ||
| Marital history and obstetric history | 43 | ||
| Past obstetric history | 44 | ||
| Past history | 44 | ||
| Past surgical history | 44 | ||
| Past medical history | 44 | ||
| Family history | 44 | ||
| Personal history | 44 | ||
| Examination | 44 | ||
| General examination | 44 | ||
| Obstetric examination | 45 | ||
| Summary | 45 | ||
| Diagnosis | 45 | ||
| Investigations | 46 | ||
| Case discussion | 48 | ||
| Key points | 51 | ||
| Frequently asked questions | 52 | ||
| Case 4 - A Case of hypertension in pregnancy  | 53 | ||
| Patient’s details | 53 | ||
| Present complaints | 53 | ||
| History | 53 | ||
| Menstrual history | 53 | ||
| Marital history | 54 | ||
| Obstetric history | 54 | ||
| Past obstetric history | 54 | ||
| Past medical history | 54 | ||
| Past surgical history | 54 | ||
| Family history | 54 | ||
| Personal history | 54 | ||
| Examination | 54 | ||
| General examination | 54 | ||
| Obstetric examination | 56 | ||
| Summary | 57 | ||
| Diagnosis | 57 | ||
| Investigations | 58 | ||
| Hypertensive disorders in pregnancy | 59 | ||
| Case discussion | 59 | ||
| Basic pathology of pre-eclampsia in short | 59 | ||
| High risk factors for developing pre-eclampsia | 60 | ||
| Predictors of pre-eclampsia | 60 | ||
| Prevention of pre-eclampsia | 61 | ||
| Management | 62 | ||
| General management of pre-eclampsia | 62 | ||
| Indications for caesarean section | 63 | ||
| Management of eclampsia | 63 | ||
| Complications of pre-eclampsia | 64 | ||
| Abruptio Placenta | 64 | ||
| Key points | 66 | ||
| Frequently asked questions | 66 | ||
| Case 5 - A case of prolonged (post-term) pregnancy  | 69 | ||
| Patient’s details | 69 | ||
| Present complaints | 69 | ||
| History | 69 | ||
| Menstrual history, marital history, past history, surgical history, family history, personal history | 69 | ||
| Obstetric history | 70 | ||
| Family history | 70 | ||
| Examination | 70 | ||
| General examination | 70 | ||
| Obstetric examination | 70 | ||
| Per vaginal examination | 70 | ||
| Summary | 70 | ||
| Diagnosis | 71 | ||
| Investigations | 71 | ||
| Case discussion | 71 | ||
| Management | 72 | ||
| Management of prolonged pregnancy | 72 | ||
| Methods of foetal surveillance beyond dates | 72 | ||
| Manning’s biophysical profile | 73 | ||
| Modified biophysical profile (NST + AFI) biweekly | 73 | ||
| Amniotic fluid index | 73 | ||
| Doppler velocimetry | 74 | ||
| Induction of labour in prolonged pregnancy | 74 | ||
| Complications of prolonged pregnancy | 75 | ||
| Oligohydramnios | 76 | ||
| Key points | 77 | ||
| Frequently asked questions | 78 | ||
| Case 6 - A case of pregnancy following caesarean section | 79 | ||
| Patient’s details | 79 | ||
| Present complaints | 79 | ||
| History | 79 | ||
| Menstrual history, marital history, past medical surgical history, obstetric history, family history | 79 | ||
| Past obstetric history in detail | 79 | ||
| Examination | 80 | ||
| General examination | 80 | ||
| Obstetric examination | 80 | ||
| Summary | 81 | ||
| Diagnosis | 82 | ||
| Investigations | 82 | ||
| Case discussion | 82 | ||
| Definition of caesarean delivery | 82 | ||
| Types of caesarean section | 83 | ||
| Scar dehiscence (incomplete scar rupture—peritoneum intact) | 83 | ||
| Symptoms and signs of rupture uterus | 83 | ||
| Management of rupture uterus | 83 | ||
| The pre-requisites for allowing patient for trial of labour after caesarean/vaginal birth after caesarean | 83 | ||
| Monitoring during VBAC | 84 | ||
