Obstetrics by Ten Teachers

by Chamberlain, Geoffrey

• ISBN13: 9780340573136
• ISBN10: 0340573139
• Edition: 16th
• Format: Paperback
• Copyright: 1995-05-04
• Publisher: Hodder Education Publishers

Summary

The sixteenth edition of this successful textbook is written by leading specialists from the London teaching hospitals. The text has been extensively revised and includes recent developments in feto-maternal medicine, care of the newborn, haemostatic and psychiatric disorders in pregnancy and discussion of medico-legal problems in obstetrics.

Table of Contents

List of Contributors	ix
A History of Ten Teachers in Obstetrics	x
Preface	xiv
Introduction	xv
Anatomy and Physiology	1	(36)
The early development of the ovum	1	(6)
Ovulation	1	(1)
Formation of decidua	2	(1)
Maturation of the ovum	3	(1)
Transit and fertilization of the ovum	4	(1)
Early development and embedding of the blastocyst	4	(3)
The placenta, cord and membranes	7	(8)
Functions of the placenta	11	(1)
The chorion	12	(1)
The amnion	13	(1)
Amniotic fluid	13	(1)
The umbilical cord	14	(1)
The fetus	15	(3)
Size of the fetus	15	(1)
Fetal circulation	16	(1)
Oxygen supply of the fetus	17	(1)
Nutrition of the fetus	18	(1)
Anatomy of the normal female pelvis and the fetal skull	18	(6)
The pelvis	18	(3)
The fetal skull	21	(3)
Maternal physiology	24	(11)
Further reading	35	(2)
Normal Pregnancy	37	(42)
Clinical signs and diagnosis of pregnancy	37	(7)
The duration of pregnancy	37	(1)
Symptoms of pregnancy	37	(1)
Signs of pregnancy	38	(2)
Human chorionic gonadotrophin levels	40	(1)
Ultrasound diagnosis of pregnancy	41	(1)
Differential diagnosis of pregnancy	42	(1)
Pseudocyesis	43	(1)
The expected date of delivery	43	(1)
Ultrasound scan	44	(1)
Antenatal care	44	(11)
Pre-pregnancy counselling	45	(1)
Antenatal care	45	(2)
Antenatal fetal monitoring	47	(1)
Advice during pregnancy	48	(4)
Harmful effects of drugs on the fetus	52	(2)
Smoking during pregnancy	54	(1)
Alcohol during pregnancy	55	(1)
Obstetrical examination	55	(4)
Abdominal examination	55	(3)
Vaginal examination	58	(1)
Radiological examination	59	(1)
Ultrasound examination in obstetrics	59	(12)
Clinical applications of ultrasound	60	(6)
Assessing fetal growth and size	66	(4)
The safety of ultrasound	70	(1)
Prenatal diagnosis	71	(6)
Further reading	77	(2)
Abnormal Pregnancy	79	(88)
Abnormalities of the pelvic organs	79	(5)
Retroversion of the uterus	79	(1)
Prolapse of the pregnant uterus	80	(1)
Congenital abnormalities of the uterus and vagina	80	(1)
Uterine fibroids	80	(2)
Ovarian cysts	82	(1)
Carcinoma of the cervix uteri	83	(1)
Placental abnormalities	84	(2)
Placental site, anatomy and adherence	84	(1)
The umbilical cord	85	(1)
Gestational trophoblastic disease	86	(3)
Aetiology	86	(1)
Biological behaviour and histological classification	86	(1)
Recognition of molar pregnancy	87	(1)
Management	88	(1)
Surveillance	88	(1)
Treatment of gestational trophoblastic tumour	88	(1)
Chemotherapy	89	(1)
Choice of chemotherapy	89	(1)
Antepartum haemorrhage	89	(8)
Placental abruption	90	(4)
Placenta praevia	94	(3)
Vasa praevia	97	(1)
Polyhydramnios and oligohydramnios	97	(3)
Polyhydramnios	97	(2)
Oligohydramnios	99	(1)
Amniotic adhesions	99	(1)
