Varney's Midwifery

by Burst, Helen Varney; Kriebs, Jan M.; Gegor, Carolyn L.; Varney, Helen

• ISBN13: 9780763718565
• ISBN10: 0763718564
• Edition: 4th
• Format: Hardcover
• Copyright: 2003-05-01
• Publisher: Jones & Bartlett Publishers, Inc.

Summary

Known as the bible” of midwifery, this new edition of Varney’s Midwifery has been extensively revised and updated to reflect the full scope of current midwifery practice in a balance of art and science, a blend of spirituality and evidence-based care, and a commitment to being with women.

Table of Contents

Contributor List for the Fourth Edition	xxvii
Preface to the Fourth Edition	xxix
Acknowledgments	xxx
Preface to the Third Edition	xxxii
Preface to the Second Edition	xxxv
Preface to the First Edition	xxxviii
Part I Midwifery
The Profession and History of Midwifery in the United States	3	(26)
Definitions and Practice	3	(1)
Beliefs Characterizing Midwifery	4	(1)
Early History	5	(1)
Factors Leading to Disrepute	5	(2)
The Early Twentieth Century	7	(3)
The First Nurse-Midwifery Education Programs	10	(2)
The 1940s and 1950s	12	(1)
The 1960s	13	(1)
The 1970s	14	(3)
The 1980s	17	(1)
The 1990s and Early 2000s	18	(1)
The American College of Nurse-Midwives	19	(4)
References	23	(1)
Bibliography	24	(5)
Basics of Management of Care	29	(20)
Primary Care and Scope of Practice	29	(1)
Independent and Collaborative Management of Care	30	(1)
The Management Process	31	(2)
Screening for Abnormality and Differential Diagnosis	33	(2)
Physical Assessment for a Database	35	(10)
References	45	(1)
Additional References	46	(3)
Part II Primary Care of Women
Cultural Competence in Midwifery Practice	49	(10)
Jo-Anna L. Rorie
The Demographic Shift	50	(1)
Women of Color Population Overview	51	(1)
Culturally Competent Care	52	(1)
Application of the Cultural Competence Continuum	53	(3)
Conclusion	56	(1)
References	56	(1)
Additional References	57	(2)
International Midwifery and Safe Motherhood	59	(26)
Margaret A. Marshall
Joyce E. Thompson
Introduction	59	(1)
The Situation Worldwide	60	(4)
The Newborn	64	(2)
Global Partners Promoting the Health of Women and Childbearing Families	66	(10)
Frequently Asked Questions About International Midwifery	76	(3)
Future Trends and Challenges in International Midwifery	79	(1)
References	80	(1)
Bibliography	81	(2)
Appendix A: Sources for International Health Low Cost Books	83	(1)
Appendix B: Helpful Websites and Videos	83	(2)
Preconception Care	85	(14)
Health and Risk Assessment	87	(1)
Counseling Specific to Preconception Care	88	(1)
Medical Risk Factors	89	(4)
Environmental and Workplace Issues	93	(2)
Preconception Issues for Men	95	(1)
Other Considerations	96	(1)
Intervention	96	(1)
References	97	(2)
Nutrition in Women's Health	99	(36)
Jenifer O. Fahey
Principles of Nutrition	99	(13)
Weight and Body Fat Measurements and Overweight and Obesity	112	(3)
Cardiovascular Disease	115	(1)
Cancer	116	(1)
Diabetes	117	(1)
Nutrition, the Menstrual Cycle, and Fertility	118	(1)
Adolescence	118	(1)
Nutrition During Menopause and Beyond	119	(1)
Eating Disorders	120	(2)
Nutrition and Vegetarianism	122	(1)
Nutrition and the Female Athlete	122	(1)
Alcohol and Nutrition	123	(1)
Nutritional Guidelines	123	(6)
Conclusion	129	(1)