| Advantages of LSCS over classical section | 84 | ||
| Indications for classical caesarean in modern obstetrics | 85 | ||
| Indications for caesarean hysterectomy | 85 | ||
| Key points | 86 | ||
| Frequently asked questions | 86 | ||
| Case 7 - A case of heart disease complicating pregnancy  | 87 | ||
| Patient’s details | 87 | ||
| Present complaints | 87 | ||
| History | 87 | ||
| Menstrual history | 87 | ||
| Marital history | 87 | ||
| Obstetric history | 88 | ||
| Past obstetric history | 88 | ||
| Past surgical history | 88 | ||
| Past medical history | 88 | ||
| Family history | 88 | ||
| Examination | 88 | ||
| General examination | 88 | ||
| Cardiovascular system | 89 | ||
| Respiratory system | 89 | ||
| Abdominal examination | 89 | ||
| Obstetric examination | 89 | ||
| Summary | 89 | ||
| Diagnosis | 90 | ||
| Investigations | 90 | ||
| Case discussion | 90 | ||
| Cardiovascular changes during pregnancy | 90 | ||
| Conditions which can precipitate cardiac failure | 90 | ||
| The criteria to diagnose heart disease in pregnancy | 91 | ||
| Time of hospitalisation in cardiac disease complicating pregnancy | 92 | ||
| Conduct of labour in a heart disease complicating pregnancy | 92 | ||
| Complications during antenatal period, labour and in puerperium | 92 | ||
| Indications where pregnancy is to be avoided | 92 | ||
| Indications for cardiac surgery during pregnancy | 92 | ||
| Place of caesarean section in heart disease complicating pregnancy | 93 | ||
| Contraception in heart disease complicating pregnancy | 93 | ||
| Maternal outcome | 93 | ||
| Rule of five | 93 | ||
| Anti-coagulation guidelines | 94 | ||
| Key points | 94 | ||
| Frequently asked questions | 94 | ||
| Case 8 - A case of malpresentation  | 97 | ||
| Patient’s details | 97 | ||
| Present complaints | 97 | ||
| Special history | 97 | ||
| Menstrual history | 97 | ||
| Marital history | 97 | ||
| Obstetric history | 97 | ||
| Past obstetric history | 97 | ||
| Conditions which predispose to malpresentation | 98 | ||
| Family history, personal history | 98 | ||
| Past surgical history | 98 | ||
| Examination | 98 | ||
| General examination | 98 | ||
| Obstetric examination | 98 | ||
| Breech presentation | 98 | ||
| Transverse lie | 98 | ||
| Face presentation | 98 | ||
| Summary | 100 | ||
| Diagnosis | 100 | ||
| Investigations | 100 | ||
| Case discussion-breech presentation | 100 | ||
| Mechanism of labour | 101 | ||
| Assisted breech delivery | 102 | ||
| Breech extraction | 102 | ||
| Techniques to deliver the head in breech | 102 | ||
| Complicated breech | 103 | ||
| Complications of breech delivery (inherent for breech delivery) | 103 | ||
| External cephalic version (ECV) | 103 | ||
| Indications for caesarean in breech presentation | 104 | ||
| Key points | 104 | ||
| Frequently asked questions | 105 | ||
| Case 9 - A case of multiple pregnancy  | 107 | ||
| Patient’s details | 107 | ||
| Present complaints | 107 | ||
| History | 107 | ||
| Menstrual history | 107 | ||
| Marital history | 107 | ||
| Obstetric history | 107 | ||
| Past obstetric history | 107 | ||
| Present obstetric history | 108 | ||
| Past Medical And Surgical History | 108 | ||
| Personal history | 108 | ||
| Family history | 108 | ||
| Examination | 108 | ||
| General examination | 108 | ||
| Obstetric examination | 108 | ||
| Summary | 109 | ||
| Diagnosis | 109 | ||
| Investigations | 109 | ||
| Quintero’s classification of severity of twin-to-twin transfusion | 111 | ||
