Essentials of Obstetrics Sabaratnam Arulkumaran, V Sivanesaratnam, Alokendu Chatterjee, Pratap Kumar
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1Essentials of OBSTETRICS2
3Essentials of OBSTETRICS
Second Edition
Editors Sabaratnam Arulkumaran DCH FRCS FRCOG FAMS MD PhD Hon: FACOG FSLCOG FSOGC Professor and Head, Division of Obstetrics and Gynecology St George's Hospital Medical School, London, United Kingdom V Sivanesaratnam MBBS (S'pore) FRCOG FICS FACS FAMM JSM Professor, Department of Obstetrics and Gynecology Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Alokendu Chatterjee FRCOG FICS Formerly, Professor and Head, Department of Obstetrics and Gynecology NRS Medical College and Hospital, Calcutta Salt Lake City, Kolkata, India Pratap Kumar MD DGO FICS FICOG FICMCH Professor and Head, Department of Obstetrics and Gynecology Kasturba Medical College, Manipal Karnataka, India Foreword Shirish S Sheth
4Published by
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Jaypee Brothers Medical Publishers (P) Ltd
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Essentials of Obstetrics
© 2011, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editors and the publisher.
This book has been published in good faith that the material provided by contributors is original. Every effort is made to ensure accuracy of material, but the publisher, printer and editors will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only.
First Edition: 2005
Second Edition: 2011
9788184489095
Typeset at JPBMP typesetting unit
Printed at Ajanta Offset
5Contributors 11Foreword
This book rightly focuses on undergraduates since the future truly rests on them.
We live in an era of hope with awesome scientific advances, with an ever-growing need to identify fetal well-being and obstetric aberrations. This book is truly the work of select obstetricians who have a deep concern for women's health and in these chapters, they have dealt with practical aspects, with utmost care to provide a crystal clear pathway to obstetric management for the undergraduates.
The greatest benchmark for the disparity in medical care between rich and poor countries is their obstetric outcome—their reproductive status. The editors' deep concern for this problem is easily visualized through a comprehensive chapter on Safe Motherhood and the emphasis on Fundamentals of Reproduction as an opening chapter, at the same time not ignoring important players like endocrinal and immunological components.
I feel privileged and happy to welcome this addition to our literature and look forward to it becoming a boon to all hues of Obs-Gyne practitioners. Its rich contents should please every undergraduate as well as his teachers.
Shirish S Sheth
Consultant Gynecologist
Breach Candy Hospital
Sir Hurkisondas Hospital
Past President, FIGO12
13Preface to the Second Edition
The knowledge in obstetrics is expanding and one finds it difficult to keep pace with the recent researches and advancements in the field. This essential book provides a practical and accessible guide towards emergency situations encountered in obstetrics. Some people tend to think of obstetrics as a subject just dealing with childbirth and its complications, but in reality this subject encompasses a breadth of topics which have been aptly exemplified in the 48 chapters covered in this book. The book proceeds with issues related to contraception, implantation and growth of the fetus and placenta. From this point onwards, it expands to the knowledge needed for prenatal care followed by normal pregnancy and childbirth. The various obstetric and medical complications in the antenatal period are covered by topics on normal and abnormal labor including operative deliveries. This ends with details related to normal and complicated puerperium.
This new edition has been completely revised and reorganized to present a more up-to-date approach to the field of obstetrics with a special emphasis on women's health issues. In the new edition, two new chapters have been incorporated, which include “Pelvis and Fetal Skull”, and “Contracted Pelvis, CPD and Trial of Labor”. The multi-color design with illustrations and photographs complement the text. Being a multicontributor book, repetition of certain facts and subjects is likely to occur. In this new edition, the authors have tried their best to rectify this discrepancy.
The book would serve as a very useful source of knowledge for the undergraduates. The editors had a difficult task of trimming down many chapters to make this book a reference source for undergraduates. The contributors and editors of this book whole-heartedly hope that this volume, as was with the first, would turn out to be of great assistance to both undergraduate students and practicing doctors. This book is a basic reading book for postgraduates; the knowledge provided straddles between what is needed for an undergraduate and a postgraduate. The readers are kindly requested to communicate any mistake and omissions to the publishers or the editors, so that they can be incorporated in the next/reprint edition.
Sabaratnam Arulkumaran
V Sivanesaratnam
Alokendu Chatterjee
Pratap Kumar14
15Preface to the First Edition
The knowledge in obstetrics is expanding and one finds it difficult to keep pace with recent research. Research findings of today form the basis of practice in years to come. The core knowledge keeps changing and forms the basis of understanding of the disease process and management and is covered in this book. One may think of obstetrics as childbirth and its complications, but the expansion of knowledge in this area is exemplified by 46 chapters under 2 subsections. The book starts with issues related to conception, implantation and growth of the fetus and placenta. From this point, it expands to the knowledge needed for prenatal care followed by normal pregnancy and childbirth. The various obstetric and medical complications in the antenatal period are covered followed by normal and abnormal labor including operative deliveries. It ends with normal and complicated puerperium.
This book is multiauthored and hence the tendency for some overlap and repetition of knowledge. The editors have taken great effort in avoiding such duplications, but where it is felt that it may enhance continuity of reading an individual chapter, little change has been made. The editors have been selected based on their individual expertise, which has been useful to provide the best knowledge. This has led to the standards set high for many chapters. The knowledge provided straddles between what is needed for an undergraduate and a postgraduate. The editors had the difficult task of trimming down many chapters to make this book a reference source for undergraduates. In addition, it will form a basic reading book for postgraduates. The editors are from a variety of backgrounds and countries. This has led to some differences in the style and reporting of incidence of disease, but it does not alter the subject material.
We believe that this will be a good reference source for undergraduates and would welcome any comments or criticism that will help us to make this book better in the next edition. Your suggestions can be sent to any one of the editors or the publishers.
Sabaratnam Arulkumaran
V Sivanesaratnam
Alokendu Chatterjee
Pratap Kumar16
17Acknowledgement
We strongly believe that no task whatsoever in this world can be achieved without God's permission and divine intervention. So our first words of thanks go to the Almighty for helping us in the initiation and completion of this challenging task.
We would like to thank all our patients without whose support and endurance this task would not have been possible. We acknowledge the patience, support, guidance and blessings of our families for their consistent help and inspiration.
Last but not the least, we would like to thank the entire staff of Jaypee Publications, especially the editor, Ms Shikha Gupta for editing this manuscript. Saying mere thanks to Shri Jitendar P Vij (Chairman and Managing Director) of M/S Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, would be an underestimation of his assistance and support. We are simply overwhelmed with gratitude for his commendable enthusiasm and encouragement in support of this book.