References	129	(4)
Additional References	133	(2)
Primary Care and Midwifery	135	(30)
Primary Care	135	(3)
Hematologic Conditions	138	(3)
The Cardiovascular System	141	(2)
Respiratory Diseases	143	(4)
Gastrointestinal Disorders and Abdominal Pain	147	(3)
Assessing Abdominal Pain	150	(1)
Genitourinary Problems	151	(1)
Diabetes	152	(2)
Thyroid Disease	154	(2)
Carpal Tunnel Syndrome	156	(1)
Headache	156	(2)
Depression	158	(2)
Conclusion	160	(1)
References	160	(4)
Additional References	164	(1)
Chronic Infectious Diseases	165	(22)
HIV/AIDS	165	(10)
Tuberculosis	175	(2)
Hepatitis	177	(6)
Mary Curran
References	183	(4)
Women and Exercise	187	(62)
Ann Cowlin
The Value of Exercise to Women's Health	187	(1)
A New Exercise Model for Adolescent Girls	188	(5)
Appropriate Exercise during Pregnancy	193	(21)
Exercise for Postpartum Recovery	214	(6)
Essential Exercise for Menopause	220	(11)
Exercise in the Senior Years	231	(2)
Summary	233	(1)
References	233	(14)
Additional References	247	(2)
Pharmacology and Midwifery	249	(50)
Mary C. Brucker
Mary Ann Faucher
Introduction	249	(1)
The Lexicon of Pharmacology	249	(2)
Drugs in Modern Society	251	(1)
Practicalities and Issues Involving Drugs	252	(3)
Adverse Drug Reactions/Adverse Drug Events	255	(1)
Drug Resistance	255	(1)
Drug-to-Drug Reactions	256	(1)
Drug Costs	256	(1)
Drugs and Herbs	257	(1)
Pregnancy and Drug Use	257	(2)
Metabolism	259	(1)
Elimination/Clearance	259	(1)
Teratology and Drugs During Pregnancy	260	(4)
Commonly Used Pharmaceuticals	264	(2)
Drugs for the Treatment of Various Medical Conditions	266	(2)
Pharmaceuticals and Breastfeeding	268	(1)
Selected Drugs and the Breastfeeding Woman	269	(3)
Conclusion	272	(1)
References	272	(4)
Additional References	276	(1)
Appendix A: Top 200 Drugs by Rank, by Generic Name, and by Brand Name	277	(12)
Appendix B: Teratology Information Systems by Location	289	(3)
Appendix C: The Transfer of Drugs and Other Chemicals into Human Milk	292	(7)
Health Issues of Lesbian and Bisexual Women	299	(14)
Laura Zeidenstein
Background	299	(2)
Data Collection	301	(1)
Management of Health Care Issues	302	(2)
Childbearing and Parenting	304	(3)
Special Health Concerns	307	(1)
Summary	308	(1)
References	308	(2)
Appendix: Resources	310	(3)
Substance Abuse	313	(22)
Nancy Jo Reedy
Mary C. Brucker
Introduction	313	(1)
Women and Substance Abuse	313	(2)
Attraction of Substance Abuse	315	(1)
Assessment of Drug Use	316	(1)
General Treatment Issues	317	(1)
General Management of Substance Abuse During Pregnancy	317	(1)
Substance Abuse and Lactation	318	(1)
Neonatal Implications	318	(2)
Common Substances of Abuse	320	(10)
Appendix A: Health Education Fact Sheet from the American Lung Association on Nicotine Replacement Therapy (NRT)	330	(2)
References	332	(2)
Additional References	334	(1)
Health Care of Midlife and Aging Women	335	(44)
Mary Ellen Rousseau
Definitions	335	(1)
Age at Menopause	336	(1)
Adult Development, Society, and Menopause	336	(1)
Medicalization of Menopause	336	(3)
Endocrinology	339	(1)
Changes of Perimenopause and Aging	340	(7)
Breast Cancer	347	(3)
Cardiovascular Disease	350	(2)
Osteoporosis	352	(5)
The Perimenopausal Visit	357	(1)
Postmenopausal and Older Woman Visit	358	(3)
