Bedside Obstetrics and Gynecology for Postgraduates Richa Saxena
INDEX
Page numbers followed by b refer to box, f refer to figure, fc refer to flowchart, and t refer to table
A
Abdomen 157, 694, 751
general examination of 12
inspection of 12, 66, 102b
palpation of 103b
Abdominal circumference 297, 301, 302
ultrasound measurement of 303f
Abdominal examination 12, 32, 61, 66, 102, 110, 114, 145, 158, 170, 190, 231, 257, 268, 299, 322, 340, 348, 365, 421, 452, 471, 495, 520, 670, 695, 717, 753
Abdominal hysterectomy 531, 532, 549, 550, 550t, 706
types of 532
Abdominal lump 466, 685
causes for 685b
Abdominal pain 99, 157, 193, 230, 374, 466, 500f, 594, 716, 727
differential diagnosis for 159b
Abdominal palpation 13, 66, 90, 102, 299, 300, 341
diagnostic accuracy of 299
Leopold's maneuvers of 17
Abdominal sacral colpopexy 660, 660f
Abdominal skin incision, types of 215, 215f
Abdominal vaginal method 115, 115f
Abdominal wall 473
mobility of 472
Abdominovaginal delivery 119, 119f
Ablation 679
Abnormal ovarian reserve test 785
Abnormal uterine bleeding 486, 487t, 497, 498, 499b, 501, 506, 507, 525, 546, 623, 689
conservative management of 545
differential diagnosis of 496b
management of 497fc, 498fc, 526
ABO
classification 187
compatibility 147
system 187, 187t
Abortion 4
complete 718
incomplete 718, 724
recurrent 245
septic 139, 751
threatened 231
tubal 714
unexplained 260
Abruptio placentae 155, 161fc, 163, 381, 382
Abruption 268, 319, 367
complications of 162b
fetal complications of 162
incidence of 165
maternal complications of 162
recurrence of 163
Acardiac fetus, umbilical cord of 185
Acardiac twin 184
categories of 185
types of 186
Accurate gestational age, estimation of 341, 343
Acid-fast bacilli, assessment of 503
Actaea racemosa 563
Actinomycin 241, 690
Activated partial thromboplastin time 165, 254, 262, 269
Acute ectopic pregnancy 716b
diagnosis of 718
Add-back therapy, use of 528
Addison's disease 802
Adenocarcinoma 621, 687
in situ 607, 636
papillary 687
Adenofibroma 687
Adenoma 798
malignum 621
Adenomyoma 739, 742
Adenomyosis 521, 523, 739, 745, 739f, 740742, 742f
diagnosis of 741, 742, 742f
focal 521, 744
histopathological appearance of 739f
uteri 741
Adenosarcoma 621
Adherent placenta 225, 293
management of 293
types of 293t
Adhesions
barriers, use of 536f
development of 536
lysis of 773
prevention of 679
Adjuvant therapy 679
Adnexa 767
Adnexal lesion, evaluation of 696
Adnexal mass 520t
scoring system 701t
Advanced epithelial ovarian cancer 696
Advanced glycation end product 389
Adverse reproductive outcomes, causes of 618b
Alanine
aminotransferase 359, 363
transaminase 356
Alcohol 27, 255, 780
consumption, excessive 752
Alkali hematin method 267
Alkaline phosphatase 497
levels of 557
Allen stirrups 540
Allergic reactions 439
Allis forceps 220f
Alloimmune factors 252
Alpha-fetoprotein 298, 335
presence of 335
Alpha-hydroxyprogesterone caproate 326
Alpha-methyldopa 378
Alpha-reductase deficiency 796
Alzheimer's disease 554
Ambiguous external genitalia, causes of 796b
Amenorrhea 466, 689, 716, 750, 792, 796, 807, 808
hypothalamic 793, 807
postpill 798
primary 798f, 799b, 800
secondary 96, 122, 792, 802, 903fc
type of 799
Amino metabolites, production of 576
Amniocentesis 183, 195, 196
Amniotic cavity 309t
Amniotic fluid 373, 402
amount of 309
analysis 196
changes 339
index 301, 342, 373, 406
levels 309
assessment of 181
measurement of 309
volume 28, 309, 309t
assessment of 175
Amniotic sacs 173f
Amniotomy 63
Amnisure test 335
Amoxicillin 274, 326, 457, 583
Ampicillin 335, 457, 577, 586
Amsel's criteria 575b, 576
Anal incontinence 468
Anal sphincters, repair of 290f
Analgesia 275
epidural 59, 101, 211, 329
Analgesics 676
Anaphylactoid shocks 439
Ancylostoma duodenale 431
Androblastomas 687
Androgen insensitivity syndrome 796, 796t, 806
Androgen
levels 759, 777, 805
signs of 753, 793
Androgenic agents 678
Android pelvis 100
Androstenedione 757
Anembryonic gestation 231
Anemia 145, 155, 180, 325t, 417, 418, 423, 425, 427, 427t, 471, 518
adverse effects of 440
causes of 421fc, 427
correction of 432
cytometric classification of 418t
development of 420, 471, 520
diagnosis of 270, 428fc
dimorphic 423, 426
grading of 417, 418t
hemolytic 165f, 423, 426, 427, 430, 431f
identification of 214
macrocytic 425
management of 270
megaloblastic 425, 426, 430, 430f
microcytic 423
hypochromic type of 427
mild 418
moderate 427
multifactorial etiology of 423f
normochromic normocytic 422
physiological 421
postpartum 436
prevention of 149
severe 427, 432
signs of 169, 520
Angiogenesis inhibitors, incorporation of 709
Angiogenic factors 368
Angioneogenesis 668
Angiotensin 377
converting enzyme 3, 377
inhibitors 445
infusion test 367
receptor blockers 375
Anisocytosis 429
Ankle clonus 365
Anogenital infection, uncomplicated 586
Anorexia nervosa 793, 799, 807
Anovulation, chronic 491, 804
Antenatal card 24, 42, 315, 454
Antenatal management 192, 454
Antenatal period 149, 175, 312, 401t
Antepartum fetal surveillance 27, 28fc, 341
Antepartum hemorrhage 142, 147, 180, 195, 208, 299, 315, 320, 348, 459
causes of 142fc
complications 152
extraplacental causes of 147
Antepartum period 195
Antepartum vaginal bleeding 146
causes of 158
Anterior anal laceration 290
Anterior colporrhaphy 656
principles of 656
Anterior shoulder, delivery of 56f
Anterior vaginal mucosa 264f
Anterior vaginal wall
points 650
retractor 478f
Anthropoid, presence of 100
Antiadrenal antibodies, testing for 802
Antiangiogenetic drugs 668
Antianxiety agents 558
Antiarrhythmic medicines, use of 455
Antibiotic 407
prophylaxis 214, 329, 457t, 766
therapy 326
use of 584
Antibody, measurement of 191
Anticardiolipin 253
antibodies 252, 255, 259
Anticoagulants 491
regimen, types of 459
Anti-D antibodies 192t
Anti-D immunoglobulins 138, 195b, 195t, 237
mechanism of action of 195f
Antidepressants 558
Antifibrinolytics 276
Antifungal 578
drugs 578
therapy, topical 578t
Antiglobulin test 193f
Antihypertensive agents 370, 375
Antihypertensive drugs 372
use of 375
Antihypertensive therapy 369, 386
Anti-Müllerian hormone 758
receptor 796
Antioxidants 366, 367, 613
Antiphospholipid 253
antibody 245, 252
complete profile of 262
syndrome 252f, 253, 254, 257, 261
syndrome 255t, 257, 362
classification of 255
Antiplatelet agents 312
Antiprogestins 529
Antiprogestogen 350, 678
Anti-Rh antibodies 188, 194
Antiseptic solutions, use of 291
Antithrombotic drugs 366
Antithrombotic therapy 312
Aorta, coarctation of 449, 453
Aortic clamp 289f
Aortic compression, application of 289f
Aortic regurgitation 445
Aortic stenosis 446, 453, 461
Aortocaval syndrome 444
Aortopathy 460
Apgar scores, low 85
Appendectomy 688
Appendicitis 551
Appendix 667
Appetite, loss of 518
Aquamocolumnar junction, identification of 597f
Arcus tendineus
fascia 644
pelvis 662
rectovaginalis 644
Arm prolapse 96, 96f
Aromatase inhibitors 679, 744, 778
Arrhythmia 449, 460
Arterial perfusion 181
Arteriolar diameter 366
Arteriolar smooth muscles 377
Arteriovenous anastomosis 182f
Artery disease, coronary 448
Artificial intrauterine insemination 772
Arzoxifene 564
Ascaris lumbricoides 431
Ascites 550, 695
presence of 473, 694, 695
Ascorbic acid 366
Asherman's syndrome 141, 248, 259, 285, 755, 767, 797
Ashkenazi jews 762
Aspartate aminotransferase 359, 363
Aspermia 764
Aspiration pneumonitis, prevention of 214
Aspirin 367
high-dose 460
low-dose 260, 262, 460
Assisted breech vaginal delivery 79
steps of 77f
Assisted fertilization techniques 785
Assisted hatching 786
Assisted reproductive techniques 453, 684, 692, 716, 780, 788
use of 169
Asthenozoospermia 764
Asynclitism
anterior 53f
posterior 53f
Atelectasis 347f
Atenolol 375, 381
Athletes amenorrhea 799
Atonic postpartum hemorrhage, management of 271, 274
Atonic uterus 267, 267f
causes of 267
medical management of 274
treatment of 281
Atrial contraction 309f
Atrial fibrillation 458
Atrial septal defects 449
Atrophic vaginitis 581
Atrophy 550, 556, 788
Auscultation 102, 171, 474
Autoantibodies, target of 254
Autoimmune disease 362, 798
Autoimmune disorders 367
Axillary hair development 793
Ayre's spatula 601f
Azithromycin 583
use of 584
Azoles 578
Azoospermia 763, 764, 785b
diagnosis of 763
B
Back ache, severe 158
Bacteria
adherence of 576
anaerobic 139
Calymmatobacterium granulomatis 586
Bacterial vaginosis 140, 574576, 594
Amsel's diagnostic criteria for 575b
diagnosis of 576
screening for 325
treatment of 247
Baden-Walker halfway system 641, 641t, 649
Bagel's sign 721f
Balloon tamponade 278
Bandl's ring 114f, 121
development of 121f
presence of 114
Barium enema 702, 703
Basal body temperature 771
method 771f
Basic PALM-COEIN classification system 487fc
Bearing down sensation 648
Benign ovarian tumor 521, 694
diagnosis of 696
management of 696
Benzodiazepines 380
Beta-2 glycoprotein 254
Beta-adrenoceptor agonists 406
Beta-agonists 333
Beta-blockers 375, 445, 458
use of 455
Beta-human chorionic gonadotropin 497, 498, 719, 725, 728, 730
discriminatory zone of 719
levels 232
Betamethasone 406
Betamimetics 332
drugs 403
tendency of 403
Beta-receptor blockers 377
Beta-thalassemia, pathogenesis of 424f
Bethesda system 604b
Bevacizumab 709
Biguanide compound 399
Bimanual pelvic examination 590, 671
Bimanual uterine
compression 274f
massage 274
Bimanual vaginal examination 479, 480f
Bimastoid diameter 50
Biochemical markers, concentration of 448
Biophysical profile 27, 28, 175, 301, 302, 304, 310, 311, 342, 343
components of 311f
modified 311
Biophysical tests 303
Biopsy 502, 557, 558, 584, 624, 702
Biparietal diameter 50, 301, 302
ultrasound measurement of 302f
Bipolar radiofrequency 548
Birth
injuries 122
mode of 402
spacing 27
trauma 345
weight 5
Bishop's score 115
assessment of 115
modified 39t
Bisphosphonates 566, 567t
Bispinous diameter 46
Bitemporal diameter 50
Bituberous diameter 46
Bivalent cervarix 611
Björk–Shiley mitral valve, mechanical 456
Black cohosh 563
Bladder 154, 637
catheterization 136
edematous 97f
injury 252
Blastocyst 229f
Bleeding 152, 419, 622
absence of 518
acute 242
amount of 145, 488, 489
anovulatory 490
causes of 273
cessation of 529
disorders 194, 496
duration of 139, 489
episode of 143
excessive 272
extraplacental causes of 142
higher risk of 461
intraoperative 617
intraventricular 317
mechanism of 267
nature of 488
occurrence of 145
pathophysiology of 155
pattern of 490
per vaginum 146
postoperative 617, 618
severe 149, 162
types of 145
uncontrollable 532
Bleomycin 690
Bloating, abdominal 694
Blocking antibodies 252
absence of 253f
Blood
accumulation of 797f
adult unit of 201
cellular indices 428
characteristics of 145, 200, 201
clotting disorders 158
coagulation, homeostatic regulation of 253
flow 288f, 309f
redistribution of 418
glucose
assessment 395f
levels 257, 395
testing 404
values 393
group 187, 187t, 188t, 190, 230, 231, 190, 257
A 187
AB 187
B 187
O 187
typing 718
index 425, 429
investigations 369, 395
loss 269, 269t, 294, 419, 423, 516
abnormal 520
amount of 159, 266, 489
excessive 155, 471, 493
postpartum, estimation of 267
total 237
volume of 486
pressure 190, 363, 363f, 450, 470, 471, 495
diastolic 362f
measurement of 556
reading, measurement of 364
systolic 362f
smear, normal 430f
sugar
estimation of 557
fasting 394
transfusion 281, 386, 432
indications of 432
reaction 294
urea 370, 652
vessels
appearance of 608f
normal 608f
vasoconstriction of 418
volume 201, 444
calculation of 200
restoration of 273
B-lynch compression sutures 283, 284, 284f
application of 284f
B-lynch square sutures, modified 284
Body
mass index 25t, 299, 315, 321, 362, 410, 493, 519, 556, 631, 692
surface area 730
Bone
densitometry, process of 558f
health 564
marrow
density 565f
examination 431, 432b
findings 432b
Bonney's approach 534
Bonney's hood 534
approach 535f
Bonney's myomectomy clamp 533
Bony pelvis, deformities of 61
Borderline tumors, epidemiology of 688
Boric acid capsules 579
Bovine hemoglobin concentrate 435
Bowel mesentery 707
Bowl metastases 694
Brachial plexus
anatomy of 415f
injuries 414
left-sided 411f
Brachytherapy 634
application of 635f
Brain
injury, ischemic 315
sparing effect 306f
Braxton hicks contractions 8, 9
Breast 11f, 491, 695
cancer 555, 561, 569
high-risk factors for 558
changes 716
development, staging of 471
exact site of 11
examination 11f, 471, 495, 623, 752, 794
lump, detection of 495
ovarian cancer syndrome 692
Tanner stages of 794f
Breastfeeding 27, 201, 579
Breathing exercises 222
Breathlessness 450
Breech
complete 65
delivery, spontaneous 76
engagement of 76f
extraction
reverse 119, 119f
total 76
gestation 67f
position of 65f
presentation 6568, 68fc, 86t
causes of 66
fetal risk factors for 66
intrapartum management of 78fc
types of 65f, 67, 86
vaginal delivery 72b, 76, 79b
mechanism of 76f
types of 76
Brenner's tumors 686, 687
Brisk knee jerks 372
Broad ligament hematoma 715
Broad spectrum antibiotics 274
Brow presentation 109, 111, 111f
Bullous edema, presence of 509
Burns–Marshall technique 75, 81, 81f
Buserelin 528, 782
Butoconazole 578
C
Cabergoline 799
Caffeine 255
consumption 780
Calcium 367, 559
antagonist 381
channel blockers 332
Caldwell and Moloy's classification 42f
Campylobacter jejuni 139
Cancer
advanced stage of 623
antigen 125 743
serum 673
cachexia 623, 695
cells, exfoliation of 691
cervix 596, 619, 633f
deposits 704f
develops, type of 691
genome atlas classification 510
grading 628
gynecological 465
high-grade 705
low-grade 705
moderate-grade 705
nonendometrioid 513
ovaries 691, 697
routes of spread of 628b
stage 707fc
Cancerous lesions, previous history of 622
Candida
albicans 579
wet mount preparation of 577f
infection 577, 577b
organisms, diagnosis of 593
vulvovaginitis 578t
indications of 591
Cannon ball appearance 235, 236f
Capillary blood glucose levels 403
Captopril 381
Carbetocin 275
Carbohydrate metabolism 391t
Carbon dioxide
embolism 550
transportation of 417f
Carbonyl iron 437
Carboplatin 511
Carboprost 274
Carcinoma 777
cervix 142
laparoscopic surgery in 634
embryonal 687
endometrium 513
management of 508
staging of 508
treatment of 513
in situ 596, 604, 626
ovaries, staging of 699t
Carcinosarcoma 621
Cardiac apex, point of 451
Cardiac complications 460b, 460t
Cardiac decompensation 442
signs of 445
Cardiac disease 453, 453b, 460, 461
severe 375
Cardiac dysfunction, preexisting 449
Cardiac lesions
acquired 445
congenital 445
Cardiac surgical interventions 453
Cardinal–uterosacral ligament complex 644
Cardiomyopathy, hypertrophic 458
Cardiorespiratory diseases 420
Cardiotocographic examination 160
Cardiotocography 28, 302, 304, 314
Cardiovascular disease 441, 567, 807
development of 447
high risk for 554
Cardiovascular disorders, acquired 447
Cardiovascular drugs 366, 458f
Cardiovascular health after maternal placental syndromes 447
Cardiovascular system 421, 443, 798
examination 474
exact site of 451
Carneous degeneration 551
Carnett's sign 670, 671f
Cefazolin 457
Ceftriaxone 121, 457
Cells
free fetal DNA 196, 197
Cellular fibroids 552
Cellular hyperplasia, process of 295
Central nervous system 360, 458
complications 338
Central venous pressure 273, 375
Cephalexin 457
Cephalic index 302
Cephalic presentation 341
types of 40f
Cephalopelvic disproportion 112, 112t, 117b, 118, 176, 205
Cephalosporin, third-generation 121
Cerclage
contraindications for 251
