An Evidence-Based Clinical Textbook in Obstetrics & Gynaecology for MRCOG-2 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
Abacavir 21
Abdomen 566
linea alba of 718
X-ray of 331
Abdominal circumference 415, 416, 518
ultrasound measurement of 418f
Abdominal discomfort, mild-to-moderate 177
Abdominal examination 44, 88, 96, 102, 168, 178, 257, 267, 279, 321, 322, 379, 397, 538, 792, 854
Abdominal girth 352
Abdominal incision, closure of 768
Abdominal laparotomy, conventional 645
Abdominal pain 177, 177t, 288, 306, 307, 349, 488, 641, 763, 878
management principles for 178
postpartum 177
Abdominal pregnancy, diagnostic criteria for 384b
Ablative methods 808
Abnormal tissue, excision of 809
Abnormal uterine artery Doppler waveforms 419f
Abortion 145, 649
Act 1967 894
completion of 398t
consecutive spontaneous 340
criminal 612
incomplete 394, 395, 399
induced 894, 896f
inevitable 394, 397f, 399
medical 896898, 898t
missed 394, 395, 399
pain relief for 898
septic 401, 703
spontaneous 240, 267, 394
surgical methods of 898, 898t
threatened 394, 395, 399, 406
tubal 381
types of 394
unsafe 361
Abruptio placentae 145, 237, 240, 251, 267, 289fc
pathophysiology of 287fc
Abruption, chronic 65
Abscess
diverticular 189
iliopsoas 177
Absolute pre-pregnancy pulmonary function tests 122
Acanthosis nigricans 720f
Acardiac twins 264
ablation of 265
Acetaminophen 40, 374
Achondrogenesis 54
Achondroplasia 54, 74
Aciclovir 205, 208
Acidaemia, neonatal 354
Acid-base balance 198
Acidosis
metabolic 519, 567
neonatal 322
Acne 667
Acquired immunodeficiency syndrome 209
Acrocephalopolydactylous dysplasia 434
Actinomycin D 409
Activated partial thromboplastin time 38, 103, 115, 117, 290, 536
Activins 594
role of 594
Acupuncture 669
Acute painful crisis 152
management of 151
Acute respiratory distress syndrome 215, 222, 226, 233
Add-back therapy 658, 667
Addison's disease 687, 733, 735
Adenocarcinoma, endometrial 782f
Adenomyoma 670
Adenomyosis 650, 670, 671f, 672, 673
diagnosis of 671, 673
features of 671t
treatment of 673
uteri, treatment of 672
Adenosine triphosphate, 515
Adenovirus 226
Adequate body weight, maintenance of 169
Adherent placenta 531
management of 531
Adhesions 716
division of 668
Adiana method 889
Adjuvant therapy 668
following radical hysterectomy 823
Adnexal masses 189, 258, 382, 790
encountered during pregnancy 190b
types of 189b
Adrenal disorders 733
Adrenal function, tests for 734
Adrenaline 540, 563
Adrenogenital syndrome 75
Adrenoleukodystrophy 76
Advanced life support 14
Advisory Committee on Cervical Screening 803
Aedes aegypti 219
Aerobic metabolism 515
Air
bronchograms 569
sound of 32
Airway 32, 539
management, advanced 540
Alanine
aminotransferase 88
transaminase 132
Alcohol 374
adverse effect of 244
consumption 244
prevalence of 242
teratogenic effect of 244
usage during pregnancy 46, 242, 251
Alendronate 609
Alkaline phosphatase 132
Allergic reactions 271
Allis forceps 486
Alloimmune traits 338
Alloimmunisation 150
Allotypic antigens 396
Alopecia 111, 733
Alpha 1-antitrypsin deficiency 75
Alpha-adrenergic agonists 761
Alpha-blockers 761
Alpha-fetoprotein 51
levels of 49, 793
screening 49
Alphaprodine 374, 513
Alpha-thalassaemia 75
disorder 146t
types of 145, 146
Alport syndrome 77
Alveolar damage, diffuse 226
Alzheimer's disease 74
Amantadine 371
Ambiguous genitalia 581, 582, 584
Amenorrhoea 604, 606, 683, 685, 687
causes of 686
management of 690
primary 683
secondary 683, 688fc
American College of Obstetricians and Gynecologists 239, 456, 492
American College of Physicians 7
American College of Rheumatology 112
American Diabetes Association 167
American Fertility Society Classification of Endometriosis, revised 665t
American Medical Association 3
American Society for Reproductive Medicine 699f
American Society of Anesthesiologists Guidelines 25
American Society of Anesthesiologists Physical Status Classification System 26t
American Society of Reproductive Medicine 710
Amino acids, excitatory 520
Amino-3-hydroxy-5-methyl-4 isoxazole propionate 520
Aminoglycosides 371
Aminopterin 370
Amiodarone 370, 371, 442
Amitriptyline 374, 629
Amniocentesis 55, 56, 57, 60, 221, 358
procedure of 58f
Amnioinfusion 275, 356
transcervical 516
Amnion, squamous metaplasia of 355
Amniotic adhesions 356
Amniotic banding 370
Amniotic fluid 266, 352, 429, 680
analysis 301, 436
embolism 536, 541
diagnosis of 536
pathophysiology of 536, 536fc
index 66, 69, 259, 353, 433, 517,
leakage 61
meconium-stained 196
smelling 272
volume 516518
Amniotomy 443, 457
advantages of 462
Amnisure 273
Amoxicillin 199
Amphetamine 247, 374
groups of 250
influence of 250
Ampicillin 275, 849
Anaemia 23, 140, 250, 262, 263, 265, 565, 628, 641, 785
acute 151
autoimmune haemolytic 733
classification of 140t
dimorphic 140
haemolytic 112, 115, 140, 428
macrocytic 140
megaloblastic 140, 144, 144f, 153
microcytic hypochromic 140
normocytic normochromic 140
pernicious 733, 735
severe 213, 215
transfusion dependent 427
Anaesthesia 92, 123, 465, 481, 637, 889, 895
effects of 890
epidural 325, 473
general 24, 27, 170
local 28, 57
mode of 284
types of 27
Anaesthetist, role of 26
Anal sphincter injuries, care of 475
Analgesia 127, 465
adequate 494
epidural 276, 310, 325, 467, 469, 472
obstetric 466
patient-controlled 40, 486
postoperative 39
regional 466
Analgesic agents 775
Analgesic drugs 200
Anaphylaxis 541
Anastrozole 667
Androgen 372, 374, 605, 653
excess, signs of 684, 704
insensitivity syndrome 690
levels 719
production of 719fc
Androgenic agents 667
Andropause 738
Androstenedione 677, 710, 714
Aneurysm 100
Angiogenesis inhibitors, incorporation of 798
Angiogram, CT pulmonary 162
Angiotensin-converting enzyme 90, 99, 172, 201
inhibitors 150, 355
Angiotensin-receptor blockers 150
Anogenital examination 622
Anogenital infection, uncomplicated 843
Anorectal mucosa 473, 474f
Anorexia nervosa 690
Anosmia 687
Anovulation 733
chronic 688, 787
hyperprolactinaemic 701
Antenatal care 89, 96, 98, 102, 224, 248
Antenatal corticosteroid 285
administration 569
Antenatal haemoglobinopathy screening 150
Antenatal maternal and foetal surveillance 117
Antenatal period 133, 141, 150, 168, 173
management during 616
Antenatal surveillance 436
Antenatal visits 104, 141, 259
Antepartum period 120, 122, 130
Antepartum stillbirth 573
Anterior colporrhaphy 751
intraoperative complications of 756
principles of 751
Anthropomorphic measurements and growth chart 684
Antiadrenal antibodies, testing for 687
Antiandrogens 723
Antianxiety agents 606
Antiarrhythmic medicines, use of 104
Antibiotic 199, 212, 230, 271, 371, 546, 737, 773
administration of 275, 531
choice of 773
preoperative 25
prophylaxis 147, 481, 545, 637
intrapartum 571b
therapy 268
Antibody 116
antinuclear 111, 338
screen 436
Anticholinergic agents 763
Anticholinergic drugs 761
Anticoagulant 160
therapy 162, 165
Anticonvulsant therapy 520
Anti-cytomegalovirus, interpretation of 428t
Anti-D administration 303
Anti-D antibodies, causes of 294
Anti-D immunoglobulins 297b, 298b, 391
dose of 295
mechanism of action of 297f
Antidepressants 606
Anti-embolism stockings 159
Antiemetic drugs 137
Antiepileptic drugs 125, 128, 370
Antifungal agents, intravaginal administration of 852
Antifungal drugs 850
Antifungal therapy, topical 850t
Anti-hepatitis B core antigen 217
Antihistamines 136, 374
Antihypertensive medications 90
Antihypertensive treatment 98
Antimicrobial therapy 200
intrapartum 334
Antimotility drug 136
Anti-Müllerian hormone 579, 582, 593, 705, 738
Antineoplastic drugs 371
Antioxidant 669
Antiphospholipid antibody 336, 338, 338f, 341
complete profile of 117
syndrome 65, 111, 114, 116b, 117t, 118, 163, 164, 166, 342344, 396, 399
clinical features of 115t
diagnosis of 115
physical features of 115t
revised Sapporo classification criteria for 115t
test for 164
Antiphospholipid syndrome
classic 114
familial 114
Antiplatelet agents 420
Antiprogesterone 441
Antiprogestins 645
Antiprogestogens 666, 667
Antiresorptive agents 667
Antiretroviral medications 211b
Antiretroviral therapy 209f, 210, 212
use of 210
Antiseptic solution 481
Antispasmodics 761
Antisperm antibodies, adenomyosis uteri 696
Antithrombin deficiency, testing for 164
Antithrombotic therapy 420
Antithyroid antibodies 338
Antithyroid drugs 374
Anti-tumour necrosis factor 343
Antiviral 230
drug, absence of 424
therapy 429
Antral follicle count 705, 738
total 738
Anxiety 6, 548, 628, 657
Aorta 687
coarctation of 589
Aortic dissection 103
Aortic valve disease 589
Aortocaval compression 540
APGAR score 560t, 561t
evaluation of 559
low 315
Aplastic crisis 426
Appendiceal abscess 189
Appendicitis, acute 177
Arcus tendineus 768f
Areola
enlargement of 684
projection of 684
Aromatase binding sites 667
Aromatase inhibitors 645, 667, 712
third-generation 667
Arrhythmia 434
Arterial blood gases 161
Arterial oxygen, partial pressure of 224,
Arterial thrombotic events 740
Arteriovenous anastomosis 264f
Artery, umbilical 418
Arthralgia 111
Arthritis 111
non-erosive 112
Arthrogryposis 222
Artificial urinary sphincter, use of 768
Ascites 426, 435, 648
Asepsis, principles of 29
Aseptic technique 57
Asherman's syndrome 339, 399, 401, 699, 726
Aspartate
aminotransferase 88
transaminase 132
Aspermia 695
Asphyxia
intrapartum 510, 519
neonatal 105
neonatorum 559
Aspiration, risk of 540
Aspirin 88, 114, 116, 158
low-dose 116, 117
prophylactic 173
Assisted reproductive techniques 155, 255, 696, 725, 732, 743
Assisted vaginal delivery 458
Association of Anaesthetists of Great Britain and Ireland 25
Asthenozoospermia 695
Asthma 119, 119, 124
adenomyosis uteri 121f
classification of 120t
management of 121fc
mild 120
moderate 120
severe 120
Atazanavir 211
Atelectasis 36
Atherosclerosis, peripheral 628
Atoll sign 226
Atonic uterus, management of 527
Atopic dermatitis 120
Atopic eruption 193, 195, 196f
Atrial flutter 434
Atrial septal defect 79
Atrophy 648, 717
endometrial 667
features suggestive of 605
Atropine 371, 538
Attention-deficit hyperactivity disorder 246
Audit cycle 14f
steps for 14
Auscultation 102
intermittent 514
Autoimmune antibodies, detection of 113
Autoimmune connective tissue disorders 111
Autoimmune disorders 111, 342, 589, 733
investigations for 861
screening for 734
Autoimmune factors 338
Autonomy 4
Autosomal dominant disorder 74
inheritance of 74f
Autosomal dominant trait 75f
features suggestive of 74b
Autosomal recessive 76
conditions, features of 76b
disorder 75f
pattern of inheritance of 75f
trait 76f
Autosomal trisomies 396
Avascular bone necrosis 149
Aversion disorders 626
Axillary lump, unexplained 366
Azathioprine 114, 128
Azoospermia 695
persistent 737
B
Babcock clamp 889f
Baby-Friendly Hospital Initiative 553
Backache 47, 468
transient 468
Bacteraemia 250
Bacterial infection, secondary 215
Bacterial vaginitis 852
Bacterial vaginosis 248, 251, 266, 336, 338, 847849, 851, 852
Amsel diagnostic criteria for 847b
Bacteriuria, asymptomatic 198, 199, 199b, 199t, 201, 771
Baden-Walker halfway system 747, 748t
Bag and mask ventilation 562f
Bagel's sign 381f
Ballard examination 568
Balloon foetal endoscopic tracheal occlusion 443
Barbiturates 371, 374
Bariatric surgery 717
Barrier method 871, 875, 885, 892
Bartter's syndrome 357
Basal body temperature method 884, 884f
Basal cell nevus syndrome 74
Baseline follicle-stimulating hormone levels 738
Basic life support 538
Becker muscular dystrophy 76
Behavioural therapy 762
Belimumab 114
Benzodiazepines 371
Benzyl penicillin 275
Beta-agonists 270
Beta-haemolytic Streptococcus 543, 554
Beta-human chorionic gonadotrophin 380
serum 381, 405
titres 409
