BOOK
Essentials of Obstetrics and Gynaecology E-Book
Barry O'Reilly | Cecilia Bottomley | Janice Rymer
(2012)
Additional Information
Book Details
Abstract
Essentials of Obstetrics and Gynaecology
The perfect clinical companion; fully revised and updated for this new edition.
- Concise
- Evidence-based
- Focussed on the core curriculum
- Comprehensive coverage sign-posted by clear, consistent headings, from definition, aetiology, pathophysiology, history taking, general advice, clinical features, investigations, management, treatment, prognosis and assessment to risk factors and differential diagnoses.
- Includes self-assessment, emergency procedures and normal values.
-
The perfect clinical companion; fully revised and updated for this new edition.
- Concise
- Evidence-based
- Focussed on the core curriculum
- Comprehensive coverage sign-posted by clear, consistent headings, from definition, aetiology, pathophysiology, history taking, general advice, clinical features, investigations, management, treatment, prognosis and assessment to risk factors and differential diagnoses.
- Includes self-assessment, emergency procedures and normal values.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Essentials of Obstetrics and Gynaecology | iii | ||
| Copyright | iv | ||
| Series preface | v | ||
| Preface | vii | ||
| Contents | ix | ||
| Section 1: History-taking and examination in obstetricsand gynaecology | 1 | ||
| Chapter 1: Gynaecology history-taking | 3 | ||
| The consultation | 3 | ||
| Presenting complaint | 3 | ||
| Abnormal bleeding | 3 | ||
| Urinary symptoms | 4 | ||
| Past history | 4 | ||
| Past medical history | 5 | ||
| Past surgical history | 5 | ||
| Systems review | 5 | ||
| Drug history | 5 | ||
| Family history | 5 | ||
| Personal and social history | 5 | ||
| Presenting a history | 5 | ||
| Chapter 2: Gynaecological examination | 7 | ||
| Abdominal examination | 7 | ||
| Pelvic examination | 7 | ||
| Presenting an examination | 9 | ||
| Chapter 3: Obstetric history-taking | 11 | ||
| Parity | 11 | ||
| Gravidity | 11 | ||
| Gestation | 11 | ||
| Naegele’s rule | 11 | ||
| Presenting complaint | 11 | ||
| Past history | 12 | ||
| Past obstetrical history | 12 | ||
| Past gynaecological history | 12 | ||
| Past medical history | 12 | ||
| Family history | 12 | ||
| Personal and social history | 12 | ||
| Presenting a history | 12 | ||
| Chapter 4: Obstetric examination | 13 | ||
| General examination | 13 | ||
| Abdominal examination | 13 | ||
| Inspection | 13 | ||
| Palpation | 13 | ||
| Auscultation | 15 | ||
| Section 2: Gynaecology | 17 | ||
| Chapter 5: The menstrual cycle, menstrual disorders, infertility and the menopause | 19 | ||
| The menstrual cycle | 19 | ||
| Hypothalamus and pituitary | 20 | ||
| Ovary | 20 | ||
| Follicular phase | 20 | ||
| Ovulation | 20 | ||
| Luteal phase | 20 | ||
| Endometrium | 20 | ||
| Proliferative phase | 20 | ||
| Secretory phase | 20 | ||
| Menstruation | 20 | ||
| Menstrual disorders | 21 | ||
| Menorrhagia | 21 | ||
| Prevalence | 21 | ||
| Age | 22 | ||
| Aetiology | 22 | ||
| Presentation | 22 | ||
| History | 22 | ||
| Examination | 22 | ||
| Investigations | 23 | ||
| Management | 23 | ||