indications for 251
procedures, types of 327
Cerebral artery
anterior 306
Doppler analysis 373
Cerebral hemorrhage 381, 382
development of 382
Cerebral palsy 202, 317, 337
Cerebroplacental ratio 297, 309, 314
Cervarix 611
use of 612
Cervical biopsy 610f
Cervical canal 485
Cervical cancer 610, 619, 621f, 622f, 628, 629, 629fc, 630fc, 636, 638t
changes, management of 624
detection of 599
downstaging of 628
early-stage 629
histologic diagnosis of 625b
magnitude of 620
morphological progression of 598f
pathology of 619
preinvasive 597
prevention of 610
screening 599, 604
protocol for 599
tools for 600fc
specimen of 620
spread of 628
staging 626, 630
system for 626t
treatment of 629, 636
vaccination against 622
Cervical cells
precancerous 599
preparation of 607
Cervical cerclage
classification of 327t
role of 327
use of 327
Cervical condylomata 599
Cervical conization 626
Cervical culture 504, 593, 673
Cervical cytology 703
Cervical dilatation 38, 38f, 61, 119
normal 110
Cervical discharge 750
Cervical dysplasia 751
progression of 597f
Cervical epithelium, normal 598f
Cervical erosions 146
Cervical extension 513
Cervical factor
evaluation of 764
infertility 754
treatment of 772
Cervical fibroids 532
Cervical glandular intraepithelial neoplasia 602
Cervical incompetence 141, 245, 248, 251f, 263, 326, 334
development of 250b
management of 263
presence of 320
test for 260
treatment for 250
Cervical inflammation 618
Cervical intraepithelial neoplasia 596, 597, 597f, 602, 604
treatment of 617
Cervical lacerations 141, 416
Cervical length 326
measurement of 322, 324f
ultrasound assessment of 323
Cervical malformations 321
Cervical mass 624f
Cervical mucus 7
ferning pattern of 755f
production, bioassay of 805
thickening of 787
Cervical pathology, screening for 468
Cervical plasticity, loss of 618
Cervical polyps 488
presence of 142
Cervical pregnancy 737
diagnostic criteria for 725b
Cervical punch biopsy forceps 610f
Cervical ripening 59
Cervical softening 9f
Cervical squamous epithelium 598
Cervical stenosis 618, 755
Cervical surgery 618b
Cervical tears 291, 467
Cervical trauma 136, 321
Cervical tuberculosis, diagnosis of 624
Cervicitis, severe 599
Cervicography 609
Cervicopexy, abdominal 658
Cervix 8, 9, 154, 622, 751, 766
adenocarcinoma of 636
anatomical location of 620f
complications, adenocarcinoma of 637
fungating growth of 622f
incompetent 250
laser vaporization of 616f
malignant tumors of 621t
per speculum examination of 269f
premature dilatation of 618
pulling anterior lip of 264f
surface of 608f
transvaginal sonography of 625f
ulcerative growth of 622f
visual inspection of 604
Cesarean birth 205b
Cesarean delivery 95, 120, 145, 210b, 213t, 221b, 225t, 329, 382, 448
advantages of 212b
alternative techniques for 222
classification of 213
disadvantages of 212
indications for 109b, 204, 344b, 403b
previous 224t
timing for 178, 212
Cesarean scar
over abdomen, previous 13f
pregnancy 725b, 737
previous 224
Cesarean section 95f, 109, 119, 162, 178, 204, 204b, 205, 207fc, 220, 314
classical 223
hemostatic 222
indications for 74b, 178, 204b, 374, 384b, 456b
lower segment 153
previous 204
rate of 206
second stage of 119
steps of 217f, 219f
surgery for 214
time of 152b
Chadwick's sign 8
Chancroid 587
Chaperone 465
Chemoradiation 634
therapy 631
Chemotherapy 238, 631, 635, 708
drugs 752, 798
high-dose 241
indications for 240, 708b
side effects to 712
types of 709
Chest 798
examination 695
pain 450
acute history of 450
pleuritic 450
X-ray 235, 236f
Chlamydia 140, 247, 256, 269, 335, 582, 590, 593, 760, 750
antibody 768, 769
trachomatis 136, 319, 573, 765, 769
life cycle of 582f
screening tests for 765
treatment of 583
Chlamydial infection 582584
clinical features 582
Chlorpromazine 380
Chocolate cysts 666
Chorioadenoma destruens 242
Chorioamnionitis 63, 159, 267, 268, 334, 337, 594
Choriocarcinoma 228, 242, 687
gestational 242
Chorioepithelioma 242
Chorionic sacs 172f
Chorionic villus sampling 261
Chromosomal abnormality 203
presence of 245
Chromosomal defects 181
Chromosomal disorders
occurrence of 175
screening for 175
Chronic pelvic pain 665
causes of 666t, 674
management of 673fc
Cilial epithelium 761
Circulatory collapse 294
Cisplatin 241, 631, 690
use of 632
Citalopram 559
Clamping cord 56
Claviceps purpurea 275
Clavulanate potassium 326
Cleidotomy 414
Clindamycin 577
phosphate vaginal cream 594
use of 584
Clomiphene 744
citrate 265, 751, 775, 777, 780, 787
use of 686
Closed mitral valvuloplasty 446, 447
Clostridium welchii 351
Clotrimazole 578
Clubfoot 181
Clue cells 592
presence of 576
Coagulation 355
disorder 492, 519
factors, study of 496
pathways 164fc
profile 231, 269
abnormal results of 165t
restoration of 273
Coagulopathy 487
Coelomic epithelium 686
Coelomic metaplasia, theory of 667
Cold-knife conization 614
Coliforms 139
Colonoscopy 674, 703
Color Doppler ultrasound 87f
Colostrum, antenatal banking of 405
Colpocleisis
advantages of 661b
procedure of 662f
Colpoperineorrhaphy 656
Colporrhaphy, posterior 656
Colposcopic directed biopsy 599, 609
Colposcopic examination 607f, 625
Colposcopy 607, 617
indications for 608b
management 602fc
Columnar epithelial cells 585
Complete blood count 231, 255, 496, 497, 521, 673, 718, 729, 730
Complex tubal adnexal mass 721f
Computed tomography 239, 804
examination 485
scan 703f
Conception, abnormalities in 747
Condom
catheter 280
insertion of 280f
tamponade 280
use of 613
Cone biopsy 614, 614f, 615f, 631
Congenital malformations 181b, 407, 767
screening for 401
Conization 617
Conjoined twins 170f, 171f, 185
types of 170f
Conjugated equine estrogen 530, 807
Conjunctiva, lower palpebral 10f, 420f
Connective tissue
disorders 460, 461
Constriction ring 114
Continuous maternal blood pressure monitoring 372
Contraception 27, 238, 454, 491, 558, 750
types of 467
Contractions
grading duration of 36t
strength of 34
stress test 28
Controlled cord traction 270, 271f
Controlled ovarian hyperstimulation 783
Contusions 416
Coombs test, indirect 349
Cor pulmonale 460
Cord
accidents 348
clamping 329
entanglement 186, 186f
risk of 71
presentation 204
prolapse 86, 86f, 87f, 337, 348
causes of 86, 86t
incidence of 86, 86t
management of 86, 87fc
Cordocentesis 195, 198
procedure of 199f
risks of 198
Cornual block, bilateral 765f
Cornual ectopic pregnancy 722f
Cornual ostium 765
Cornual pregnancy 726b
Coronavirus disease vaccination 26
Corpus cancer syndrome 492, 494
Corpus luteum 468
cysts 686
Corticosteroid 386, 391, 579
therapy 329, 333
use of 402
Corticotropin-releasing hormone 319
Coumadin 262
Couvelaire uterus 163, 163f
Coyne spoon 120
Cramp, abdominal 577, 637
Cranial bones, collapse of 349
Craniopagus twins, autopsy specimen of 170f
Creatinine, serum 370
Crown-rump length 301, 340
Cryosurgery 614
Cryptozoospermia 764
Cul-de-sac 671, 682f
obliteration of 655, 667, 669
Culdocentesis 724
procedure of 724f
Culdoplasty 655
Cullen's sign 472
Cusco's speculum 146, 477, 478, 478f
insertion of 478
Cushing's syndrome 794
Cyanosis 450
Cyclical rectal bleeding 667
Cyclooxygenase 743
Cyclophosphamide 241, 690
Cyst
functional 685, 701f
stool examination for 430
Cystadenocarcinoma, papillary 687
Cystadenofibroma 687
Cystadenoma 687
papillary 687
Cystic degeneration 551
Cystic fibrosis 408
screening for 762
Cystic ovarian neoplasm 234
Cystitis, interstitial 666
Cystocele 556, 642f
moderate 642f
repair, procedure of 657f
Cystostomy 531
Cystourethritis 637
Cytoflowmetry 232
Cytokines 425
role of 319t
Cytologic screening 599
Cytological analysis 603
Cytological tests 584
Cytomegalovirus 200, 298
Cytoreduction 707
Cytoreductive surgery 706, 708
procedure of 707b
Cytosine 802
D
Dabigatran 459
Dactinomycin 240, 241
Daily fetal movement count 27, 300, 312, 342, 343, 371, 373
chart 175
Danazol 527, 530, 678, 681, 743
Danish Osteoporosis Prevention Study 568
Das’ four categories 185
Dawn phenomenon 399
Debulking surgery 706
Deep transverse arrest 104
causes of 104b
Deep transverse perineal muscle 644, 645, 645f
Deep vein thrombosis 254, 458
Degenerated menstrual endometrium, reflux of 667
Dehydroepiandrosterone 758, 779
sulfate 340, 757, 758, 779
Delivery 329
deciding time of 327, 335
decisions 314
expected date of 3
method of 5
mode of 71, 152, 177, 316, 350, 370
route of 647
time of 177, 198, 199, 313, 330, 344, 373, 440
Delphi consensus criteria 296
Dementia 569
Denosumab 567
binds 567
Deoxyribonucleic acid 581, 600, 608, 729
Dermoid cyst 700f
Desvenlafaxine 559
Detemir 398
Diabetes
classification of 388
control of 261
education 397
effect of 401b
mellitus 246, 362, 388, 389fc, 392, 395, 402, 403t, 404t, 406, 802
complications of 389fc
disorders of 388t
gestational 180, 388, 390, 393t, 394, 396, 398f, 399, 403b, 405, 405t, 406, 406t, 408b, 409
insulin dependent 388
noninsulin-dependent 388
pregestational 407
triad of 467
Diabetic ketoacidosis 388, 407
development of 407b
management of 407b
Diagonal conjugate, measurement of 45, 45f
Diamniotic dichorionic
pregnancy 174f
twins 172f, 173f
Diamniotic monochorionic monozygotic twin pregnancy 167
Diathermy 526, 679
Diazepam 380
use of 380
Diazoxide 376, 377
Dichorionic diamniotic twin gestation 178
Dietary iron, absorption of 434b
Dietary salt restriction 455
Diethylstilbestrol 256, 258, 725, 750
Diffuse adenomyosis 744
presence of 539
Digoxin 455, 458
Dihydralazine 380
Dihydrotestosterone 796
Dilatation and curettage 497, 498, 503, 505
advantages of 504b
complications of 504b
indications for 504b
Dilated veins, presence of 471
Dilute Russell viper venom time 254
Dilute vasopressin 533
Dinoprostone, use of 210
Direct antiglobulin test 193f
Disseminated intravascular coagulation 156, 159, 163, 163fc, 164b, 165, 165f, 165t
causes of 164
common sign of 164
treatment of 165
Distal tubal obstruction 774
Distant metastasis 699
Distress, psychological 808
Diuretics 455
use of 376b
Dizygotic twin 166, 167t, 168f
formation of 167f
Dominant follicle 756, 767
presence of 484f
Donor insemination 787
indications for 787
Donor ovum 806
Donovanosis 586
Dopamine
agonist 799
infusion 375
Doppler analysis, arterial changes on 309
Doppler blood flow 701t
Doppler study 304t
types of 304
Doppler ultrasonography 28, 235
Doppler ultrasound 148, 196, 305f
principle of 305f
Doppler waveforms, types of 28f
Double-rimmed gestational sac 22f
Douglas pouch 694, 707, 721f, 722f, 724, 724f, 753
Dowager's hump 565
Down's syndrome 26, 175
Doxycycline 583
Doyen's retractor, insertion of 216, 217f
Dual energy X-ray absorptiometry 558
Ductus venosus 302, 308f, 309f, 314
blood flow in 308f
Doppler 307
Dührssen's incision 85f
Dydrogesterone 260
Dye, bilateral spillage of 765f
Dyschezia 739
Dysfunctional uterine bleeding 486, 498
Dysgerminoma 687, 690
Dyskaryosis, low-grade 603
Dysmaturity syndrome 345
Dysmenorrhea 466, 518, 527
congestive 466
severe 684
Dyspareunia 467, 589, 739, 750
severe 684
Dysphagia 419, 596
Dysplasia
bronchopulmonary 318
mild 596, 617
moderate 597
presence of 599
severe 597
Dysplastic cervical changes, complication of 617
Dyspnea 363, 450
acute onset of 450
exertional 450
severe 450
Dystocia 60, 204
dystrophy syndrome 114
Dysuria 589
E
Early pregnancy 231
symptoms of 169
Ears 798
Eclampsia 275, 365, 374, 381, 382, 384b
complications of 381
management of 382, 383fc
ominous features of 383, 384b
prevention of 382
treatment of 382
Ectopic adnexal mass, chronic 715
Ectopic endometrial glands, growth of 740f
Ectopic pregnancy 195, 482, 713, 713f, 714f, 715718, 718t, 719, 721, 721f, 723, 724, 728fc, 738, 767, 788
classical 714
course of 714, 714f
diagnosis of 719fc, 722t
differential diagnoses of 717t
expectant management of 728b
implantation of 713t
laparoscopic management of 733
left-sided 722f
management of 727, 733
occurrence of 714f
persistent 737, 738
presence of 138
rupture of 733, 737
sac 731
treatment of 729b
tubal 722f, 734, 736f
types of 737t
unruptured 717, 724f
Edema 370
peripheral 450, 451
pitting 11f
presence of 451
testing for 11f
Eduard Gratacos criteria 314t
Edwards’ syndrome 175
Ehlers-Danlos syndrome 460, 461
Eisenmenger's syndrome 453, 460
Ejaculatory failure 784b
Ejaculatory sexual dysfunction 771
Ejection fraction 453
Elective cesarean section 74, 206, 211, 213
preparations for 214
Elective single embryo transfer 789
Electrocoagulation 614
Electrosurgery, use of 536
Elemental iron, amount of 436, 437t
Elevated liver enzymes 360, 373, 374
Eltroxin 807
Embolism, pulmonary 255, 450
Embryo
culture of 789
number of 780
transfer 716, 783
Embryonic sex cords 688
Emergency cesarean section 75
indications for 152b, 316b
Emergency delivery, indications for 152
Empty uterine cavity 725
Empty uterus 721, 721f
Enalapril 381
Encephalopathy, neonatal 317
End-diastolic flow, absent 297
Endemic infection, management of 435
Endocarditis, infective 450
Endocervical canal 251f, 615, 765
Endocervical curettage 626
Endocervical glandular involvement 509
Endocervical mucosa 686
Endocervical stromal sarcoma 621
Endocervix 792
Endocrinopathy 495
Endodermal sinus tumor 687, 690
Endometrial ablation 530, 545547, 547f, 549, 550b
indications for 546b
methods 548
procedures for 547b, 549f
techniques 545, 547
use of 547b
Endometrial adenocarcinoma 499f
Endometrial adhesions, laparoscopic excision of 683f
Endometrial aspiration 504, 504f, 558
procedure 504
Endometrial biopsy 501, 503505, 767, 768
complications of 503, 503b
histological findings on 502
indications for 502b
Endometrial cancer 486, 492, 500b, 508510, 511f, 512t, 525, 569, 694, 741
adjuvant therapy for 511
classification for 510
diagnosis of 488b, 741
differentiation of 510b
gynecological management of 508
management of 508, 511
pathology of 508
predisposing factors of 508
prognostic risk groups of 509
protective factors for 495b
risk factors for 493, 494b
screening for 505, 508
staging of 509, 509t
subgroups of 510
surgical management of 511t
syndromes, hereditary 492t
type 1 488t
type 2 488t
Endometrial carcinoma 467, 488, 494fc, 499f, 501, 509, 551, 552, 689
high-risk 510
Endometrial cavity 533, 675, 767
distortion of 756
Endometrial cycle, secretory phase of 468
Endometrial fertility index 680
Endometrial glands 469, 470
Endometrial histopathology 504
Endometrial hyperplasia 488, 505, 552, 569, 741, 777, 807
classification of 506t
diagnosis of 741
management of 507, 507fc
Endometrial inflammation 553
Endometrial malignancy 490
Endometrial polyp 488, 501f, 516, 523, 741
Endometrial resection 549, 550, 550t, 502, 542, 546, 557
Endometrial sampling 558
procedure of 502
Endometrial surface 682f
Endometrial thickness 485
measurement of 499, 805
Endometrial tumors 686
Endometrioid cancer 621
Endometrioid endometrial cancer 510
Endometrioid intraepithelial neoplasia, histopathological appearance of 506f
Endometrioid tumors 687
Endometrioma, malignant transformation of 667
Endometriosis 466, 468, 482, 666, 670, 672, 676fc, 680, 680b, 682b, 684, 715, 740, 741, 750, 760, 761t, 788, 796
associated pain 679
treatment for 676
deep infiltrating 684
development of 669
etiopathogenesis of 667
excision of 679
immunity for 667
indications of 682
infertility in 680
lesions of 674b
management of 668, 674
mild 761
minimal 761
moderate to severe 671
nonclassic 760
occurrence of 667
origin of 667
pathogenesis of 667
severe 761
small nodules of 674
staging of 675, 676t, 677f
surgery 679
treatment of 675, 684, 780