| Case discussion | 111 | ||
| Prognosis or outcome is influenced by the chorionicity rather than the zygosity | 111 | ||
| Antenatal management of multiple pregnancy | 111 | ||
| Unique complications of monochorionic twins | 112 | ||
| Intrapartum management of twins | 112 | ||
| Management | 113 | ||
| Management of twin gestation | 113 | ||
| Indications for lscs in twins | 114 | ||
| Case discussion in post-partum haemorrhage | 114 | ||
| Management of PPH | 115 | ||
| Key points | 115 | ||
| Frequently asked questions | 116 | ||
| Case 10 - A case of Rh negative pregnancy  | 117 | ||
| Patient’s details | 117 | ||
| Present complaints | 117 | ||
| History | 117 | ||
| Present pregnancy | 117 | ||
| Menstrual history, marital history, obstetric history, past medical and surgical history | 117 | ||
| Past obstetric history | 118 | ||
| Past history | 118 | ||
| Examination | 118 | ||
| General examination | 118 | ||
| Obstetric examination | 118 | ||
| Summary | 118 | ||
| Diagnosis | 118 | ||
| Investigations | 118 | ||
| Case discussion | 119 | ||
| In Rh isoimmunisation or Alloimmunisation | 119 | ||
| Rh isoimmunisation depends on | 119 | ||
| Erythroblastosis foetalis | 120 | ||
| In ABO incompatibility | 120 | ||
| Anti D administration | 120 | ||
| USG findings in hydrops foetalis | 120 | ||
| Management | 123 | ||
| Management Rh negative pregnancy | 123 | ||
| Key points | 123 | ||
| Frequently asked questions | 124 | ||
| Case 11 - A case of cephalopelvic disproportion  | 125 | ||
| Patient’s details | 125 | ||
| Present complaints | 125 | ||
| Menstrual history | 125 | ||
| Marital history | 125 | ||
| Obstetric history | 125 | ||
| Past obstetric history | 125 | ||
| Medical history | 126 | ||
| Surgical history (pertaining to CPD) | 126 | ||
| Family history | 126 | ||
| Personal history | 126 | ||
| General examination | 126 | ||
| Obstetric examination | 127 | ||
| Clinical methods of diagnosing CPD | 127 | ||
| Summary | 131 | ||
| Diagnosis | 131 | ||
| Investigations | 131 | ||
| Case discussion | 132 | ||
| Management | 134 | ||
| Management of cephalopelvic disproportion | 134 | ||
| Key points | 135 | ||
| Frequently asked questions | 135 | ||
| Case 12 - A case of diabetes complicating pregnancy  | 137 | ||
| Patient’s details | 137 | ||
| Present complaints | 137 | ||
| History | 137 | ||
| Menstrual history and marital history | 137 | ||
| Past obstetric history | 137 | ||
| Past medical history | 138 | ||
| Family history | 138 | ||
| Personal history | 138 | ||
| General examination | 138 | ||
| Obstetric examination | 138 | ||
| Summary | 138 | ||
| Diagnosis | 138 | ||
| Investigations | 139 | ||
| Case discussion | 139 | ||
| GDM | 139 | ||
| Management of GDM | 143 | ||
| Polyhydramnios | 143 | ||
| Management of polyhydramnios | 145 | ||
| Key points | 145 | ||
| Frequently asked questions | 145 | ||
| Case 13 - A case of recurrent pregnancy loss | 147 | ||
| Patient details | 147 | ||
| Present complaints | 147 | ||
| History | 147 | ||
| Menstrual history and marital history | 147 | ||
| Present obstetric history | 147 | ||
| Past history | 147 | ||
| H/O consanguinity | 149 | ||
| Past medical history | 149 | ||
| Past surgical history | 149 | ||
| Family history | 149 | ||
| Personal history | 149 | ||
| General examination and obstetric examination | 149 | ||
| Summary | 149 | ||
| Diagnosis | 150 | ||
| Investigations | 150 | ||
| Case discussion | 151 | ||
| Causes for RPL | 151 | ||