| First-line treatments | 23 | ||
| Second-line treatments | 23 | ||
| Levonorgestrel-releasing intrauterine system | 23 | ||
| Endometrial ablation techniques | 23 | ||
| Hysteroscopic endometrial ablation techniques | 24 | ||
| Transcervical resection of the endometrium | 24 | ||
| Complications of transcervical resection of the endometrium | 24 | ||
| Uterine perforation | 24 | ||
| Fluid overload | 24 | ||
| Bleeding | 24 | ||
| Infection | 24 | ||
| Late complications | 24 | ||
| Outcome of transcervical resection of the endometrium | 24 | ||
| Rollerball endometrial ablation | 25 | ||
| Endometrial laser ablation | 25 | ||
| Non-hysteroscopic endometrial ablation techniques | 25 | ||
| Thermal balloon ablation | 25 | ||
| Microwave endometrial ablation | 25 | ||
| Photodynamic therapy, cryotherapy, radiofrequency ablation and free fluid endometrial ablation | 25 | ||
| Third-line treatment | 25 | ||
| Dysmenorrhoea | 26 | ||
| Definition | 26 | ||
| Prevalence | 26 | ||
| Aetiology | 26 | ||
| Clinical features | 26 | ||
| Examination | 26 | ||
| Investigations | 26 | ||
| Management | 26 | ||
| Amenorrhoea and oligomenorrhoea | 27 | ||
| Definitions | 27 | ||
| Incidence | 27 | ||
| Primary amenorrhoea | 27 | ||
| Aetiology | 27 | ||
| Clinical features | 27 | ||
| Examination | 27 | ||
| Investigations | 27 | ||
| Management | 29 | ||
| Secondary amenorrhoea | 29 | ||
| History | 29 | ||
| Examination | 29 | ||
| Investigations | 29 | ||
| Management | 30 | ||
| Polycystic ovaries | 30 | ||
| Premature ovarian failure (spontaneous or iatrogenic) | 30 | ||
| Anorexia- or exercise-related amenorrhoea | 30 | ||
| Prolactinoma | 30 | ||
| Hypothyroidism | 30 | ||
| Asherman’s syndrome | 31 | ||
| Contraceptive-related amenorrhoea | 31 | ||
| Intermenstrual and postcoital bleeding | 31 | ||
| Aetiology of intermenstrual and postcoital bleeding | 31 | ||
| Hormonal and contraception-related causes | 31 | ||
| Uterine causes | 31 | ||
| Cervical causes | 31 | ||
| Vaginal causes | 31 | ||
| Non-gynaecological causes | 31 | ||
| Clinical features | 31 | ||
| Examination | 31 | ||
| Investigations | 32 | ||
| Management | 32 | ||
| Premenstrual syndrome | 32 | ||
| Pathophysiology | 32 | ||
| Clinical features | 32 | ||
| Diagnosis | 33 | ||
| Treatment | 33 | ||
| Ovulation inhibition | 33 | ||
| Serotonin-specific reuptake inhibitors | 33 | ||
| Alternative treatments | 33 | ||
| Polycystic ovarian syndrome | 33 | ||
| Definition | 33 | ||
| Incidence | 34 | ||
| Aetiology | 34 | ||
| Pathophysiology | 34 | ||
| Presentation | 34 | ||
| Clinical features | 34 | ||
| Examination | 35 | ||
| Investigations | 35 | ||
| Management | 35 | ||
| Contraception in polycystic ovarian syndrome | 36 | ||
| Prognosis | 36 | ||
| Infertility | 36 | ||
| Definitions | 36 | ||
| Incidence | 36 | ||
| Age | 37 | ||
| Aetiology | 37 | ||
| History | 37 | ||
| Examination | 38 | ||
| Investigations | 38 | ||
| Female investigations | 38 | ||
| Hormone profile | 38 | ||
| Blood tests | 39 | ||
| Transvaginal ultrasound scan | 39 | ||
| Further investigations | 39 | ||
| Tests for tubal patency | 39 | ||
| Hysterosalpingogram | 39 | ||
| Hystercontrastsalpingography | 39 | ||
| Laparoscopy and dye | 39 | ||