type of 761
Endometriotic lesions 666f, 669, 760
ablation of 683f
Endometritis 618, 755
postpartum 594
Endometrium 470, 503, 686
early proliferative phase 484
functional layer of 470
layer of 468, 546f
lumen of 485
proliferative 469f
secretory phase 470f
thickened 501t
transcervical resection of 545, 548, 548f
Endomyometrial ablation 745
Endothelial dysfunction 360, 368
Endothelium 355
Enterocele 641, 642f
Enzyme
aromatase 744, 778
linked immunosorbent assay 255, 583
Epidural analgesia 59, 101, 211, 329
administration of 60f
Epinephrine 439
Episiotomy 268, 290, 329
mediolateral 58, 268
Epithelial cell 592
abnormalities 604
adhesion molecule 492
Epithelial ovarian cancer 692, 694t, 708, 708b
diagnosis of 705
Epithelial ovarian carcinoma 696
Epithelial tumors 686
different types of 686
unclassified 687
Erb's palsy 415
Erectile dysfunction 752
Ergometrine 275
stimulant action of 275
Ergot alkaloids 275
Erythroblastosis fetalis 189, 202
clinical manifestations of 202
Erythrocytes, escape of 407
Erythromycin 583, 586
Escherichia coli 544, 573
Estradiol levels 468
Estriol 391
Estrogen 560
cardioprotective mechanisms of 568b
cream 562
deficiency 561
dominance 740
exogenous 488, 807
levels of 647, 767
measurement of levels of 558
plus progestin trial 568
replacement therapy 683
secreting ovarian tumors 494
status 589
therapy 559
Ethamsylate 527
Etoposide 242
European Menopause and Andropause Society 568
European Society for Radiotherapy and Oncology 509
European Society of Hysteroscopy Classification of Myomas 538f
European Society of Pathology 509
Exablate 2000 system 545
Exchange transfusion 201
procedure of 201
Exercise 25, 366, 397, 761
Exophytic endometrial cancer growth, hysteroscopic appearance of 505f
External anal sphincter 644
repair, technique of 290
External aortic compression 288
application of 289f
External ballottement 7, 7f
External beam radiotherapy 632
External cephalic version 68, 69t, 93
complications of 71, 94, 95b
contraindications for 93t
prerequisites for 69, 93
procedure 70, 93
timing for 69
External parasitic twin 181
External radiation therapy 635
External suture, placement of 655f
External version score 71, 71t
Extraovarian primary cancers 696
Extrauterine pregnancy 10t
diagnosis of 720
Extremities, exact site of 753
Eye 798
examination 752
F
Face, edema of 363, 365
Fallopian tube 691, 697, 699t, 713, 715, 721f, 723f, 751, 753, 754, 760, 768, 796
epithelium of 686
patency of 259, 485, 765
Falloposcopy 768
Fallot, tetralogy of 449, 453, 460
Familial breast ovarian cancer syndrome 692
Familial gynecological cancer, risk reduction in 705
Fascia, posterior 662f
Fascial incision 215f
Febrile morbidity, incidence of 544
Federation of Gynecology and Obstetrics 628
Female external genitalia 796
anatomy of 475f
inspection of 477f
Female gonads, embryological development of 795f
Female infertility, causes of 754
Female internal genitalia 796
anatomy of 475f
Female pelvic anatomy, normal 642f
Female pelvis, blood supply to 282
Female reproductive tract 764
Femininity, loss of 808
Femoral artery 542f
Femur length 297, 303
Ferning 335, 755f
Ferric carboxymaltose 438
Ferrous fumarate 437
Ferrous gluconate 437
Ferrous glycine sulfate 437
Ferrous succinate 437
Ferrous sulfate 437
amount of 437
anhydrous 437
dry 437
Fertility 749
effect on 544, 745
preserving surgery 706
sparing
surgery 631
therapy 513
treatment 513, 513b
Fertilization, normal process of 229f
Fetal acidosis 63
Fetal acoustic stimulation 71
Fetal anemia 192b, 198f
assessment of 196
development of 196
treatment of 199
Fetal ascites 203f
Fetal asphyxia 98
Fetal assessment
method of 27
rationale for 372
Fetal attitude 16
types of 17f
Fetal bleeding diathesis 204
Fetal blood
cells 189
sampling 192
small amounts of 188
Fetal body parts, palpation of 7
Fetal bradycardia 158, 445
Fetal circulation 308f
persistent 317
Fetal complications 63, 64, 85, 98, 162, 165, 180, 181, 202, 317, 334, 337, 338, 344, 381, 406, 407, 414, 440, 461
Fetal congenital malformations, diagnosis of 324
Fetal death 155, 165, 350
Fetal descent, abdominal assessment of 34
Fetal disorders 340
Fetal distress 155, 165, 344, 374
Fetal dysmaturity syndrome 346b
Fetal echocardiography 455
Fetal erythroblastosis fetalis, pathogenesis of 202fc
Fetal face, direction of 413f
Fetal fibronectin 322, 325f
levels 325
Fetal growth
restriction 297t, 367
stages of 296t
ultrasound monitoring of 402
Fetal head 74b, 168
anterior fontanels in 49f
asynclitism of 51
crowning of 55f
delivery of 54, 55f, 219f
diameter of 53f
elevators 120
engagement of 39, 51t
entrapment 85
extension of 67
mobility of 114
molding of 106, 106f
occipitolateral position of 31f
palpation of 103f, 299
position of 61
posterior fontanels in 49f
Fetal heart 309
absent 349
auscultation 20, 67, 91
rate 54, 79, 205, 373
location of 21f
transient reduction of 95
sound 7, 156, 159, 161, 171
Fetal hemoglobin 425, 428
Fetal hydrops 192, 203
development of 203b
Fetal hypoglycemia
development of 399
pathogenesis of 404fc
Fetal hypoxemia 374
Fetal infection 320
Fetal inflammatory response 320
Fetal intrauterine blood transfusion 200
Fetal lie 15
types of 15, 15f, 15t
Fetal macrosomia 267, 268, 337
pathogenesis of 410fc
Fetal malpresentation 204, 374
Fetal middle cerebral artery 196
Doppler velocimetry of 191
Fetal ponderal index 303
Fetal position 16, 39
Fetal presentation 15, 38
abnormal 29
diagnosis of 17
types of 16f, 16t
Fetal problems 408t
Fetal red cells 192t
Fetal reduction, selective 184
Fetal scalp
bones, molding of 41f
electrode 329
Fetal shoulder 91f, 119
and arm, delivery of 79, 80f
presentation 91f
Fetal size, assessment of 32
Fetal skull 48, 50f
bones of 48f, 350f
diameters of 50, 50f
molding of 41t
parts of 49
Fetal sleep patterns 310
Fetal status, nonreassuring 204
Fetal surveillance 175, 196, 262, 312, 329, 343, 369, 401t, 454
antenatal measures of 316
measures of 303
test of 343, 343t
Fetal trauma 337
Fetal weight
estimated 295, 297, 301, 314
ultrasound based estimation of 303t
Fetal well-being, tests for 341
Feto-fetal transfusion syndrome 183
Feto-maternal hemorrhage 188, 195
estimating volume of 190
Fetopelvic disproportion, assessment of 114, 121
Fetus 95f
descent of 106
exact site of 13
in-fetu 181
intra-abdominal version of 95f
management of 92fc
normal 198f
palpation of 15
posterior shoulder of 413f
Fever, causes of 518b
Fibrin degradation products 165
Fibrinogen levels 350
Fibrinolysins 527
Fibrinolytic pathway 164fc
Fibroblast growth factor receptors 710
Fibroids 516, 518b, 552, 553, 553b, 751
anatomical location of 756
blocking blood supply of 543f
destruction of 541
development of 519
FIGO classification of 516, 517f
growth 796
histological appearance of 516f
large 520
medical management of 526
possible effects of 553
presence of 231
treatment of 544, 545f
types of 516
ultrasound appearance of 523f
uterus 521, 522fc, 525fc
management of 521, 526
Fibromas 688
Fibromyomas belonging 538
Fifth-line salvage therapy 579
FIGO classification system 487
FIGO revised cervical cancer staging 627f
Figure-of-eight 8, 9f
Fimbria 680
Fimbrial expression 732
Finger clubbing 450
Finger-Prick method 395f
First antenatal visit 3, 23
First-line salvage therapy 579
Fitz-Hugh-Curtis syndrome 583, 583f
Five-finger rotation 108
Flamm and Geiger scoring system 208, 208t
Flexion
complete 17f
moderate 17f
Flow cytometry 191
Fluconazole 578
Fluid
thrill 474, 474f
Fluorescent treponemal antibody absorption 588
Fluorouracil 631
Fluoxetine 559
Focal endometrial vascular disturbance 553
Folate deficiency 426, 427t
Folic acid 230, 423, 435, 436f
deficiency of 427
regular intake of 396
Folinic acid 240, 241
Follicle-stimulating hormone 754, 757, 758, 762, 776, 805
concentration, serum 805
Follicular aspiration 781f, 784
Follicular ovarian masses 686
Follicular stimulation 781f
Food, fortification of 435
Foot dorsiflexion 222
Footling breech 65
Forceps
application of 82b, 83f
rotation 109
use of 268
Foul-smelling discharge 623
causes of 623b
per vaginum 491
Fourth-degree tear, repair of 290
Fourth-line salvage therapy 579
Fractures 566f
risk assessment tool 565
Fragile X mental retardation 801
testing for 802
Fragile X syndrome 802
typical features of 802b
Frank's breech 65, 65f, 67f
Frank's dilators 806
Free vaginal mesh techniques 662
Fresh frozen plasma 460
Friedman's criteria 63
Friedman's labor graph 61t
Full-hand method 108
Functional murmur, characteristics of 451b
Fundal grip 18, 67, 90
Fundal height 13
causes of 171
estimation of 14
Fundoscopy 794
Furosemide 375
G
Gabapentin 559
Gait 114
Galactorrhea 491, 750, 793, 799
management of 804fc
presence of 496
Gamete
culture of 789
intrafallopian transfer 786
Gangrene, development of 550
Gardnerella mobiluncus 575
Gardnerella vaginalis 575
Gastrointestinal abnormalities 408
Gastrointestinal effects 637
Gastrointestinal malignancy 703
Gastrointestinal pathology 696
Gelatin microspheres 542
Gene mutation 492
Genetic disorders 340
Genetic syndromes 181, 203
Genital herpes 584
treatment of 584
Genital hiatus 650f
Genital masculinization 796
Genital organs 8, 8t
Genital prolapse 467
Genital tract abnormalities 801fc
Genital trauma 491
Genital ulcer disease, management of 584
Genitourinary atrophy 807
Genitourinary fistula 98f
development of 96, 122
Gentamicin 274
Germ cell tumors 686, 687, 689691
types of 689fc
Gestation
abdominal measurement of 13f
ectopic 242, 720
neonatal 326
period of 139, 150, 328, 329, 336, 371, 432
Gestational age 199t, 299, 314
estimation of 301
small for 295, 296, 296t, 299, 368
Gestational diabetes mellitus 180, 388, 390, 393t, 394, 396, 398f, 399, 403b, 405, 405t, 406, 406t, 408b, 409
development of 393b
diagnosis of 393t, 394
management of 392, 394
medical management of 394
obstetric management of 394
pathogenesis of 391
screening for 392
treatment of 399
Gestational hypertension 355358, 368, 369, 369b, 447
management of 368
Gestational sac 719, 721f, 721t, 722f
tubal 721
Gestational trophoblastic disease 138, 227, 238b, 241b, 242
classification of 228b
Gestational trophoblastic neoplasia 228
development of 230, 230b
diagnosis of 236, 237b
FIGO staging of 240t, 241t
Gestrinone 678, 679
Girth, abdominal 340
Glibenclamide 398, 399
Globin levels 440
Glossitis 577
Glucose
challenge test 392, 393
intolerance, postpartum evaluation for 405t
metabolism 390
monitoring 399
tolerance 390
Glyburide 398, 399
efficacy of 399
Glycemic control, worsening of 402
Gonadal dysgenesis 802
Gonadorelin 777
Gonadotropin 777, 778, 787
levels 805
loss of 527
releasing hormone 525527, 546, 676, 682, 743, 777, 782
agonist 527, 546, 678, 782
analogs 681, 686, 743
antagonists 528, 782
Gonorrhea 585, 585f, 593, 760
diagnosis 585
etiology 585
investigations 586
management 586
Goodell's sign 8, 9f
Goserelin 528, 678, 782
Grand multipara 4
Grandmother theory 195
Granulation tissue 586
Granulocyte colony-stimulating factor, employment of 241
Granuloma inguinale 586, 599
Granulomatous cervical conditions 599
Granulosa cells 468, 688
tumor 688, 689
histopathological pattern of 689f
Grasping protruding fundus 292f
Grey Turner's sign 472
Groin traction 84
Group B Streptococcus
prophylaxis 326
role of 319
Growth
benign 686
chart 793
discordant 181
hormone 806
rapidity of 694
restriction 373
pathogenic 295, 296, 296t
Guanine 802
Guillain-Barré syndrome 254
Gynandroblastoma 687
Gynecologic oncology group 707
Gynecological malignancy, screening for 468
Gynecological management 508
H
Haemophilus
ducreyi 587
influenzae 139
vaginalis 575
Halban's cul-de-sac closure 655
Halban's culdoplasty 655f
Hands
edema of 363, 365
palm of 10f
Haplotypes 188t
Hartmann's solution 273, 281
Hayman compression suture, application of 284f
Hayman technique 284
Head circumference 297, 301
Head of family, education of 6t
Headache 363, 577, 793
Healthy diet, components of 435f
Heart disease 442, 443b, 451t, 452, 453b, 454t, 457, 460, 460b
clinical indicators of 451b
congenital 408, 449, 460
implications of 443
incidence of 461
rheumatic 443, 452
Heart failure 442
chronic 458
congestive 442, 445
increased risk of 460
rheumatic 452
treatment of 454
Heavy menstrual bleeding 515, 517, 522
causes of 515t
Hefner's cerclage 250, 265
Hegar's sign 8, 9, 9f
HELLP syndrome 373, 374, 384, 385t, 386fc
classification 385
complications 387
diagnosis 384
differential diagnosis 385
hemolysis in 385
Mississippi of 385t
pathophysiology 384
physical examination 385
symptoms 384
treatment 385
Helmet cells 165f
Hematochezia 667
Hematocrit 366, 370, 428, 433
value 427
Hematologic malignancies 425
Hematoma 291
infralevator 291
prevent formation of 291
supralevator 291
Hematometra 285, 796
Hematoperitoneum 716
Hemivertebra 796
Hemochromatosis 752
Hemodilution, physiological 422
Hemoglobin 417, 418, 428, 443, 652
alpha 424, 425, 428
concentration 418, 422
restoration of 273
electrophoresis 431
estimation of 429f, 432t, 718
glycosylated 246
levels 727
molecules, role of 417f
oxygen dissociation curve 418
production 422, 423
routine determination of 433
synthesis 434
Hemoglobinopathy 423, 427
Hemolysis 360, 373, 374
Hemolytic disorders 189
Hemophilia 496
Hemorrhage 419, 736
accidental 551
antepartum 142, 147, 180, 195, 208, 299, 315, 320, 348, 459
cerebral 381, 382
decidual 319
intracranial 122
intranatal 440
intraperitoneal 472
intraventricular 315, 318, 330
life-threatening 736
massive 281
maternal 252
postpartum 63, 120, 122, 163, 180, 266, 269b, 272, 272b, 273b, 274t, 294, 416, 423
retroperitoneal 472
severe 139
warning 145
Hemostasis 456
Hemostatic compression sutures 283
Heparin 367
unfractionated 262, 458
Hepatic failure 492
Hepatitis
B 200
C 200
Hernia, inguinal 753
Herpes
genitalis 584
simplex virus 247, 581
viral infection 257
High-grade squamous intraepithelial lesion 596, 597f, 604, 622
Hingorani's sign 520
Hip
bones 114
delivery of 76f
dislocation, congenital 181
Hirsutism 466, 749
management of 779fc
Histrelin 528
Hockey-stick incision 223
Hodgkin's disease 622
Hoffman's exercises 12
Home uterine activity monitoring 324
Hookworm
infection 435
infestation 420
Horizontal uterine incision 534f
Hormonal contraceptives 677
Hormonal influence, independent of 468
Hormonal replacement therapy 561
Hormonal therapies 677, 681
Hormonal treatment, use of 681
Hormone
adrenocorticotropic 340, 758, 804
antidiuretic 275
assays 497
receptor status 513
replacement therapy 238, 498, 507, 527, 561, 623, 636, 692, 806
effect of 567f
pills of 560f
therapy 554, 559
Hot flushes 555
treatment of 559
Hot Seitz bath, use of 562
Huhner test 764
Human chorionic gonadotropin 686, 718, 729, 730, 783
levels of 468
Human epididymis protein 700
Human fertilization 174
Human immunodeficiency virus infection 622
Human leukocyte antigen 258
Human menopausal gonadotropin 686, 774, 776, 807
Human ovarian tumors 686
Human papillomavirus 599, 600, 602, 610, 611t
high-risk 602, 619
infection, prevention of 611
test 613
use of 603
triage 602
vaccination 611
Hyaline membrane disease 337
Hydatidiform mole 227, 228, 238, 359
complete 227f, 229f
Hydralazine 376378, 445, 449
side effects of 378
Hydramnios 90, 158, 406
Hydrops fetalis 202, 203f
Hydrosalpinx
laparoscopic appearance of 760f
treatment of 774
Hyperandrogenemia 471
Hyperandrogenism 749, 757
biochemical 757
symptoms of 757
Hyperbilirubinemia 202
Hyperemesis gravidarum 180
Hyperextension 17f