Beta-hydroxysteroid dehydrogenase 593f
Beta-thalassaemia trait 75, 145
Bevacizumab 798
Bicornuate uterus 382f, 396, 707
Biliary atresia 568
Biliary cirrhosis, primary 733
Bilirubin levels, serum 132
Bimanual pelvic examination 663
Bimanual uterine
compression 529f
massage 527
Biochemical markers 417
Biochemical screening 49, 50
first trimester 50
second trimester 50
Biofeedback therapy 866
Biophysical profile 65, 68, 69, 259, 353, 510, 517
criteria 69t
score 518
Biophysical tests 418
Biopsy 186, 815, 824, 830, 842
endometrial 606, 634
gonadal 583, 585
ovarian 734
ultrasound-guided 183
Biparietal diameter, ultrasound measurement of 417f
Biphasic pills 871
Bipolar diathermy 30, 30f
Birth
asphyxia 565
defects 355
alcohol-related 242, 245, 246
mode of 90, 169
place of 126, 232
premature 286
timing of 91, 96, 98, 169, 232
trauma 322, 354
Bisacromial diameter 503
Bishop's score 461, 461t
Bisphosphonates 608, 609t
preparations of 609
Biventricular cardiac hypertrophy 264
Bladder 285f, 286f, 771
catheterisation 895
diary, maintenance of 762, 775
dysfunction 499
neck
identification of 767
sling 765
suspension procedures 768f
overactive 762
pain syndrome 771, 774, 776
aetiology 774
diagnosis 774
management 775
sensation 775
Blake's cysts 222
Blastocyst 678, 730f
formation of 678
implantation of 680f
Bleeding 178, 279, 882
abnormalities 780, 881
antepartum 278
during and following abortion 401, 402
episode, duration of 634
gastrointestinal 271
intermenstrual 633, 785
intra-abdominal 365
intraoperative 811
mild-moderate 282
piles 140
postcoital 633
postoperative 811, 812
postpartum 278
volume of 634
Bleomycin 737
Blighted ovum 381, 395
Blindness, colour 76
Bloating 667
Blood
borne
infections 248
transmission 426
viruses, screening tests for 57
coagulation
disorder 335
studies 527
cultures 545
filled pockets 484
film 213
flow, impairment of 159
glucose level 340, 538
maintenance of 168, 174
monitoring of 169, 173
group 45, 88, 331, 340
typing 380
indices 141, 144
investigations 113, 180, 545, 854
loss 140, 444, 785
massive 527b
reduction in 648
parameters 141
pressure 23, 88, 95, 96, 516, 781
maintenance of 162
measurement 89, 96
monitoring of 173
products 284
sample 59
tests 44, 89, 96, 200, 280, 782
preoperative 481
transfusion 143
requirement for 282
transmitted infections, screening for 615
type 436
B-lynch suture 529f
Body mass index 22, 23, 23t, 44, 122, 155, 157, 167, 396, 684, 703, 741, 781
calculation of 719
Bone
density
average 608
reduced 667
scan 147
loss, prevention of 735
marrow
examination 141
studies 144
mineral density
assessment of 608
scan 734
Bony pelvis, deformities of 457
Borderline ovarian tumours, adenomyosis uteri 799
Botulinum toxin 764
Bowel
obstruction 177, 444
preparation 25
Brachial plexus 508f
injuries 507
Brachytherapy 821
interstitial 821
intracavitary 821
Bradyarrhythmia 434
Bradycardia 62
Bradyzoite 425
Brain
abnormality 221, 246
atrophy 222
Braxton Hicks contractions 450
Breast
abscess 555
formation 33
absence of 601
cancer 23, 182, 184, 366, 409, 610, 739
familial 74
pathogenesis of 779
risk of 604, 608
development
normal 601
precocious 599f
staging for 23
Tanner stages of 598t, 684f
engorgement 33, 554, 555b, 598
enlargement of 684
examination 23, 44, 544, 684, 703, 792
malignancy 182, 192
normal 601
Breastfeeding 92, 110, 113, 127, 130, 148, 181, 182, 210, 212, 232, 429, 553, 862, 873
Breathing 32, 539, 560
shortness of 88
Breathlessness 119
Breech
presentation 304, 305, 305b, 305f, 321, 328, 346, 463, 479
diagnosis of 305
types of 304f
trial of 309
vaginal delivery 309, 309b, 310, 315, 492
indications for 309b
Brisk pupillary reaction 538
British Committee for Standards in Haematology Guidelines 164
British National Formulary 199
British Nursing Index 8
Bromide 371
Bromocriptine 371
Bronchitis, postoperative 36
Brow presentation 321, 322f, 328
Brucella 396
Budd-Chiari syndrome 116
Bupivacaine 467
Bupropion 629
Burkholderia cepacia 122
Burns-Marshall method 312
Burns-Marshall technique 312, 312f
Busulfan 737
Butoconazole 850
Butorphanol 466, 513
C
Cabergoline 371
Caesarean delivery 210, 211, 230, 232, 232fc, 269, 282, 305, 318, 319, 322, 345, 346b, 347, 348t, 479, 480t, 487, 488b, 489
classical 283, 318
classification of 481
elective 211b, 309
emergency 318, 347, 617, 887, 893
indications for 230b, 479
maternal request for 479, 480
planning 282
previous history of 279
requirement of 126, 444
steps of 482f
technical difficulty of 284b
timing of 481
Caesarean scar
history of 345
pregnancy, diagnostic criteria for 384b
Caesarean section 104, 152, 158, 265, 322, 458, 491
ambulation after 487
classical 319, 488
elective repeat 345, 346, 349
emergency 282b
haemostatic 488
perimortem 540
prelabour 267
previous 262, 463
Caesarean wound inspection 544
Calcium channel blockers 270, 761
Calendar method 884
Campylobacter 545, 546
Cancer
antigen 125 672
serum 664
cachexia 785
early stage 818, 825
endometrial 610, 779, 785
evaluating spread of 782
risk 588
spread of 816f
stage 187, 782, 825
treatment 737
Candida
albicans 850
vulvovaginitis 850t
Candidal infection 849
complicated 850b
Cannabis 247
Carbamazepine 127, 369, 370
Carbetocin 526
Carbimazole 109, 371
Carbohydrate deficient transferrin 243
Carbon dioxide, partial pressure of 231
Carbon monoxide
levels of 237
test 238
Carbon-coated zirconium 768
Carboprost 350, 529
Carboxymethylcellulose
combination 668
gel 668
Carcinoembryonic antigen, levels of 793
Carcinogens 241
Carcinoma
cervix during pregnancy 188b
epithelial 189
gastrointestinal 189
in situ 801
ovaries, staging for 794t
Cardiac anomalies 53, 245, 589
Cardiac care 541
Cardiac disease 101, 361
prevention of 364b
Cardiomyopathy, hypertrophic 74, 171
Cardiosplenic syndromes 434
Cardiotocographic abnormalities 134
Cardiotocography 65, 67, 326, 457, 513b, 514, 517
Cardiovascular complications 272, 563
Cardiovascular disease 363, 604, 609, 611, 691, 710, 735, 763, 873
Cardiovascular risk factor 24
Cardiovascular system 22
examination of 24, 102
Cataracts 206
Cavity, endometrial 641f
Cefalexin 199
Cefazolin 200, 275
Cell
hyperplasia 416
salvage 532
Cell-free DNA 62, 63
testing, principle of 63f
Cellulitis 250
Centers for Disease Control and Prevention 140, 849
Central nervous stimulants 247
Central nervous system 66, 87, 245, 357, 425, 600, 693
complications 272
defects 442
depressants 247
spectrum of 244
tumours 136
Central venous pressure 33
Cephalic application 492
Cephalic presentation, types of 321
Cephalohaematoma 499
neonatal 491
Cephalopelvic disproportion 261, 319, 480, 493
Cerebellar
atrophy 222
hypoplasia 429
Cerebral
complications 95
palsy 266, 277, 327, 430, 519
Cerebrovascular accident 149
Cerebrovascular system 248
Cervical
anomalies 339
cancer 185, 187fc, 188, 814, 818fc, 819fc, 823
clinical staging of 186
early stage 823
previous vaccination against 185
staging 816, 816t, 817f, 819
cap 886, 887
cerclage 271, 342
culture 664, 848, 854
cytology 186
dilatation 267, 494
discharge, history of 702
dysplasia 703
dystocia, secondary 188
endometriosis 806
erosions 280, 397
factor
adenomyosis uteri 707
evaluation of 707
infertility 698
glandular intraepithelial neoplasia 811, 811fc
incompetence 339, 342, 344, 396, 401, 403
development of 340b
diagnosis of 340
tests for 341
insemination 707
intraepithelial neoplasia 801, 805, 808fc
lacerations 401, 403
length measurement 267
malignancy
during pregnancy 185, 192
signs of 186
symptoms of 186
mucus 884
alterations of 812
method 884f
thickening of 715
plasticity, loss of 812
pregnancy, diagnostic criteria for 384b
preparation 896
ripening 460
smear abnormalities 803
stenosis 812
surgery 812b
history of 272
tear 458
repair of 475, 475f
Cervicitis 806
Cervicopexy, abdominal 752
Cervicovaginal cultures 57
Cerviprim 461
Cervix 285f, 683
cancer of 801, 821f
dilation of 452f
effacement of 452f
evaluation of state of 461
examination of 268
infection of 806
laser vapourisation of 810f
posterior aspect of 815f
premature dilatation of 812
transvaginal sonography of 816f
tubercular lesion of 806
Chemoradiation 821
primary 834
therapy 818
Chemotherapeutic agents 181
types of 181
Chemotherapy 786, 797, 818, 822, 823, 827
intraperitoneal 797
intravenous 797
systemic 797
types of 737, 797
Chest 565
compression 562
infant 562f
encircling technique 562f
examination 792
imaging 792
pain 878
non-specific 102
syndrome, acute 150
tightness 119
ultrasound 223, 224
white-out of 569
X-ray 22, 98, 161, 570f, 782
Chickenpox 203
complicated 205
infection 203, 206, 235
Child sexual abuse 620, 621
Chills 178
Chlamydia 210, 273, 338, 396, 707
antibodies 707
trachomatis 266, 661, 707, 839, 845, 848, 853, 860, 883, 887, 895
life cycle of 840f
Chlamydial infection 839, 841, 845
Chloral hydrate 374
Chlorambucil 737
Chloramphenicol 371, 374
Chlormethine 737
Chloroquine 374
Chlorpropamide 370, 374
Cholera 545
Cholestasis, intrahepatic 193194, 195f
Cholestyramine 132, 197
Cholinesterase 369
Chorioamnionitis 272, 275, 458, 493, 851
acute 272
chronic 272
diagnosis of 276
monitoring for 275
risk of 273
Chorioamniotic membranes, sealing of 275
Chorionic sacs 260f
Chorionic villus
biopsy 56
sampling 55, 56, 58, 61, 210, 341
transabdominal 58, 59f
transcervical 58
Chorionicity 258
determination of 259
Chorioretinitis 206, 425
Choroid plexus cysts 222
Christmas disease 76
Chromosomal abnormalities 416, 438
Chromosomal aneuploidies 78t
Chromosomal banding 55
Chromosomal disorders 71
Chromosomal translocation 71f
Chronic obstructive pulmonary disease 24
Chronic pelvic pain 638, 660, 857
causes of 660b
management of 662fc
Ciclosporin 114
Ciprofloxacin 371
Circulation 32, 539
Clamping cord 455
Classical congenital rubella syndrome 424
Clavicle 317
Clear cell adenocarcinoma 824
Cleft
lip, aetiology of 241
palate, aetiology of 241
Cleidotomy 507
Clenbuterol 763
Clitoral hypertrophy 584
Clitoral measurement 684
Clitoral reconstruction, role of 618
Clitorodynia 863
Clomiphene 697
administration of 743
citrate 703, 709, 712, 714, 717, 742, 743
challenge test 705
protocol 727
use of 727
Clonazepam 370
Clonic stage 93
Clostridium
difficile 30
infection 773
septicum 543
welchii 335
Clotrimazole 850
Coagulopathy 196, 541
Cocaine 247, 250, 374
hydrochloride 247
powder of 247
Cochrane Central Register of Controlled Trials 8
Cochrane methodology register 8
Codeine 247
Coelomic metaplasia, theory of 662
Cognitive behavioural therapy 249, 656
Coitus interruptus 884
Cold clammy skin 248
Cold-knife conisation 809, 810f
Colour Doppler 286
examination 382
Colpoperineorrhaphy 751
procedure of 754f
Colposcopy 635, 806, 865
Coma 93
Combined oral contraceptive 723, 875
pills 408, 652, 657, 672, 871, 878
cyclical use of 657
Combined spinal epidural analgesia technique 468
Comparative genomic hybridisation 55
Complete abortion 395
Complete androgen insensitivity syndrome 581
Complete blood count 88, 115, 144, 348, 380, 435, 635, 641, 662, 664, 749
Complete mole 404, 404t, 411
Complex procedural hierarchy 17
Compression duplex ultrasound 160
Compression stockings 163
Computed tomography 190, 689
pulmonary angiogram 161, 162
Computer-integrated patient-controlled epidural analgesia 469
Conception
cycles, natural 725
normal 677
retained products of 531
Condom 248, 686, 875
female 885, 885f, 887
male 885, 885f, 887
use of 807
Cone biopsy 809, 818
Congenital adrenal hyperplasia 581, 710, 721
diagnosis of 722fc
Congenital anomalies 241, 263, 373, 565, 589
screening for 125
Congenital defects 438, 698
Congenital infection 235, 425
risk of 428
Congenital malformations 171, 182
screening for 169
types of 171b
Conisation 272
Conjoined twins 265
types of 257