| Postcoital test | 39 | ||
| Male investigations | 39 | ||
| Semen analysis | 39 | ||
| Semen deficiency definitions | 40 | ||
| Further investigations | 40 | ||
| Management | 40 | ||
| Sperm dysfunction | 40 | ||
| Tubal infertility | 40 | ||
| Anovulatory infertility | 41 | ||
| Polycystic ovarian syndrome | 41 | ||
| Endometriosis | 41 | ||
| Fibroids | 41 | ||
| Social factors | 42 | ||
| Unexplained infertility | 42 | ||
| Assisted conception techniques | 42 | ||
| Ovulation induction | 42 | ||
| Intrauterine insemination | 42 | ||
| In vitro fertilization | 42 | ||
| Complications of in vitro fertilization | 43 | ||
| Ovarian hyperstimulation | 43 | ||
| Multiple pregnancies | 43 | ||
| Ectopic pregnancy | 43 | ||
| Intracytoplasmic sperm injection | 43 | ||
| Gamete intrafallopian transfer | 44 | ||
| Alternative infertility options | 44 | ||
| Human Fertilisation and Embryology Authority | 44 | ||
| Ovarian failure | 44 | ||
| Definitions | 44 | ||
| Menopause | 44 | ||
| The climacteric (menopause transition) | 44 | ||
| Premature ovarian failure | 44 | ||
| Age | 44 | ||
| Pathophysiology | 45 | ||
| Clinical features of menopause | 45 | ||
| Signs | 45 | ||
| Investigations | 45 | ||
| Management | 45 | ||
| Hormone replacement therapy | 45 | ||
| Symptom control | 45 | ||
| Osteoporosis prevention | 46 | ||
| Types of hormone replacement therapy | 46 | ||
| Sequential hormone replacement therapy | 46 | ||
| Continuous combined hormone replacement therapy | 46 | ||
| Unopposed oestrogen | 46 | ||
| Tibolone | 46 | ||
| Modes of administration | 46 | ||
| Oral | 46 | ||
| Transdermal | 46 | ||
| Implants | 46 | ||
| Topical | 46 | ||
| Combined approach | 47 | ||
| Side effects of hormone replacement therapy | 47 | ||
| Vaginal bleeding | 47 | ||
| Oestrogenic effects | 47 | ||
| Progestogenic effects | 47 | ||
| Weight gain | 47 | ||
| Contraindications to hormone replacement therapy | 47 | ||
| Risks of hormone replacement therapy | 47 | ||
| Breast cancer | 47 | ||
| Thrombosis | 48 | ||
| Endometrial cancer | 48 | ||
| Cardiovascular disease | 48 | ||
| Benefits of hormone replacement therapy | 48 | ||
| Osteoporosis | 48 | ||
| Bowel cancer | 48 | ||
| Alzheimer’s disease and rheumatoid arthritis | 48 | ||
| Counselling about hormone replacement therapy | 48 | ||
| Alternatives to hormone replacement therapy | 48 | ||
| Selective oestrogen receptor modulators | 48 | ||
| Clonidine | 49 | ||
| Osteoporosis | 49 | ||
| Risk factors | 49 | ||
| Management | 49 | ||
| Lifestyle and diet | 49 | ||
| Hormone replacement therapy | 49 | ||
| Bisphosphonates | 49 | ||
| Contraception and the menopause | 50 | ||
| Premature ovarian failure | 50 | ||
| Incidence | 50 | ||
| Aetiology | 50 | ||
| Clinical features | 50 | ||
| Investigations | 50 | ||
| Management | 50 | ||
| Oestrogen replacement | 50 | ||
| Fertility options | 51 | ||
| Psychological issues | 51 | ||
| Summary | 51 | ||
| Chapter 6: Pelvic pain, endometriosis andminimal-access surgery | 53 | ||
| Pelvic pain | 53 | ||
| Aetiology | 53 | ||
| Acute pelvic pain | 53 | ||
| Pregnancy-related: | 53 | ||
| Non-pregnancy-related: | 53 | ||
| Non-gynaecological: | 53 | ||