Hyperglycemia 393, 403
maternal 408t
Hyperkalemia 790
Hypermagnesemia 380
Hyperosmolar nonketotic diabetic coma 388
Hyperplasia 507
benign endometrial 506f
trophoblastic 236f
Hyperplastic trophoblastic tissue, presence of 236
Hyperprolactinemia 246, 758, 788, 798, 807
Hyperreflexia 370
Hypersegmented neutrophil 430f
Hyperspermia 764
Hypertension 405
chronic 158, 355, 356, 358, 362, 365, 377t, 420
classification of 355, 358t
degree of 358
gestational 355358, 368, 369, 369b, 447
postpartum 380
pregnancy induced 361
primary pulmonary 460
pulmonary 333
refractory 375
severe 355, 376t
pulmonary 460
treatment of 231
Hypertensive diseases 362
Hypertensive disorders, classification of 356fc, 356t
Hyperthermic intraperitoneal chemotherapy 711
advantages of 711b
Hyperthyroidism 231
symptoms of 231, 256b
Hypertriglyceridemia 317
Hypertrophic decidual vasculopathy 359, 361f
Hypertrophy, myometrial 739
Hyperviscosity syndrome 317
Hypocalcemia 317, 380
Hypoechogenic mass 552f
Hypofibrinogenemia, risk for 350
Hypogastric artery ligation 285
Hypoglycemia 317
development of 403
increased risk of 405
risks of 400
Hypoglycemic therapy 396
Hypogonadism 752
hypergonadotropic 802
hypogonadotropic 802
Hypogonadotropic hypogonadic state 678
Hypoinsulinemia 317
Hyponatremia 790
Hypopituitarism 807
Hypoplasia, pulmonary 337
Hyporeflexia 380
Hypospermia 764
Hypotension 141, 493, 717
prevention of 214
sudden 377
Hypothalamic amenorrhea 793, 807
causes for 793
Hypothalamic pituitary disease 754
Hypothalamus 470
level of 799
normal functioning 792
Hypothermia 317
Hypothyroidism 246
maternal 246
Hypotonia 380
Hypovolemic shock 294
evidence of 717
Hysterectomy 155, 153f, 238, 530, 531, 531f, 532, 549, 617, 655b, 656, 679, 683, 744
advantage of 531
disadvantages of 531b
extrafascial 631
indications for 531b, 656b
obstetric 288
technique of 532
total abdominal 507, 688
types of 633f
Hysterogram 225
Hysterosalpingo-contrast sonography 766, 769
Hysterosalpingogram 765, 765f, 766, 775
normal 765f
Hysterosalpingography 259, 485
Hysteroscopic myomectomy 526, 530, 532, 533, 537, 538b
indications for 537b
Hysteroscopy 260, 505, 537f, 767
operative 261
Hysterotomy 541f
closure 540
I
Idiopathic preterm labor 321
Idiopathic thrombocytopenic purpura 496
Iliococcygeus 645
Imidazoles 578
Immature teratomas 689
management of 696
Immunity 622
Immunization 25
Immunoassay 583
Immunodeficiency 578
Immunoglobulin 439
Immunohistochemistry 510
Immunological defects 668
Immunological tests 584
Immunosuppressive agents, use of 578
Imperforate hymen 797, 797f
In vitro fertilization 261t, 299, 684, 725, 780, 781, 786
Inadequate trophoblastic invasion 359, 361f
Incision over uterine surface 540
Increta 153, 283
Indigo carmine dye 768
Indirect antiglobulin test 193f
Indomethacin 332, 406
Induction theory 668
Infections 140, 155, 226, 265, 268, 319, 337, 544, 550, 599, 618
duration of 588
recurrent 436
screening for 26
spread of 320b
Infectious disease 256
Inferior mesenteric artery 512
Infertile couple
evaluation of 762
management of 772b
workup of 762b
Infertility 465, 466, 468, 552, 618, 680, 693, 749, 750, 761t, 793, 808
causes of 680, 732, 749t, 761, 764
duration of 750
evaluation of 768
female causes of 750f
mechanisms for 680b
primary 750
secondary 750
tubal factors of 773
type of 750
unexplained 780
Inflammation 756
Inflammatory cells 756
Inflammatory mediators, role of 391
Inflammatory pelvic masses 674
Inguinal lymph nodes, develop enlargement of 587
Inguinofemoral nodes 623
Injury 86, 157
Insulin 407
glargine 398
infusion, low-dose 403t
injection 400f
sites for 400
preparation, types of 398, 398t
resistance 777
sensitizing agents, use of 265
therapy 397
types of 398
Interleukin 319, 425, 708
Intermenstrual bleeding 518
causes of 518b, 623b
Internal anal sphincters, repair of 290
Internal artery ligation, time of 286f
Internal ballottement 7, 7f, 231
Internal iliac artery 287f
ligation 287f, 294
Internal podalic version 94, 174
complications 96
technique of 95f, 179
Internal radiation therapy 634
Internal sutures, placement of 655f
Interstitial brachytherapy 635
Intervening membrane 173f
Intestinal glands 690f
Intra-abdominal tumor 473, 694
Intra-amniotic dye injection 335
Intracavitary brachytherapy 634
Intracavitary fibroid 524f
Intracytoplasmic sperm injection 785, 786f
Intraepithelial lesions, high-grade 599
Intraepithelial neoplasia 598, 626
Intramural fibroid 523f, 524f
Intramuscular injection 379
Intranatal period 440
Intrapartum antibiotic prophylaxis 456
Intrapartum care 76, 456
Intrapartum management 78fc, 105, 176fc, 198, 210, 329, 344, 384
Intrapartum monitoring 211
Intrapartum period 149, 176, 195, 313, 371, 402, 440
Intraperitoneal chemotherapy 709
Intraperitoneal transfusion 200
Intrathoracic tumors 203
Intrauterine abnormalities 485
Intrauterine adhesions 485
visualization of 249f
Intrauterine clots 159
Intrauterine contraceptive device 496, 497, 726
removal of 546
Intrauterine death 158, 315, 339, 348, 349, 402, 406
causes of 348, 348t
prevention 349
Intrauterine device 491, 504, 515, 581, 767
Intrauterine embryo transfer 784
Intrauterine fetal death 408
evaluation of 349t
Intrauterine gestation 720
Intrauterine gestational sac 719, 720
Intrauterine growth restriction 28, 74, 178, 295, 297, 304, 312, 316, 317, 345, 360, 371, 374, 381, 410, 553
classification of 296f
diagnosis of 300
fetuses, management for 315fc
management of 300
Intrauterine infection 320b, 334, 594
chronic 299
Intrauterine insemination 765, 773b, 778
Intrauterine pregnancy 10t, 22f, 718, 719, 789
abnormal 720
signs of 720
Intrauterine procedures 195
Intrauterine transfusion 197
blood for 200
Intravascular blood transfusion 200
Intrinsic factor, deficiency of 426f
Introitus 37
Invasive cancer 629
management of 624
Invasive carcinoma 626
Invasive cervical carcinoma, treatment of 630t
Invasive epithelial ovarian cancers, types of 686
Invasive hemodynamic monitoring 375
Invasive placenta 268
Invasive squamous cell carcinoma, histopathology of 598f
Inverted T-shaped incision 223
IOTA simple rules 700
Iron 417, 436f
absorption 434b
deficiency 423, 430
deficient diet 422
dextran injections, use of 439
folic acid supplementation 436
formulations 437t
medication 437b
metabolism 430
normal 431f
parenteral forms of 437
polysaccharide 437
requirements 422t
rich foods 434
salts 437
stores
depletion of 423
recovery of 422
studies, serum 430
sucrose 436, 438
supplementation 434, 436
exogenous 435
therapy 432, 433b, 439
Irregular bleeding 499f, 500f, 529
Irritable bowel
disease 674
syndrome 666
Ischial spine 47, 644
assessment of 47f
Isoflavones 563
Isometric exercise test 367
Isoxsuprine 333
Isthmus extension 513
Itching 589
Itraconazole 578
J
Jacquemier's sign 8, 8f
Jaundice 189
development of 201
Jejunum 424
Jello sign 159
Joel-Cohen blunt incision 215
Johnson's method 292, 292f
Joshi's sling 659
J-shaped incision 223
K
Kahn's test 588
Kallmann syndrome 754
Kangaroo care 330f
Kaolin clotting time 254
Karman's cannula 138
Kegel exercises 652
Keratin pearls 621f
Ketoacidosis 403
Ketosis prone 388
Khanna's sling surgery 659
Kidney
disease, chronic 362
function test 366, 383, 524, 729, 730
injury, acute 356
transplant 622
Kielland's forceps 109
Kissing ulcers 587
Kleihauer–Betke test 190, 191f
Klumpke's palsy 415
Knee jerks 365
Koilonychia 420f
Kuppuswamy's socioeconomic scale, modified 6t
Kyphosis, maternal 101
L
Labetalol 376, 377, 381
Labia majora 37
Labor 37, 351
abnormal progress of 61
active management of 269
classification of 33t
dysfunctional 440
dystocia 62
failure of progress of 118
first stage of 31, 105, 118, 440
fourth stage of 270
induction of 54, 59, 59b, 59t, 118, 314, 350, 402t, 456
initiation of 340fc
management in 402
mechanism of 92
normal 51, 52f
onset of 109
pain
false 36, 36t, 340
true 36, 36t
premature 180
prolonged 60, 122
second stage of 106, 118, 440
spontaneous onset of 350
stage of 32t, 33f, 75
third stage of 31, 179, 269, 270, 440, 457
triad of 72, 117, 118t
Lactate dehydrogenase 689
Lactic acidosis 388
Lambda sign 174
Lambdoid suture 48
Laparoscopic assisted vaginal hysterectomy 531, 664
Laparoscopic examination 260, 723
Laparoscopic excision 683f
Laparoscopic myolysis 526
Laparoscopic myomectomy 535, 535f, 536, 536b
advantages of 535, 536b
complications of 536, 536b
safety of 532
Laparoscopic ovarian drilling 777, 778, 779f
Laparoscopic salpingectomy 735
procedure of 735f
Laparoscopic salpingotomy 736f
Laparoscopic surgery 679, 682, 732, 733b, 735
advantages of 733b
Laparoscopic uterine
artery ligation 544
nerve ablation 684
Laparoscopy 618, 674, 679, 731, 762, 768, 773
role of 705
Laparotomy 211, 618, 679, 731, 733
emergency 737
exploratory 703
indications for 733b
Laryngopharynx 419
Laser
ablation 614
selective 184
cervical conization 616f
excision 615
Lash procedure 250, 265
Lasofoxifene 744
Last menstrual period 299
Latent syphilis 588
Late-onset fetal growth restriction, diagnosis of 295
Latex agglutination test 581
Laurence–Moon–Biedl syndrome 754
Le Fort colpocleisis 660
indications for 661
Lecithin 150
Lee-Frankenhãuser plexus 684
Left ischial spine, assessment of 116f
Left low uterine vessel ligation 287
Left mentum 18
anterior 18, 21
transverse 18
Left ventricular ejection fraction 460
Leg elevation 222
Leiomyomas 482, 515, 516f, 518, 530, 741, 755
management of 532, 532b
types of 516f
Leiomyomatosis, cutaneous 519
Leiomyosarcoma 551, 552f, 621
Leopold's maneuvers 1719, 20f, 66f, 67, 90, 90f, 91
Lesions 590
recurrent 636
types of 452
Letrozole 774, 776, 778
advantages of 780b
Leukemia 425
Leukomalacia, periventricular 315
Leukoplakia 609
Leuprolide 678, 777
acetate depot 528
Leuprorelin 528, 782
Levator ani muscle 644, 645, 645f, 646f
Levonorgestrel-releasing intrauterine system 506, 507, 529, 678, 743
Leydig cells 688
Lidocaine 458
Ligase chain reactions 583
Ligatures, placement of 288f
Light-headedness 450
Limbs, lower 76f, 114
Lincosamides 577
Linea nigra 12, 13f
Linear salpingostomy 732
Lipoprotein
high-density 554
low-density 554
Liquid-based cytology 605, 606f, 607f
Liquor
adequacy of 67
amount of 34, 35t
meconium staining of 344b
Lithotomy position 476
Liver
dullness 473
function 381, 497
test 366, 371, 383, 385, 729, 730
Glisson's capsule of 363
Longitudinal vaginal septum 795f
Loop electrosurgical excision procedure 250, 616, 616f
Løvset's maneuver 80, 83, 84f
Low birth weight babies 594
Low uterine vessel ligation, right 287
Low vascular resistance, pregnancy induced 442
Lower genital tract 591t
infection 334
assessment of 324
Lower oculocerebral syndrome 754
Lower uterine segment 36, 143, 283
Low-grade squamous intraepithelial lesion 597f, 604
treatment of 617b
Low-molecular-weight heparin 262, 316, 367, 442, 458
Lugol's iodine 600, 604, 606f
application of 609
Lumbar vertebra 796
Lump, presence of 694
Lungs 242
hyperexpanded areas of 347f
Lupron 678
Lupus anticoagulant 252, 255
testing for 259
Luteal phase defect 246, 768
treatment of 261
Lutein cells 688
Luteinizing hormone 527, 757, 758, 762, 776, 805
hypersecretion of 246
Lymph node 514, 625, 707
enlargement 624
involvement 638t
metastasis 513
regional 699
sampling 511
Lymphadenectomy 512, 632, 688
indications for 512fc
levels of 634t
Lymphadenopathy 471, 623
Lymphatic spread, metastatic theory of 668
Lymphedema 637
Lymphogranuloma venereum 586, 599
Lymphoma 425
Lymphovascular space 511
invasion 510, 513, 629, 631
Lynch syndrome 493f, 494, 494fc, 692
genetic screening of 493b
M
Macroadenomas 798
Macroalbuminuria 396
Macrosomia 209, 345, 408
causes of 409b
development of 409f
management of 409
Magnesium
levels of 379
sulfate 330, 332, 375, 378, 379t, 380, 382, 386
dose of 380
mode of action of 378
regimens 379
use of 333b, 378
Magnetic resonance imaging 239, 801, 804
examination 485
Malaria 420, 435, 716
Male genital organs 752
Male infertility
causes of 754, 754t, 762
treatment of 771, 772fc
Malena 419
Malignancy 465, 482, 485, 521
detection of 685
diagnosis of 623
high clinical suspicion of 530
index, risk of 701, 702b
suspicion of 551
symptoms suggestive of 589
Malignant ovarian tumor, management of 696
Malignant transformation, increased risk of 619
Mammalian cells 776
Manchester method 635f
Manchester repair 656, 657
procedure for 657, 659f
Marfan's syndrome 453, 456, 460
Mari's chart 199t
Marijuana 761
Martin classification 385t
Mass
abdominal 465, 472
bilateral 473
cancerous 686f
causes of 495b
classification of 701t
consistency of 473, 694
extrapelvic 685
intra-abdominal 473
margins of 472
Massive transfusion protocol, activation of 281
Mastodynia 7
Maternal cardiovascular hemodynamic status 297
Maternal chromosomes, set of 228
Maternal complications 88, 96, 180, 203, 334, 337, 406
Maternal death 162, 374, 407
Maternal early warning score 270t
Maternal fetal medicine unit 208
Maternal mirror syndrome 203
Maternal mortality rate, high 440
Maternal pelvis 42, 44f, 45f
anterior rotation of 43f
Maternal perineum 411f
Maternal placental syndromes 447
Maternal serum 191
creatine kinase 723
Maternal spiral arterioles, maladaptation of 359
Maternal syndrome 360
Maternal vitals, monitoring of 374
Maternal weight 372
record 340
Maternal wellbeing, optimization of 62
Mature teratomas 689
histological picture of 690f
Mauriceau–Smellie–Veit maneuver 75, 81, 82f
Mayer–Rokitansky–Küster–Hauser syndrome 795, 795f, 806
McCall's culdoplasty 655, 655f
McDonald cervical cerclage 263
McDonald procedure 250, 263, 263f
McIndoe's vaginoplasty 806
McRoberts maneuver 411, 412, 412f
Mean corpuscular hemoglobin 425, 429
concentration 418, 425, 429
Mean corpuscular volume 418, 425, 427429
Meconium
aspiration 346f
consequences of 347f
syndrome 317, 344, 346, 347f
staining 346
Medical disorders, presence of 30
Mefenamic acid 527
Megaloblastic anemia 425, 426, 430, 430f
pathogenesis of 426f
Meigs’ syndrome 688
Melasma 11f
Membranes
artificial rupture of 161, 342
assessment of 39
management of premature rupture of 336fc
premature rupture of 319, 322, 334, 594
preterm
premature rupture of 208, 406, 618
ruptures, bag of 78
stripping of 341
sweeping 343
Mendelson syndrome 403
Menometrorrhagia 533
Menopausal hormone therapy 554, 559, 561b, 562, 562b, 566, 569b, 693
use of 560, 561t
use of 562
Menopause 554, 562
anatomical changes 555
clinical presentation 555, 557
effects of 557f
etiology 555
hormone therapy 559
physiology of 559
premature 554, 637, 712
treatment of 559, 563f
Menorrhagia 486, 521, 530, 744
treatment of 527b
Menstrual bleeding 792
abnormal 465, 466
pathophysiology of 792
Menstrual blood loss, estimates of 489
Menstrual calendar 526
Menstrual cycle 669, 693, 767, 768, 771
anovulatory 490, 490t
infrequent 751
irregular 751
middle of 468
normal 468, 469f
ovulatory 490, 490t
phases of 546f
regular 751
regulation of 468
Menstruation
cessation of 6
ectopic 466
physiology of 468
Mentum, anterior rotation of 111
Mentzer's index 424
lower 424
Mesenchymal tissue, tumors of 621
Mesosalpinx 734
Metabolic acidosis 122
Metabolic disorders 203
Metaplasia 514, 596, 712
squamous 609
Metastasis, pulmonary 236f
Metastatic disease 235
low-risk 240
treatment of 240
Metformin 265, 398, 399, 780, 790
adverse effects of 780
use of 399
Methergine 274, 440
Methotrexate 240, 241, 727, 729731
adjuvant therapy, use of 155
administration 731b
multidose regime 730b
single-dose 729, 730b