Menopausal Therapeutic Interventions, Preventive Measures, and Health Promotion	361	(5)
The Menopause as Opportunity	366	(1)
References	367	(12)
Part III Reproductive Health Care
Common Diagnoses in Women's Gynecological Health	379	(60)
William F. McCool
Dawn Durain
Issues Concerning the Menstrual Cycle	379	(17)
Abdominal and Pelvic Pain	396	(8)
Pelvic Masses	404	(3)
Congenital Uterine Anomalies	407	(1)
Pelvic Floor	408	(1)
Urinary Incontinence	409	(1)
Effects of DES Use	410	(1)
Special Considerations in Gynecologic Care	411	(2)
Cancer Screening/Diagnoses	413	(15)
Conclusion	428	(1)
References	429	(10)
Infections of the Genital Tract	439	(22)
Vulvovaginal/Cervical Infections and Sexually Transmitted Diseases	439	(18)
Pelvic Inflammatory Disease	457	(1)
Anaphylactic Shock	458	(1)
References	458	(3)
Family Planning and Contraception	461	(10)
History and Concepts of Family Planning	461	(1)
Selection of a Contraceptive Method	462	(3)
Effectiveness of a Contraceptive Method	465	(1)
Folklore Methods	466	(1)
Sterilization	467	(1)
Future Methods of Contraception	468	(1)
References	468	(1)
Bibliography	469	(2)
Natural Methods of Family Planning	471	(10)
Carmela Cavero
The Calendar Method (Rhythm Method)	472	(1)
The Ovulation Method (Cervical Mucus Method; Billings Method; Creighton Model)	472	(2)
The Basal Body Temperature Method	474	(1)
The Sympto-Thermal Method	475	(3)
Lactation Amenorrhea Method	478	(1)
Client/Couple Instruction	478	(1)
Technology and Natural Family Planning	478	(1)
References	478	(1)
Bibliography	478	(1)
Resources	479	(2)
Nonhormonal Contraceptive Methods	481	(18)
Spermicidal Preparations	481	(3)
Condoms	484	(3)
Diaphragms	487	(6)
Cervical Caps	493	(3)
Other Vaginal Contraceptive Barrier Methods	496	(1)
References	496	(1)
Additional References	497	(2)
Intrauterine Contraceptive Devices	499	(14)
Description, Effectiveness, User Response, and Noncontraceptive Benefits	499	(1)
Contraindications and Side Effects	500	(1)
Management Plan for the IUD	501	(9)
References	510	(3)
Hormonal Contraception	513	(30)
Combination Pills	513	(14)
Progestin-Only Contraceptive Pills (Minipills)	527	(1)
Emergency Postcoital Contraception	528	(3)
Injectable Hormonal Contraception	531	(3)
Subdermal Implants	534	(2)
Contraceptive Vaginal Ring (NuvaRing)	536	(1)
Transdermal Contraceptive Patch (OrthroEvra)	537	(2)
References	539	(1)
Additional References	540	(3)
Part IV Antepartal Care
Normal Pregnancy Database: Adaptations of the Mother, Development and Growth of the Embryo and the Fetus, and the Placenta	543	(28)
Maternal Anatomical and Physiological Changes	543	(6)
Maternal Physiological Changes	549	(4)
Maternal Psychological Adjustment and Processes	553	(3)
Fetal Growth and Development	556	(8)
Placental Development, Circulation, and Functions	564	(4)
References	568	(1)
Additional References	569	(2)
Management Plan for Normal Pregnancy	571	(52)
Philosophy and Scope	571	(2)
Diagnosis and Early Management of Care During Pregnancy	573	(4)
Assessment and Evaluation of the Well-Being of the Woman	577	(10)
Case Study	587	(4)
Common Discomforts of Pregnancy and Their Relief Measures	591	(7)
Nutritional Intervention in Pregnancy	598	(10)
Instruction and Anticipatory Guidance	608	(4)