Connective tissue disorders 111, 342
Conscious sedation 28
Consecutive spontaneous abortions 340
Conservative management 319, 531, 535
Conservative surgery 673
Conservative treatment 642
Constipation 47, 137, 138b, 139, 182, 651, 756
chronic 137
management of 137, 138fc
Contact dermatitis 862
Contraception 148, 871
advice related to 152, 212, 896
agents 872f
barrier method of 885, 892
counselling regarding 637
emergency 871, 888
failure of 875t
following gestational trophoblastic disease 408
methods of 871, 871b, 875, 891
permanent 871
method of 888, 893
postcoital 871
progestogen-only 871
temporary 871
Contraceptive
hormonal 666, 717, 871
implants, subdermal 878
methods
combined hormonal 874876, 871, 891
long-acting reversible 872
pill, progesterone-only 372
Contraction stress test 65, 68, 510, 517
Controlled cord traction, methods of 532f
Controlled ovarian
hyperstimulation 739, 743
stimulation 739
Conventional therapy 667
Coomb's serum 294
Coomb's test 294, 296f
indirect 294
Cooper's ligaments 768f
Copper device 883f
parts of 882f
Cord
accidents 330
clamping 230
timing of 269
entanglement, risk of 308
haematoma 61
presentation 326329
prolapse 276, 316, 326329
causes of 326, 326t
diagnostic of 326f
incidence of 329
tumour of 434
umbilical 326f, 532f
Cordocentesis 56, 57, 59, 61
procedure of 59f
Cornual pregnancy, diagnostic criteria for 384b
Corona viral pneumonia 226
Coronavirus 230b
disease 2019 229, 230
infection 222, 236
Corpus callosum 222
Corpus luteum 594
formation of 679
haematoma 651
ovulation of 679
Cortical development, malformation of 222
Corticosteroids 116, 136, 137, 197, 274, 436, 696, 850
course of 261
therapy 271
topical 862
Cosmetic vaginal surgery 584
Co-trimoxazole 371
Cotton swab test 864
Cough 119
stress test 764
Coumarin anticoagulants 374
Counselling, antenatal 345
Couvelaire uterus 289, 289f
COVID-19 222, 229, 230, 233fc, 235
infection 223, 224t, 228, 229, 229fc, 233, 234
mode of transmission of 223b
pathophysiology of 223
stages of 226
Coxiella burnetii 546
Cramps, abdominal 240, 713
Cranial abnormalities 222
Crazy paving appearance 225
C-reactive protein 111, 272, 538, 854
Crigler-Najjar syndrome 568
Criminal abortion 612
Crohn's disease 733
Crown-rump length 397
ultrasound measurement of 417f
Cryopreservation 184, 730
Cryosurgery 808
Cryptorchidism 694
Cryptozoospermia 695
CT chest severity score 226
Cubitus valgus 588
Cul-de-sac 664f, 750f
obliteration of 749
Culdoplasty 749
Cushing's disease 684, 721
Cushing's syndrome 600, 710
Cyanosis 102, 565
Cyclic adenosine monophosphate 593f
Cyclooxygenase 271
Cyclophosphamide 114, 128, 409, 737
Cypionate 629
Cyproterone 722
acetate 371, 712
Cystadenocarcinomas 788
Cystadenoma
mucinous 189
serous 189, 788
Cystic fibrosis 75, 121, 122, 124, 171, 438, 694
complications of 122
Cystitis 39, 199t, 250
acute 198, 200
interstitial 661
Cystoscopy 768
Cystourethritis 785
Cysts
benign non-ovarian 189
benign ovarian 189
contents, spillage of 191
functional 189
multiple follicular 710
paratubal 189
periventricular 222, 429
subcapsular 714
Cytogenetic analysis 332, 340
Cytokines 339, 593
Cytological screening test 802, 842
Cytomegalovirus 56, 133, 337, 339, 357, 427
congenital 429
hyperimmune globulins 429
infection 427, 432
Cytoreductive surgery 795
procedure of 795b
Cytotoxic chemotherapy 734
D
Dactinomycin 737
intravenous 409
Daily foetal movement count 65, 421, 517
Danazol 636, 657, 665, 667, 668, 672
Darifenacin 763
Daunavir 211
Dead baby, examination of 332
Dead foetus, mode of delivery of 333
Deafness 428
Deaths
postneonatal 362
prevention of 363365
types of 362
Decidua basalis 268
Decubitus ulceration 756
Deep transverse perineal muscle 758f
Deep vein thrombosis 25, 113, 154, 159, 165, 489, 639, 786
causes of 159
Degenerative disorders 438
Dehydration 23
Dehydroepiandrosterone 709, 719, 722
sulphate 709, 710, 719, 722
Deinfibulation, requirement for 616
Delayed puberty 599, 601, 603
causes of 601t
Delivery 333
abdominal 479
estimated date 91
mode of 113, 123, 174, 211, 230, 232, 261, 262, 269, 275, 436
operative 491
premature 215
timing of 143, 174, 183, 230, 261, 421, 422, 436
Delphi technique 16, 16f
Dementia 610
Denosumab 609
Dental hygiene, Poor 250
Deoxyribonucleic acid 144, 802
Depot medroxyprogesterone acetate 874, 878, 879
Depression 628, 660, 724
postpartum 548, 549, 551, 552
schizophrenia 548
Dermatologic disorders 194t
Dermatoses 859
Dermoid 189
Desferrioxamine 147
Desmopressin 763
Detrusor overactivity 769
Dextran 158
Dextroamphetamine 247
Dextrorotated uterus 483
Dextrose 563
Diabetes
complications of 172
development of 167b
education 168
history of 22
insipidus
nephrogenic 76
neurohypophyseal 74
mellitus 65, 167, 170, 337, 503, 687, 710, 733, 735
delayed complications of 175fc
gestational 45, 65, 122, 123, 167, 168t, 169b, 170t, 171b, 176
immediate metabolic consequences of 175fc
insulin-dependent 50
maternal 357
type 1 589
type 2 625, 691
pre-existing 167, 176
testing for 122
Diabetic ketoacidosis 136
characteristic features of 176b
classification of 176t
Diabetic neuropathy 628
Diamniotic dichorionic monozygotic twin pregnancy 256, 257f
Diamniotic monochorionic monozygotic twin pregnancy 256, 257f
Diaphragm 875, 886, 887
Diarrhoea 365, 544, 651
Diathermy 30, 30f, 668
complications of 31
Diazepam 374
Dichorionic twins 259
Diet 46, 172
Diethylstilbestrol 370, 699
Differential leucocyte count 25
Digital anomalies 54
Digital vaginal examination 273, 326
Digoxin 442
Dihydrotestosterone 677, 710, 718
Di-iodo-tyrosine 106
Dilatation 896
Dinoprostone 461
vaginal instillation of 461
Diploid cell 678
Dipstick test 772
Direct maternal death, causes of 363
Disability 539
Discoid
lupus 111
rash 112
Dissecting rectus sheath 483
Disseminated intravascular coagulation 132, 205, 213, 290, 290t, 333, 525, 536
pathophysiology of 290fc
Distant infection 543
Distant metastasis 794
Distress, psychological 691
Diverticulitis 177
Dizygotic twins 255, 256f, 256t
formation of 255f
Dizziness 102, 365, 651, 657
Dolutegravir 211
Domestic violence 47
Dominant follicle 592f, 593
Dopamine agonist 555, 690
Doppler
assessment 435
foetal heart rate monitoring 44
indices, types of 419t
sonography 67
ultrasound 160, 162
velocity waveforms 418
waveform analysis 260
Dorsal lithotomy 310
Double-blind trials 9
Down syndrome 45, 50t, 51, 55, 78, 136, 210, 438
biochemical screening for 50
prenatal diagnosis of 55
risk of 50
Doxorubicin 184, 737
Doyen's retractor, insertion of 483
Drains, use of 40
Drospirenone 657, 712, 722, 723
Drug
abuse 248250
pharmacotherapy for 249
categories 247
interaction 888
pharmacokinetics 370
plasma concentrations 370
toxicity, monitoring for 210
usage during pregnancy 246, 251
Dryness 604
Dubin-Johnson syndrome 568
Dubowitz examination 567
Duchenne muscular dystrophy 76
Ductus venosus 422
Dührssen incision 315f
Duloxetine 763
Duodenal atresia 357
Dydrogesterone 607
Dysfunctional uterine bleeding 779, 811
differential diagnosis of 634b
Dyslipidaemia 709
Dysmenorrhoea 599, 617, 650, 651, 655, 660, 666, 671, 882
management of 652fc
primary 650, 653
secondary 650, 653
types of 650
Dysmorphia 245
Dyspareunia 604, 605, 626, 627629, 660
causes of 626, 626t
deep 626
postpartum 628
superficial 626
Dysphoric disorder, premenstrual 654
Dysplasia
bronchopulmonary 266, 569
severe 801
Dyspnoea 88, 102, 536
Dystrophia myotonica 74
Dystrophy, hyperplastic 859
Dysuria 604, 605, 772
E
Early pregnancy
assessment unit 389
bleeding, management of 386fc
complications 365
loss 235
screening 588
Echocardiography 149, 536
Echogenic cystic lesions 66
Eclampsia 85, 93, 95fc, 100, 132, 360, 463, 541
aetiology 93
diagnosis 93
differential diagnosis 93
obstetric management 93
Ectoderm 681
Ectopic pregnancy 177, 240, 297, 298, 298b, 379, 381, 382f, 383f, 385, 388fc, 389b, 393, 397, 731, 857, 883
causes of 379
contents of 386
cornual 382f
diagnosis of 365, 387fc
different types of 383
expectant management of 389b
laparoscopic management of 391
management of 385
ruptured 382, 393
transvaginal ultrasonography diagnosis of 382t
types of 385, 388t
Eczema 120
Edinburg postnatal depression score 550f
Edwards syndrome 51, 78
Efavirenz 211
Eflornithine 723
Egg, poor quality of 741
Ejaculation, premature 692
Ejaculatory failure, management of 697
Elective single embryo transfer 731
Electrocardiogram 98, 161
Electroencephalogram 125
Electrolyte levels, serum 583
Electronic foetal monitoring 66, 268, 510, 517
Elejalde syndrome 434
Eltroxin 690
Embryo
blastocyst stage of 730f
cleavage stage 729
conversion of 679f
cryopreservation of 739
culture of 729, 732
early development of 681f
early stage 681f
simultaneously 255
transfer 728, 729
Embryological development, abnormal 579
Embryonic chromosomal abnormalities 337
Embryonic disc 681
Emergency contraception 871, 888
advice related to 625
progestogen-only 887
Emesis index, pregnancy unique quantification of 134t
Emtricitabine 211
Enanthate 629
Encephalitis 207
Encephalomalacia, multicystic 263
Encephalopathy
degree of 520
neonatal 519, 520
Endocarditis 250
infective 102
prophylaxis, intrapartum 104
Endocrine 336
anomalies 589
factors 337, 860
problems, treatment of 341
system, autoimmune disorders of 733
Endoderm 681
proliferation of 580f
Endometrial ablation 636, 637b, 638, 639, 673
procedure for 636
techniques 637b
Endometrial biopsy 606, 634
indications for 782b
Endometrial cancer 610, 779, 785
advanced stage of 781f
aetiology 779
complications 785
development of 688, 781b
diagnosis 780
differential diagnosis 782
FIGO staging of 784t
risk factors for 634
Endometrial cavity 641f
distortion of 699
Endometrial development, normal 683
Endometrial hyperplasia 552, 610, 657, 670, 690, 691
classification of 780t
development of 657
management of 782, 783fc
Endometrial neoplasia, exclusion of 637
Endometrial sampling 606
Endometrial stripe 381
Endometrial thickness, abnormal 781f
Endometrioid intraepithelial neoplasia 780
Endometrioma 189
ovarian 664
Endometriosis 339, 650, 660, 661, 662, 665, 666fc, 701, 703
ablation of 668
classification of 664
excision of 668
lesion 663f, 665
mild 701, 741
minimal 701
severe 701
surgery 668
symptoms of 663, 667
types of 701
Endometriosis-associated infertility
management of 665
treatment of 668
Endometriosis-associated pain 668
treatment of 668
Endometritis 177, 699, 853
chronic 338
postpartum 273, 851
Endometrium
proliferative 595f
secretory phase 595f, 683
transforms proliferating 683
Endomyometrial ablation 673
Endopelvic fascia 768
point of attachment of 768f
Endotracheal intubation, magnified view of 562f
Endotracheal tube, placement of 562
Enterococcus faecalis 543
Enterocolitis, necrotising 567, 569, 570
Entonox 466
Enzyme immunoassay 430
Enzyme-linked immunosorbent assay 428
testing 425
Ephedrine 371, 763
Epidural anaesthesia 325, 473
Epidural analgesia 276, 310, 325, 467, 469, 472
administration of 467f
Epilepsy 125, 364
and pregnancy 125, 127b, 131
diagnosis of 125
symptom of 125
Epinephrine 563
Epirubicin 184
Episiotomy 472, 474, 495
administration of 500
Epispadias 692
Epistaxis 22
Epstein-Barr virus 133
Erectile dysfunction 692
Ergot 374
alkaloids 350
Ergotamine 371
Erythema 160
infectiosum 426
Erythroblastosis foetalis 302
Erythrocyte sedimentation rate 111, 662
Erythromycin 374
Erythropoietin 143
Escherichia coli 36, 266, 554, 771, 776
Eslicarbazepine 127
Etamsylate 644
Ethanol 244
Ethinyloestradiol 691, 723
Etoposide 409
Euglycaemia 167
European League Against Rheumatism 112
European Organisation for Research and Treatment of Cancer 796
European Society of Gynaecological Endoscopy System 646f
Evra® patch 871, 876, 877