therapy 729b
Methyldopa 369, 377
Methylergometrine 274, 275
Methylergonovine, dose of 275
Metoclopramide 407
Metoprolol 381
Metronidazole 121, 274, 576, 577, 581, 594
Metrorrhagia 486, 740, 744
Miconazole 578
Microadenomas 798
Microalbuminuria 396
Microaneurysm 407
Microcolon, congenital 408
Microhemagglutination assay 588
Micronized progesterone 803, 807
Micronormoblastic erythroid hyperplasia 432
Microseptostomy 184
Microsurgery 773
Microvillous cells 470
Micturition, frequency of 8
Middle cerebral artery 301, 304, 305, 306f, 314, 371
Doppler studies 306
index of 300
peak systolic velocity 183, 197, 199, 200
Midpelvis 47
assessment of 40
contraction 112
diameters of 47
Mifepristone 350, 529, 731
Migraine 254
Mild placental abruption 160, 162
Minimal small incisions 538f
Minimum invasive surgery 634, 731
Mirena 560
Miscarriage 139, 180, 250, 750, 788
causes of 252f, 253f
previous 256
recurrent 256, 258fc, 260, 261t, 467
spontaneous 195
threatened 195
Misgav Ladach technique 222
Misoprostol 274, 276, 350, 384, 451
dosage of 351t
Mitral balloon valvotomy, percutaneous 447
Mitral regurgitation 445
Mitral stenosis 445, 446f, 447, 453, 460
Mitral valve disease 443
Mixed epithelial tumors 687
Mixed gonadal dysgenesis 798
Mixter's forceps 287f
placement of 287f
Molar gestation
pathophysiology of 229f
signs in 230b
symptom of 230, 230b
Molar pregnancy
complete 236f
management of 233fc, 237
Molding
diagnosis of 40
grading degree of 40
Molecular markers 510
clinical significance of 511t
Molecular tumor markers 514
Moles, complete 228t, 233
Monilial infection 577
Monoamniotic monochorionic
monozygotic twin pregnancy 167
twins 172f
Monochorionic diamniotic twin 173f
gestation 178
Monochorionic monoamniotic twin 173f
gestation 178
Monochorionic multifetal gestation, complications of 175
Monochorionic twins
diagnosis of 171
management of 171
Monozygotic twin 167, 167t, 168f, 181
formation of 168f
gestation 186
pregnancy
diamniotic dichorionic 169f
diamniotic monochorionic 169f
monoamniotic monochorionic 169f
types of 167, 168f
Monsel's paste 609
Morcellation 540
Morison's pouch 722
Morphine sulfate, administration of 449
Morphological uterus sonographic assessment 742f
Morphology 763
Morris waste space 48, 48f
Moschcowitz culdoplasty 655, 655f
Motile trichomonads 581
Mucinous cystadenoma 688, 700f, 703f
Mucinous tumors 687, 688
Müllerian agenesis 795, 808
Müllerian anomalies 247
Müllerian defects 485
Müllerian inhibiting substance 797
Müllerian remnants 796
Müllerian rests 668
Müllerian structures 795, 798
Müller–Munro Kerr method 115
Multidose methotrexate regimen, protocol for 730
Multifetal gestation 90, 158, 166, 168, 181b, 789
clinical presentation 169
general physical examination 169
Multifetal pregnancy 275
reduction 789
procedure of 174
Multigravida 4
Multimodal spectroscopy 609
Multipara 4
Multiple drug allergies 439
Multiple gestation 145, 178t, 231, 367
Multiple placentas 172
Multiple pregnancy 204, 334, 359, 787
complications of 180
iatrogenic 788
risk of 789
Multiple prosthetic valves 458
Multiple subserosal fibroids 531f
Multiple uterine 519
fibroids 521
Muscle, abdominal 472
Musculoskeletal disease 666
Mutation 494
analysis 510
Myasthenia gravis 333, 380
Mycobacterium tuberculosis 247
Mycoplasma 256
genitalium 573
hominis 319, 575
Myelitis, transverse 254
Myeloma 425
Myocardial infarction 388, 450, 458
acute 448
Myolysis 541
Myoma 516, 526, 530b, 535f, 696
coagulation 541
enucleation of 540
large 533
location 540
removal of 532, 540
shelling out of 541f
Myomectomy 465, 525, 530, 532, 533, 533b, 756
abdominal 533, 534f, 539, 539b
immediate 533
indications for 532b
principles of 532
route of 526
type of 533
Myometrial invasion 513
depth of 511
Myometrium 242, 740f
hyperplastic 740
mottled texture of 742f
placental invasion of 153f
thickness of 287
upper segment of 275
N
Naegele's obliquity 53f
Naegele's pelvis 112, 113f
Naegele's rule 3
Nafarelin 528, 782
Nasopharyngeal symptoms 419
National Anemia Prophylaxis Program 435
National Chlamydia Screening Programme 583
National Diabetes Data Group Criteria 394t
National Health Service Cancer Screening Programme 601
National Health Service Trusts 393
National High Blood Pressure Education Program 377
Necator americanus 431
Necrotizing enterocolitis 318
Necrotizing fasciitis 550
Neglected arm prolapse, consequences of 97fc
Neisseria gonorrhoeae 136, 256, 335, 573, 583
Neoadjuvant chemotherapy protocol 710
Neonatal complications 317, 334, 337, 460
Neoplastic ovarian growths, histological classification of 687b
Neoplastic tissue 609
Nephropathy, diabetic 407
Neural tube defects 181, 408
Neurological injury 416
Neurontin 559
Neuropathic origin, pain of 665
Neuropathy, diabetic 407
Neuroprotection 333
Nifedipine 331, 332, 376, 377, 381
Nile blue sulfate 335
Nitrates 449, 458
Nitrazine paper test 335
Nitric oxide 361
donors 332, 333
Nitroglycerin 376
Nocturnal leg cramps 419
Nodular endometrial lesions 682f
Nodules, pulmonary 236f
Nonadherent placenta 292
Nonendometrioid endometrial cancer 509, 510
Nonepithelial cell tumors 621
Nonepithelial ovarian cancer 686
Nonimmune hydrops, causes of 203t
Nonmetastatic disease, treatment of 240
Nonpolyposis colorectal cancer, hereditary 492, 494
Nonprostaglandin methods 211
Nonrapid eye movement, average period of 310
Nonreactive nonstress test, implications of 310
Nonreassuring fetal heart rate pattern 337
Nonresectoscopic endometrial ablation techniques 548
Nonsexually transmitted bacteria 715
Nonsteroidal anti-inflammatory drugs 221, 501, 525, 527, 676, 743
Nonstress test 27, 28, 175, 302, 304, 309, 311, 342, 343, 371
procedure 309
Nontreponemal tests 588
Nontubal ectopic pregnancy
diagnostic criteria for 724
treatment of 736
types of 724
Norepinephrine reuptake inhibitors 559
Normal cervical squamous epithelium, transformation of 598f
Normal uterine artery 305f
blood flow 305f
Normocytic anemia 421
causes of 421
Normozoospermia 764
Novasure device 549f
Novel angiogenesis inhibiting agents 710, 710t
Nuchal arms 79
Nuchal arms, delivery of 80f
Nuchal translucency, measurement of levels of 22f
Nuclear factor kappa B
cells 319
ligand 567
Nucleic acid amplification test 583, 586
Nulligravida 4
Nullipara 4
Nulliparity 362, 494
Nulliparous prolapse, management of 651
Nutrition 24, 613
Nystatin 578
dose of 578
O
O'sullivan's method 292
Obesity 256
Obliterative procedures 660
Obstructed labor 64, 96, 97f, 112, 120
diagnosis 121
etiology of 121, 122t
management 121
Obstructive pulmonary disease 752
Occipitoposterior position 17f, 99
clinical presentation 102
development of 100
general physical examination 102
investigations 103
management 103
maternal complications 109
obstetric management 103
specific systemic examination 102
treatment 103
Offensive vaginal discharge 499f
Oligoasthenoteratozoospermia 764
Oligohydramnios 309, 349, 373
causes of 35
Oligomenorrhea 486
Oligospermia 761
Oligozoospermia 764
severe 763
Oliguria 363
Omental metastases 694
Oncovin 241
Oocyte 750, 784
aspiration, excess 789
classification 784
cryopreservation 789
donation 787
indications for 787
insemination 781f
retrieval 783
Oogenesis 756
Oophorectomy 632, 683
bilateral 683
Operative delivery 268
Optimal cytoreduction 707
Oral antiviral medications 584
Oral contraceptive
agents 528
pill 525, 573, 676, 693
form of 491
use of 590
Oral estrogens 807
Oral glucose tolerance test 257, 394f, 394t
Oral hypoglycemic agents 399
Oral iron
dose of 437
salt 437
therapy 438b
failure of 433b
Oral metronidazole 577
Organ transplant 622
Organic cardiac disease 275
Organisms, anaerobic 140
Orgasmic disorders 466
Ornidazole 577
Osada procedure 744
Osiander's sign 8
Ospemifene 564, 744
oral tablet of 562
Osteochondral junction 114
Osteomalacic pelvis 112, 113f
Osteopenia 565
Osteoporosis 262, 554, 556, 564, 566f, 567f, 807
complications of 564
development of 565b
diagnosis of 564
maternal 459
postmenopausal 564
prevention of 562, 564, 567b
treatment 559
Ouahba's technique 285
Ova, stool examination for 430
Ovarian cancer 685, 686, 691, 692t, 693b, 705, 711, 712, 712b
grading of 705
high-grade 708
management for 696
moderate 708
risk of 702
screening for 705
serous 510
spread of 692f
syndrome, hereditary 692
types of 691
Ovarian cycle 468
Ovarian cyst 468, 482, 551, 698fc, 700f
development of 529
excision of 467
ruptured 724
simple 697fc
Ovarian endometrioma 674
Ovarian factor 769, 776fc
infertility 756
treatment of 774
Ovarian function, evaluation of 805
Ovarian hilum 788
Ovarian hyperstimulation syndrome 770, 775, 778, 780, 788, 789, 789f, 790t, 791fc
complications of 791
management of 790, 791fc
pathogenesis of 790
signs of 790
Ovarian malignancy 703, 708
presence of 685
risk of 702
screening for 705
spread of 691
Ovarian masses 685
Ovarian neoplastic growth, types of 686
Ovarian pregnancy 726b, 737
Ovarian stimulation 785
Ovarian torsion 788
Ovarian tumors 231
borderline 688
different types of 696
epidemiology of 685
histogenesis of 686
Ovarian volume 770
Ovary 557, 680
dermoid cyst of 689
disorders of 797
mesothelium of 686
mucinous cystadenoma of 688
normal 792
functioning 792
left-sided 235f
postmenopausal 557
removal of 637
right-sided 235f
thyroid tumor of 690
Ovasure test 702
Overdistended uterus 268
Ovulation 470
disturbances of 553
induction 265, 790
medicines 768
prediction kit 770
trigger 777
Ovulatory bleeding 490
Ovulatory disorders 756
classification of 757t
Ovulatory dysfunction 487, 749
causes of 756
Ovum
death of 726
fertilization of 781f
Oxidative stress 368
Oxidized cellulose 806
Oxygen
dissociation curve 419f
sigmoid shape of 418
hemoglobin for 418
transportation of 417f
Oxytocin 63, 106, 274, 275, 384, 440
administration of 276
antagonists 332
infusion 350
contraindication of 106b
use of 237
P
Packed cell volume 428
Paclitaxel 242, 511
Pain 518, 669
abdominal 99, 157, 193, 230, 374, 466, 500f, 594, 716, 727
acute 518b
aggravating factors for 466
anginal 453
chronic 544
diagnosis of 666
duration of 669
epigastric 370
exact site of 466
following treatment 731
intensity of 466
killers, use of 291
localization 669
lower back 648
nature of 466
persistent 544
radiation of 466
relieving factors for 466
severe abdominal 211
severity of 669
treatment of 666
Painless bleeding, episode of 143
Pallor 10, 495
development of 420fc
PALM COEIN classification system 487
Palmer's sign 8, 9
Palpation 171
abdominal 13, 66, 90, 102, 299, 300, 341
Pancreatic beta cells 399
Papanicolaou smear 485, 504, 524, 599, 600, 604, 606, 762
abnormal 594, 596
examination 558
kit 600, 600f
previous 491
history of 750
Papanicolaou stain 601
Papanicolaou test 485
Papilledema 365
Para-aortic lymph node dissection 509
boundaries of 512
Para-aortic lymphadenectomy 512, 632
Paracervical block 767
Parametritis 139, 618
Paraneoplastic syndrome 694
Parathyroid hormone levels 565
Parental prostaglandins, administration of 276
Parenteral iron 438
therapy 436
use of 438b
use of 439, 440b
Parietal bone, anterior part of 105
Parietal peritoneum 217f
Paroxetine 559
Paroxysmal nocturnal dyspnea 450
Partial hydatidiform mole 229f
diagnosis of 227
Partial mole 228t, 235
pathophysiology of 228
Partogram 54
Patau's syndrome 175
Patent ductus arteriosus 449
Paterson-Kelly syndrome 421
Pathological vaginal discharge 573, 590
causes of 573t
Patwardhan's method 120
Pawlik's grip 18
Pedal edema 11f, 421, 421f, 623
Pedicle, torsion of 550
Pelosi's technique 222
Pelvic abscess 618
Pelvic adhesions 674, 715
Pelvic anatomy, normal 483, 484f
Pelvic assessment 40, 116f
Pelvic blood vessels 282f, 286f
Pelvic bones 114
Pelvic brim 67
boundaries of 44f
Pelvic cavity 35f, 46, 768
diameters of 46
Pelvic diaphragm, muscles of 644, 645f
Pelvic endometriosis, clinical features of 670
Pelvic examination 64, 115, 257, 474, 476, 476b, 495, 520, 542, 590, 649, 671, 695, 717, 740, 753, 794
components of 476
indications of 115
prerequisites for 115
Pelvic exenteration 635
Pelvic floor
deep perineal muscles of 644
exercises 652
muscles of 644, 645f, 647f
superficial muscles of 644, 645f
Pelvic grip
second 18
third 103f
Pelvic hemorrhage 242
Pelvic infection 715, 751
Pelvic inflammatory disease 496, 582, 594, 618, 669, 692, 717, 760
acute 573
Pelvic inlet 43, 76f
assessment of 40
contraction 112
diameters of 44
oblique diameters of 46
superior view of 46f
transverse diameter of 45
Pelvic lymph node dissection, boundaries of 512, 513t
Pelvic masses 651, 685
Pelvic organ 473
prolapse 466, 468, 556, 641, 651, 651t
evaluation of 641t
surgery for 654
Pelvic outlet 43, 46
assessment of 40
diameters of 46
evaluation 116f
Pelvic pain 465, 527, 665, 665, 670, 671f
chronic 665
early acute abdominal 544
severe 684
Pelvic pathology
diagnosis of 674
surgical treatment of 782
Pelvic prolapse 466
quantification of 649, 650f
Pelvic radiation 793
Pelvic scar tissue 715
Pelvic sepsis 242
Pelvic ultrasonography 762
Pelvis 42f, 113f, 751, 768f
deep infiltrating endometriosis of 684
false 42
laparoscopic visualization of 779f
true 43
types of 43t
ultrasound of 232
Percreta 153, 283
Pereira technique 285, 285f
Perianal area 584
Perigee system 663f
Perinatal deaths, previous 5
Perinatal morbidity 347
Perinatal mortality 72, 344, 347, 618
Perineal body 644, 645, 650f
attachments of 646f
Perineal injury
repair of 289
severe 347
Perineal tear 645, 652
degrees of 289f
first degree 289f
fourth degree 289f
second degree 289f
third degree 289f
Perineum
central tendinous point of 645
female 644f
Peripartum cardiomyopathy 448, 448b, 453
Peripheral smear 165f, 385, 426, 427, 429, 430, 430f, 521
Peritoneal defects 760
Peritoneal incision 215f
Peritoneum 216, 697
closure of 220f
Peritubular adhesions 732
Perrault syndrome 798
Persistent corpus luteum cysts 767
Persistent disease
ruling out presence of 238
treatment of 239
Pessary, use of 653b
Petechiae 365
Pethidine 380
Pfannenstiel incision 216f
closure of 220f
sharp 215
Phenergan 380
Phenytoin 380
use of 380
Phosphatase 492, 494, 506
Phosphate 407
Phytoestrogens 563
Pictorial blood loss assessment chart 489, 489f
Pinard's maneuver 85, 85f
Pitocin overdose 122
Pituitary gland 527
normal functioning 792
Piver-Rutledge classification 633t
Placenta 143, 154, 273, 292
accreta 153155, 225t, 283
spectrum, diagnosis of 154
delivery of 179, 219f
exact site of 349
fundal implantation of 267
increta 153f, 154f
large 268
manual removal of 293, 293f
normal 155f
percreta 154f
previa 142, 143, 143f, 144, 145, 149b, 150fc, 151, 151b, 158, 159, 159t, 225, 268, 293, 374
degrees of 143
diagnosis of 146, 147
low-lying 144f
marginal 144f
partial 144f
presence of 78
risk of 145, 225t
total 144f
region of 227
rending asunder of 155
Placental abruption 147, 155, 155f, 156, 158, 159t, 160, 160f, 246, 447
clinical classification of 156, 156t
concealed type of 157f
diagnosis of 159
pathophysiology of 156fc
prevention of 149, 160
severe cases of 160
signs of 157
symptoms of 157
treatment 160
types of 157, 157f
Placental alkaline phosphatase 689
Placental alpha macroglobulin 336
Placental disease 297
Placental function 296, 345fc
Placental insufficiency 296, 348
Placental perfusion 367
Placental separation, degree of 157
Placental site trophoblastic tumor 243
Placental syndrome 359
Placental tissues
develop 227
exact site of 349
Plantar flexion 222
Plasma
antibody 187
cell endometritis 594
glucose value 393