References	612	(2)
Bibliography	614	(5)
Appendix A: Immunization During Pregnancy	619	(4)
Fetal Assessment	623	(38)
First Trimester Assessment of Pregnancy Well-Being	623	(4)
Second Trimester Screening	627	(3)
Invasive Fetal Assessment Throughout Gestation	630	(2)
Third Trimester Fetal Assessment	632	(20)
References	652	(6)
Additional References	658	(3)
Screening for and Collaborative Management of Antepartal Complications	661	(54)
First Trimester Bleeding	662	(4)
Ectopic Pregnancy	666	(1)
Hydatidiform Mole	667	(1)
Hyperemesis Gravidarum	668	(1)
Incompetent Internal Cervical Os	669	(1)
Infections	670	(1)
Tuberculosis	670	(4)
Hepatitis	674	(1)
Rubella	674	(2)
Cytomegalovirus	676	(1)
Toxoplasmosis	677	(1)
Varicella	678	(2)
Parvovirus B19 (Fifth Disease, Erythema Infectiosum)	680	(1)
Urinary Tract Infections	681	(2)
Anemias and Hemoglobinopathies	683	(5)
Heart Disease	688	(1)
Thyroid Disorders	689	(1)
Asthma	690	(1)
Multiple Pregnancy	691	(3)
Polyhydramnios (Hydramnios)	694	(1)
Oligohydramnios	694	(1)
Diabetes Mellitus	695	(4)
Rh(D) Isoimmunization	699	(3)
Placenta Previa	702	(1)
Abruptio Placentae	703	(2)
Management of Hemorrhage Due to Placenta Previa or Abruptio Placentae	705	(1)
Hypertensive Disorders of Pregnancy	705	(7)
References	712	(3)
Complications of Gestational Age Assessment and the Postdate Pregnancy	715	(22)
Carol L. Wood
Fetal Age Determination	715	(3)
The Size/Date Discrepancy: Identifying the Problem	718	(3)
Postdate Pregnancy: The Clinical Problem	721	(1)
Anatomy and Physiology of the Cervix	722	(1)
Management Approach for the Postdate Pregnancy: Anticipatory Versus Active	723	(6)
Summary	729	(1)
References	730	(7)
Part V Intrapartal Care
The Normal First Stage of Labor	737	(56)
Signs and Symptoms of Impending Labor	737	(2)
Database for the First Stage of Labor	739	(15)
Management of Care During the First Stage of Labor	754	(36)
References	790	(3)
Fetal Assessment During Labor	793	(28)
Introduction and History	793	(1)
Physiology and Scope of Problem	794	(17)
Midwifery Management of Nonreassuring Fetal Heart Rate Patterns	811	(2)
Methods to Evaluate Fetal Acid-Base Balance Directly	813	(2)
Fetal Oxygen Saturation Monitoring	815	(1)
Admission to L&D and Establishing Initial Well-Being	816	(1)
Summary	817	(1)
References	818	(3)
The Normal Second Stage of Labor	821	(32)
Database for the Second Stage of Labor	821	(8)
Management Plan for the Second Stage of Labor	829	(16)
References	845	(1)
Bibliography (Chapters 26 and 28)	846	(7)
Screening for and Collaborative Management of Selected Complications During the First and Second Stages of Labor	853	(30)
Previous Cesarean Section	853	(3)
Preterm Labor/Birth	856	(7)
Premature Rupture of the Membranes	863	(4)
Amnionitis and Chorioamnionitis	867	(1)
Group B Streptococcus	868	(2)
Umbilical Cord Prolapse	870	(2)
Cephalopelvic Disproportion	872	(1)
Deep Transverse Arrest	873	(1)
Uterine Dysfunction	874	(2)
Maternal Exhaustion (Maternal Distress; Ketoacidosis)	876	(1)
Uterine Rupture	876	(1)
Blood Transfusion Reaction	877	(1)
References	878	(3)
Additional References	881	(2)
Management of Selected Obstetric Complications and Deviations from Normal	883	(22)
Management of Shoulder Dystocia	883	(7)