| Management | 151 | ||
| Management of anti-phospholipid antibody syndrome | 151 | ||
| Incompetent os causes & Management | 151 | ||
| Antenatal foetal surveillance of RPL | 152 | ||
| Basic principals in the management of RPL | 153 | ||
| Key points | 153 | ||
| Frequently asked questions | 154 | ||
| Case 14 - A case of foetal growth restriction | 155 | ||
| Patient’s details | 155 | ||
| Present complaints | 155 | ||
| History | 155 | ||
| Menstrual history and marital history | 155 | ||
| Present obstetric history | 155 | ||
| Past obstetric history | 155 | ||
| Past medical history | 156 | ||
| Family history | 156 | ||
| Personal history | 156 | ||
| General examination | 156 | ||
| Obstetric examination | 156 | ||
| Summary | 156 | ||
| Diagnosis | 156 | ||
| Investigations | 157 | ||
| Case discussion | 157 | ||
| FGR | 157 | ||
| Types of FGR | 157 | ||
| Causes | 157 | ||
| Diagnosis of FGR | 157 | ||
| Antenatal foetal assessment of FGR | 158 | ||
| Induction of labour and conduct of labour in FGR | 158 | ||
| Indications for elective LSCS | 159 | ||
| Complications of FGR | 159 | ||
| Key points | 159 | ||
| Frequently asked questions | 160 | ||
| Case 15 - Normal puerperium and postnatal care | 161 | ||
| Patient’s details | 161 | ||
| History | 161 | ||
| Examination | 161 | ||
| Examination of the mother | 161 | ||
| General examination | 161 | ||
| Abdominal examination | 161 | ||
| Examination of perineum | 162 | ||
| Summary | 162 | ||
| Case discussion | 162 | ||
| Definition of normal puerperium | 162 | ||
| Following physiological changes occur in normal puerperium | 162 | ||
| After pains | 163 | ||
| Endometrial and placental changes | 163 | ||
| Lochia | 163 | ||
| Cervix | 164 | ||
| Menstruation and ovulation | 164 | ||
| Other pelvic organs | 164 | ||
| Peritoneum and abdominal wall changes | 164 | ||
| Changes in breast and lactation | 165 | ||
| Physiology of lactation | 165 | ||
| Care of normal puerperium | 166 | ||
| Key points | 168 | ||
| Frequently asked questions | 169 | ||
| Case 16 - Viva voce (oral exam) | 171 | ||
| Bony pelvis and foetal skull | 171 | ||
| The pelvic brim | 172 | ||
| The pelvic outlet | 174 | ||
| Foetal skull | 177 | ||
| Foetal skull, sutures and fontanelles | 177 | ||
| Foetal skull diameters | 178 | ||
| Moulding of the head | 179 | ||
| Instruments | 180 | ||
| Rubber catheter | 180 | ||
| Foley’s catheter | 180 | ||
| Sim’s speculum | 181 | ||
| Ovum forceps | 181 | ||
| Hegar’s dilators | 182 | ||
| Sponge holding forceps | 182 | ||
| Uterine curette | 183 | ||
| Obstetric forceps | 183 | ||
| Prophylactic forceps | 184 | ||
| Wrigley’s outlet forceps | 184 | ||
| Outlet forceps | 184 | ||
| Axis traction forceps | 184 | ||
| Trial forceps | 185 | ||
| Failed forceps | 185 | ||
| MR syringe and Karman’s cannula | 185 | ||
| Suction cannula | 186 | ||
| Episiotomy scissors | 187 | ||
| Ventouse (vacuum extractor) | 187 | ||
| Disposable cord clamp | 189 | ||
| Hand Doppler | 190 | ||
| Pinard’s foetoscope | 190 | ||
| Umbilical cord cutting scissors | 191 | ||
| Disposal manual mucus sucker | 191 | ||
| Bulb sucker | 192 | ||
| Medicines | 192 | ||
| Inj. carboprost | 192 | ||
| Inj. oxytocin | 192 | ||
| Inj. methylergometrine | 193 | ||
| Tab. misoprostol | 193 | ||
| Tab. mifepristone—RU486 | 193 | ||
| Dinoprostone gel—PGE2o | 194 | ||
| Inj. magnesium sulphate | 194 | ||
| LSCS procedure | 194 | ||
| Specimens | 198 | ||
| Specimen of anencephalus baby foetus | 198 | ||