protein-A 299, 315
volume 443
Plasmapheresis 387
Platelet
activation of 254
count 231, 366, 370, 521
low 360, 373, 374
measurement of levels of 231
derived growth factor receptors 710
Platinum resistant disease 711
Plummer-Vinson syndrome 421
Pneumothorax 347f
Poikilocytosis 429
Poliomyelitis 114
Polycystic ovarian syndrome 245, 246, 265, 468, 491, 494, 515, 692, 756, 757, 758, 776, 778, 780, 787, 798, 801, 807
pathophysiology of 758fc
treatment of 777
Polycystic ovary 767
bilateral 759f
disease 493
Polycythemia
blood tests for 404
secondary 518
Polyembryoma 687
Polyhydramnios 114, 180, 185, 192, 267, 309, 334, 406
causes of 35
Polymaltose 437
Polymerase chain reaction tests 581
Polypoidal cancerous growth 704f
Polypropylene tapes 662
Polyurethane condoms 562
Polyvinyl alcohol 542
Pop-Q staging system 649, 650, 650f, 651t
Population-based screening program 603
Porcine dermis 662
Porcine small intestine submucosa 662
Positron emission tomography 485, 702
Postcoital bleeding 619
causes of 623t
Postcoital test 764
Postdated pregnancy 339
management of 341
Postembolization syndrome 544
Posterior arm, delivery of 414, 414f
Posterior shoulder, delivery of 56f, 84
Posterior vaginal wall 641
mucosa 264f
points 650
Postmaturity syndrome 337
Postmenopausal age group 490
Postmenopausal bleeding 487, 495b
causes of 488t
evaluation of 508fc
Postmenopausal estrogen therapy 494
Postnatal jaundice, mild degree of 189f
Postoperative adhesions, prevention of 536f
Postpartum hemorrhage 63, 120, 122, 163, 180, 266, 269b, 272, 272b, 273b, 274t, 294, 416, 423
causes of 267, 267b
control of 457
etiology of 271
management of 271, 272fc
prevention of 270, 271
secondary 266, 294
severe 277
traumatic causes for 267
Postpartum period 195, 372, 381, 384
Postpartum pituitary necrosis 751
Postpartum sterilization 495
Postprandial glycemic control 399
Post-term pregnancy 340, 341, 343, 345fc 347, 347f
management of 341, 342fc, 343
Post-testicular defects 754
Potassium 407
chloride 731
hydroxide 576
preparation 593
Whiff test 593
Povidone iodine solution 766
Powder-burn lesions 682f, 760
Prader-Willi syndrome 754
Prague's maneuver 83f
reverse 83
Precipitate labor 64
complications 64
diagnosis 64
etiology 64
management 64
Preconception period 395, 396
Preeclampsia 158, 180, 204, 230, 242, 320, 355, 357t, 361f, 362, 362b, 365, 372, 381t, 406
atypical 356
clinical
classification of 358t
features of 355, 357f
complications of 381
etiopathogenesis of 358
increased risk of 362
management of 369, 371fc
mild 359t, 370
pathophysiology of 358, 359, 359t, 360fc
predictive tests for 367
presence of 447
recurrent 367
risk for 246
severe 275, 359t, 373, 373b, 374b, 375, 378, 382, 384b
symptoms of 363
treatment of 372
Pregnancy 11f, 30, 174, 231, 359b, 396, 396t, 399, 421, 443, 447, 452, 458, 458t, 470, 553, 584
abdominal 726b, 737
anticipation of 454
complications 553, 594
duration of 444f
early 231
ectopic 195, 482, 713, 713f, 714f, 715718, 718t, 719, 721, 721f, 723, 724, 728fc, 738, 767, 788
effect of 442
fatty liver of 180
first trimester of 6, 355
heterotopic 727b, 737, 789
hypertensive disorders of 180, 381
location of 722
loss 244t
recurrent 257, 530
second trimester 618
management of 300
medical termination of 453b, 467
monochorionic 173, 174f
normal 3
onterstitial 725b, 737
physiologic hemodilution of 428
physiological effects of 390
postmature 339
post-term 340, 341, 343, 345fc 347, 347f
previous 190, 321t
primary abdominal 726
related disorders 231
second trimester of 7, 355
symptoms suggestive of 491
test 21, 459, 592
therapeutic termination of 195
trimesters of 408t
triplet 178
Premarin 530
Premature birth 155
Premature ovarian failure 798, 807
Prematurity, retinopathy of 315
Prenatal folic acid 454
Presacral neurectomy 679
Pressure
intra-abdominal 647
symptoms, presence of 491
Preterm birth 85, 328
classification of 318t
severity of 318
Preterm delivery 618
risk of 321t
Preterm intrauterine growth-restricted fetus 316
Preterm labor 318, 321, 322b, 324f, 327, 330, 330b, 332t, 334, 334t, 337, 406, 594
absence of 406
advanced 322
clinical presentation 321
complications 334
differential diagnosis 322
early 322
etiopathogenesis of 318
investigations 322
management of 322, 323fc, 327
obstetric management 326
pathogenesis of 318, 319b, 319fc, 319t
prediction of 318, 322
presence of 406
prevention of 175, 326b, 328fc
risk factors for 319, 320f
surgical management 334
treatment 326
Previous miscarriages 256
number of 245
Primary amenorrhea 798f, 799b, 800
causes of 793f
evaluation of 800fc, 801fc
Primigravida 4, 65
management of 68
Primipara 4
Primordial prevention 610
Primrose 563
Procainamide 458
Progesterone 391, 491, 560, 723
absence of 796
only hormonal contraception 715
only pills 743
receptor modulators 529
therapy 328
use of 326
Progestin
challenge test 805
exogenous 528
role 326
Progestogen 527, 678
only pills 405
routine 261
Prolapse
degree of 649, 654
laparoscopic surgery for 663
pessary treatment for 652
surgery 661, 662b
symptoms of 648
uterus 641, 656b
third-degree 651
Prostaglandin 210, 276, 342, 343, 360, 384, 468, 731
E 319
E2 210, 319
F2 alpha 319, 340
preparations, role of 343
synthetase inhibitors 331, 332, 527
Prosthetic heart valve 458, 459
Prosthetic material
types of 662b
use of 661
Prosthetic mitral valve 458
Protamine zinc insulin 398
Proteinuria 364
grading of 365t
measurement of levels of 364
occurrence of 365
Prune juice 230
Pruritus vulvae 591
Pseudogestational sac 721t
presence of 721
Pseudohermaphroditism, male 796
Pseudo-Meigs syndrome 520, 550
Psychiatric disorders 670, 799
Pubertal development 794
Pubic hair
development 793
pattern 793
Tanner stages of 794f
Pubic symphysis 206, 412f
Pubocervical fascia 662f
Pubococcygeus 645
Puerperium 180
Pull method 118
Pulmonary artery
catheter 375
pressure monitoring 375
Pulmonary edema 374, 375, 381
clinical signs of 375
complications of 375
prevention of 457
treatment of 446b
Pulmonary maturity, assessment of 29
Pulmonary system, exact site of 474
Pulmonary valve stenosis 449
Pulmonary vascular obstructive disease 460
Pulsatility index 297, 301, 305, 314
Pulse 450
dosage radiotherapy brachytherapy 635
oximetry 456
Pure gonadal dysgenesis 797
Push method 119
Pyelography, intravenous 524, 703
Pyometra 285
Q
Quadrivalent gardasil 611
Quadrivalent vaccines 611
R
Radiation
abdominal 793
therapy 634, 708
primary 631
Radical hysterectomy 633t, 637, 637t
modified 629
type of 633
Radical surgery 684
Radical trachelectomy 631b
Radio-femoral delay, presence of 450
Radiologic pelvimetry 117
Radiotherapy 634b, 637
Raloxifene 530, 564, 744
Rapid plasma reagin 257, 588
Rapid-acting insulin analogs 398
Rash, development of 439
Raw uterine walls 797
Reactive nonstress test, implications of 310
Reactive oxygen species 360
Rectal bleeding 694
Rectocele 643f
Rectosigmoid colon 637
resection of 706
Rectovaginal fistula 416, 573, 637
Rectovaginal septum 669, 672
Rectus sheath, closure of 219, 220f
Recurrent miscarriage 256, 258fc, 260, 261t, 467
causes of 245f, 531
Recurrent pregnancy loss 257, 530
causes of 245b
management of 257
Red blood cell antigen 187
Red cell
alloantibodies 25
distribution width 429
Reid's colposcopic index 609
modified 609t
Renal complications 338
Renal defects 408
Renal disease 362, 375
end-stage 397
Renal failure 162, 294, 492
acute 139
Renal function 381
assessment of 625
tests 497
Renal insufficiency 333, 752
Renshaw's classification 408t
Renshaw's staging system 409f
Reproductive tract malformations 749
Reserpine 377
Resistance index 305
Respiratory depression 380
Respiratory distress syndrome 317, 327, 337, 347
Respiratory rate 450
Resuscitation 272
Reticulocyte count 429, 439
Retinal arterioles, constrictions of 366
Retinal assessment 395, 396
Retinal vasculopathy 407
Retinopathy
diabetic 407
progression of 407
Retraction ring, formation of 97f
Retrieving sperms, surgical techniques for 784b
Retrograde menstruation 667
basic anatomy of 668f
Retroperitoneal tissues, dissection of 287f
Retroplacental clot, presence of 160f
Rhabdomyosarcoma, embryonal 621
Rhesus
alloimmunization 202fc
antigens 188t
blood grouping 25
classification 187
compatibility 147
incompatibility disease 188
isoimmunization
pathogenesis of 189fc
recurrence of 151
sensitized pregnancy 193
system 187, 188t
Rheumatic activity 442
Rheumatic heart valve disease 445, 460
Rh-negative pregnancy 187
case study 187
clinical presentation 190
complications 202
general physical examination 190
history 190
investigations 190
management 190
obstetric management 192
specific systemic examination 190
treatment 192
Riboflavin 434
Ribs 114
Right ischial spine, assessment of 116f
Ring of fire appearance 723f
Ritodrine 333
Robert's pelvis 113f
Robert's sign 350
Robertsonian translocations 246
Robotic myomectomy 538, 539, 541f
Robotic surgery 538f
Robotic system, cameras of 540f
Robotic technology
advantages of 539
over conventional laparoscopy, advantages of 539b
Robotic-assisted laparoscopic myomectomy 539
advantages of 539b
Robson's ten group classification system 205, 205t
Roller ball endometrial ablation 548f
Roll-over test 367
Rosette test 191, 191f
Rotterdam's criteria 757
Rubella
immunity for 762
immunization status 454
Rubin maneuver 413, 413f
Rusch urological catheter 278
S
Saccharomyces cerevisiae 611
Sacral agenesis 408, 408t, 409f
Sacral promontory, assessment of 116f
Sacral vertebra 796
Sacroiliac joints, right 110
Sacrosciatic notch, evaluation of 116f
Sacrospinous ligament 661f
Sahli's apparatus 429f
Salbutamol 333
Saline
adenine-glucose-mannitol 201
infusion sonography 498, 499, 500, 500f, 501f, 523, 524f, 766
transabdominal amnioinfusion of 71
Salpingectomy 723, 731, 734, 735b
indications for 733b
partial 734
procedure of 734
Salpingitis 618
Salpingo-oophorectomy
bilateral 507, 509, 707
unilateral 706
Salpingo-ophoritis 552
Salpingostomy 734, 735b
Salpingotomy 723, 731, 734
incision 736f
tube-sparing 735
Salvage 579
therapy
second-line 579
third-line 579
treatment 579
Sapporo's classification, revised 255t
Scanzoni's double application 109
Scar
absence of 12
defects, visualization of 225
integrity, assessment of 225
marks over abdomen 472
presence of 12
rupture, recurrence of 224t
thickness, measurement of levels of 225
Schiller's iodine 604
Schiller-Duval bodies 690
Schistosomiasis 599
Schoorel scoring system 208
Screening test, prerequisites for 600, 600b
Secondary amenorrhea 96, 122, 792, 802, 903fc
differential diagnosis of 799t
Secondary postpartum hemorrhage 266, 294
causes of 294
management of 294
treatment of 294fc
Secondary sexual characteristics 753, 799, 800
development of 794, 794b
Seizures 365
Selective estrogen receptor modulators 530, 564, 566, 775
Selective progesterone receptor modulators 529
Sellheim spoon 120
Semen
parameters 752, 763
quality, poor 749
volume, low 763
Semen analysis 762, 763
abnormal 763
results of 764t
interpretation of 763
normal parameters for 763t
parameters for 763t
Semiconservative surgery 684
Sengstaken-Blakemore tube 278, 279f
Senile vaginal atrophy 561
Sensitization, process of 189
Sentinel lymph node biopsy 513
Sepsis 122, 139, 242, 315, 318, 544
chances of 330
late-onset 330
puerperal 294
Septostomy 184
Serotonin 559
Sertoli cells 688
Sertoli-Leydig cell tumors 687
Serum
alpha-fetoprotein 723
levels 312
beta-human chorionic gonadotropin levels 718
glutamic pyruvate transaminase 497
gonadotropin levels, interpretation of 805t
human chorionic gonadotropin
concentration 720
levels 720
progesterone 771
levels 722, 770
prolactin levels 257, 805
testosterone 805
levels, detection of 764
uric acid 370
levels 366
Severe anemia 427, 432
management of 427, 430
Severe preeclampsia 275, 359t, 373, 373b, 374b, 375, 378, 382, 384b
indications of 359b
management of 372
symptoms indicative of 370
Sex cord stromal cell tumors 686688
Sexual arousal disorders 466
Sexual desire 466
Sexual dysfunction 466
Sexual history 590, 620, 750
Sexual intercourse 576
Sexual pain disorders 466
Sexual partners 576
treatment of 579
Sexually transmitted disease 573, 581, 590, 591t, 669
screening for 762
Sexually transmitted infections 562
Sheehan's syndrome 122, 751
Shirodkar's modification 657
Shirodkar's operation 250
Shirodkar's technique 263, 264f
Shock 122, 145, 440
bacterial 139
hemorrhagic 242
hypovolemic 294
index, calculation of 273
maternal 162
puerperal 294
signs of 716
symptoms of 716
Shoulder dystocia 120, 410, 411f, 412, 413b, 413f, 415f
complications of 414
development of 410, 410t, 411f
management of 410, 412fc
maternal complications of 416
prediction of 410
presence of 410
unilateral 410
Shoulder, delivery of 55f, 56
Shrink fibroids 529
Siamese twin, types of 170, 170t
Sibai's regimens 379
Sickle cell anemia 431f
Sigmoid colon 667
Sigmoidoscopy 674
Silicone arabin pessary 327
Sim's speculum 137f, 477, 478f, 502
Sim's test 764
Single placenta, presence of 173f
Singleton gestation 25t
Sinnecker's classification 796t
Sinusoidal fetal heart rate pattern 198f
Skeletal abnormalities 798
Skin
changes 7, 11f
closure 219
edema 203f
exact site of 753
preparation of 214
vertical incision of 215f
Small for gestational age 295, 296, 296t, 299, 368
fetuses, prevention of 312
Smooth triangular uterine cavity 259f
Snowstorm appearance 234
Society for Maternal Fetal Medicine 326
Sodium
bicarbonate 407
ferric ethylenediaminetetraacetate 435
nitroprusside 376, 377
Soft sore 587
Soft tissue injuries 467
Somatic origin, pain of 665
Somogyi phenomenon 399
Sonography
transabdominal 481, 483, 523, 700f, 701f
transvaginal 150, 250, 303f, 323, 324b, 481, 500b, 502, 522, 674, 700f, 701f, 720, 725, 728, 730, 801
Sonohysterography 259
Soonawala's sling 660
Sore skin 637
Spalding sign 350, 350f
Speech problems 202
Sperm 760
abnormal 784
concentrate 763, 781f
interaction 754
preparation 773
procedure of 784
retrieval 784
transport, disorders of 754
Sphingomyelin 150
Spinal cord segments, nerve roots of 414
Spine 114
exact site of 471
Spiral vessels, intradecidual segments of 298
Spironolactone 752
Sporadic embryonic losses, half of 246
Squamocolumnar junction 609
normal 601f
Squamous cell carcinoma 621
histopathological appearance of 621f
Stallworthy's sign 146
Stargazing sign 67
Stem cell carcinoma 621
Stenosed mitral valves 446f
Sterile per speculum examination 334
Steroid
anabolic 752
hormones 391
Stillbirth 165, 346, 406
exact site of 349
Stimulation 63
Stitching uterine incision 220f
Streptococcus infection 330
Streptomycin 586
Stress 256
Striae gravidarum
over abdomen 13f
presence of 12
Stroke 460, 569
ischemic 562
volume 443
Stroma 470
Stuck twin syndrome 183f
Stump 552
Sturmdorf sutures, application of 615f
Subcutaneous fat 215f
loss of 346
Subepithelial connective tissue 585
Submentum 49
Submucosal fibroid 485, 516, 523, 526, 537f, 553
Submucosal myoma, appearance of 537f
Subserosal myoma, removal of 535
Subserous fibroid 535f
Suction cannula 277
procedure 277
Sudden infant death syndrome 155
Sulfonylurea 399
Superficial transverse perineal muscle 644, 645, 645f
Supine hypotension syndrome 444
pathogenesis of 445f
Suprapubic pain, severe 625f
Suprapubic pressure 411, 412
application of 412f, 413f
Surgery
abdominal 467
conservative 732, 744
indications for 242b, 530b, 682b
Surgical therapy, indications for 732b
Sutures, application of 617