Excessive hair 718f
Excision 668
Exercise 702
in pregnancy 46
Exophytic endometrial cancer growth, hysteroscopic appearance of 635f
Expulsion 883
External cephalic version 307, 308, 308t, 309f, 315
complications of 308
prerequisites for 308
procedure of 308, 309f
timing of 307
External genitalia 602, 613
development of 579, 580f
examination of 583, 598, 622
External pneumatic leg compression 38
Extracorporeal membrane oxygenation 233
Extremities, examination of 704
Eye 565
examination 703
problems 878
F
Face 322, 565
presentation 320, 320f, 328
diagnosis of 321
Face-to-face breastfeeding support 555
Facial
acne 720f
clefts 54
defects 442
mask, use of 227
Factor V leiden 74
Failure rate, high 885
Fainting 651
Fallopian tube 381f, 593, 700, 794t, 889f
cancer 826828
laparoscopic staging in 827
infection 740
torsion 177
Falloposcopy 707
Family planning methods, natural 875, 883, 892
Fascia lata 765
Fat distribution 598
Fatigue 102, 111, 651, 657, 734
Fatty liver, acute 132, 138, 177
Fear 6
Febrile illness, mild 425
Febrile morbidity 499
postoperative 36
Female condom 885, 885f, 887
Female genital mutilation 47, 612, 613, 615, 616
classification of 613
management of 616
prevalence of 613, 614f
World Health Organization Classification of 613t, 614f
Female infertility 698
causes of 698b
Feminism, signs of 582
Femur length 416
ultrasound measurement of 418f
Fentanyl 466
Ferning 273
Ferriman-Gallwey scoring system 718, 719
modified 721f
Fertilisation 679f
dizygotic 255
egg 594
failure of 741
monozygotic 255
normal process of 405f
prevention of 871
Fertility 589, 737
awareness-based methods 872t
loss of 737
natural regulation of 871
preservation 737739
problems 737
sparing surgery 818
types of 738
Fever 11, 178, 544
benign 543
familial mediterranean 75
mild exanthematous 424
Fibres, parasympathetic 472
Fibrin
degradation product 290
glue, role of 275
Fibrinogen degradation product 536
Fibrinolysins 643
Fibroblast growth factor receptors 798
Fibrochondrogenesis 54
Fibroid 304, 406, 640, 649, 673, 703
anatomical location of 700
degeneration of 177, 650
development of 640
intracavitary 641f
submucous 646f
subserosal 641f
types of 640f
uterus 642fc, 643fc
Fibromyomas 640
Fibronectin 267, 268
levels, measurement of 267, 268b
test 268
Fibrosis 613
Finasteride 723
Fine needle aspiration cytology 108
Finger clubbing 102
Fistula formation 756
Fitz-Hugh-Curtis syndrome 857f
Flecainide 442
Flexion point 497f
Fluconazole 370
Fluid 563
and electrolyte
balance 33
management 229
and oral food after caesarean section 486
intake 151
intravenous 569
therapy 90
Flu-like symptoms 428
Fluorescence in situ hybridisation 55, 80, 439, 588
Fluorescent immunoassay techniques 424
Flutamide 722, 723
Foetal alcohol
spectrum disorders 244, 245b
syndrome 242, 244, 245, 245f, 246
partial 246
Foetal anaemia 426, 437, 442
Foetal analgesia 443
Foetal aneuploidy 62b
screening for 259
Foetal anomalies 210, 438, 438b, 440fc
biochemical screening for 49
detection of 332
screening for 45, 210
ultrasound screening for 49, 439
Foetal anticonvulsant syndrome 126t
Foetal arm prolapse 318
Foetal arrhythmias, treatment of 437, 442
Foetal arterial systems 353
Foetal asphyxia 318, 517fc
antepartum 510
development of 570fc
intrapartum 510, 519
Foetal assessment 130
Foetal autopsy 331
Foetal behavioural studies 246
Foetal biophysical profile 436
Foetal biparietal diameter 500
Foetal bleeding disorders 480
Foetal blood
lactate sampling 559
pH sampling 559
sampling 515b
vessels 291f
Foetal bradycardia 511f
Foetal brain magnetic resonance imaging 221
Foetal cardiac myocytes 426
Foetal complication 95, 143, 148, 170, 206, 212, 221, 234, 250, 263, 267, 272, 286, 290, 315, 321, 327, 358, 413, 503
Foetal compromise 282
Foetal congenital
anomalies 352
malformations 171
Foetal cutaneous scarring 60
Foetal damage 424
Foetal death 286, 330, 332, 396
Foetal defects 61
Foetal deformities 277
Foetal demise 395, 444
previous 65
Foetal descent 452
Foetal distress 152, 196, 286, 308, 353, 480, 518t
causes of 559t
development of 519
evidence of 516
intrapartum 515
management of 516b
signs of 511
Foetal echocardiogram 435
Foetal effects 240, 373
Foetal electrocardiogram analysis 516
Foetal endoscopic tracheal occlusion 444f
Foetal face, direction of 506f
Foetal fibronectin 268
Foetal growth
monitoring of 260
restriction 137, 147, 152, 284, 346, 415, 417, 463
stages of 416t
Foetal haemorrhage, massive 513
Foetal head
engagement of 494
entrapment 315
palpation of 324f
part of 494
position of 457
sides of 495
station of 452, 452f
Foetal heart
absent 331
auscultation 317
decelerations 493
rate 60, 67, 276, 306, 461, 510, 512, 516
abnormalities 215
pattern 276
traces, categorisation of 513t
sound 257
tracing 513f
Foetal hypoxia 396, 510
causes of 510b
consequences of 519fc
Foetal indications 262, 461, 493
Foetal infection 218, 424, 430
severe 426
Foetal injury 499, 501
irreversible 505
Foetal investigation 280
Foetal karyotype 331
Foetal loss 61, 62, 113
Foetal lung maturity, assessment of 461
Foetal macrosomia 258, 347, 463, 500
pathogenesis of 171fc
Foetal malformations 145, 356
Foetal management 425
Foetal microcephaly 221
Foetal monitoring 91, 96, 98, 127, 169, 173, 268, 284, 310, 429, 453, 461
antenatal 47
continuous 458
Foetal movement
count 67
reduced 65, 88
Foetal organs
compression of 356
malformation of 370
Foetal polyuria 357
Foetal popliteal fossa 315f
Foetal position 451
abnormal 320
Foetal presentation 450, 451
abnormal 316
Foetal pulse oximetry 516
Foetal red cells 303
Foetal scalp
blood 515
sampling 515
lactate
estimation 515
measurement 515
Foetal shoulders 503
and arms, delivery of 311f
Foetal skull
bones 331f
degree of moulding of 453t
moulding of 452, 453f
Foetal structural defect 442
Foetal surgery 442, 444
Foetal surveillance 104, 113, 183, 230, 268, 356
antepartum tests of 559
intrapartum tests of 559
management protocol for 516
Foetal tachycardia 512f
Foetal therapy 436
Foetal trauma 277
Foetal umbilical artery Doppler evaluation 65
Foetal varicella syndrome 203, 204, 206
Foetal weight, estimated 518
Foetal well-being
adjuvant tests of 515
assessment of 258
confirmation of 60
tests for 65, 352
Foetus
development of 681f
management of 317fc
Folate supplements 145
Foley catheter 767
Folic acid 150, 172
deficiency of 140
regular intake of 169
supplementation 126, 148, 150
Follicle
secondary 592
stimulating hormone 592, 600, 604, 644, 677, 686, 688, 690, 693, 701, 704, 709, 710, 726
tertiary 592
Follicular aspiration 729
Follicular development 593
and ovulation, inhibition of 878
Follistatin 594
role of 594
Food diary, maintenance of 775
Foot dorsiflexion 487
Forceps 491, 499
application 495
contraindications for 493
blades of 495
correct application of 497b
delivery 491, 493, 494, 501t, 502
prerequisites for 494
Fourth-degree laceration, repair of 473
Fraction of inspired oxygen 224, 231
Fragile X mental retardation 686
testing for 687
Fragile X syndrome 77
Fraser's competence 623
Fraser's guidelines 623
Free thyroxine 109, 331
levels 602
Fresh frozen plasma 290, 526
Friedman's criteria 458
Friedman's curve 449f
Friedreich's ataxia 75
Functional constipation, Rome III criteria for 138b
Fundal grip 316
G
Gabapentin 606
Galactokinesis 554
Galactopoiesis 554
Galactorrhoea 702
Galactosaemia 75
Gallbladder disease 177
Gametes, culture of 732
Gametogenesis 677
Gamma-glutamyl transpeptidase 243
Gamma-hydroxybutyric acid 247
Gardnerella vaginalis 853
Gastroenteritis 136
Gastroesophageal reflux 177
Gastrointestinal abnormalities 171
Gastrointestinal diseases 132
Gastrointestinal disorders 136
Gastrointestinal function, normal 487
Gastrointestinal tract 357
Gaucher's disease 75, 434
General anaesthesia 24, 27, 170
Genetic
abnormalities 341
counselling 80, 341
defects 438
disease 694
disorders 71
factors 662, 860
screening 150
testing 436
Genital cosmetic surgery, female 615
Genital herpes 206, 841, 845
management of 842
recurrent 207
Genital infection 618
screening for 210
Genital injury 612
Genital organs, female 824
Genital scarring 617
Genital sexual arousal disorder 627
Genital surgery, infant 585
Genital tract 491
abnormalities 686fc
injuries 612
management of 612
trauma 525
Genitalia 566, 568
external 602, 613
internal 579
Genitourinary anomalies 250
Genitourinary medicine 207, 266, 839
Genitourinary tract disorders 136
Germ
cell tumour 189, 789, 799
layers 681
Gestation 358
multifoetal 255, 259t
period of 90, 91, 94, 181, 266, 358, 566t
Gestational age 188
estimation of 895
small for 44, 97, 415, 417
ultrasound assessment of 461
Gestational diabetes mellitus 45, 65, 122, 123, 167, 168t, 169b, 170t, 171b, 176
pathogenesis of 167, 167fc
screening for 45
Gestational sac 258f, 381f, 382f
Gestational trophoblastic disease 136, 404, 407b, 408
Gestodene 722
Gestrinone 665, 667
Gillick's competence 623
Giuffrè-Tsukahara syndrome 77
Glandular cells, atypical 787
Glasgow coma scale 538t
Glibenclamide 168
Glomerular filtration rate 113, 198
estimated 199
Glomerulations 775, 775f
Glomerulonephritis 111
Glucocorticoids 371
antenatal 57
Gluconeogenesis 567
Glucose
intolerance 122
tolerance test 168t
Glucose-6-phosphate dehydrogenase 213, 435
deficiency 76
Glutethimide 374
Glycaemic control 147, 173
optimisation of 172
Glycerol suppositories 138
Glyceryl trinitrate, use of 316
Glycogen storage disease 75
Glycogenolysis 567
Glycoprotein 267
Goldfish bowl 18
technique, set-up of 17f
Goldman's cardiac risk index 24, 24t
Gonadal dysfunction 737
Gonadal dysgenesis 581, 587, 687
Gonadal examination 585
Gonadal failure, primary 601
Gonadal sex 583
Gonadal shielding 739
Gonadoblastoma 789
Gonadotoxic chemotherapy 734
Gonadotrophin
inhibiting pituitary 667
injections 743
levels 602, 685, 721
measurement of 599
pituitary 728
therapy 658
Gonadotrophin-releasing analogues 658
Gonadotrophin-releasing hormone 642, 652, 656, 660, 662, 693, 728
agonist 636, 644, 667, 723, 728, 734, 739
protocols 728
use of 727
analogue 184, 600, 672
antagonist
protocols 728
use of 727
Gonads
development of 579
intra-abdominal 586
removal of 589
Gonorrhoea 210, 843, 843f, 845
Graafian follicle 592
Graduated elastic compression stockings 160
Grand multipara 318
Granulosa cell 592
layers 593
Grave's disease 107
Gravid uterus 369
Greasy skin 667
Groin traction 314, 314f
Ground glass
granularity 569
opacities 225, 225f
Group B streptococcal
colonisation 266
infection 275b, 571
Growth
hormones 588
restriction 182
Guillain-Barré syndrome 115
Gynaecological disorders 489
previous 489
Gynaecological examination 615
Gynaecological management 606
Gynaecological oncology 777
Gynaecological surgery 34
Gynecologic cancer inter group 798
Gynecologic oncology group 784, 796
H
Haematocrit 25, 88, 141, 144, 435
Haematological tests 216
Haematoma 612
epidural 500
formation, risk of 486
subaponeurotic 500
subgaleal 491, 500
Haematopoietic dysfunction 22
Haematosalpinx 382, 383f
Haematuria 526
Haemochromatosis 75
Haemoglobin 141, 144, 435
electrophoresis 141
estimation 545
glycosylated 337
level 25, 45
Haemoglobinopathies 65, 140, 145
screening for 45
Haemogram 199
Haemolysis 132
elevated liver enzymes, and low platelet count syndrome 85, 87, 93, 94, 94fc, 132, 138, 177
Haemolytic anaemia, chronic 149, 426
Haemophilus
ducreyi 844
influenzae 36, 554
Haemorrhage 34, 61, 361, 365, 467, 499, 769
antepartum 44, 140, 152, 267, 278, 278fc, 282, 330, 349, 417
extensive 613
foetomaternal 61, 294, 296b, 308
intracranial 429, 500, 541, 567
intraoperative 637
massive 284b
postpartum 546
pin-point petechial 775f
postpartum 14, 132, 140, 155, 271, 278, 349, 360, 458, 489, 525, 527b, 529t, 532
