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Obstetrics and Gynecology: Maintenance of Knowledge, An Issue of Obstetrics and Gynecology Clinics, E-Book

Obstetrics and Gynecology: Maintenance of Knowledge, An Issue of Obstetrics and Gynecology Clinics, E-Book

Janice L. Bacon | Paul G. Tomich

(2017)

Additional Information

Book Details

Abstract

The acquisition and implementation of new findings for clinical care in obstetrics and gynecology is at a more rapid pace than ever before. More understanding of the pathophysiology of disease coupled with improved screening technology and genetic information requires physicians to constantly update their knowledge-base and familiarize themselves with guidelines and advances in techniques as well as question old euphemisms. Medical specialties, including obstetrics and gynecology have moved from board certification as a solitary achievement to maintaining current knowledge- a continuous lifelong learning process. This issue of Obstetrics and Gynecology Clinics is dedicated to clinical care for patients with evidence-based recommendations: “state of the art” advice and updates. Articles are specifically devoted to Contraception: menarche to menopause; Vaginitis: beyond symptoms; Abnormal uterine bleeding; Recognition and therapeutic options for malignancy of the cervix and uterus; Gestational diabetes: Diagnosis, classification and clinical care; Hypertensive disorders in pregnancy; Obstetric emergencies: Shoulder dystocia and postpartum hemorrhage; Prenatal diagnosis: tools and tests for screening; Clinical recognition and screening for common breast disorders and malignancy; and Recognizing and managing common urogynecologic disorders.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Obstetrics and Gynecology: Maintenanceof Knowledge\r i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITORS iii
AUTHORS iii
Contents v
Foreword: Lifelong Learning Requires Maintenance of Knowledge v
Preface: Maintenance of Knowledge v
Contraception: Menarche to Menopause v
Vaginitis: Beyond the Basics v
Abnormal Uterine Bleeding: Current Classification and Clinical Management v
Recognition and Therapeutic Options for Malignancy of the Cervix and Uterus v
Gestational Diabetes: Diagnosis, Classification, and Clinical Care vi
Updates on the Recognition, Prevention and Management of Hypertension in Pregnancy vi
Obstetric Emergencies: Shoulder Dystocia and Postpartum Hemorrhage vi
Prenatal Diagnosis: Screening and Diagnostic Tools vii
Cancer Recognition and Screening for Common Breast Disorders and Malignancy vii
Recognizing and Managing Common Urogynecologic Disorders vii
The Menopausal Transition vii
Special Article viii
Burnout in Obstetricians and Gynecologists297 viii
OBSTETRICS AND GYNECOLOGY CLINICS\r ix
FORTHCOMING ISSUES ix
September 2017 ix
December 2017 ix
March 2018 ix
RECENT ISSUES ix
March 2017 ix
December 2016 ix
September 2016 ix
Foreword: Lifelong Learning Requires Maintenance of Knowledge\r xi
Preface:\rMaintenance of Knowledge xiii
Contraception 143
Key points 143
TYPES OF CONTRACEPTION 144
NATURAL FAMILY PLANNING 144
BARRIER METHODS 144
Diaphragms 144
Contraceptive Sponges 145
Cervical Caps 145
Female Condoms 146
Male Condoms 146
Spermicide 147
ORAL CONTRACEPTION 147
EMERGENCY CONTRACEPTION 149
INJECTABLE PROGESTIN 149
LONG-ACTING REVERSIBLE CONTRACEPTION METHODS 149
PROGESTERONE CONTRACEPTIVE IMPLANTS 151
INTRAUTERINE DEVICES 151
STERILIZATION 152
SPECIFIC POPULATION CONSIDERATIONS 153
POLICY IMPLICATIONS 153
TOOLS FOR PROVIDERS 153
REFERENCES 154
Vaginitis 159
Key points 159
BACKGROUND 159
THE VAGINAL ECOSYSTEM 160
The Role of Estrogen 161
EVALUATION OF VAGINAL COMPLAINTS 161
History and Physical Examination 161
Laboratory Testing 163
PHYSIOLOGIC DISCHARGE 163
VULVOVAGINAL CANDIDIASIS 165
Causative Organisms 165
Signs and Symptoms 165
Diagnostic Testing 165
Uncomplicated Versus Complicated Candida Infections 166
Treatment 166
BACTERIAL VAGINOSIS 168
Signs and Symptoms 169
Diagnostic Testing 169
Recurrent Bacterial Vaginosis 169
Treatment 170
TRICHOMONAS VAGINITIS 171
Signs and Symptoms 171
Recurrent and Persistent Trichomonas Infections 171
Treatment 171
DESQUAMATIVE INFLAMMATORY VAGINITIS 172
CYTOLYTIC VAGINOSIS 173
SUMMARY 174
REFERENCES 174
Abnormal Uterine Bleeding 179
Key points 179
ENDOMETRIAL AND ENDOCERVICAL POLYPS 181
ADENOMYOSIS 182
LEIOMYOMATA 183