Delivery of an Infant with a Face Presentation	890	(2)
Delivery of an Infant with a Breech Presentation	892	(7)
Delivery of a Woman with Multiple Gestation	899	(2)
References	901	(1)
Bibliography	902	(3)
The Normal Third Stage of Labor	905	(8)
Database for the Third Stage of Labor	905	(2)
Management Plan for the Third Stage of Labor	907	(4)
References	911	(2)
Third Stage Complications and Management	913	(4)
Retained Placenta	913	(1)
Third Stage Hemorrhage	914	(1)
Placenta Accreta	914	(1)
Uterine Inversion	915	(1)
References	916	(1)
The Normal Fourth Stage of Labor	917	(8)
Database for the Fourth Stage of Labor	917	(2)
Management Plan for the Fourth Stage of Labor	919	(2)
Initiation of Family Relationships with the Newborn	921	(2)
References	923	(2)
Management of Immediate Postpartum Hemorrhage	925	(4)
Causes of Immediate Postpartum Hemorrhage	925	(1)
Predisposing Factors	926	(1)
Preparatory Measures	926	(1)
Action, Effect, Dosage, and Route of Oxytocic Drugs	926	(1)
Management Steps	927	(1)
References	928	(1)
Birth in the Home and in the Birth Center	929	(32)
Alice J. Bailes
Marsha E. Jackson
Introduction	929	(1)
History	930	(3)
Helen Varney Burst
Characteristics of Birth Center and Home Birth	933	(3)
Birth Center and Home Birth Practice Models	936	(2)
Midwife/Client Relationship	938	(1)
Initial Visit	939	(4)
Return Visits	943	(1)
The Family's Preparation for Birth and Postpartum	943	(2)
The Experience of Birth at Home or in the Birth Center	945	(2)
The Early Postpartum Period and Follow-up	947	(1)
Maintaining Safety	947	(7)
How to Accomplish an Effective Hospital Transfer	954	(1)
Business Issues	955	(1)
Special Home and Birth Center Resources	956	(1)
References	957	(4)
Part VI Newborn Care
Physiological Transition to Extrauterine Life	961	(12)
Mary Kathleen McHugh
Immediate Extrauterine Transition	961	(6)
Ongoing Extrauterine Transition	967	(5)
References	972	(1)
Immediate Care and Assessment of the Healthy Newborn	973	(10)
Mary Kathleen McHugh
Assessment Prior to Birth	973	(1)
Assessment at the Moment of Birth	973	(1)
Care During the First Hours After Birth	974	(3)
Plan of Care for the First Few Days of Life	977	(2)
Planning Discharge	979	(3)
References	982	(1)
Resuscitation at Birth	983	(16)
Mary Kathleen McHugh
Infrastructure for Safe Resuscitation of the Newborn	983	(1)
Pathophysiology of Asphyxia	984	(2)
Care of the Newborn Following Resuscitation	986	(1)
The Process of Resuscitation	987	(8)
Special Situations in Neonatal Resuscitation	995	(1)
Quality Assurance and Risk Management	996	(1)
References	997	(2)
Examination of the Newborn	999	(12)
Mary Kathleen McHugh
Structuring the Newborn Examination	999	(3)
Gestational Age Assessment	1002	(2)
Physical Examination of the Newborn	1004	(5)
References	1009	(2)
Primary Care of the Newborn: The First Six Weeks	1011	(18)
Mary Kathleen McHugh
The Midwife's Role in Neonatal Well-Child Care	1011	(3)
Newborn Behavior	1014	(2)
Developmental Milestones in the First Six Weeks	1016	(1)
Psychological Tasks of Early Infancy	1016	(2)
Physical Care of the Newborn	1018	(1)
The Circumcision Decision	1019	(1)
Nonnutritive Sucking	1020	(1)
Feeding	1020	(3)
Common Variations in the First Six Weeks	1023	(2)
