An Obstetrics and Gynaecology Vade-mecum

by James, David K.; Johnson, Ian R.; McEwan, Alec

• ISBN13: 9780340692745
• ISBN10: 034069274X
• Format: Nonspecific Binding
• Copyright: 2001-03-08
• Publisher: Hodder Education Publishers

Summary

This practical pocket book provides the junior physician with concise information on all aspects of obstetrics and gynaecology. For use in the clinic and on the ward, and particularly in emergency situations when 'quick thinking' is paramount, the punchy and direct text is provided in noteform for rapid and easy assimiliation. In addition to assisting the trainee in making quick and appropriate diagnoses and management decisions, the bookshelves of all ObGyn residents.

Table of Contents

Contributors	xi
Preface	xiii
SECTION 1: OBSTERICS
Diagnosing Pregnancy	5	(3)
Symptoms and signs	5	(1)
Pregnancy tests	6	(2)
The Antenatal Clinic	8	(7)
Aims of antenatal care	8	(1)
Preconception/pre-pregnancy visit	8	(1)
Booking visit	9	(1)
Risk assessment	10	(2)
Follow-up clinics	12	(2)
Records	14	(1)
Normal Labour and Delivery	15	(4)
Stages of labour	15	(1)
Management	16	(3)
The Normal Puerperium	19	(5)
From pregnancy to pre-pregnancy state	19	(2)
Management	21	(1)
Postnatal contraception	21	(3)
Planned Delivery	24	(11)
Elective Caesarean section	24	(6)
Induction of labour	30	(5)
The High-Risk Assessment Unit and Day Care	35	(2)
Perinatal Meetings	37	(2)
The Obstetric Flying Squad	39	(2)
Problems at Booking	41	(27)
Previous obstetric problems	41	(7)
Medical problems	48	(11)
Prenatal diagnostic testing	59	(3)
Substance abuse	62	(1)
Problems specific to the pregnancy	63	(5)
Outpatient (Antepartum) Problems	68	(30)
Minor problems	68	(2)
Hypertension in pregnancy	70	(4)
Gestational diabetes	74	(1)
Blood disorders	75	(3)
Abnormal liver function	78	(1)
Skin rashes	79	(1)
Abnormal screening results	80	(6)
Abnormal uterine size (and fetal surveillance)	86	(7)
Reduced fetal movements	93	(1)
Abnormal presentation	93	(3)
Failure of engagement	96	(1)
Prolonged pregnancy	96	(2)
Problems During Labour	98	(27)
Poor progress in the first stage of labour	98	(2)
Poor progress in the second stage of labour	100	(3)
Malpresentation/malposition	103	(3)
Shoulder dystocia	106	(1)
Abnormalities of the cardiotocograph	107	(5)
Meconium staining of the amniotic fluid	112	(1)
Stillbirth	112	(2)
Maternal problems	114	(11)
Antepartum Emergencies	125	(32)
Abdominal pain	125	(5)
Antepartum haemorrhage	130	(6)
Preterm uterine activity	136	(4)
Preterm (pre-labour) rupture of membranes	140	(1)
Decreased fetal movements	141	(2)
Intrauterine fetal death (IUFD)	143	(3)
Severe obstetric emergencies	146	(1)
Major haemorrhage	146	(2)
Severe hypertension	148	(5)
Eclampsia	153	(1)
Clotting abnormalities	154	(1)
Thromboembolism	155	(2)
Postnatal Problems	157	(11)
Pyrexia	157	(3)
Mental illness in the puerperium	160	(2)
Secondary postpartum haemorrhage	162	(3)
The urinary tract in the puerperium	165	(2)
Breast disease	167	(1)
Contraceptive issues	167	(1)
Practical Procedures	168	(21)
Episiotomy	168	(3)
Forceps delivery	171	(4)
Ventouse delivery	175	(2)
Fetal scalp blood sampling	177	(2)
Manual removal of the placenta	179	(2)
Resuscitation of the newborn	181	(8)
SECTION 2: GYNAECOLOGY
Properative Care	189	(6)
General considerations	189	(1)
History and examination	190	(1)
Prophylactic antibiotics	191	(1)
Thromboembolic disease prophylaxis	192	(2)
Other general preoperative considerations	194	(1)
Common Procedures	195	(20)
Hysterectomy	195	(5)
Operations for genuine stress incontinence	200	(2)
Pelvic floor repair	202	(1)