primary 35
reactionary 35
secondary 36
postpartum 531
traumatic postpartum 188
uncontrollable maternal 489
Haemorrhoids 47
Haemostasis, disorders of 634b
Haemostatic brace sutures 528
Hair, abdominal 718f
Halban's cul-de-sac closure 750
Halban's culdoplasty 750f
Hallucinogens 247
Halo sign, reverse 226, 226f
Hanging drop test 32
Haploid number 579
Hashimoto's thyroiditis 108
Hashish 247
Haultain's procedure 536
Hayman compression suture, application of 530f
Head
circumference 416
examination of 565
Headache 651, 657, 667, 763, 874, 878
Health technology assessment database 8
Healthcare professionals 621
Heart 425, 566
attack 100
disease 101, 690
causes for 101t
congenital 103, 171, 416
coronary 690
cyanotic 65
failure 343
rate 33, 560, 561
baseline 511
features of 511
tracing 511f
valves, mechanical 102
Heartburn 47
Heavy menstrual bleeding 633, 634b, 635b, 637b, 639t, 640, 643fc
pharmaceutical treatments for 635
surgical treatments for 636
Helicobacter pylori 134
Hemivulvodynia 863
Heparin 114, 116
unfractionated 26, 38, 103, 155, 157
Hepatic disease 25, 122, 132
Hepatic dysfunction 430
Hepatic infarction 138
Hepatic insufficiency 427
Hepatic rupture 138
Hepatitis 136, 361
A 133, 215, 217
complications of 218
management of 217
virus 215
acute 177
viral 132
antigens 217f
B 132, 133, 215, 217, 248, 251, 618
complications of 218
infection 216fc, 217, 236, 618
management of 217
postexposure 624
screening for 45
surface antigen 215216
vaccine 217
virus 45, 215, 624
C 133, 215, 216, 218, 248, 251, 618
complications of 219
infection 132, 133
virus 215, 624
D 215, 218
management of 218
virus 215
E 215, 217
complications 219
management of 218
virus 215
G 215, 217
complications of 219
management of 218
virus 215
types of 132
virus 480
infection 215
Herbal medicine 669
Hereditary non-polyposis colon cancer 74
Hernia
diaphragmatic 442
inguinal 692, 694
Heroin 248, 374
Herpes
infection 235
simplex 479
virus 427, 480, 830, 841
virus 337
zoster 203
Heterotopic pregnancy 732
diagnostic criteria for 385b
High-density lipoprotein-cholesterol 711
Highly active antiretroviral therapy 61, 211
Hirsutism 667, 718, 719b
causes of 718b
evaluation of 719
idiopathic 718
management of 721, 722fc
Histone-to-protamine exchange 741
Hockey-stick incision 488
Hodgkin's disease 185
Hodgkin's lymphoma 180, 737
Homan's sign, positive 160, 489
Home testing kits 223
Homocystinuria 75
Hookworm infestation 140
Hormonal replacement therapy 610
Hormonal systems 871
Hormonal therapy 665, 668, 671, 696
use of 666
Hormonal treatment, use of 668
Hormone
adrenocortical 374, 689, 709, 722
estimation 583
replacement therapy 34, 408, 582, 588, 656, 658, 734, 763, 783
requirement for 34
role of 658
short-term use of 604
therapy 604
Hospital maternity unit 280
Hospital-acquired infection 223
Hot flushes 605, 667
treatment of 606
Howell-Jolly bodies 144, 149
Hughes syndrome 114
Human chorionic gonadotrophin 50, 51, 66, 107, 342, 384, 386388, 389, 600, 662, 703, 728, 739
Human Fertilisation and Embryology Act 1990 894
Human Fertilisation and Embryology Authority 255
Human herpesvirus 203
Human immunodeficiency virus 45, 57, 209, 211, 480, 618, 624
infection 212, 235, 856
maternal 555
screening for 45, 209
testing for 212
Human immunoglobulins, normal 425
Human leucocyte antigen 195, 338
Human menopausal gonadotrophins 712
Human papillomavirus 185, 802, 802t, 804, 811, 829
infection, prevention of 806
vaccination programme 807
Human parvovirus B19 426
Human teratogenic drugs 370b
Humerus 317
Hunner's lesions, classic 775
Hunner's ulcers 775f
Huntington's chorea 74
Huntington's procedure 536
Hurler's syndrome 75, 434
Hutchinson's teeth 430
Hutchinson's triad 430
Hyaline
degeneration 648
membrane disease 276
Hyaluronic acid 668
Hydatidiform mole 258, 404
complete 404, 405f
partial 405f
Hydralazine 99, 111
Hydramnios 258
mild degree of 357
Hydration
adequate 137
maternal 356
Hydrocephalus 430
Hydromorphone 247
Hydrops foetalis 136, 303, 433
Hydrosalpinx
chronic 854f
retort-shaped tubal mass suggestive of 854f
Hydroxycarbamide 150
Hydroxychloroquine 114
Hydroxylase deficiency 75
Hydroxyprogesterone 270
Hydroxyurea 150
Hyperandrogenaemia 23
Hyperandrogenism 709, 723
Hyperbilirubinaemia 171, 302, 485
Hypercalcaemia 137
familial hypocalciuric 74
Hypercapnia 510
Hypercholesterolaemia, familial 74, 75
Hypercoagulability 159
Hyperdynamic left ventricle 232
Hyperemesis gravidarum 107, 134, 135t, 136, 139
history of 136
severe 132
Hyperglycaemia, maternal 171t
Hyperinsulinaemia 709
Hyperkalaemia 715
Hyperkeratosis 806
Hyperlactataemia 213
Hyperparasitaemia 213
Hyperplasia 129, 780
atypical 634, 780
endometrial 552, 610, 657, 670, 690, 691
Hyperprolactinaemia 337, 690, 717
Hyperproteinaemia 263
Hyperspermia 695
Hypertension 24, 240, 589, 763
chronic 85, 97, 99t, 113, 100
classification of 86t
degree of 96
gestational 85, 95, 96t, 97, 100
mild 89, 97, 99
gestational 96
moderate 89, 97, 99
gestational 96
plus proteinuria 86
portal 122
primary pulmonary 74
pulmonary 103, 115, 122, 149
severe 89, 97, 99, 99t, 271
gestational 95, 96
Hypertensive diseases 361
Hypertensive disorders 65, 85, 119
classification of 86fc
types of 85t
Hyperthermia
malignant 74
maternal 371
Hyperthyroidism 65, 107110, 136
Hypertrophy, myometrial 670
Hypoactive sexual desire disorders 626
Hypoalbuminaemia, severe 201
Hypocalcaemia 171
Hypoglycaemia 169, 171, 215, 423, 520, 566, 567
neonatal 566
risk of 172
Hypogonadism
hypergonadotrophic 601, 687
hypogonadotrophic 601, 687
secondary 693
Hypomagnesaemia 171
Hyponatraemia 715
maternal 137
Hypo-oestrogenic symptoms 658
Hypoparathyroid 733
Hypopituitarism 690
Hypoplasia
femoral 54
pulmonary 276, 277, 356
Hypospadias 694
repair 692
Hypospermia 695
Hyposplenism 149
Hypotension 270, 401
maternal 468
Hypothalamic amenorrhoea 690, 691
treatment of 690
Hypothalamic-pituitary
disease 693
dysfunction 628
Hypothalamus
normal functioning 683
pituitary ovarian axis 700
Hypothermia 567
neuroprotective nature of 563
treatment of 567
Hypothyroidism 107, 108, 110, 137, 337
maternal 337
Hypotonia 567
Hypovolaemia 467
signs of 365
Hypoxaemia 510
Hypoxia 510, 520
Hypoxic-ischaemic encephalopathy 69, 509, 519
pathophysiology of 520fc
Hysterectomy 22, 283, 407, 637639, 645, 668, 672, 673, 749b, 811
caesarean 489, 649
extrafascial 818
laparoscopic 638
obstetric 489
peripartum 489
radical 823t
resuscitative 541
route of 638
total 783
abdominal 658, 782, 783
types of 821f
Hysterosalpingo-contrast sonography 707
Hysterosalpingogram 706
Hysteroscopic myomectomy 646b, 646f
advantages of 645
Hysteroscopic sterilisation 889
process of 890f
Hysteroscopy 32, 635, 642, 782
operative 341
Hysterotomy 443
I
Iatrogenic multiple pregnancy 731
Ibandronate 609
Idiopathic thrombocytopenic purpura 733
Ifosfamide 737
Ileal atresia 250
Iliopectineal ligaments 768f
Immune hydrops 437
foetalis 433
Immunisation 147, 210
active 217
passive 217
Immunoassay 840
Immunoglobulin 112, 116
G 203
Immunological defects 662
Immunological tests 842
Immunotherapy 343
Implantation
failure 741
recurrent 341
prevention of 871
In utero transfer 268
In vitro fertilisation 155, 341, 582, 725, 726, 743
indications for 341t, 726
In vitro maturation 725
Incision 889
Incontinence
persistence of 476
types of 764
Incontinentia pigmenti 77
Indomethacin 271, 358
therapy 358
Induced abortion 894, 896f
Induction
failure of 463
methods for 461
Inevitable abortion 394, 397f, 399
Inevitable miscarriage 395
Infant life (preservation) Act 1929 894
Infection 60, 62, 152, 266, 272, 401, 402, 426, 488, 648, 756, 812, 860
assessment for 151
control 230
intra-abdominal 717
intra-amniotic 177, 273
intrauterine 851
maternal 203, 337, 427, 428, 480
neonatal 273
opportunistic 212
postoperative 38
prevention of 220
primary 427, 431
screening for 45, 398, 420
secondary 427
severe 337
signs of 122
spread of 228, 426, 774
vertical transmission of 61, 62
Inferior vena cava filters 38, 159, 163
Infertile couple, work-up of 704b
Infertility 182, 244, 618, 691, 692, 698, 812, 857
causes of 741
duration of 702
evaluation 742
female 698, 726
idiopathic 741
male factor 707, 726
treatment of 734
tubal factors of 707
types of 702
unexplained 707, 741, 742
Inflammation 700
Inflammatory bowel disease 155, 157, 177
Influenza 226
Information, disclosure of 4, 583
Infusion sonography 641f
Inheritance
autosomal
dominant pattern of 74
recessive pattern of 74
X-linked
dominant mode of 77
recessive mode of 76
Inhibins 594
role of 594
Injectable contraceptives 879, 892
progestogen-only 871, 874, 878, 879
types of 879t
Injury
endothelial 159
forensic documentation of 620
maternal 501
mechanism of 508f
neonatal 315
traumatic 458
Insemination 743
artificial 725
Insomnia 667
Instrumental vaginal delivery 472, 491, 495
classification of 492, 492t
indications for 493
Insulin
sensitisers 723
therapy 169, 173
indications for 169b
Intact erythrocytes 515
Intensive care unit 214, 229, 268
Intensive therapy unit 33
Interleukins 593
Internal anatomical sex 583
Internal genitalia, development of 579
Internal iliac artery 530f, 532
ligation, process of 530f
International Association of Diabetes and Pregnancy Study Groups 168
International Breast Cancer Intervention Study 780
International Classification of Diseases, Injuries and Causes of Death 360
International Collaboration on Ovarian Neoplasms Study 797, 798
International Federation of Gynecology and Obstetrics 410f, 633fc, 794, 830
International Normalized Ratio 103
International Ovarian Tumour Analysis 190, 790
International Society for Premenstrual Disorders 654
International Society for Study of Hypertension in Pregnancy 85
International Society for Study of Vulvovaginal Diseases 859
Classification of Vulval Pain 863t
Intracytoplasmic sperm injection 52, 742
Intrafallopian transfer 725
Intrapartum care 92, 97, 104, 126, 148, 151
Intrapartum management 94, 207
Intrapartum period 120, 123, 130, 143, 174, 447, 526
management during 169, 616
Intrapartum tests 514b559
Intrauterine ball 881
Intrauterine contraceptive 872, 873t
devices 408, 652, 871, 875, 881, 892
methods of insertion of 882f
Intrauterine copper device 883f
Intrauterine death 66, 132, 171, 215, 330, 333
causes of 330t
Intrauterine devices 127, 706, 871
copper-bearing 874
danazol-loaded 672
in situ 856
Intrauterine foetal death 330, 331, 335
confirmation of 331
evaluation of 331b
single 263
Intrauterine foetal demise 196
Intrauterine gestational sac, absence of 380
Intrauterine growth
restriction 44, 56, 6567, 79, 87, 88, 90, 105, 114, 119, 145, 196, 215, 240, 261263, 355, 394, 415, 416, 418, 421fc, 517, 559
diagnosis of 258
symmetric 415
Intrauterine hypoxia, continuation of 559
Intrauterine infection, chronic 416
Intrauterine insemination 696, 711, 725, 742
Intrauterine pregnancy 397, 732
normal 380
Intrauterine system 871, 878
Intravenous broad-spectrum antibiotic therapy 334
Intraventricular synechiae 429
Intrinsic sphincter deficiency 761
Invasive cervical
cancer 814
carcinoma, treatment of 819t
Invasive disease, management of 186
Invasive prenatal diagnosis 55, 63
Inversion 72
Inverted T-shaped incision 488
Iodide 106, 371
Iodine 106
Iron
chelation therapy 146
deficiency anaemia 140, 141, 141f, 141t, 152
causes of 140, 140b
treatment of 142fc, 143
deficiency of 140
intravenous 142
overload
management of 150
screening for 149
studies, serum 141, 144
supplements 46, 141
use of 138
therapy, parental 142
Irradiation 370
Irritable bowel syndrome 661
Ischaemia 717
Isoimmunisation 65
Isoniazid 111
Isosorbide mononitrate 462
Isotretinoin 371
Itching 604
J
Jaundice 132, 302, 568
causes of 568