| Chronic pelvic pain | 53 | ||
| Gynaecological: | 53 | ||
| Non-gynaecological: | 54 | ||
| Clinical features | 54 | ||
| Examination | 54 | ||
| Investigations | 55 | ||
| Management | 55 | ||
| Acute pelvic pain | 55 | ||
| Pelvic pain in early pregnancy: | 55 | ||
| Acute pelvic inflammatory disease: | 55 | ||
| Ovarian cyst accident: | 55 | ||
| Appendicitis: | 55 | ||
| Appendix mass and abscess: | 56 | ||
| Chronic pelvic pain | 56 | ||
| Pelvic inflammatory disease: | 56 | ||
| Adhesions: | 56 | ||
| Ovarian cysts (see Chapter 7): | 56 | ||
| Fibroids (see Chapter 7): | 56 | ||
| Chronic pelvic pain syndrome: | 56 | ||
| Irritable bowel syndrome: | 57 | ||
| Constipation: | 57 | ||
| Urinary tract infection/interstitial cystitis/renal calculi: | 57 | ||
| Functional pain: | 57 | ||
| Endometriosis | 57 | ||
| Definition | 57 | ||
| Incidence | 57 | ||
| Age | 57 | ||
| Aetiology | 57 | ||
| Pathology | 58 | ||
| History | 58 | ||
| Examination | 58 | ||
| Abdominal palpation | 58 | ||
| Investigations | 58 | ||
| Treatment | 59 | ||
| Medical | 59 | ||
| Analgesia: | 59 | ||
| Hormonal medical treatment: | 59 | ||
| Combined oral contraceptive pill: | 59 | ||
| Progestogens: | 59 | ||
| Gonadotrophin-releasing hormone analogues: | 59 | ||
| Antiandrogens: | 61 | ||
| Surgical | 61 | ||
| Laparoscopic diathermy/laser ablation or excision: | 61 | ||
| Surgical excision: | 61 | ||
| Laparoscopic uterosacral nerve ablation: | 61 | ||
| Total abdominal hysterectomy: | 61 | ||
| Support | 61 | ||
| Fertility | 61 | ||
| Prognosis | 62 | ||
| Adenomyosis | 62 | ||
| Minimal-access surgery | 62 | ||
| Laparoscopy | 62 | ||
| Preoperative counselling | 62 | ||
| Technique | 63 | ||
| Closure of the wounds | 64 | ||
| Postoperative management | 64 | ||
| Complications | 64 | ||
| Safety in laparoscopy | 64 | ||
| Contraindications | 65 | ||
| Electrosurgery in laparoscopy | 65 | ||
| Unipolar: | 65 | ||
| Bipolar: | 65 | ||
| Lasers in laparoscopy | 65 | ||
| Hysteroscopy | 65 | ||
| Preprocedure counselling | 65 | ||
| Technique | 66 | ||
| Distension media | 67 | ||
| Types of hysteroscope | 67 | ||
| Antibiotic prophylaxis | 67 | ||
| Complications | 67 | ||
| Haemorrhage: | 67 | ||
| Infection: | 67 | ||
| Cervical shock: | 67 | ||
| False passage: | 67 | ||
| Uterine perforation: | 67 | ||
| Fluid overload: | 68 | ||
| Contraindications | 68 | ||
| Summary | 68 | ||
| Chapter 7: Problems of the female genital tract | 69 | ||
| Benign conditions of the vulva | 69 | ||
| Bartholin’s cyst | 69 | ||
| Vulvodynia | 70 | ||
| Definition | 70 | ||
| Assessment | 70 | ||
| Dermatoses | 70 | ||
| Eczema | 70 | ||
| Lichen planus | 70 | ||
| Lichen sclerosus | 70 | ||
| Vulvar vestibulitis | 70 | ||
| Vulvar intraepithelial neoplasia | 71 | ||
| Clinical features | 71 | ||
| Symptoms | 71 | ||
| Physical signs | 71 | ||
| Diagnosis | 71 | ||
| Management | 71 | ||
| Carcinoma of the vulva | 72 | ||
| Clinical features | 72 | ||
| FIGO staging | 72 | ||
| Investigations | 72 | ||
| Management | 72 | ||
| Prognosis | 73 | ||
| Benign conditions of the cervix | 73 | ||
| Cervical ectropion | 73 | ||
| Cervical polyps | 73 | ||
| Cervical neoplasia | 73 | ||
| Role of human papillomavirus | 73 | ||