Hypertensive disorders in pregnancy	100	(11)
Pregnancy induced hypertension	100	(5)
Eclampsia	105	(4)
Chronic hypertension preceding pregnancy	109	(1)
Placental abruption and hypertension during pregnancy	110	(1)
Intercurrent diseases during pregnancy	111	(27)
Renal disease	111	(4)
Anaemia	115	(4)
Heart disease	119	(3)
Diabetes	122	(4)
Infections during pregnancy	126	(5)
Sexually transmitted diseases	131	(3)
Diseases of the alimentary tract	134	(2)
Neurological disease	136	(1)
Endocrine disorders	136	(2)
Psychiatric disorders in pregnancy and the puerperium	138	(2)
Drug dependence	139	(1)
Puerperal disorders	139	(1)
The fetus at risk in late pregnancy	140	(8)
Placental insufficiency during pregnancy	141	(1)
Intrauterine growth retardation	141	(4)
Postmaturity	145	(2)
Intrauterine death of the fetus	147	(1)
Multiple pregnancy	148	(6)
Varieties of twins	149	(5)
Counselling in obstetrics	154	(2)
Diagnosis of intrauterine death or fetal abnormality	154	(1)
Intrauterine death or termination due to abnormality	155	(1)
Longer term follow up	155	(1)
The next pregnancy	156	(1)
Fetal loss in early pregnancy	156	(6)
Abortion or miscarriage	156	(1)
Pathological anatomy	157	(1)
Clinical varieties of abortion	158	(4)
Ectopic pregnancy	162	(3)
Aetiology	162	(1)
Pathological anatomy	162	(1)
Clinical course and management	163	(2)
Other causes of haemorrhage during early pregnancy	165	(1)
Further reading	165	(2)
Normal Labour	167	(28)
The stages of normal labour	167	(6)
The onset of labour	167	(1)
The uterine segments	168	(1)
The stages of labour	168	(5)
The mechanism of normal labour	173	(5)
Mechanism of labour with vertex presentations	174	(4)
Management of normal labour	178	(9)
Management of the first stage	179	(4)
Management of the second stage	183	(1)
Delivery of the baby	183	(2)
Management of the third stage	185	(2)
The relief of pain in labour	187	(7)
The ideal analgesic	188	(1)
Spinal anaesthesia	189	(2)
Anaesthesia for caesarean section	191	(1)
General anaesthesia in obstetric practice	191	(1)
Anaesthesia associated maternal mortality	192	(1)
The use of oxytocic drugs	193	(1)
Further reading	194	(1)
Abnormal Labour	195	(54)
Prolonged labour	195	(3)
The partogram	195	(3)
Fetal malposition and malpresentation	198	(18)
Occipitoposterior position	198	(4)
Deep transverse arrest of the head	202	(1)
Face presentation	202	(2)
Brow presentation	204	(2)
Breech presentation	206	(8)
Transverse and oblique lie	214	(2)
Fetal malformations that cause difficulty in labour	216	(1)
Pelvic abnormalities and disproportion	216	(10)
Pelvic abnormalities	216	(4)
Cephalopelvic disproportion	220	(3)
Obstructed labour	223	(3)
Premature labour and preterm premature rupture membranes	226	(3)
Aetiology and diagnosis	226	(1)
Principles of management	226	(1)
Predicting and preventing preterm labour	227	(2)
Fetal distress during labour	229	(5)
Continuous monitoring of the fetal heart rate	229	(4)
Fetal scalp blood sampling	233	(1)
Traumatic lesions	234	(7)
Rupture of the uterus	234	(3)
Acute inversion of the uterus	237	(1)
Laceration of the cervix	238	(1)
Laceration of the perineum and vagina	238	(1)
Fistulae	239	(1)
Haematoma of the vulva	240	(1)