Eating Patterns and Weight Gain	1025	(1)
Physiological Jaundice	1026	(1)
References	1027	(2)
Recognition and Immediate Care of Sick Newborns	1029	(12)
Mary Kathleen McHugh
The Midwife's Roles and Responsibilities	1029	(1)
The Sick Newborn	1030	(3)
Signs of Possible Infection	1033	(1)
Signs of Birth Injuries	1034	(1)
Signs of Neurological Disease	1035	(1)
Signs of Surgical Emergencies	1036	(1)
Signs of Drug Exposure in the Newborn	1036	(3)
Infants of Diabetic Mothers	1039	(1)
Signs of Intrauterine Growth Restriction	1039	(1)
References	1040	(1)
Part VII Postpartal Care
The Normal Puerperium	1041	(26)
Database for the Puerperium	1041	(11)
Management Plan for the Puerperium	1052	(12)
References	1064	(1)
Additional References	1065	(2)
Infant Feeding	1067	(26)
Karin Cadwell
Cynthia Turner-Maffei
Sarah Coulter Danner
Breastfeeding-Optimal Infant Nourishment	1067	(2)
The Baby-Friendly Hospital Initiative	1069	(1)
The International Code of Marketing of Breast-milk Substitutes	1070	(1)
Anatomy and Physiology of Lactation	1070	(2)
Antepartum Preparation for Breastfeeding	1072	(2)
The Effect of Birth Practices on Breastfeeding	1074	(1)
Successful Breastfeeding	1074	(4)
Problem Prevention and Management	1078	(1)
Breast Discomfort	1079	(2)
Milk Supply	1081	(4)
When Breast Is Not Best	1085	(2)
Conclusion	1087	(1)
References	1087	(4)
Professional Resources and Equipment and Supply Resources	1091	(2)
Screening for and Midwifery Management of Puerperal Abnormality	1093	(14)
Puerperal Morbidity	1093	(1)
Puerperal Infection	1094	(1)
Other Puerperal Complications	1095	(3)
Postpartum Depression	1098	(3)
Attachment Failure and the Potential for Child Abuse or Neglect	1101	(1)
References	1102	(1)
Additional References	1103	(4)
Part VIII Skills
Universal Precautions	1107	(2)
References	1108	(1)
Finger Puncture	1109	(4)
Bibliography	1111	(2)
Venipuncture	1113	(8)
Bibliography	1120	(1)
Inserting an Intravenous Catheter	1121	(4)
Bibliography	1124	(1)
Giving Intravenous Medications	1125	(2)
Spin-Down Hematocrit	1127	(4)
Removal of Norplant	1131	(4)
References	1133	(2)
Breast Examination	1135	(12)
Relevant History	1135	(1)
Physical Examination	1136	(6)
Variations in Breast Examination and Findings for the Pregnant Woman	1142	(1)
Variations in Breast Examination for the Postpartal Woman	1143	(1)
Teaching Breast Self-Examination	1144	(1)
References	1144	(1)
Additional References	1145	(2)
Obstetric Abdominal Examination	1147	(14)
Antepartal/Intrapartal Abdominal Examination	1147	(9)
Postpartal Abdominal Examination	1156	(3)
References	1159	(1)
Additional References	1159	(2)
Checking for Costovertebral Angle Tenderness	1161	(2)
Anatomy	1161	(1)
Significance and Charting	1161	(1)
Procedure and Rationale for Examination	1161	(2)
Checking for Deep Tendon Reflexes and Clonus	1163	(6)
Deep Tendon Reflexes	1163	(4)
Clonus	1167	(1)
Bibliography	1167	(2)
Pelvic Examination	1169	(26)
Procedures, Observations or Findings, and Significance	1169	(24)
Bibliography	1193	(2)
Obtaining a Specimen for Papanicolaou (Pap) Diagnostic Evaluation	1195	(4)
Reference	1197	(2)
Obtaining a Specimen for Gonococcal (GC) and Chlamydia Diagnostic Testing	1199	(2)
Making a Wet Smear Slide of Vaginal Secretions	1201	(2)