| Cervical cytology | 73 | ||
| Definitions | 73 | ||
| Cervical screening | 74 | ||
| Cervical intraepithelial neoplasia | 74 | ||
| Management | 74 | ||
| Treatment | 75 | ||
| Cervical intraepithelial glandular neoplasia | 75 | ||
| Carcinoma of the cervix | 75 | ||
| Presentation | 75 | ||
| Investigations | 75 | ||
| Management | 76 | ||
| Surgery | 76 | ||
| Preoperative assessment: | 76 | ||
| Technique: | 76 | ||
| Complications: | 76 | ||
| Radiotherapy | 77 | ||
| Early-stage cervical cancer | 77 | ||
| Follow-up | 77 | ||
| Prognosis | 77 | ||
| Adenocarcinoma of the cervix | 77 | ||
| Benign tumours of the uterus | 77 | ||
| Polyps | 77 | ||
| Uterine fibroids | 78 | ||
| Presentation | 78 | ||
| Management | 78 | ||
| Medical | 78 | ||
| Surgery | 78 | ||
| Adenomyosis | 79 | ||
| Presentation | 79 | ||
| Management | 79 | ||
| Congenital abnormalities of the uterus | 79 | ||
| Endometrial carcinoma | 79 | ||
| FIGO staging of endometrial cancer (updated 2009) | 80 | ||
| Microscopic appearance | 80 | ||
| Management | 80 | ||
| Prognosis | 80 | ||
| 5-year survival | 80 | ||
| Follow-up | 80 | ||
| Ovarian cysts | 80 | ||
| Ovarian cysts in postmenopausal women | 81 | ||
| Low risk | 81 | ||
| High risk | 81 | ||
| Tumours of the ovary | 81 | ||
| Epithelial tumours | 81 | ||
| Germ cell tumours | 82 | ||
| Sex cord tumours | 82 | ||
| Ovarian carcinoma | 82 | ||
| Aetiology | 82 | ||
| Microscopic appearance | 83 | ||
| Presentation | 83 | ||
| Management | 83 | ||
| Ultrasound | 83 | ||
| Tumour markers | 83 | ||
| Surgery | 83 | ||
| Chemotherapy | 84 | ||
| FIGO staging (and 5-year survival rate) | 84 | ||
| Gynaecological cancer in pregnancy | 84 | ||
| Carcinoma of the cervix | 84 | ||
| Management | 84 | ||
| Carcinoma of the ovary | 84 | ||
| Carcinoma of the vulva and endometrium | 85 | ||
| Summary | 85 | ||
| Chapter 8: Uterovaginal prolapse and urinary incontinence | 87 | ||
| Uterovaginal prolapse | 87 | ||
| Definition | 87 | ||
| Incidence | 87 | ||
| Anatomy of the pelvic floor | 88 | ||
| Types of prolapse | 88 | ||
| Aetiology of prolapse | 89 | ||
| Congenital | 89 | ||
| Childbirth | 89 | ||
| Menopause | 89 | ||
| Iatrogenic | 89 | ||
| Chronic predisposing factors | 89 | ||
| Clinical assessment | 89 | ||
| History | 90 | ||
| Examination | 90 | ||
| Urodynamics | 90 | ||
| Treatment | 90 | ||
| Conservative measures | 91 | ||
| Surgical procedures | 92 | ||
| Urinary incontinence | 94 | ||
| Physiology of micturition | 95 | ||
| Bladder innervation | 95 | ||
| Assessment | 95 | ||
| History | 95 | ||
| Examination | 95 | ||
| Investigation of urinary incontinence | 96 | ||
| Overactive bladder | 96 | ||
| Management | 97 | ||
| Stress incontinence | 97 | ||
| Aetiology | 97 | ||
| Management | 98 | ||
| Overflow incontinence | 99 | ||
| Causes | 99 | ||
| Obstruction to urinary flow | 99 | ||
| Detrusor dysfunction | 99 | ||
| Management | 99 | ||
| Treatment | 99 | ||
| True incontinence | 99 | ||
| Assessment | 99 | ||
| Management | 100 | ||
| Summary | 100 | ||
| Chapter 9: Family planning and sexual health | 101 | ||
| Sexual health | 101 | ||
| Family planning | 102 | ||
| The Pearl index | 102 | ||
| History | 103 | ||