prolonged 568
Jehovah's witnesses 532
Joel-Cohen blunt incision 483
Johnson's manoeuvre 535
Johnson's method 535f
Joint
disability 245
disease 426
J-shaped incision 488
Jugular venous distension 24
K
Kahn's test 844
Kallmann's syndrome 76, 687
Kaolin clotting time 115
Karyotype
analysis 355, 588, 602
parental 340
Karyotypic abnormalities 580, 587
Keratitis, interstitial 430
Ketamine 465
Ketoacidosis 174
Ketone levels, monitoring of 172
Ketonuria 135
Kidney 771
disease, chronic 200
function test 25, 88, 782
stones 136
Killer cells, natural 338
Klebsiella pneumoniae 36
Kleihauer test 280
Kleihauer-Betke acid-elution smear 436
Kleihauer-Betke test 295
Klinefelter syndrome 580, 582
Klumpke's palsy 508
Korsakoff's psychosis 137
Korsakoff's syndrome 137
Kruger's practice 695
L
Labetalol 99, 372
Labial fusion 658
Labour 263, 333, 360
abnormal 455t
progress of 449, 456
analgesia, methods for 27t
and delivery, normal 449, 459
first stage of 143, 325, 449
induction of 126, 230, 333, 348, 349, 453, 460, 461t, 462, 463
medical methods for 461
management of 310
normal 454, 454f
progress of 449
obstructed 318, 322, 361
pain
management of 465
relief in 334
premature 188
preterm 61, 132, 177, 231, 244, 262, 266, 268, 276, 277, 394, 444, 649, 851
prolonged 455, 459
second stage of 143, 231, 325, 348
term 177
termination of second stage of 493
third stage of 104, 284, 526
transfusion in 265
various stages of 449t
Lactation 184
abnormalities in 554
inhibition of 552
normal 553
suppression of 334
Lactational amenorrhoea method 884
Lactic acidosis, risk of 211
Lactogenesis 553
Lactulose 138, 475
Lambda sign 260f
Laminaria tents 463
Lamivudine 211
Lamotrigine 127
Laparo-endoscopic single-site surgery 391
Laparoscopic ovarian drilling 712, 713, 713f, 714
Laparoscopic surgery 191, 391, 392b, 757
advantages of 392b
Laparoscopic uterosacral nerve ablation 668
Laparoscopy 31, 178, 191, 386, 392, 665, 706
role of 742
second-look 796
Laparotomy 443
emergency 351
indications for 392b
technique 343
Laser
ablation 264, 809
excision 809
Laufe's forceps 313
Laxatives 138
Lea's shield 886, 887
device 886f
Learning pyramid 16f
Lecithin-sphingomyelin ratio 90, 94, 281
Leflunomide 114
Leg
elevation 487
pain, severe 878
veins, varicose ulceration of 160
Leiomyomas 339, 634, 650, 672, 699
submucous 648
Leopold's manoeuvre 316, 451, 451f
Leptin, role of 691
Letrozole 667, 739
Leucocyte count, total 25
Leucomalacia 266
Leucopenia 112
Leukaemia, acute myeloid 409
Levator ani muscle 758f, 759f
Levonorgestrel-releasing intrauterine system 636, 644, 656, 657, 667, 672, 780, 783, 874, 875
Levothyroxine sodium 690
Leydig cells 677
Libido 605
Libman-Sacks endocarditis 116
Lichen planus 627, 859, 859f, 862
Lichen sclerosus 627, 859, 861f, 862
Lichen simplex 862
chronicus 859, 860, 860f
Lidocaine
ointment 629
topical 207
Ligase chain reactions 840
Liley's chart 301f
Limb 566
defects 356
reduction defects 251
Lincosamides 849
Lipid cell tumours 789
Lip-philtrum guide 245f
Lisinopril 370
Listeria monocytogenes 545
Lithium 370, 371, 374
Liver 425
biopsy 132
disease 874
during pregnancy 132, 138
pregnancy-related 177
disorders, hereditary 568
function test 25, 88, 113, 132, 133, 135, 216, 563, 589, 782
iron concentration assessment 147
tumours 874
Local anaesthesia 28, 57
Locally destructive methods 808
Lochiometra 188
Long QT syndrome 74
Loop electrosurgical excision procedure 340, 803, 810
Losartan 371
Løvset's manoeuvre 313, 314f
Low-birth weight babies 113, 132, 851
risk of 240
Lower extremity, lymphoedema of 786, 834
Low-molecular-weight heparin 26, 38, 103, 116, 117, 155, 157, 231
administration of 467
Lump 182
Lung 563
collapse 36
CT scan of 225
defects 356, 442
function 123
involvement, unilateral 226f
Lupus anticoagulant 114, 115
Lupus nephritis 112
Luteal phase
defect 337, 341
management of 730
Luteinising hormone 592, 600, 604, 677, 686, 688, 690, 704, 710
Lymph nodes, regional 794
Lymphadenectomy
bilateral inguinal 786
inguinofemoral 832
Lymphadenopathy 23
Lymphatic and vascular spread, metastatic theory of 662
Lymphoedema 786
congenital 434
distichiasis syndrome 434
infantile 588
Lymphopenia 112
Lynch syndrome 781
Lysergic acid diethylamide 247
M
Macrosomia 171, 346, 353
Macular rash, transient 424
Maculopapular rash 544
erythematous 426
Magnesium
hydrochloride 138
sulphate 91, 271, 374
toxicity 541
Magnetic resonance imaging 128, 190, 220, 285f, 286f, 384, 686, 689
functional 125
scan 782f
Major depressive episode, criteria for 549b
Malaise 544
Malar rash 112
Malaria 212
complicated 213b
congenital 215
during pregnancy 212, 214, 235
parasite 213
severe 213b, 214
Malarial infestation 140
Malarial parasite 213
Male condom 885, 885f, 887
Male infertility 692
causes of 693t
Male partner, complications in 618
Malignancy 397
index I, risk of 190b, 790
ruling out presence of 642
treatment of 692, 737
Malignant ovarian tumours, primary 189
Mammogenesis 553
Mammography 183
Manchester repair 751
steps of 755f
Maniac-depressive illness 548
Marcaine 467
Marfan syndrome 74
Marijuana 247
Marshall-Marchetti-Krantz procedure 768
Masculinisation, signs of 583
Mask ventilation 540
Massage 669
Mast cell tryptase levels 538
Mastitis 33, 555
infective 554
Mastodynia, premenstrual 656
Maternal alcohol exposure 244, 245
Maternal androgens 584
Maternal blood
group, determination of 56
volume 369
Maternal cardiovascular instability 284
Maternal cocaine abuse 251
Maternal collapse 534, 542
causes of 537t
management of 541
reversible causes of 540
Maternal complication 95, 143, 148, 152, 170, 212, 214, 221, 234, 250, 276, 316, 321, 327, 358, 499, 508, 552
Maternal deaths 270, 289, 361, 362, 468
causes of 361t, 364
Maternal foetal transfusion, risk of 485
Maternal ill health, severe 555
Maternal infection 203, 337, 425, 427, 428, 480
Maternal methadone 250
dosage 250
Maternal mortality 360
load of 361
rate of 360, 362
ratio 360
Maternal origin, X chromosome of 587
Maternal pelvis
assessment of 494
liquor abnormalities 316
Maternal risk assessment, principles of 44
Maternal sepsis
red flag signs of 363b
risk factors for 544b
Maternal serum alpha foetoprotein 60, 356
Maternal tests 435
Maternal tissues 491, 499
Maternal well-being, optimisation of 457
Mature teratoma 189
Maturity onset diabetes of young 74
Mauriceau-Smellie-Veit manoeuvre 312, 312f
Mayer-Rokitansky-Küster-Hauser syndrome 582, 698
McCall's culdoplasty 749, 750, 750f
McDonald's procedure 342, 342f
McRobert's manoeuvre 505, 505f, 506, 509
Mean arterial pressure 545
Mean corpuscular haemoglobin 141, 144
concentration 140, 141, 146
Mean corpuscular volume 140, 141
Measles, mumps, and rubella vaccine 425
Mebeverine hydrochloride 661
Meconium
aspiration 354, 570fc
syndrome 354, 519, 569, 570f, 570t
clearing airway of 561
Medical abortion 896898
early 897
Medical disorders, chronic 655
Medical therapy 696
majority of 666
use of 400
Medication, assessment of 172
Meditation 669
Mefenamic acid 643
Megaloblastic anaemia 140, 144, 144f, 153
Meiosis, prophase of 591
Melanoma 409
familial 74
Melphalan 737
Membranes 354, 463
artificial rupture of 90, 289, 462464
low rupture of 462
premature rupture of 119, 188, 240, 266, 269, 272, 274, 274fc, 276, 277, 451, 812, 851
preterm premature rupture of 61, 65, 272274, 355, 812
rupture 261, 449, 450, 462
bag of 266
status of 494
sweeping of 354
Menarche 598
early 182
Mendelson syndrome 36
Meningomyelocele 443f
Menopausal hormone therapy 604, 606, 608, 610
preparations, types of 606
uses of 607, 607t
Menopausal replacement therapy 606
Menopause 604, 605, 605t, 606, 628, 733
early 610
iatrogenic 629
late 182
premature 604, 733, 735, 786, 822
Menorrhagia 22, 633, 671, 785
history of 634
Menstrual abnormalities 599
Menstrual bleeding
ceases 650
pathophysiology of 683
Menstrual blood loss 633, 648
Menstrual calendar 661
maintain 642
Menstrual cycle 591, 594
normal 591f
regulation of 594, 691
typical 594
Menstrual disorder, core 655
Menstrual irregularities 712, 733, 879
Menstrual symptoms, physiological 654
Menstruation
abnormalities of 631
failure of 601
Mental
Capacity Act 19, 623
disability 336
health
assessment 210
problems 364
status 622
retardation, severe 182
symptoms 605
Meperidine 247, 374, 465, 513
hydrochloride 40
Mepivacaine 374
Mercaptopurine 737
Mesenteric venous thrombosis 177
Mesoderm 580f, 681
Metabolic disorders 138, 438
Metabolic rate 567
Metabolic syndrome, criteria for 711t
Metastasis 799, 826, 827
Metastatic disease 184, 409
staging for 183
Metformin 709, 713, 722
supplementation 342
Methadone 249, 374
exposure 250
maintenance
therapy 248
treatment 249
therapy 251
Methamphetamine 247
Methergine 529
Methicillin-resistant Staphylococcus aureus 24, 543
Methicillin-sensitive Staphylococcus aureus 36
Methimazole 109, 370
Methotrexate 114, 370, 409, 737
therapy 283, 390b
Methoxamine 763
Methyldopa 90, 99, 371, 372
Methylene blue 370
Methylergometrine 529
Methylphenidate 247
Methyltestosterone 629
Metoclopramide 136
Metronidazole 371, 372, 849
Miconazole 850
Micrencephaly 222
Micro-array-based comparative genomic hybridisation 80
Microcatheters 469
Micronised progesterone 690
gel 687
Microphthalmia 206, 222
Middle cerebral artery 418, 426
Doppler studies 419
peak systolic velocity 264, 299, 426
Midline cystocele, repair of 752f
Midline episiotomy, use of 471
Midodrine 763
Mifepristone 441, 462
Migraine headaches 607
Mineral supplements 259
Mini clinical evaluation exercise 18
Minimally invasive slings 768
Minimum inhibitory concentration 773
Minipill 878
Mirabegron 763
Mirror syndrome 435
Miscarriage 60, 61, 177, 188, 215, 235, 244, 263, 298, 298b, 336, 381, 394, 396, 399, 401
causes of 394, 395fc
diagnosis of 397
inevitable 395
process 401
recurrent 171, 336338, 341, 341t, 342, 343
risk of 336, 344
second-trimester 339
spontaneous 152, 394, 396t
sporadic 336
subsequent consecutive 340
third-trimester 340
threatened 298
types of 395t, 400, 400t
Misgav Ladach technique 487
Misoprostol 350, 370, 462, 529
Missed abortion 394, 395, 399
Mitral regurgitation, chronic 101
Mitral stenosis 102
management of 102
Mixter's forceps 530f
placement of 530f
Modified biophysical profile 69
interpretation of 69t
Modified early warning score 33, 33t, 538
Molar gestation, pathophysiology of 404, 405f
Molar pregnancy
management of 406fc
partial 407
Mole, partial 404, 404t, 408, 411
Monitoring blood glucose levels 169
Monoamniotic monochorionic monozygotic twin pregnancy 257, 257f, 260f
Monochorionic diamniotic pregnancy, early 260f
Monochorionic pregnancy, T sign indicative of 260f
Monochorionic twins 259, 261, 265
Mono-iodo-tyrosine 106
Monophasic pills 871
Monopolar diathermy 30f
Monozygotic twins 256, 256f, 256t
different types of 256
formation of 255f
types of 257f
Mood 734
disturbances 548
Morbidly adherent placenta 278, 285, 479, 480
Morganella morganii 543
Morning sickness 134, 136b, 136t, 139
management of 135
Morphine 374
sulphate 40
Mortality rate
high 827
infant 573
Morula
cells 678
formation of 678, 679
Moschcowitz culdoplasty 750, 750f
Mosquito net, use of 219
Mouth 565
Mucopolysaccharidoses 75
Müllerian abnormalities 396
Müllerian agenesis 582, 690
Müllerian anomalies 339
Müllerian tubercle 580f
Müllerian-inhibiting
substance 579
system 582
Multidisciplinary approach 186, 865
Multidisciplinary management 210, 436
Multidisciplinary obstetric simulated emergency scenarios 14
Multidisciplinary team 104, 162
approach 147, 150, 172, 228, 439, 545, 575, 762
management 125, 154, 164
Multifoetal pregnancy 279
reduction 260, 261, 732
Multiorgan damage 263
Multiple endocrine neoplasia 74
Multiple follicles, stimulating development of 727