| Specimen of Hydrocephalus Foetus | 198 | ||
| Specimen of encephalocoele | 199 | ||
| Conjoint twins—Thoracopagus | 200 | ||
| Specimen of vesicular mole | 200 | ||
| Specimen of rupture uterus | 201 | ||
| Specimen of Couvelaire uterus without cervix | 202 | ||
| NST and CTG | 203 | ||
| USG pictures | 206 | ||
| Gestational Sac with yolk sac | 206 | ||
| Foetal cardiac activity | 207 | ||
| Crown–rump length (CRL) | 207 | ||
| Usg findings of missed abortion | 207 | ||
| USG for NT | 208 | ||
| USG of vesicular mole | 208 | ||
| Twin peak sign | 208 | ||
| Placenta previa | 209 | ||
| USG picture of incompetent OS | 211 | ||
| USG shows ectopic gestation | 213 | ||
| Partogram | 213 | ||
| Part 2 - Gynaecological cases | 215 | ||
| Case 1 - Gynaec case sheet writing | 217 | ||
| Gynaecological history taking and physical examination | 217 | ||
| Patient’s details and history | 217 | ||
| Importance of age | 217 | ||
| Occupation | 218 | ||
| Importance of socioeconomic class | 218 | ||
| Importance of parity | 218 | ||
| Present complaints | 218 | ||
| Menstrual problems | 218 | ||
| Pain abdomen | 220 | ||
| Vaginal discharge | 221 | ||
| Mass abdomen | 221 | ||
| Mass descending P/V | 221 | ||
| Problems related to coitus | 222 | ||
| History | 222 | ||
| Menstrual history | 222 | ||
| Marital history | 222 | ||
| Obstetric history | 222 | ||
| Contraception history | 222 | ||
| Past medical history | 223 | ||
| Past surgical history | 223 | ||
| Treatment history and screening test | 223 | ||
| Family history | 223 | ||
| Personal and social history | 223 | ||
| Examination | 223 | ||
| Physical examination | 223 | ||
| General examination | 223 | ||
| Abdominal examination | 224 | ||
| Gynaec examination | 225 | ||
| Summary | 231 | ||
| Diagnosis | 231 | ||
| Case 2 - A case of vaginal discharge  | 233 | ||
| Patient’s Details\r | 233 | ||
| Present complaints | 233 | ||
| History | 233 | ||
| Menstrual/marital/past obstetric history/contraceptive history/medical/surgical/family history/personal history | 233 | ||
| Past medical history | 234 | ||
| Examination | 234 | ||
| General examination | 234 | ||
| Local examination | 234 | ||
| Bimanual pelvic examination | 234 | ||
| Summary | 234 | ||
| Diagnosis | 234 | ||
| Investigations | 235 | ||
| Routine and specific investigations | 235 | ||
| Specific investigations | 235 | ||
| Case discussion | 235 | ||
| Vaginal discharge | 235 | ||
| Pelvic inflammatory disease causes vaginal discharge | 238 | ||
| Key points | 239 | ||
| Frequently asked questions | 240 | ||
| Case 3 - Abnormal uterine bleeding  | 241 | ||
| Patient’s details | 241 | ||
| Present complaints (may be) | 241 | ||
| History | 242 | ||
| History of present illness | 242 | ||
| Previous menstrual history | 242 | ||
| Past obstetric history | 242 | ||
| Contraceptive history | 242 | ||
| Past medical history | 243 | ||
| Past surgical history | 243 | ||
| Family history | 243 | ||
| Examination | 243 | ||
| General examination | 243 | ||
| Abdominal examination | 243 | ||
| Speculum examination | 243 | ||
| Bimanual pelvic examination | 243 | ||
| Per rectal examination | 244 | ||
| Summary | 244 | ||
| Diagnosis | 244 | ||
| Investigations | 244 | ||
| Case discussion | 245 | ||
| Management of AUB | 249 | ||
| Medical management for AUB | 250 | ||
| Non-hormonal treatment | 250 | ||
| Hormonal treatment | 250 | ||
| Surgical treatment | 251 | ||
| Minimally invasive surgery | 251 | ||