| Barrier methods | 103 | ||
| Male condom | 103 | ||
| Mode of action | 103 | ||
| How to use | 103 | ||
| Benefits | 103 | ||
| Disadvantages | 103 | ||
| Female condom | 104 | ||
| Diaphragm and cap | 104 | ||
| Section 3: Obstetrics | 151 | ||
| Chapter 11: Prepregnancy counselling, prenatal diagnosis and antenatal care | 153 | ||
| Prepregnancy counselling | 153 | ||
| History | 153 | ||
| General advice | 154 | ||
| Timing of intercourse | 154 | ||
| Smoking | 154 | ||
| Alcohol | 154 | ||
| Recreational drugs | 154 | ||
| Weight | 154 | ||
| Exercise | 155 | ||
| Diet | 155 | ||
| Vitamins | 155 | ||
| Medications | 155 | ||
| Drugs associated with subfertility | 155 | ||
| Drugs in pregnancy | 155 | ||
| Rubella | 156 | ||
| Fetal abnormality and genetic disorders | 156 | ||
| Preimplantation genetic diagnosis | 156 | ||
| Specific medical conditions | 157 | ||
| Diabetes | 157 | ||
| Epilepsy | 157 | ||
| Cardiac disease | 157 | ||
| Hypertension | 157 | ||
| Renal disease | 157 | ||
| Prenatal diagnosis | 158 | ||
| Screening tests | 158 | ||
| Serum screening | 158 | ||
| Ultrasound scan | 158 | ||
| Combined tests | 159 | ||
| Limits of screening tests | 159 | ||
| Pretest counselling | 159 | ||
| False positives and unnecessary tests | 159 | ||
| False-negative results | 159 | ||
| Twins | 159 | ||
| Screening tests to detect other abnormalities | 159 | ||
| AFP | 159 | ||
| Increased NT | 159 | ||
| Structural abnormalities | 159 | ||
| Diagnostic tests | 160 | ||
| Amniocentesis | 160 | ||
| Chorionic villous sampling | 160 | ||
| Cordocentesis | 160 | ||
| Ultrasound in pregnancy | 160 | ||
| First trimester (10–14 weeks) | 160 | ||
| Second trimester (18–24 weeks) | 161 | ||
| Further scans | 161 | ||
| Other ultrasound screening tests | 161 | ||
| Fetal echocardiography | 161 | ||
| Uterine artery Doppler | 161 | ||
| Cervical length | 162 | ||
| Antenatal care | 162 | ||
| Booking (6–12 weeks) | 163 | ||
| Booking blood tests | 163 | ||
| 16 weeks | 164 | ||
| 25 weeks | 164 | ||
| 28 weeks | 164 | ||
| 31 weeks | 164 | ||
| 34 weeks | 164 | ||
| 36 weeks | 164 | ||
| 38 weeks | 164 | ||
| 40 weeks | 164 | ||
| 41 weeks | 164 | ||
| Obstetric-led care | 165 | ||
| Rhesus disease and other red-cell alloimmune antibodies | 165 | ||
| Other antibodies | 165 | ||
| Effect on the fetus | 166 | ||
| Effect on the mother | 166 | ||
| Antenatal education | 166 | ||
| Seat belts in pregnancy | 166 | ||
| Flying in pregnancy | 166 | ||
| Summary | 166 | ||
| Chapter 12: Physiology of pregnancy and pregnancy problems | 169 | ||
| Physiology of pregnancy | 170 | ||
| Cardiovascular | 170 | ||
| Respiratory | 170 | ||
| Haematological | 170 | ||
| Renal | 171 | ||
| Hepatic | 171 | ||
| Gastrointestinal | 171 | ||
| Metabolic | 171 | ||
| Endocrine | 171 | ||
| Minor disorders of pregnancy | 171 | ||
| Nausea and vomiting | 171 | ||
| Incidence | 171 | ||
| Pathophysiology | 172 | ||
| Clinical features of hyperemesis | 172 | ||
| Management | 172 | ||
| Intravenous fluids | 172 | ||
| Antiemetics | 172 | ||
| Thiamine | 172 | ||
| Folic acid | 173 | ||
| Heartburn | 173 | ||
| Constipation | 173 | ||
| Haemorrhoids | 173 | ||
| Urinary frequency | 173 | ||