Termination of pregnancy	203	(3)
Gynaecological endoscopic surgery	206	(6)
Myomectomy	212	(3)
Routine Postoperative Care and Complications	215	(4)
Pain control	215	(1)
Routine postoperative observations	215	(1)
Pulmonary complications	216	(1)
Bowel function	216	(1)
Fever	217	(1)
Urinary tract complications	217	(1)
Wound complications	218	(1)
Operative mortality	218	(1)
Contraception	219	(11)
Combined oral contraceptive pill	219	(3)
Progesterone only pill	222	(1)
Injectables	223	(1)
Contraceptive implants	223	(1)
Intrauterine devices	223	(3)
Barrier methods	226	(1)
Postcoital contraception	227	(1)
Sterilization	227	(3)
The Menopause and Hormone Replacement Therapy	230	(7)
Symptoms associated with the climacteric	230	(1)
Long-term implications of the menopause	231	(2)
Hormone replacement therapy	233	(2)
Premature menopause	235	(2)
Clinic Problems	237	(48)
History	237	(1)
Absence of menstruation	238	(4)
Heavy and/or irregular periods	242	(6)
Postmenopausal bleeding	248	(1)
Painful periods	249	(2)
Chronic pelvic pain	251	(4)
Management of a Pelvic mass	255	(4)
The abnormal smear	259	(2)
Prolapse	261	(3)
Urinary urgency and incontinence (with urodynamics)	264	(5)
Vaginal discharge	269	(2)
Common vulval problems	271	(2)
The infertile couple	273	(6)
Hirsutism	279	(3)
Recurrent miscarriage	282	(3)
Oncology and Palliative Care	285	(10)
Cancer services in the UK	285	(1)
Ovarian carcinoma	285	(2)
Carcinoma of the uterus	287	(1)
Cervical carcinoma	288	(1)
Carcinoma of the vulva	289	(1)
Molar pregnancy and gestational trophoblastic disease	290	(2)
Palliative care	292	(3)
Gynaecological Emergencies	295	(13)
Bleeding in early pregnancy	295	(7)
Hyperemesis	302	(1)
Pain and a positive pregnancy test	303	(1)
Pelvic pain and a negative pregnancy test	304	(2)
Ovarian hyperstimulation syndrome	306	(2)
Practical Procedures	308	(1)
Urethral catheterization	308	(1)
Hormone implants	309	(1)
Prostaglandin-induced termination of pregnancy	310	(1)
Insertion and removal of intrauterine contraceptive device	311	(2)
Taking a cervical smear	313	(1)
Cervical cryocautery and loop diathermy	313	(1)
Endometrial biopsy	314	(1)
Outpatient hysteroscopy	315	(1)
Dilatiation and curettage	316	(5)
SECTION 3: APPENDICES
Appendix I A Pharmacopoeia of Commonly Prescribed Drugs in Obstetrics and Gynaecology	321	(9)
Appendix II The Use of Drugs during Pregnancy and Breastfeeding	330	(1)
Use of drugs during pregnancy	331	(6)
Use of drugs during breastfeeding	337	(5)
Appendix III Biochemistry and haematology Reference Ranges	342	(1)
Haematology	342	(1)
Biochemistry	343	(2)
Appendix IV Endocrinological Reference Values	345	(1)
Cyclical Hormones	345	(1)
Non-cyclical hormones	345	(1)
Appendix V Sperm Parameters	346	(1)
Appendix VI Risk of Down's Syndrome Pregnancy According to Maternal Age	347	(1)
Appendix VII FIGO Classification of Gynaecological Malignancies	348	(1)
Cervical	348	(1)
Vulval	349	(1)
Epithelial ovarian	350	(1)
Endometrial	351	(2)
Appendix VIII Charts	353	(1)
Fig. A.1 Relationship between crown rump length and gestational age	353	(1)
Fig. A.2 Relationship between biparietal diameter and menstrual age	354	(1)
Fig. A.3 Growth of the femur with gestational age	355	(1)
Fig. A.4 Relationship between head circumference and gestational age	356	(1)
Fig. A.5 Growth of abdominal circumference with gestational age	357	(1)
Fig. A.6 Relationship between birth weight and gestational age	358	(1)
Fig. A.7 Birth weight centiles for babies of 25--31 weeks	359	(1)
Table A.1 Imperial to metric weight conversion table	360	(1)
Appendix IX List of Suggested Postgraduate Texts	361