| Ablative procedures | 251 | ||
| Steps of abdominal hysterectomy | 252 | ||
| Key points | 252 | ||
| Frequently asked questions | 252 | ||
| Case 4 - A case of genital prolapse  | 255 | ||
| Patient’s details | 255 | ||
| Present complaints | 255 | ||
| History | 255 | ||
| Menstrual history, marital history, obstetric history, contraceptive history, past medical and surgical hisory, family hist... | 255 | ||
| PAST Obstetric history | 256 | ||
| Contraceptive history | 256 | ||
| Past medical & surgical history | 256 | ||
| Personal history | 256 | ||
| Examination | 256 | ||
| General examination | 256 | ||
| Abdominal examination | 256 | ||
| Gynaec examination | 256 | ||
| Bimanual pelvic examination | 259 | ||
| Per rectal examination | 259 | ||
| Summary | 259 | ||
| Diagnosis | 259 | ||
| Differential diagnosis | 259 | ||
| Investigations | 259 | ||
| Case discussion | 261 | ||
| Management | 262 | ||
| Key points | 264 | ||
| Frequently asked questions | 264 | ||
| Case 5 - A case of fibroid uterus  | 265 | ||
| Patient’s details | 265 | ||
| Present complaints | 265 | ||
| History | 265 | ||
| Menstrual history | 265 | ||
| Marital history | 265 | ||
| Past obstetric history | 266 | ||
| Contraceptive history | 266 | ||
| Past history | 266 | ||
| Family history | 266 | ||
| Personal history | 266 | ||
| Examination | 266 | ||
| General examination | 266 | ||
| Abdominal examination | 266 | ||
| Gynaec examination | 266 | ||
| Speculum examination | 267 | ||
| Bimanual pelvic examination | 267 | ||
| Summary | 267 | ||
| Diagnosis | 267 | ||
| Differential diagnosis | 267 | ||
| Investigations | 268 | ||
| Routine and Specific investigations | 268 | ||
| Case discussion | 269 | ||
| Symptoms of fibroid and their causes | 269 | ||
| Causes for infertility in fibroid | 269 | ||
| Types of secondary changes and degenerations in fibroid | 270 | ||
| Complications of fibroid | 270 | ||
| Fibroid should be treated in the following conditions | 270 | ||
| Drugs used in medical management | 270 | ||
| Usefulness of medical management | 270 | ||
| Disadvantages of medical management | 271 | ||
| Disadvantages of GnRH analogues | 271 | ||
| Indications for myomectomy | 271 | ||
| Pre-requisites for myomectomy | 271 | ||
| Complications of myomectomy | 272 | ||
| Red degeneration of fibroid | 272 | ||
| Complications in pregnancy with fibroid | 272 | ||
| Newer modalities in treatment of fibroid | 272 | ||
| Indications for hysterectomy in fibroids | 273 | ||
| Management | 273 | ||
| Key points | 273 | ||
| Frequently asked questions | 274 | ||
| Case 6 - A case of cancer cervix  | 275 | ||
| Patient’s details | 275 | ||
| Present complaints (may be) | 275 | ||
| History | 275 | ||
| History of presenting illness | 275 | ||
| Menstrual history | 275 | ||
| Marital history | 276 | ||
| Obstetric history | 276 | ||
| Contraceptive history | 276 | ||
| Past history | 276 | ||
| Past surgical history | 276 | ||
| Family history | 276 | ||
| Personal history | 276 | ||
| Examination | 276 | ||
| General examination | 276 | ||
| Abdominal examination | 276 | ||
| Gynaec examination | 277 | ||
| External genitalia | 277 | ||
| Speculum examination | 277 | ||
| Bimanual pelvic examination | 277 | ||
| Per rectal examination | 277 | ||
| Summary | 277 | ||
| Diagnosis | 277 | ||
| Provisional clinical diagnosis | 277 | ||
| Differential diagnosis | 277 | ||
| Investigations | 278 | ||
| Case discussion | 278 | ||
| Management | 281 | ||