MALIGNANCY AND HYPERPLASIA 185
COAGULOPATHY 186
Ovulatory Function 188
Endometrial 189
Iatrogenic 190
Not Yet Classified 190
REFERENCES 190
Recognition and Therapeutic Options for Malignancy of the Cervix and Uterus 195
Key points 195
CERVICAL CANCER 196
Epidemiology/Risk Factors 196
Cervical Cancer Prevention and Human Papillomavirus Vaccine 196
Cervical Cancer Screening 197
Cervical Cancer Fertility-Sparing Treatment 199
ENDOMETRIAL CANCER 199
Epidemiology/Risk Factors 199
Presentation, Diagnosis, and Treatment 200
Endometrial Intraepithelial Neoplasia 201
Endometrial Cancer Genetics 202
Endometrial Cancer Fertility-Sparing Treatment 203
Choosing Wisely Campaign Highlights 205
REFERENCES 205
Gestational Diabetes 207
Key points 207
BACKGROUND 207
DIAGNOSIS OF GESTATIONAL DIABETES 209
CLINICAL CARE 211
Lifestyle Management and Glucose Monitoring 211
Pharmacologic Therapy 211
Antenatal Fetal Testing 213
Assessment of Fetal Growth 213
Timing of Delivery 213
Intrapartum Glucose Management 214
Postpartum Care 214
Contraception 215
SUMMARY 215
REFERENCES 215
Updates on the Recognition, Prevention and Management of Hypertension in Pregnancy 219
Key points 219
INTRODUCTION 219
DEFINING PREECLAMPSIA 220
PREVENTING PREECLAMPSIA 221
TREATING HYPERTENSION 224
SUMMARY/DISCUSSION 228
ACKNOWLEDGMENTS 228
REFERENCES 228
Obstetric Emergencies 231
Key points 231
INTRODUCTION 231
SHOULDER DYSTOCIA 232
Definition 232
Incidence 232
Risk Factors 232
Prevention 234
Management 234
POSTPARTUM HEMORRHAGE 236
Diagnosis 236
Incidence 236
Risk Factors 237
Prevention 237
Management 240
SUMMARY 240
REFERENCES 241
Prenatal Diagnosis 245
Key points 245
INTRODUCTION 245
HISTORY OF SCREENING 247
SCREENING TESTS 247
FIRST-TRIMESTER SCREEN 247
QUADRUPLE MARKER SCREEN 248
INTEGRATED, STEPWISE SEQUENTIAL, AND CONTINGENT SCREENING 249
CELL-FREE FETAL DNA 249
ULTRASOUND ONLY 251
DIAGNOSTIC TESTING 252
CHORIONIC VILLUS SAMPLING 252
AMNIOCENTESIS 252
CYTOGENETIC EVALUATIONS 253
PREIMPLANTATION GENETIC DIAGNOSIS 254
SUMMARY 254
REFERENCES 254
Cancer Recognition and Screening for Common Breast Disorders and Malignancy 257
Key points 257
INCIDENCE 257
RECOMMENDED SCREENING 259
Mammogram 259
Clinical Breast Examination, Breast Self-examination, Breast Self-examination Instruction, and Breast Self-awareness 260
Risks and Benefits of Screening Mammogram, Breast Self-examination, Breast Self-examination Instruction, Clinical Breast Ex ... 260
RISK FACTORS FOR BREAST CANCER 262
Risk Tools 262
Genetics 263
Dense Breasts 263
Factors Affecting the Relative Risk of Breast Cancer 263
BENIGN BREAST DISORDERS 263
Palpable Breast Mass 263
Nipple Discharge 264
Breast Pain 264
Skin Changes 265
Inflammatory Breast Disorders 266
ADOLESCENTS 266
Palpable Breast Mass 266
Breast Asymmetry 267
Juvenile Hypertrophy of the Breasts 267
Breast Reduction Surgery 267
Breast Augmentation 267
REFERENCES 267
Recognizing and Managing Common Urogynecologic Disorders 271
Key points 271
INTRODUCTION 271
URINARY INCONTINENCE 272
Types of Urinary Incontinence 272
Evaluation of Urinary Incontinence 272
Conservative Management of Urinary Incontinence 276
Procedures in Urinary Incontinence—Overactive Bladder 277
Surgery to Treat Stress Urinary Incontinence 278
PELVIC ORGAN PROLAPSE 279
Assessment of Pelvic Organ Prolapse 279
Conservative Treatment of Pelvic Organ Prolapse 279
Pelvic Organ Prolapse Surgery 280
SUMMARY 281
REFERENCES 282
The Menopausal Transition 285
Key points 285
THE LATE REPRODUCTIVE YEARS 286
MENOPAUSAL TRANSITION (PERIMENOPAUSE) 287
MENOPAUSE 287
SYMPTOMS AND PHYSICAL CHANGES OF MENOPAUSE 288
Vasomotor Symptoms 288
Sleep Disturbance 289
Headache 289
Cognition and Mood 290
Urogenital Atrophy 291
Joint and Bone Changes 292
CARDIOVASCULAR CHANGES IN MENOPAUSE 293
BREAST CANCER AND MENOPAUSE 293
VENOUS THROMBOEMBOLISM 293
NORTH AMERICAN MENOPAUSE SOCIETY RECOMMENDATIONS 294
Skin and Hair 294
Eyes 294
Ears 294
Teeth and Oral Cavity 294
Gallbladder Disease 294
Epilepsy 295
REFERENCES 295
Burnout in Obstetricians and Gynecologists 297
Key points 297
INTRODUCTION 297
THE PROBLEM IS PERVASIVE 298
All Physicians are at Risk 298
The Prevalence in Obstetricians and Gynecologists 299
Residents and Young Physicians are at Increased Risk 299
IDENTIFYING THE CAUSE 300
STRESS VERSUS BURNOUT 301
PERILS OF BURNOUT 301
AM I BURNED OUT? 303
PREVENTION 304
REVERSING BURNOUT 305
SUMMARY 305
REFERENCES 306
Index 311