Broad ligament haematoma	240	(1)
Maternal nerve injuries	241	(1)
Postpartum haemorrhage	241	(6)
Primary postpartum haemorrhage	241	(4)
Secondary postpartum haemorrhage	245	(1)
Shock in obstetrics	245	(1)
Postpartum pituitary necrosis	246	(1)
Further reading	247	(2)
Normal Puerperium	249	(18)
The puerperium	249	(4)
The baby	253	(6)
The respiratory system at birth	253	(2)
The immediate care of the healthy infant	255	(3)
Normal progress of the full term infant	258	(1)
Infant feeding	259	(7)
Breast or bottle feeding?	260	(1)
Lactation	260	(3)
Breastfeeding	263	(1)
Difficulties in breastfeeding	263	(1)
Artificial feeding	264	(2)
Further reading	266	(1)
Abnormal Puerperium	267	(18)
Puerperal pyrexia	267	(4)
Genital tract infection	267	(3)
Urinary tract infection	270	(1)
Breast infection	271	(1)
Thrombophlebitis	271	(1)
Wound infection	271	(1)
Respiratory tract infection	271	(1)
Intercurrent febrile illness	271	(1)
Breast disorders in the puerperium	271	(3)
Engorgement	271	(1)
Cracked nipples	272	(1)
Acute puerperal mastitis	272	(1)
Breast abscess	273	(1)
Inhibition of lactation	273	(1)
Galactocoele	273	(1)
Carcinoma of the lactation breast	273	(1)
Disorders of haemostasis in pregnancy	274	(6)
Haemostasis	274	(4)
Coagulation and fibrinolytic systems in pregnancy and labour	278	(1)
Coagulation disorders specific to pregnancy and labour	278	(2)
Coagulation disorders coincident with pregnancy	280	(1)
Thrombocytopaenia in pregnancy	280	(3)
Thromboembolic disease in pregnancy	283	(1)
Further reading	284	(1)
Obstetric Procedures	285	(20)
External version	285	(18)
Induction of labour	285	(3)
Episiotomy	288	(1)
Forceps delivery	289	(7)
Vacuum extractor (Ventouse)	296	(1)
Internal version	297	(1)
Caesarean section	297	(6)
Further reading	303	(2)
Problems of the Newborn	305	(38)
Resuscitation	305	(18)
Low birthweight infants	309	(1)
Very low weight infants	310	(1)
Stabilizing the very low birth weight infant	310	(1)
Specific problems	311	(1)
Temperature control	311	(1)
Respiratory problems	312	(2)
Nutrition	314	(1)
Osteopenia of prematurity (rickets)	315	(1)
Intraventricular haemorrhage and ischaemic brain injury	315	(1)
Patent ductus arteriosus	316	(1)
Infection	317	(1)
Anaemia of prematurity	317	(1)
Necrotizing enterocolitis	318	(1)
Retinopathy of prematurity	318	(1)
Growth	318	(1)
Parents	318	(1)
Discharge from hospital	319	(1)
Neurodevelopmental outcome	319	(1)
The asphyxiated infant	319	(2)
Birth trauma	321	(2)
Respiratory distress	323	(2)
Jaundice in the newborn infant	325	(3)
Infections	328	(2)
Metabolic problems	330	(1)
Hypoglycaemia	330	(1)
Gastrointestinal problems	331	(1)
Vomiting	331	(1)
Diarrhoea	332	(1)
Haematological problems	332	(3)
Rhesus and ABO incompatibility	332	(3)
Congenital malformations	335	(7)
Lower limb malformations	341	(1)
Further reading	342	(1)
Medico-Legal Problems in Obstetrics	343	(8)
Litigation in obstetrics	343	(1)
Pre-pregnancy and genetic counselling	344	(1)
Pregnancy	345	(1)
Labour and delivery	346	(2)
The postnatal period	348	(1)
Home confinement	348	(1)
Further reading	349	(2)
Vital Statistics	351	(12)
Maternal mortality	352	(5)
Stillbirths and neonatal deaths: Perinatal mortality	357	(4)
Further reading	361	(2)
Index	363