| Pre-invasive lesions of cervix | 281 | ||
| Malignant lesions of cervix—cancer cervix | 282 | ||
| Staging of cancer cervix | 283 | ||
| Early disease of cancer cervix | 284 | ||
| Surgical management for cancer cervix | 284 | ||
| Advantages of surgery over radiotherapy | 285 | ||
| Wertheim’s hysterectomy also known as Meig Obayashi Type 3 or radical hysterectomy | 285 | ||
| Schauta Mitra’s hysterectomy—vaginal approach | 285 | ||
| Complications of surgery | 285 | ||
| Radiotherapy | 285 | ||
| Key points | 286 | ||
| Frequently asked questions | 287 | ||
| Case 7 - A case of infertility  | 289 | ||
| Patient’s details | 289 | ||
| History | 289 | ||
| History of presenting illness | 289 | ||
| Menstrual history | 290 | ||
| Marital history | 290 | ||
| Coital history | 290 | ||
| Andrological history—male partner | 290 | ||
| Obstetric history | 291 | ||
| Contraceptive history | 291 | ||
| Personal history | 291 | ||
| Family history | 291 | ||
| Examination | 291 | ||
| General examination | 291 | ||
| Abdominal examination | 291 | ||
| Gynaec examination | 291 | ||
| Summary | 292 | ||
| Provisional diagnosis | 292 | ||
| Investigations | 292 | ||
| Male partner | 292 | ||
| Female partner | 293 | ||
| Case discussion | 294 | ||
| Definition of infertility | 294 | ||
| Sterility | 294 | ||
| Causes of infertility | 294 | ||
| Causes for female infertility | 294 | ||
| Male factor evaluation | 295 | ||
| WHO criteria 2010—semen analysis | 295 | ||
| Terminology | 295 | ||
| Latest WHO recommendations for normal semen analysis reference values | 295 | ||
| Causes for low volume | 295 | ||
| Management | 296 | ||
| Male partner | 296 | ||
| Intra-uterine insemination—husband’s semen—AIH | 296 | ||
| Intra-uterine insemination—donor semen—AID | 297 | ||
| Azoospermis: | 297 | ||
| Female partner | 297 | ||
| Management of female infertility | 297 | ||
| Key points | 298 | ||
| Frequently asked questions | 298 | ||
| Case 8 - A case of primary amenorrhoea | 299 | ||
| Patient’s details | 299 | ||
| History | 299 | ||
| History of presenting illness | 299 | ||
| Family history | 299 | ||
| Examination | 300 | ||
| General examination | 300 | ||
| Examination for breast development | 300 | ||
| Examination of axillary and pubic hair | 300 | ||
| Examination of thyroid | 300 | ||
| Gynaec examination | 300 | ||
| Per-rectal examination | 300 | ||
| Summary | 300 | ||
| Diagnosis | 301 | ||
| Investigations | 301 | ||
| Routine | 301 | ||
| Specific investigations | 301 | ||
| Case discussion | 301 | ||
| Definition of primary amenorrhoea | 301 | ||
| Primary amenorrhoea | 301 | ||
| Tanner’s staging of breast development | 301 | ||
| Primary amenorrhoea—causes | 302 | ||
| Eugonadotrophic primary amenorrhoea | 302 | ||
| Testicular feminization syndrome | 303 | ||
| Adrenogenital syndrome | 303 | ||
| Turner’s syndrome Hypergonadotropic hypogonadism | 304 | ||
| Hypogonadotropic hypogonadism | 305 | ||
| Hyperprolactinaemia—increased prolactin (PRL) | 305 | ||
| Key points | 306 | ||
| Frequently asked questions | 306 | ||
| Case 9 - A case of secondary amenorrhoea | 307 | ||
| Patient’s details | 307 | ||
| History | 307 | ||
| History of presenting illness | 307 | ||
| Menstrual history | 307 | ||
| Past obstetric history | 307 | ||
| Past medical history | 308 | ||
| Past surgical history | 308 | ||
| Family history | 308 | ||
| Personal history | 308 | ||
| Examination | 308 | ||
| General examination | 308 | ||
| CVS, RS, CNS examination | 308 | ||