Multiple pregnancy 65, 136, 262t, 319, 406, 442, 714
history of 271, 279
reduce risk of 731
risk of 743
Multiprofessional fire-drill training 15
Multisystem organ damage 427
Muscle
cramps 667
myometrial 527
relaxants 28
tone 560
abnormalities of 251
Musculoskeletal deformity 430
Musculoskeletal disease 660
Musculoskeletal systems 660
Mutagens 241
Myasthenia gravis 129131
Mycobacterium
avium 211
tuberculosis 123, 338
Mycophenolate 114
Mycoplasma
hominis 266
pneumoniae 226
Myocardial infarction 22, 103
Myocarditis 427
Myoma 640, 645b
Myomectomy 639, 645
laparoscopic 645
Myometrium 671f
N
Naloxone 563
Naproxen 666
Narcotic 247, 248, 513
overdose, signs of 248
parenteral 465
Nasal irritation, chronic 247
Nasal polyps 120
National Asthma Education Program 119, 120t
National Chlamydia Screening Programme 840
National Diabetes Data Group 167
National Health Service 90, 109, 146, 168, 238, 239
Cancer Screening Programme 803
National Health System 16b, 21
National High Blood Pressure Education Program 85, 99
National Institute for Health and Care Excellence 25, 43, 168, 238, 270, 296, 349
Classification of Foetal Heart Rate Features 514t
Guidelines 508
National Institute on Drug Abuse 247
National Patient Safety Agency Alerts 11
National Perinatal Epidemiology Unit 534
National Recommendations for Down Syndrome Screening 52
National Screening Committee and Midwives Information and Resource Service 47
Nausea 47, 134, 135, 135fc, 178, 182, 667, 713, 763
Neck 565
examination 23
Neisseria gonorrhoea 266, 398, 848
Neoadjuvant chemotherapy 796
role of 823
Neonatal abstinence syndrome 249
Neonatal deaths 271, 277, 340, 573
early 362
late 362
Neonatal respiratory
depression 465
distress 465
Neonatal resuscitation 560fc, 563t
steps for 559
Neonatal withdrawal syndrome 249
Neoplasia, gestational trophoblastic 404, 409, 411
Neoplastic ovarian growths 789b
Nephrolithiasis 177
Nerve
blocks, types of 27f
injuries 769
stimulation 762
Nervous system 566
Neural tube defects 49, 51, 145, 171
biochemical screening for 49
Neuralgia, postherpetic 842
Neuraxial analgesia, use of 470
Neurodevelopmental disorder, alcohol-related 242, 244246
Neurofibromatosis 74
Neurologic dysfunction, long-term 510
Neurologic morbidity, long-term 427
Neurological damage 563
Neurological disorders 125, 136, 137, 363
Neurological injury 508
Neurontin 606
Neuropathic origin 660
Neuroprotection 268, 275
New York Heart Association classification 103
New York Heart Association Functional Classification of Heart Failure 104t
Nexplanon® 880
Nicotine 241
effects of 237
patches 239
replacement therapy 46, 238, 239
use of 238
Nifedipine 90, 98, 99, 270
Night sweats 606
Nipple changes 182
Nitabuch's fibrinoid layer 285
Nitrazine
paper test 273
pH paper 848
Nitric oxide 520
Nitrofurantoin 199, 371, 374
Nitrosamine 241
N-methyl-D-aspartate 520
Nodal status, incorporation of 818
Nodular endometrial lesions 664f
Non-endocrine system 733
Non-gynaecological diseases 385
Non-hormonal method 871, 872, 887
Non-hysterectomy surgery 636
Non-immune foetal hydrops 426, 433, 437
Non-invasive prenatal
diagnosis 55, 62, 64, 80
testing 62
Non-invasive techniques 439
Non-metastatic disease 409
Non-neoplastic epithelial disorders 859, 867
classification of 859b
Non-neoplastic vulvar lesions 830
Non-nicotine medications 239
Non-pharmacological
methods 39, 465
therapy 27, 137
Non-severe pre-eclampsia 86t
Nonsteroidal anti-inflammatory
agents 39
drugs 28, 35, 113, 150, 271, 396, 486, 635, 637, 642, 643, 652, 662, 666, 672, 703, 895
Non-stress test 6569, 113, 130, 259, 308, 353, 510
classification of 68t
Non-treponemal tests 844
Non-tubal ectopic pregnancy, diagnosis of 383f
Non-verbal communication 5
Non-vitamin K antagonist oral anticoagulants 158
Noonan syndrome 588
Noradrenaline reuptake inhibitors 656
Norephedrine 763
Norethisterone enanthate 879
Norgestimate 722
Normal placenta 287f
Normozoospermia 695
Northern Ireland Maternal and Infant Loss Steering Group 576
Notorious human teratogen 370
Novel angiogenesis-inhibiting agents 798, 798t
Nuchal arms 311
delivery of 311f
Nuchal translucency 50f, 258
Nucleic acid amplification test 840, 843, 848
Nulliparous breeches 307
Nutritional advice 46, 807
Nutritional supplements 46, 88
Nuvaring® 871, 876, 877
Nystatin 850
O
O'Sullivan's method 535
Obesity 22, 182, 873
Obligate intracellular parasite 425
Obstetric
anal injuries, risk of 476
and gynaecological practice, management in 615
cholestasis 133, 138
complications 165, 618
emergency 489
scenarios 14
grips 451
haemorrhage 278, 525
rate of 525
hysterectomy 489
indications for 489b
management 268, 288, 320, 322, 324, 352, 420, 438
procedure 308
Obstruction, intestinal 37, 37t
Obturator internus fascia 768f
Occipitoposterior position 321, 322, 328, 472
Ocular anomalies 589
Oedema 88, 160, 554
acute pulmonary 493
peripheral 102
pulmonary 201, 215
severe pulmonary 201
Oesophageal atresia 357
Oestradiol 597, 600, 635, 736
levels 593, 726
serum 727
Oestriol, unconjugated 51
Oestrogen 334, 374, 605, 606, 666, 683, 763, 871, 887
cardioprotective mechanisms of 609b
deficiency 589
dominance 670
endogenous 690
formulations 629
plus progestin trial 609
therapy 735
Offences Against Person Act 1861 894
Ogilvie syndrome 37
Oligoasthenoteratozoospermia 695
Oligohydramnios 65, 284, 316, 355, 355f, 356, 359
Oligozoospermia 695
Ondansetron 136
Oocyte 677, 678, 726
aspiration 729, 731
classification 729
cryopreservation of 739
insemination 727, 729
retrieval 728
Oogenesis 591, 677
stages of 677, 678f
Oophorectomy 638
surgical 604
Oophoritis 853
Operative vaginal delivery 500
use of vacuum for 493
Ophthalmoscopic examination 88
Opiates 40, 247, 248, 538
Opioids 251, 468
drugs 465
systemic 465
Opium 247
Opportunistic infection 212
prophylaxis of 211
Optimal cytoreduction 796
Oral antiviral medications 842
Oral contraceptive 736
agents 644, 722
pills 642, 662, 666, 688, 875
use of 655
Oral fluid intake 200
Oral glucose tolerance test 45, 168, 711
Oral hypoglycaemic agents 168
Oral iron
supplements 142
therapy 148
Oral oestrogen 610
Oral pills 629
Oral progesterone 657
Oral progestogens 374
Orgasmic disorder 626, 627
Orthopnoea 102
Ortolani and Barlow manoeuvres 566
Osmotic dilators, natural 463
Osmotic diuresis 357
Osmotic fragility 141
Osmotic laxatives 138
Ospemifene 629
Osphena 629
Osteitis pubis 768, 769
Osteochondrodysplasias 54
Osteogenesis imperfecta 54
Osteopenia 607, 608
Osteoporosis 589, 605, 607, 690, 735
development of 607b, 608
treatment of 606, 609
Ovarian cancer 74, 189t, 737, 739, 790, 793b, 799, 800
aetiology 791
diagnosis 792
epithelial 189t, 792t, 796b
follow-up after treatment for 798
screening for 793
Ovarian cycle 591
Ovarian cyst 442, 650, 715, 791fc, 792
aspiration of 191
formation 740
functional 882
haemorrhagic 177
ruptured 177
Ovarian factors
infertility 698, 700
tests for 704
treatment of 707
Ovarian failure 687
diagnosis of 687
Ovarian follicle 733
act 593
development of 592f
maturation of 679
Ovarian fossa, lifting ovaries out of 713f
Ovarian function
loss of 738
resumption of 714
Ovarian hormonal deficiency 733
Ovarian hormone withdrawal 650
Ovarian hyperstimulation syndrome 155, 711, 715, 715f, 716fc, 725, 731, 739
classification of 715t
management of 716fc
Ovarian insufficiency 733
primary 733
secondary 733
Ovarian masses
asymptomatic 191
benign 788, 799
categorisation of 793t
malignant 191
Ovarian neoplasia 788
Ovarian pregnancy, diagnostic criteria for 384b
Ovarian protection 739
Ovarian reserve
indicators of 738
tests for 742, 734
Ovarian stimulation 727, 728, 743
Ovarian testosterone 710
Ovarian tissue, cryopreservation of 739
Ovarian torsion 177
Ovarian transposition 739
Ovarian tumours 189, 192, 406
secondary malignant 189
Ovarian volume 705
Ovaries 598, 606
back, migration of 740
cancer of 23
normal functioning 683
removal of 638
virilising tumours of 582
Overt cord prolapse 326f
Ovulation
failure of 741
fertilisation 677
induction of 712
inhibition of 727
method 884
pain 651
prediction kit 705
prevention of 871, 876
process of 679f
suppression using hormonal regimens 657
Ovulatory disorders, World Health Organization classification of 701t
Ovulatory dysfunction 700
causes of 700
Oxcarbazepine 127
Oxybutynin 763
Oxycodone 247
Oxygen
administration of 561
saturation 151, 231, 232
maintenance of 229
supplementation 540
therapy, prophylactic 521
Oxytocic infusion 408
Oxytocin 266, 348, 350, 457, 462, 529
antagonist 270
augmentation 334
challenge test 68
induction 310
infusion 516
use of 457
P
Paget's disease 830
Pain 182, 882, 890
acute 151b
chronic 740
diffuse abdominal 177
exercise-related 660
in lower abdomen 177
killers 773
management 865
after caesarean section 486
modifiers 865, 866
neuropathic 182
on dorsiflexion of foot 160
perineal 476
persistent 178
postoperative 39
premenstrual 660
relief 230, 461
methods of 465
severe 178
suprapubic 816f
Painful crisis 149
Painless cervical dilatation 340
Pallor 140
Palm-Coein classification system, basic 633fc
Palmer's test 32
Palpable cord 160
Palpation, abdominal 352, 544
Palpitation 102, 270
Pancreatic diseases 177
Pancreatic insufficiency, degree of 122
Pap smear 815, 824, 826
previous history of 702
Papules, erythematous 195f
Paracentric inversion 73f
Paracervical nerve block 28, 28f
Paracetamol 40, 207, 214
Paraesthesia 657
Parainfluenza 226
Parakeratosis 806
Paralysis, hypokalaemic periodic 74
Paramesonephric ducts, fusion of 579f
Paramethadione 370
Parametrial phlegmon 546
Parasites 545
Parkinson's disease 761
familial 74
Partial androgen insensitivity syndrome 581
Partial thromboplastin time 290
Partogram 453, 457
Parvovirus 357
infection 426, 427, 432
Patau's syndrome 79
Patent ductus arteriosus 424, 569
Paternity testing 625
Peak expiratory flow rate 120, 121
Peau d'orange appearance 107
Pedal oedema 141
Pedigree chart 74, 75f78f
Pelosi's technique 487
Pelvic
abnormalities 457
adhesions 857
assessment 452
cavity 471
congestion 650
diaphragm, muscles of 758f
examination 24, 44, 379, 634, 651, 671, 684, 719, 762, 792, 824, 826, 830, 854, 882
exenteration 822
floor 471
abnormalities 745
internal palpation of muscles of 864
ligaments of 759f
muscles of 758f
superficial muscles of 758f
infection 379, 841
history of 703
inflammatory disease 22, 177, 250, 379, 618, 640, 652, 698, 700, 851, 853, 855b, 856, 856b, 883
aetiology 853
complications 857
diagnosis 853
differential diagnosis 854
management 854
stages of 853t
irradiation, external 785
kidney 189
lymph node sampling, indications for 784b
musculature 325
organ prolapse 749, 769
evaluation of 748t
quantification system 747, 748, 748f, 748t
pain 650
causes of 660, 661
prolapse, quantification of 748f
sidewalls 664
tumour 318, 319
ultrasonography 706, 734
Pelvis
contracted 262, 318
laparoscopic visualisation of 713f
manoeuvres 506
ultrasound of 405
Pemphigoid gestationis 193195, 196f
Penicillamine 370
Peptic ulcer 462
disease 136, 271
Per speculum examination 451, 526, 663, 802, 815, 824, 830, 882
Percutaneous balloon mitral valvotomy 102
Percutaneous oestradiol patch and implant 657
Percutaneous umbilical cord blood sampling 56
Percutaneous vesicoamniotic shunting 443
Pericarditis 112
Pericentric inversion 73f
Periconceptional care 146
Perimenopause 655
Perinatal asphyxia 522, 559
Perinatal deaths 332
causes of 574t
extended 573
Perinatal mental health services 550, 551b
Perinatal mortality 69, 573, 812
rate 573, 576
review tool 575
surveillance report 330, 573
Perinatal post-mortem examination 332
Perineal body, attachments of 759
Perineal injury 471
occurrence of 472b
repair of 529
Sultan's classification of 471b