Suturing anal sphincters, overlap method of 291f
Swelling, abdominal examination of 695
Swollen chorionic villi 236
Swyer's syndrome 797
Symphysiotomy 120
Symphysis fundal height 295, 315
Symphysis
estimation of 300
fundus
growth curve 14, 14f, 300
height, measurement of levels of 13, 14f
Syncytiotrophoblast 227
Syntocinon 275
Syntometrine 275
Syphilis 257, 587
congenital 299, 588
diagnosis 587
serologic test for 255, 349
stages of 588
tertiary 588
Systemic chemotherapy 709
benefits of 634
Systemic lupus erythematosus 245, 258
T
T sign 174
Tachyarrhythmia, supraventricular 449
Tachycardia 211, 493
Talipes equinovarus 181
Tamoxifen 494, 744, 778
citrate 778
therapy 494
Tamponade 277
Tanner stages 794, 794b
Teeth 556
Teletherapy 635
Tenaculum 502
Tenderness, abdominal 472
Teratomas 687, 690f
Teratospermia 764
Teratozoospermia 764
Terbutaline 333
Terconazole 578
Teriperatide 567
Testes 688
acquired disorders of 754
undescended 753
Testicular disease 754
Testicular feminization 808
Testicular seminoma 690
Testicular trauma 751
Tetanus toxoid 25
Tetracycline 577, 583, 586
Thalassemia 424, 425, 425t, 431f
Theca
cells 688
lutein cyst 235, 235f, 686
Third-degree tear, repair of 290
Thoracopagus twins, autopsy specimen of 170f
Three line sign 484
Three-finger rotation, procedure of 107
Thrombin 268
time 165
Thrombocytopenia, heparin-induced 459
Thromboembolic complication
development of 442
prevention of 457
Thromboembolism 221, 226, 294
Thrombophilia
inherited 252, 265
screening 260
Thrombophilic state 253
Thromboprophylaxis 151, 214, 221
peripartum management of 458
regimes 262t
Thrombosis 254
prevention of 261
syndrome 459
Thyroid
dysfunction 261, 750, 807
symptoms of 492, 519
examination 471, 752, 794
function test 257, 496, 805
gland 10
stimulating hormone 258, 804
storm 231
testing 496
tissue 690f
Tibolone 559, 564, 567
Tilt test 268
Tioconazole 578
Tiredness 637
Tissue 268
abnormal 614
destruction of 618
protrusion of 648
Tocolysis 329, 330
Tocolytic agents 330, 331, 403
Tocolytic drug 406
Tocolytic therapy 328, 331b
contraindications for 330b
initiation of 327, 331
Tongue 10f
burning of 419
Tonic uterine contractions 98
Topical azole antifungal agents 578
Toremifene 744
Torsion 550
Total iron
binding capacity 425, 428
requirement reflects 439
Total peripheral vascular resistance 443
Toxemia, preeclamptic 361
Toxic effects 761
Toxoplasma gondii 247
Trachelectomy, procedure of 631
Tranexamic acid 276, 360
Transabdominal cerclage 250, 265
Transabdominal imaging 148f, 523
Transcervical fibroid tissue passage 544
Transdermal skin patches 559, 560
Transformation zone 609
large loop excision of 602, 615, 616f
Transobturator cystocele repair 663, 663f
Transobturator tension 662
Transvaginal examination 482
Transvaginal sacrospinous ligament fixation 660, 661f
Transvaginal sonography 150, 250, 303f, 323, 324b, 481, 500b, 502, 522, 674, 700f, 701f, 720, 725, 728, 730, 801
advantages of 482
disadvantages of 483
technique of 483f
Transvaginal ultrasound 269, 324f, 482, 483, 499, 499f, 522
cervical length 328
Transvaginal uterine artery clamp 277, 278f
application of 278f
Transverse diameter, measurement of levels of 47f
Transverse lie 89, 90, 92f
management 91
Transverse lower uterine incision 95f
Transverse sutures around uterus 285f
Transverse vaginal septum 795f
Trauma 157, 226
neonatal 86
Trendelenburg's position 520
Treponema
organisms 588
pallidum 587
Treponemal tests 588
Triazole 578
agents 578
antifungals 578
Trichofuran suppositories 581
Trichomonads 592
Trichomonas vaginalis 319, 573, 580f
transmission of 580f
Trichomonas vaginitis 579
Trichomoniasis 574, 575f, 579, 593
risk factors for 581
Tricuspid arteries 453
Triple stripe appearance 260f
Triptorelin 528, 782
Trisacryl gelatin 542
Trisomy 12 519
Trocar placement 540
Trophoblast 229f
abnormal 242
Trophoblastic tissue
embolization of 242
neoplasm of 227
Trophotoxic substances 731
T-sign, presence of 174f
Tubal disease, treatment of 775fc
Tubal factors 759, 768
infertility, treatment option for 775t
Tubal ligation 750
Tubal mole 714
Tubal obstruction 773
causes of 760
Tubal ostium, hysteroscopic evaluation of 767f
Tubal patency 775t
laparoscopic test for 769f
Tubal pregnancy, laparoscopic management of 732
Tubal ring sign 721
Tubal rupture 714, 715
Tubal surgery 715, 717
Tube, congenital abnormalities of 716
Tuberculosis 715
Tubo-ovarian
artery 734
mass 760f
Tubotubal anastomosis, steps of 774f
Tumor
abdominal 203
diagnosis of 473
fixation of 694
intraperitoneal 473
monodermal 690
necrosis factor 319
node, and metastasis
classification 697
staging system 626
nonmetastatic 240
phenotype 492
pituitary 799
retroperitoneal 473
serous 688
size 513
synchronous 696
trophoblastic 228, 242
volume reduction 524f
Tumor markers 698
loss of 514
types of 712t
Tunica albuginea 758
Turner's syndrome 781, 797, 798f, 801, 802, 806
diagnosis of 808
stigmata of 752, 798b
Turtle sign 410, 411f
Twin 174, 178
breech, management of 73
delivery of 174
embolization syndrome 186, 186f
in utero, designation of 171
peak sign 174, 174f
presentations, types of 179, 179t
reversed arterial perfusion syndrome 184
syndrome 169
types of 177
Twin gestation 177, 177t, 178, 180, 181, 209
etiology of 166
incidence of 166
types of 166, 177, 177t
Twin pregnancy 171
occurrence of 174
recurrence of 180
Twin-to-twin transfusion 181
quintero stages of 183
syndrome 178, 182f, 298, 348
diagnosis of 183b
ultrasound findings 182
Twinning, mechanism of 166
Two-finger vaginal examination 479f
Tyrode solution 786
Tzanck smear 584
U
Ulceration, benign 599
Ultrasonography 197, 299, 767
transabdominal 148
transrectal 684
transvaginal 148, 684
Ultrasound 771
Doppler flow velocimetry 303
estimated fetal weight 303
examination 22, 27, 103, 136, 159, 335, 340, 498, 522, 674, 741
use of 4981
imaging 225
indicated cerclage 327
parameters 341
principle of 481, 481f
probes 482f
transabdominal 269, 498
transperineal 117f
transvaginal 269, 324f, 482, 483, 499, 499f, 522
types of 482
Umbilical artery 297, 304, 315, 316
blood flow patterns 307f
circulation 306f
Doppler analysis 306, 313
waveform analysis 312, 313
Umbilical blood flow 308b
Umbilical cord 194
blood sampling, percutaneous 196
compression 122
Umbilical eversion 471
Umbilical inversion 471
Umbilical vein 302
diameter 192
Upper gastrointestinal hemorrhage 419
Upper quadrant abdominal pain, right 363
Upper respiratory tract procedures 457t
Upper segment
scar, strength of 223
uterine scar 217
Ureaplasma urealyticum 319, 573
Ureters, peristalsis of 531
Urethra 561
Urethrocele 641, 642f
Urge incontinence 466
Urinalysis 269
Urinary catheter 214, 222
Urinary dysfunction 637
Urinary symptoms 7, 518, 556, 589, 648
Urinary tract 226
infection 159, 389, 466
Urinary urgency 694
Urine 372, 718
analysis 673
culture 652, 673
examination 652
human chorionic gonadotropin 713
levels 496
pregnancy test 520, 718
positive 793
retention of 518
Urogenital atrophy
mild 561
moderate-to-severe 561
Urogenital diaphragm, muscles of 644, 645f
U-suturing technique 286f
modified 285, 286f
Uterine 321
abnormalities, diagnosis of 259f
cancer, recurrence of 560
distension, pathogenic 319
environment 518
evaluation 546
exploration 211
fundus 539
hyperstimulation, increased risk of 343
hypertonicity 158
infection 139, 242, 291
ischemia 544
leiomyosarcomas, occurrence of 551
mass 520, 520t
massage 266
obstruction, face of 121
origin, pain of 466
papillary serous carcinoma 510
softening 716
sound 502
surface, appearance of 683f
surgery 153
suspension 660
synechiae 773
tone diminishes 348
trauma 136, 740
tumor 474f
vault, descent of 641
volume 741
walls, strengthening of 537
Uterine anomalies 324
classification of 248f
congenital 247
correction of 334
structural 260
Uterine artery 282, 297, 304, 542f
blood flow patterns 305f
Doppler 304
waveforms, abnormal 305f
ligation 286
Uterine artery embolization 287, 294, 522, 524f, 525, 526, 531, 542, 543, 745
complications 543
contraindications of 542b
investigations 542
procedure 542
Uterine atony
development of 267
postpartum 163
Uterine bleeding 594
abnormal 486, 487t, 497, 498, 499b, 501, 506, 507, 525, 546, 623, 689
excessive 530
normal 487t
Uterine cavity 293, 539, 753, 765
distortion of 247
size of 502
transvaginal sonography 499
Uterine contractions 34, 158
abnormal 101
duration of 34
Uterine factor
infertility 755
tests for 765
tubal factors of 773
Uterine fibroids 248, 468, 520, 740
classification system of 517t
symptomatic 465
Uterine incision 219f
classical 223
closure of 218
double layered closure of 218
extension of 218f
single layered closure of 218
types of 217
Uterine inversion
diagnosis 291
treatment 292
Uterine leiomyomas
cure for 531
presence of 158
treatment modality for 530
Uterine malformations 247, 780
drug-induced 755
Uterine muscle 224, 534
fibers, arrangement of 9f
Uterine myomas 515, 550
treatment options for 525t
Uterine perforation 139, 550, 617
recurrence of 139
Uterine prolapse 641, 642f, 647, 650f
causes of 646
development of 652
diagnosis of 648, 651
stages of 650f
surgery for 661
tubal factors of 653f
Uterine rupture 223, 224, 224b, 252, 416, 536b
types of 224
Uterine scar 667
lower segment 217
Uterine septa 260
lysis of 773
Uterine septum 247, 249f
resection of 249f
Uterine tamponade 277, 279f, 280f, 281
application of 280
Uterine vessel 288
ligation
bilateral 287
technique of 287
unilateral 287
low 288
Utero-ovarian vessel 288
ligation, bilateral 287
Uteroplacental apoplexy 163
Uteroplacental dysfunction 358
Uteroplacental function, assessment of 304
Uteroplacental insufficiency 381
Uteroplacental pathology, indications of 175
Uteroplacental perfusion 378
Uterosacral ligaments 643, 671, 684
Uterotonics, use of 221
Uterus 8, 248, 274, 557, 671, 740, 767, 796
abnormal hardness of 36b
acute inversion of 291
bicornuate 259, 521, 722f, 765, 767, 773
blood supply to 282f
brace sutures of 282
curettage of 294
cut specimen of 739f
didelphys 765
exact site of 13
gentle repositioning of 292f
inversion of 291
medical evacuation of 195
removal of 531
rupture of 96, 122, 225, 289
septate 259, 765, 767
serosal surface of 667
shape of 260
size of 14, 479
supports of 643
surgical evacuation of 195
transvaginal ultrasound of 260f
T-shaped 755
ultrasound examination of 499
unicornuate 765, 780
visualization of 217f
V
Vacuum aspiration, procedure of 136
Vagina 242, 556, 584, 643
appearance of 575f
epithelial lining of 561
lactobacilli in 575
potential space of 643
suspension of 655
Vaginal atrophy 561
Vaginal birth 75
after cesarean 206, 207, 213
delivery 206
after cesarean section 206, 209, 210
advantages of 209
contraindications for 209
prediction of 207
recurrence of 209
indications for 177
previous 207
Vaginal bleeding 157, 211, 230, 716, 717
abnormal 624f
excessive 242
Vaginal breech delivery 72, 74
indications for 74b
Vaginal clindamycin cream 577
Vaginal cuff 650
removal of 617
Vaginal culture 593
Vaginal cysts 651
Vaginal delivery 54, 178, 178b, 456
instrumental 250
mechanism of 106, 107f
normal 54
operative 108, 109
prerequisites for 79
spontaneous 111
Vaginal discharge 466, 573, 588, 591, 592fc, 593f, 750
causes of 589t, 591, 591t, 594t
Gram's staining of 576
management of 591
pathological causes of 573t
physiological causes of 573t
types of 575f, 590
Vaginal douching 576
Vaginal dryness 528, 554, 555
Vaginal epithelial cells, exfoliation of 576
Vaginal estrogen 561, 562
low-dose 561
preparations 560
ring 562
tablet 562
Vaginal examination 21, 36, 37, 38b, 61, 67, 67f, 91, 91f, 102, 105, 110, 121, 146, 158, 171, 231, 322, 341, 465, 495, 713
contraindications for 37
indications for 37, 37b
preparation for 37
prerequisites for 36
Vaginal fluid sample 322
Vaginal hematomas 291
Vaginal hysterectomy 531, 664
Vaginal infection, history of 491
Vaginal injuries, repair of 289
Vaginal intraepithelial neoplasia 589
Vaginal introitus 41, 55f, 651
Vaginal irritation 589
Vaginal length, total 650f, 651
Vaginal lubricants 561
Vaginal moisturizing agents 561
Vaginal mucosa 289, 291, 649, 753
thickness of 590
Vaginal mucosal inflammation, signs of 590
Vaginal pH 578, 581
Vaginal probe, use of 482
Vaginal prolapse 655b
Vaginal repair 661
Vaginal route 531
Vaginal secretions 335
Vaginal septum 795, 795f
Vaginal stenosis 637
Vaginal swab, high 257, 269, 652
Vaginal tears 290
Vaginal tissue, levels of support for 643t
Vaginal touch picture 110f
Vaginal vault 660
Vaginal walls 656
Vaginismus 466
Vaginitis 591b
causes of 574t
emphysematous 594
Vaginosis 575
Valium 380
Valvular heart disease 442
Vanishing twins 173
Varicocele 753
Varicosities 180, 471
Vasa previa 146, 147f, 180
diagnosis of 147f
Vascular disease, peripheral 388
Vascular endothelial growth factor 708
receptors 710
Vascular resistance 308b, 367
Doppler evaluation of 175
Vascular spread, metastatic theory of 668
Vasectomy 750
Vasoactive substances, secretion of 553
Vasomotor symptoms, control of 564
Vasopressin 277
Vasospasm 360
Vault granulation tissue 573
Vault prolapse
diagnosis of 660
management of 660
surgical management of 660
Vecchietti's technique 806
Vein, normal ratio of 366
Vena cava, inferior 302
Venereal disease research laboratory test 257, 588
Venlafaxine 559
Venous thromboembolism
incidence of 564
recurrence of 562
Ventricular septal defects 449
Vertex 15, 49
Vertical incision 215f
closure of 220f
Vesicovaginal fistula 122, 252, 573
Vessels
abnormal 609
atypical 609
Vincristine 241, 690
Virilization, signs of 793
Virkud's composite sling operation 659
Visceral origin, pain of 665
Viscoelastic testing 281
Visual disturbances 793
Visual fields, assessment of 794
Visual inspection, method of 604
Vital signs 268, 450, 470
Vitamin
A 230, 434
B12 426f, 434
deficiency of 427, 427t
supplementation 426
C 366, 563
D 366, 559
deficiency of 565
low levels of 565
E 366, 563
K, administration of 460
Vitrification 789
von Willebrand disease 268, 496
Vulva 556
appearance of 575f
Vulvar cysts 651
Vulvar intraepithelial neoplasia 589
Vulvar pruritus, chronic 558
Vulvovaginal candidiasis 574, 575f, 577, 591
Vulvovaginal itching 574
Vulvovaginitis 574, 591, 594
recurrent 577
W
Waiter's tip position 415
Warfarin 458460, 491
low-dose 459
Weak scar, causes of 225b
Weight gain 25, 365
distribution of 25f
extreme 761
Weight loss 518
extreme 761
Weinstein scoring system 208, 208t
Wet mount 593f
preparation 592
Wheel-spoke appearance 789f
Whiff test 576, 576f
White blood cells 592, 764
White's classification system 390, 390b
Willis circle 306f
Woods’ screw maneuver 412, 413, 413f, 414
reverse 412, 414, 414f
Worsening dysmenorrhea 751
Wurm's stitch, application of 265f
X
X chromosome 797, 802
Xenograft 662
X-ray abdomen 349
XY karyotype 797
Y
Yolk sac
development 690
tumor 690
Z
Zatuchni and Andros score 72t
Zavanelli maneuver 414, 415f
Zinc 423, 434
Zoladex 528, 678
Zoledronic acid 567
Zona pellucida 786
Z-score 565
Zuspan regimen 379
Zygote intrafallopian transfer 787
×
Chapter Notes

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Bedside Obstetrics and Gynecology for Postgraduates
Bedside Obstetrics and Gynecology for Postgraduates
THIRD EDITION Richa Saxena MBBS MD (Obstetrics and Gynecology) RCOG Associate PG Diploma in Clinical Research Obstetrician Gynecologist—Let's Talk Woman's Health Mentor—Cracking MRCOG New Delhi, India
Jaypee Brothers Medical Publishers (P) Ltd.