| Abdominal examination | 308 | ||
| Gynaec examination | 308 | ||
| Summary | 309 | ||
| Provisional diagnosis | 309 | ||
| Investigations | 309 | ||
| Routine investigations | 309 | ||
| Specific investigations | 309 | ||
| Case discussion | 309 | ||
| Definition of secondary amenorrhoea | 309 | ||
| Management | 309 | ||
| Causes of secondary amenorrhoea | 310 | ||
| Progesterone challenge test (helps to find out level of fault) | 310 | ||
| PCOS/PCOD | 310 | ||
| Hyperprolactinaemia | 311 | ||
| Treatment of secondary amenorrhoea due to other conditions | 311 | ||
| Treatment of hirsutism | 311 | ||
| Premature ovarian failure | 312 | ||
| Key points | 313 | ||
| Frequently asked questions | 313 | ||
| Case 10 - A case of ovarian tumour  | 315 | ||
| Patient’s details | 315 | ||
| Present complaints | 315 | ||
| History | 316 | ||
| Menstrual history | 316 | ||
| Past obstetric history | 316 | ||
| Family history | 316 | ||
| Past medical history | 316 | ||
| Past surgical history | 316 | ||
| Personal history | 316 | ||
| Examination | 316 | ||
| General examination | 316 | ||
| Abdominal examination | 317 | ||
| Speculum examination | 318 | ||
| Bimanual pelvic examination | 318 | ||
| Per rectal examination | 319 | ||
| Summary | 319 | ||
| Diagnosis | 319 | ||
| Investigations | 319 | ||
| Routine investigations | 319 | ||
| Specific | 319 | ||
| Case discussion | 320 | ||
| Functional cysts of ovary | 320 | ||
| Benign tumours of ovary | 320 | ||
| Differential diagnosis of mass abdomen | 320 | ||
| Risk factors for ovarian malignancy | 321 | ||
| Causes for ovarian cyst torsion | 321 | ||
| Complications of ovarian tumour | 322 | ||
| Management | 322 | ||
| Management of malignant ovarian tumours | 322 | ||
| Fertility sparing treatment (conservative treatment) | 323 | ||
| Chemotherapeutic agents in ovarian malignancy | 323 | ||
| Key points | 323 | ||
| Frequently asked questions | 323 | ||
| Case 11 - A case of post-menopausal bleeding PV | 325 | ||
| Patient’s details | 325 | ||
| Present complaints | 325 | ||
| History | 326 | ||
| Past menstrual history | 326 | ||
| Menopausal history | 326 | ||
| Past obstetric history | 326 | ||
| Contraceptic history | 326 | ||
| Past medical & surgical history | 326 | ||
| Marital history | 326 | ||
| Family history | 326 | ||
| Personal history | 326 | ||
| Examination | 327 | ||
| General examination | 327 | ||
| Abdominal examination | 327 | ||
| Inspection of external genitalia | 327 | ||
| Speculum examination | 327 | ||
| Bimanual pelvic examination | 327 | ||
| Per rectal examination | 327 | ||
| Summary | 327 | ||
| Diagnosis | 328 | ||
| Investigations | 328 | ||
| Routine investigations | 328 | ||
| Case Discussion | 328 | ||
| Menopause | 328 | ||
| Menopausal symptoms | 328 | ||
| Management of menopausal symptoms | 329 | ||
| Menopausal hormone therapy benefits | 329 | ||
| Timing of investigation | 329 | ||
| Causes for post-menopausal bleeding PV | 329 | ||
| Risk factors for endometrial carcinoma | 329 | ||
| Treatment of endometrial carcinoma | 329 | ||
| Evaluation of post-menopausal bleeding PV | 330 | ||
| Key points | 330 | ||
| Frequently asked questions | 331 | ||
| Case 12 - A Case of urinary incontinence | 333 | ||
| Patient’s details | 333 | ||
| Present complaints | 333 | ||
| History | 333 | ||
| Menstrual history | 333 | ||
| Marital history | 333 | ||
| Past obstetric history | 333 | ||
| Index | 369 | ||
| Back cover | Back cover |