| Breathlessness | 174 | ||
| Skin problems | 174 | ||
| Itching | 174 | ||
| Pigmentation | 174 | ||
| Backache | 174 | ||
| Symphysis pubis dysfunction | 174 | ||
| Carpal tunnel syndrome | 174 | ||
| Concentration | 175 | ||
| Oedema | 175 | ||
| Varicose veins | 175 | ||
| Vaginal discharge | 175 | ||
| Hypertensive disorders of pregnancy | 175 | ||
| Definitions | 175 | ||
| Hypertension in pregnancy | 175 | ||
| Chronic hypertension | 175 | ||
| Essential hypertension | 175 | ||
| Pregnancy-induced hypertension | 175 | ||
| Pre-eclampsia | 176 | ||
| Incidence | 176 | ||
| Aetiology | 176 | ||
| Prediction | 176 | ||
| Pathophysiology | 176 | ||
| Clinical features | 177 | ||
| History | 177 | ||
| Examination | 177 | ||
| Investigations | 177 | ||
| Urinalysis | 177 | ||
| Full blood count | 177 | ||
| Urea and electrolytes | 177 | ||
| Uric acid (urate) | 177 | ||
| Liver function tests | 178 | ||
| Albumin | 178 | ||
| Coagulation tests | 178 | ||
| Ultrasound scan | 178 | ||
| Management | 178 | ||
| Monitoring of the disease | 178 | ||
| Monitoring fetal well-being | 178 | ||
| Treatment of hypertension | 178 | ||
| Antenatal management | 178 | ||
| First-line management | 178 | ||
| Second-line management | 179 | ||
| Intrapartum management | 179 | ||
| Hydralazine | 179 | ||
| Labetalol | 179 | ||
| Nifedipine | 179 | ||
| Postnatal management of hypertension | 179 | ||
| Timing of delivery | 180 | ||
| Severe hypertension or pre-eclampsia in labour | 180 | ||
| Postnatal management | 182 | ||
| Prognosis | 182 | ||
| Prevention of pre-eclampsia | 182 | ||
| Complications of pre-eclampsia | 182 | ||
| Fetal growth restriction | 182 | ||
| Haemolysis, elevated liver enzymes and low platelets | 182 | ||
| Pulmonary oedema | 182 | ||
| Disseminated intravascular coagulation | 183 | ||
| Cerebral haemorrhage | 183 | ||
| Abruption | 183 | ||
| Eclampsia | 183 | ||
| Antepartum haemorrhage | 183 | ||
| Definition | 183 | ||
| Incidence | 183 | ||
| Aetiology | 183 | ||
| History | 184 | ||
| Examination | 184 | ||
| Investigations | 185 | ||
| Management | 185 | ||
| Placenta praevia | 186 | ||
| Placental abruption (abruptio placentae) | 186 | ||
| Complications of placental abruption | 187 | ||
| Uterine rupture | 187 | ||
| Vasa praevia | 188 | ||
| Cervical lesions | 188 | ||
| Infections of pregnancy | 190 | ||
| Urinary tract infection | 190 | ||
| Chickenpox | 190 | ||
| Section 4: Emergencies and practical procedures | 273 | ||
| Chapter 17: Emergencies and procedures | 275 | ||
| Obstetric emergencies and procedures | 275 | ||
| Antepartum haemorrhage | 275 | ||
| Severe antepartum haemorrhage | 275 | ||
| Labour ward emergencies and procedures | 277 | ||
| Unconscious patient | 277 | ||
| Index | 311 | ||
| Final medicine examination: Questions and answers | 293 | ||
| Questions | 293 | ||
| Extended matching questions | 299 | ||
| Contraception | 299 | ||
| Gynaecology presentation | 299 | ||
| Prenatal diagnosis and screening | 300 | ||
| Answers | 301 | ||
| Contraception | 303 | ||
| Gynaecology presentation | 303 | ||
| Prenatal diagnosis and screening | 303 | ||
| Appendices | 305 | ||
| Normal values | 305 | ||
| Definitions | 307 |