Using a Microscope	1203	(2)
Anatomy of the Pelvis, Pelvic Types, Evaluation of the Bony Pelvis, and Clinical Pelvimetry	1205	(12)
Anatomy	1205	(4)
Types of Pelves	1209	(2)
Procedure, Rationale, and Description of Findings	1211	(4)
Evaluation of Findings	1215	(1)
Bibliography	1215	(2)
Breast Massage, Manual Expression, and Nipple Rolling	1217	(2)
Procedure for Breast Massage	1217	(1)
Procedure for Manual Expression	1218	(1)
Procedure for Nipple Rolling	1218	(1)
Reference	1218	(1)
Additional Reference	1218	(1)
Injection of Intradermal Sterile Water Papules for Relief of Low Back Pain in Labor	1219	(4)
Saraswathi Vedam
References	1221	(2)
Inserting an Intrauterine Pressure Catheter; Amnioinfusion	1223	(4)
References	1225	(2)
Attaching a Fetal Scalp Electrode	1227	(4)
References	1229	(2)
Perineal Prep (Cleaning)	1231	(2)
Second Stage Pushing	1233	(2)
Breath Control	1233	(1)
Body Position	1233	(1)
Arm Position and Action	1234	(1)
Pubic Pressure	1234	(1)
Vaginal Stimulation	1234	(1)
Pudendal Block	1235	(4)
Local Infiltration	1239	(2)
Local Infiltration Before Birth	1239	(1)
Local Infiltration for Repair After Birth	1240	(1)
Hand Maneuvers for Birth with the Mother in Lithotomy or Modified Lithotomy Position	1241	(8)
Reference	1248	(1)
Hand Maneuvers for Birth with the Mother in Dorsal Position	1249	(4)
Hand Maneuvers for Birth with the Mother in the Hands and Knees Position	1253	(4)
Saraswathi Vedam
Hand Maneuvers for Birth with the Mother in the Squatting or Supported Squat Position	1257	(4)
Saraswathi Vedam
Inspection of the Placenta, Membranes, and Cord	1261	(6)
Database	1261	(3)
Procedure	1264	(2)
Bibliography	1266	(1)
Postbirth Inspection of the Cervix and Upper Vaginal Vault	1267	(2)
Procedure for Cervical Inspection	1267	(1)
Procedure for Inspection of the Upper Vaginal Vault	1268	(1)
Manual Removal of the Placenta	1269	(2)
Fourth Stage Intrauterine Exploration	1271	(2)
Bimanual Compression	1273	(2)
Cutting an Episiotomy and Repairing Episiotomies and Lacerations	1275	(20)
Relevant Anatomy	1275	(4)
Cutting an Episiotomy	1279	(1)
Aids to Wound Healing	1280	(1)
Manipulation of Equipment	1281	(1)
Knots and Suture Stitches	1282	(2)
Principles of and Thoughts About Episiotomy and Laceration Repair	1284	(3)
Repair of a Midline Episiotomy	1287	(3)
Repair of First and Second Degree Lacerations and Sulcus Tears	1290	(1)
Repair of Third Degree Lacerations	1290	(1)
Repair of Fourth Degree Lacerations	1291	(1)
Repair of Periurethral and Clitoral Lacerations	1291	(1)
Repair of Cervical Lacerations	1292	(1)
Defibulation and Repair	1292	(1)
References	1293	(2)
Physical Examination of the Newborn	1295	(18)
Circumcision	1313	(14)
Vivian H. Lowenstein
Relevant Male Genital Anatomy	1314	(1)
Circumcision Instruments	1314	(1)
Pain Relief	1315	(8)
Postcircumcision Care and Parental Instruction	1323	(1)
References	1324	(1)
Additional References	1325	(2)
Endometrial Biopsy	1327	(6)
Wendy Grube
William F. McCool
Indications for Endometrial Biopsy	1327	(1)
Contraindications and Precautions	1327	(1)
Potential Side Effects/Complications and Preventive Measures	1328	(1)
Procedure and Rationale	1328	(3)
Results and Management	1331	(1)
References	1332	(1)
Additional References	1332	(1)
Index	1333