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© 2023, Jaypee Brothers Medical Publishers
The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily represent those of editor(s) or publisher of the book.
All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers.
All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book.
Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
This book is sold on the understanding that the publisher is not engaged in providing professional medical services. If such advice or services are required, the services of a competent medical professional should be sought.
Every effort has been made where necessary to contact holders of copyright to obtain permission to reproduce copyright material. If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first opportunity.
Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com
Bedside Obstetrics and Gynecology for Postgraduates
First Edition: 2010
Second Edition: 2014
Third Edition: 2023
9789354659843
Printed at:
My Mother, Mrs Bharati Saxena
and all the Mothers
Who have undergone much pain and sufferings for their children.
A mother is the most trusted friend we have, when trials, heavy and sudden, fall upon us;
When adversity takes the place of prosperity;
When friends who rejoice with us in our sunshine, desert us;
When troubles thicken around us, still she will cling to us and counsel to dissipate the clouds of darkness, causing peace to return to our hearts;
and has proven time and time again that no matter whatever circumstances may come between mother and her children, their lives are interwoven forever
—Washington Irving
Preface to the Third Edition
Medicine is learned by the bedside and not in the classroom. Let not your conceptions of disease come from words heard in the lecture room or read from the book. See and then reason and compare and control. But see first
–William Osler
The third edition of the book, Bedside Obstetrics and Gynecology for Postgraduates, is motivated by the enormous popularity of the past editions and a commitment for maintaining the fundamentals of clinical examination that cannot be overlooked. In the changing world of artificial intelligence and virtual reality, dependency on technology in the diagnostic processes has increased drastically and bedside time with patients has reduced. However, it is pertinent that diagnostic imaging must be complementary and not a replacement for clinical examination. Through this book, I have endeavored to draw attention towards the importance of eliciting the clinical signs and symptoms more than pathology or radiology, especially for the postgraduate students.
Though the text in the third edition has been greatly revamped and updated with recent guidelines in the field of Obstetrics and Gynecology, the concept and focus, however, remains the same. The book, like its earlier editions, highlights the age-old traditional concept of history-taking and clinical examination. Keeping these in mind, all important Long Cases in Obstetrics and Gynecology have been described under the following headings: Case study, introduction, history and clinical presentation, general physical examination, specific systemic examination, differential diagnosis, management, investigations, treatment (obstetric/gynecological management), complications, and evidence-based clinical trials. Questions from past 10-year papers have been incorporated in each chapter at topic level for the postgraduate students to prepare and pass the practical examination as well as the university examination with utmost ease. To further emphasise the fact that the book is focused towards the postgraduates, the term “postgraduate” has been inserted in the previous title, “Bedside Obstetrics and Gynecology”.
While firmly holding on to traditional case-based approach, the third edition equally emphasizes on the evidence-based medicine, providing a wholesome learning to the postgraduates and residents. In line with this, evidence-based clinical trials have been added at the end of each chapter, which can be accessed by scanning a QR code given at the end of each chapter as well as at the end of table of contents on page XII. Each reference is linked to the source article, thereby allowing interested students to access the complete article or its abstract from there in just one click and remain updated with the recent advancements and developments in the field of obstetrics and gynecology. In the third edition, two new chapters “cephalopelvic disproportion”, and “adenomyosis”, have been added based on the reviews and feedback provided by the students who read this book and teachers/professors who reviewed the script. Keeping up with the updates, as the term, Dysfunctional Uterine Bleeding has become obsolete now, the redundant chapter has been removed in this edition. The textual matter of the book has been updated extensively with all new NICE/GTG guidelines including the new WHO portogram (WHO Care Guide, 2020), revised treatment and staging of malignancies including molecular staging of endometrial cancer, new management protocols for Rh negative pregnancy, preeclampsia, gestational diabetes, etc.
This book would serve as a valuable resource for the postgraduate students and residents, containing all the common and important case studies in the field of both Obstetrics and Gynecology, which they might encounter during the practical examinations, university examinations and clinical practice. Though mainly catering to postgraduate students, residents and practitioners, some intellectual undergraduate students who ultimately want to pursue their career in Obstetrics and Gynecology are also likely to find this book very useful.
Writing a book is a herculean task. It can never be completed without divine intervention and approval. Therefore, I have decided to end this preface with a small prayer of thanks to the Almighty, which I was taught in my childhood.
“Father, lead me day by day, ever in thy own sweet way. Teach me to be pure and good and tell me what I ought to do.”
–Amen
Simultaneously, I would like to extend my thanks and appreciation to all the related authors and publishers whose references have been used in this book. Book creation is teamwork and I acknowledge the way the entire staff of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, worked hard on this manuscript to give it a final shape. I would especially like to thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr MS Mani (Group president), Ms Chetna Malhotra (Senior Director—Professional Publishing, Marketing and Business Development), Ms Pooja Bhandari (Production Head), Ms Suchita Gera (Development Editor), Mr Ashwani Singh (Manager), Mr Rakesh Kumar (Typesetter), Ms Nirmal (Editorial Coordinator) and Ms Seema Dogra (Cover Designer) for publishing the book.
I would also like to especially thank the content strategists (Dr Mansy Gupta, Ms Isha Sindhwani, Ms Soumya Yadav) for helping me in refining the manuscript.
I strongly believe that writing a book involves a continuous learning process. Though extreme care has been taken to maintain accuracy while writing this book, constructive criticism would be greatly appreciated. Please e-mail me your comments at richa@drrichasaxena.com. Also, please feel free to visit my website, www.drrichasaxena.com for obtaining information related to various books written by me, projects that I am involved in for promotion of woman's health, and for making use of the free online resources available.
Richa Saxena
Preface to the First Edition (Extract)
The concept of a bedside book is not new, but is a novel one and unique in itself. It may sound funny, but when I told a nonmedical editor from a reputed publishing house that I was writing a book titled, “Bedside Obstetrics and Gynecology”, he laughed asking whether the book is meant to remain at the bedside of the patient or the doctor? Jokes apart, who else other than the medical personnel would know the importance of the education which takes place at the patient's bedside. In today's world of scientific advancement and technology, the clinical art of medicine is sadly dying off …
The doctors today do not believe in auscultating the patient's chest or merely palpating the patient's abdomen. A stethoscope can diagnose a consolidated lung suggestive of Kochs at a much earlier stage than a chest X-ray or even a bronchoscopic-guided biopsy. Hence, it is important for the medical personnel to become acquainted with the skills of taking history and performing a clinical examination. The purpose of the book is to promote the art of good history taking and clinical examination, and reaching the final diagnosis by obtaining only a few selective investigations or special evaluations. The book highlights the classical and systematic approach towards diagnosis of the disease. Each case study has been carefully designed to simulate the clinical practice scenarios as far as possible in order to evoke the right patient approach and clinical decision making. Unlike the small clinical vignettes described in most other books, detailed explanation of the pathology relevant to the case study in question has been described in all the chapters. One of the key features of this book is its versatility. Not only will the book be useful to the undergraduates who are required to get acquainted with the clinical examination skills but also for the busy postgraduates who are in the rush to go through the clinical scenarios.
Richa Saxena
Introduction
As previously described, this book emphasizes the patient's clinical conditions rather than the disease. For example, a patient may be presenting with jaundice, fever, and malaise, but the actual diagnosis may turn out to be hepatitis. So simply knowing about hepatitis is not enough, one needs to have the ability to diagnose the condition based on the findings of history and clinical examination.
Promoting clinical acumen is the basic purpose of this book. Each chapter has been written keeping in mind the clinical presentation of the patient. Various clinical scenarios have been divided into seven sections in all, out of which the first three deal with obstetrics and last four with gynecology. All the chapters have been divided into various subparts with the help of the symbols as described below:
Abbreviations
ACOG:
American College of Obstetricians and Gynecologists
AFI:
Amniotic Fluid Index
AFV:
Amniotic Fluid Volume
AIDS:
Acquired Immune Deficiency Syndrome
ANC:
Antenatal Care
AP:
Anteroposterior
APH:
Antepartum Hemorrhage
APLS/APS:
Antiphospholipid Antibody Syndrome/Antiphospholipid Syndrome
ARDS:
Acute Respiratory Distress Syndrome
ARM:
Artificial Rupture of Membranes
AST:
Aspartate Aminotransferase
BCSH:
British Committee for Standards in Hematology
BMI:
Body Mass Index
BP:
Blood Pressure
BPM:
Beats Per Minute
BPP:
Biophysical Profile
CBC:
Complete Blood Count
CDC:
Center of Disease Control and Prevention
CI:
Confidence Interval
CNS:
Central Nervous System
CO:
Carbon Monoxide
CPR:
Cardiopulmonary Resuscitation
CRP:
C-reactive protein
CS:
Cesarean Section
CST:
Contraction Stress Test
CT:
Computed Tomography
CTG:
Cardiotocography
CVS:
Chorionic Villus Sampling
D&C:
Dilatation and Curettage
DFMC:
Daily Fetal Movement Count
DIC:
Disseminated Intravascular Coagulation
DLC:
Differential Leukocyte Count
DVT:
Deep Vein Thrombosis
ECG:
Electrocardiogram
ECV:
External Cephalic Version
ELISA:
Enzyme-linked Immunosorbent Assay
ERCS:
Elective Repeat Cesarean Section
ESR:
Erythrocyte Sedimentation Rate
FHR:
Fetal Heart Rate
FHS:
Fetal Heart Sound
FIGO:
International Federation of Gynecology and Obstetrics
FISH:
Fluorescent in situ Hybridization
FMH:
Fetomaternal Hemorrhage
FNAC:
Fine-needle Aspiration Cytology
FSH:
Follicle-stimulating Hormone
GDG:
Guideline Development Group
GFR:
Glomerular Filtration Rate
GI:
Gastrointestinal
GnRH:
Gonadotrophin-releasing Hormone
GP:
General Practitioner
GPE:
General Physical Examinaion
GTG:
Green-top Guideline
GUM:
Genitourinary Medicine
Hb:
Hemoglobin
HIV:
Human Immunodeficiency Virus
HR:
Heart Rate
HRT:
Hormone Replacement Therapy
ICU:
Intensive Care Unit
Ig:
Immunoglobulin
IM:
Intramuscular
IUCD:
Intrauterine Contraceptive Device
IUGR:
Intrauterine Growth Restriction/Retardation
IV:
Intravenous
IVF:
In Vitro Fertilization
KFT:
Kidney Function Test
L:S ratio:
Lecithin:Sphingomyelin ratio
LFT:
Liver Function Test
LH:
Luteinizing Hormone
LMP:
Last Menstrual Period
MAS:
Meconium Aspiration Syndrome
MCH:
Mean Corpuscular Hemoglobin
MCHC:
Mean Corpuscular Hemoglobin Concentration
MCV:
Mean Corpuscular Volume
MRI:
Magnetic Resonance Imaging
MS:
Multiple Sclerosis
MTC:
Mother-to-child
NICE:
National Institute for Health and Care Excellence
NICU:
Neonatal Intensive Care Unit
NSAIDs:
Nonsteroidal Anti-inflammatory Drugs
NST:
Nonstress Test
NT:
Nuchal Thickness
OCPs:
Oral Contraceptive Pills
OPD:
Outpatient Department
OR:
Odds Ratio
OT:
Operation Theater
PC:
Platelet Count
PCOS/PCOD:
Polycystic Ovarian Syndrome/Polycystic Ovarian Disease
PCR:
Polymerase Chain Reaction
PE:
Pulmonary Embolism
PID:
Pelvic Inflammatory Disease
PIH:
Pregnancy-induced Hypertension
PO:
Per Orally or Per os
POG:
Period of Gestation
PPH:
Postpartum Hemorrhage
PROM:
Premature Rupture of Membranes
PV:
Per Vaginally
RBC:
Red Blood Cell
RCOG:
Royal College of Obstetricians and Gynecologists
RCT:
Randomized Controlled Trial
RDS:
Respiratory Distress Syndrome
RIA:
Radioimmunoassay
ROM:
Rupture of Membranes
ROS:
Reactive Oxygen Species
RPF:
Renal Plasma Flow
SC:
Subcutaneous
SL:
Sublingual
SOGC:
Society of Obstetricians and Gynecologists of Canada
STD:
Sexually Transmitted Disease
T3:
Triiodothyronine
T4:
Thyroxine
TAS:
Transabdominal Scan
TLC:
Total Leukocyte Count
TORCH:
Toxoplasmosis, Other Infections, Rubella, Cytomegalovirus, Herpes Simplex Virus
TSH:
Thyroid-stimulating Hormone
TT:
Thrombin Time
TVS:
Transvaginal Scan or Sonography
TVT:
Tension-free Vaginal Tape
UFH:
Unfractionated Heparin
US:
Ultrasonography
UTI:
Urinary Tract Infection
UV:
Ultraviolet
VBAC:
Vaginal Birth after Cesarean
VDRL:
Venereal Disease Research Laboratory
VTE:
Venous Thromboembolism
WBC:
White Blood Cell
WHO:
World Health Organization