Perineal muscles 472f
Perineal tears, repair of 473
Perineum 471
Periodontitis 250
Peripartum blood loss, visual estimation of 532
Peripartum cardiomyopathy 104, 152
Peripheral pulmonary artery stenosis 424
Peripheral smear 141, 144, 146, 149, 641
Peritoneal cavity 594
Peritoneal closure 486
Peritoneal defects 701
Peritoneal factors 698, 701
tests for 706
Peritoneal fluid, culture of 651
Peritoneal signs 178
Peritoneum 483
opening 483
Periurethral injections 768
Perl's stain 141
Persistent disease
management of 410fc
treatment of 409
Persistent genital arousal disorder 627
Persistent gestational trophoblastic neoplasia after
gestational trophoblastic disease 407
non-molar pregnancy 407
Personal fertility monitors 885
Personal protective equipment 222, 229
Pertubation 743
Pethidine 40, 465, 513
Pfannenstiel incision 269, 483
Pharmacological therapy 27, 763
Phenformin 374
Phenindione 371
Phenobarbital 127
Phenothiazines 136, 374
Phenylketonuria 75
Phenylpropanolamine 763
Phenytoin 127
Phosphatase 780
Photosensitive malar rash 111
Photosensitivity 112
Physical therapies 722, 762, 865
Pinard's manoeuvre 310, 314, 315f
Pituitary cells, stimulation of 687
Pituitary glands, normal functioning 683
Placenta 237, 285f, 286f, 288f, 531
accrete 278, 283b, 348t, 489, 532
development of 278
diagnosis of 286t
cornuofundal attachment of 304
delivery of 283
increta 489
magnetic resonance imaging of 286f
invasive 285
low-lying 280, 286
percreta 285f, 489, 532
praevia 237, 240, 262, 278, 279, 281fc, 282, 284b, 286, 292, 304, 309, 318, 416, 479, 480, 493
anterior 283
degrees of 279f
development of 480t
history of 279
major 479
mild 280
minor 479
moderate 280
risk of 348t
screening for 45
severe 280, 281fc
supports 291
tumour of 434
ultrasound grading of 66
Placental abruption 177, 286, 287f, 289b, 292, 416
aetiology 286
classification of 287t
complications 289
concealed type of 287f
diagnosis 288
foetal complications 290
revealed type of 287f
risk factors 286
Placental alpha microglobulin 1 273
Placental dysfunction 355
Placental implantation 489
Placental infraction 396
Placental insufficiency 171, 330, 355
Placental removal, manual 480
Placental tissues 268
Placental vascular tumours 434
Plant derivatives 737
Plantar flexion 487
Plasma 515
concentration 369
osmolality 198
protein A, pregnancy-associated 50, 51, 417
Plasmodium 213
falciparum 212
Platelet 526
count 88, 641
derived growth factor receptors 798
transfusion of 290
Platinum-free interval 798
Pleural effusion 435
treatment of 437
Pleuritis 112
Pneumocystis carinii pneumonia 210, 212
Pneumonia 177, 544
atypical 226
opportunistic 226
postoperative 36
Pneumothorax, spontaneous 493
Polyacrylamide hydrogel 768
Polycystic kidney 356
disease 74
autosomal dominant 74
Polycystic ovarian disease 342, 698, 709, 710, 711fc, 714
pathophysiology of 709fc
Polycystic ovarian morphology 710f
Polycystic ovarian syndrome 336, 337, 342, 396, 686, 690, 700, 701, 717, 718, 781
Polyethylene oxide 668
Polyhydramnios 65, 171, 316, 318, 356, 357f, 358, 359, 433
causes of 357
degrees of 357t
diagnosis of 356
treatment of 358
Polymerase chain reaction 52, 205, 840
Polyposis
coli 74
familial adenomatous 74
Polyps 397
endocervical 806
endometrial 339, 670
Pomeroy's technique 889, 889f
modified 889
Porphyria, acute intermittent 74
Positron emission tomography 789
Postdelivery care 314, 455
Postdural puncture headache 468
Posterior arm, delivery of 507
Posterior colporrhaphy 751
procedure of 754f
Posterior cul-de-sac 704
obliteration 665
Posterior fossa, anomalies of 222
Posterior shoulder, delivery of 314, 314f
Postmaturity syndrome 277, 354
Postmenopausal hormone therapy, use of 637
Postmortem examination 441, 575
Postnatal care 97, 100, 170
Postnatal depression, risk of 334
Postnatal period 92, 95, 133, 163, 174, 232
Postoperative care 32, 768, 890
Postpartum blues 548, 549, 551
Postpartum collapse 534
differential diagnosis of 534t
Postpartum haemorrhage 14, 132, 140, 155, 271, 278, 349, 360, 458, 489, 525, 527b, 529t, 532
causes of 525t
management of 528fc
Postpartum period 121, 129, 130, 152, 158, 523
Postrenal failure 756
Post-term pregnancy 65, 352
management of 353, 353fc
Post-testicular defects 693
Post-thrombotic syndrome 159, 160
Post-tubal ligation syndrome 890
Postvasectomy pain syndrome 891
Postvoidal residual volume, measurement of 764
Potassium
chloride 487
hydroxide
preparation 847
Whiff test 847
Potter's syndrome 356
Pouch of Douglas 704, 792
Povidone iodine solution 481
Powder-burn lesions over endometrial surface 664f
Powered air-purifying respirator 229
Prague's manoeuvre 313f
reverse 313
Preantral follicle 592
Precocious pseudopuberty 599
causes of 600
Precocious puberty 599, 600t, 603
Preconception period 172, 549
Preconceptional counselling 113, 372
Prednisolone 136, 374
Pre-eclampsia 45, 65, 85, 100, 240, 288, 346, 360, 364
causes for 87
diagnostic criteria for 86b
mild 89fc
monitoring for 150
pathophysiology of 87fc, 87t
prevention of 365b
risk factors for 87, 88b
screening for 45, 149
severe 86t, 90fc, 132, 177
Pre-existing medical disease, ruling out presence of 26
Pregnancy 101, 360, 589, 862
anembryonic 395
common symptoms of 47
complications, history of 267
ectopic 177, 240, 297, 298, 298b, 379, 382f, 383f, 385, 388fc, 389b, 393, 397, 731, 857, 883
fatty liver of 262
first half of 177
healthy low-risk 511
high-risk 65, 66
interstitial 384b
intrahepatic cholestasis of 193, 195, 195f
loss
recurrent 336b
second trimester 812
maintenance of 342
management of 183
medical termination of 4, 547, 894, 896t
methods for termination of 441
milking of 392
monitoring for 731
normal 356
outcome of 185, 647
polymorphic eruption of 194, 195f, 193, 196
postmature 352
prevention 869
prolonged 352
risk 194
second trimester of 426
termination 297, 298b, 362, 440, 441
procedure of 444
test 625, 846
therapeutic termination of 298
third trimester of 426, 427
thrombogenic state of 159
tuberculosis in 123, 124
uncomplicated post-term 354
Pregranulosa cells 591
Preimplantation
genetic diagnosis 52, 80, 341
phase 368
Pre-invasive lesions, management of 186
Premalignant lesions, signs of 586
Premature ovarian failure 341, 604, 628, 685687, 690, 733, 737
Prematurity 123, 145, 196, 263, 443
Premenstrual disorder 654, 655
core 655
physiological 655
progestogen-induced 655
Premenstrual syndrome 654656, 658
diagnostic criteria for 655b
differential diagnosis of 655b
Prenatal diagnostic
techniques 439
tests 210
Prenatal oocyte depletion 591
Prepidil 461
Prepregnancy
counselling 122, 149
glycaemic control 341
pulmonary function tests, stability of 122
Presacral ganglia 472
Presacral neurectomy 668
Pressure 505
intra-abdominal 471
Preterm birth 188, 235, 315, 340
degree of severity of 266t
screening for 45
severity of 266
Preterm breech, management of 307
Preterm delivery 123, 212, 267, 812
high risk for 267
Preterm labour 61, 132, 231, 244, 262, 266, 268, 276, 277, 394, 444, 649, 851
advanced 267
causes of 266
early 267
management of 269fc
precipitation of 273
prevention of 259
Primary amenorrhoea 683
causes of 683f, 684b, 685
evaluation of 685fc, 686fc
management of 685
treatment of 685, 689
Primary caesarean delivery, indications for 479b
Primary dysmenorrhoea 650, 653
alternative therapies for 653
Primidone 127, 370, 371, 374
Primordial germ cells 591
Procainamide 111
Progesterone 342, 604, 606, 658, 683, 730
bioadhesive gel 270
receptor modulators 645
supplementation 342
therapy 270
first trimester 342
Progestin 635, 666, 887
challenge test 687
exogenous 644
only pill 871
regimen 735
Progestogen 636, 653, 657, 658, 666, 667, 871, 875, 879, 892
only implant 871, 874
only pill 874, 875, 878, 892
three-hour 878
twelve-hour 878
releasing intrauterine devices 644
third-generation 657
use of 657
Prolactin inhibitory substance 687
Prolapse, evaluation of degree of 747
Propionate 629
Propranolol 372
Propylthiouracil 109
Prostacyclin 87
Prostaglandin 348, 441, 593, 594, 650
preparation 333
production of 271
synthetase inhibitors 358, 643
use of 348
Prostate surgery 692
Prosthetic heart valves 103fc
Prosthetic material for prolapse surgery, use of 757
Protein 259
C 164
molecules 594
S 164
Proteinuria 88
persistent 112
test for 89, 96
Proteus mirabilis 771
Protozoan 213
Prune Belly syndrome 250
Pruritus 860
Pseudocysts, peritoneal 189
Pseudoephedrine 370
Pseudogestational sac 381
Pseudohermaphroditism
female 582, 585
male 582, 585
Pseudo-Meigs syndrome 648
Pseudomonas 543
aeruginosa 122
Pseudopuberty, precocious 599
Pseudotumour cerebri 136
Psilocin 247
Psilocybin 247
Psoriasis 627, 859, 862
Psychiatric disease 654
Psychiatric disorders 655, 548, 860
antenatal 548
Psychiatric illness, management of 551
Psychological counselling 180, 865
Psychological disorders 724
Psychological therapy 721
Psychoneurological systems 660
Psychosexual counselling 865
Psychosexual dysfunction 866
Psychosis 112
Ptyalism 135
Pubarche 598
Pubertal development 684
absent 587
Puberty 597, 603
central precocious 599
delayed 599, 601, 603
normal progression of 601
precocious 599, 600t, 603
process of 597
Pubic bone 767
Pubic hair 601
development 601
Tanner stages of 598t, 684f
Pubic lice 862
Pubic symphysis 505
periosteum of 768f
Pubovaginal slings 765, 769
surgery 765, 767f
Pudendal nerve block 28, 28f
Puerperal psychosis 548, 549, 552
Puerperal pyrexia 543
Puerperal sepsis 458
Puerperium 154, 263, 360, 548
Pulmonary embolism 25, 154, 159162, 166, 537, 541
pathogenesis of 161f
Pulmonary function tests 120, 121
special 122
Pulmonary hypertension 103, 115, 122
Pulsatility index 418
Pulse 23, 102, 276
dosage 821
rate 853
Pyelonephritis 136, 198
acute 198, 199b, 200, 201, 772
Pyometra 188, 785
Pyosalpinx 827
Pyrexia 467
maternal 468, 516
Pyridoxine 136
Pyrimethamine 426
Q
Qlaira® 875, 876, 877
Quadruple test 50
Quantitative fluorescence polymerase chain reaction 80, 332
Quinine 370, 374
Quinolones 856
Quintero classification system 264t
R
Radial anomalies 54
Radiation
dose of 181
therapy 796, 821, 826, 834
adjuvant 834
external 822
internal 821
primary 818
treatment, types of 737
Radical hysterectomy 823t
classification of 820t
Radiofrequency interstitial thermal ablation 265
Radio-immune assay 216
Radioiodine 370
Radiotherapy 785, 821, 823
during pregnancy, use of 181
external beam 785
indications of 785b
Raloxifene 608, 645
Raltegravir 211
Randomised controlled trial 7, 9, 10f, 242, 305, 341, 561, 656, 855
Ranitidine 372
Rape 612, 613, 620, 621
Rapid plasma regain 845
Rapid sequence induction 231
Rash presentation 194
Raynaud phenomenon 111
Reactive oxygen species 87
Realistic simulation models, use of 15
Real-time reverse transcriptase polymerase chain reaction 223, 224, 229
Reason's Organisational Swiss Cheese model of accident causation 13f
Reciprocal translocation 71, 72f
Rectal buttonhole tears 476
Rectal examination 279, 475, 585, 663, 815
Rectus
abdominis muscle 483
fascia, Harvesting strip of 765
sheath, closure of 486
Recurrent miscarriage 171, 336338, 341, 341t, 342, 343
causes of 337, 339
history of 336
risk of 342
Recurrent urinary tract infection 772t
treatment of 774
Red blood cells 144, 213, 294, 295
indices 435
Red cell
alloantibodies 45
antibodies 147
screening for 149
count 141
distribution index 141
Red flag signs 363b, 364
Reflex irritability 560
Regional analgesia 466
Regression 6
Reifenstein syndrome 582
Remifentanil 466
Renal agenesis 356, 416
Renal anomalies 589
Renal complications 272, 563
Renal defects 171
Renal disease 198
chronic 65, 201t
Renal failure 271, 289
development of 289
Renal function tests 113, 199
Renal impairment 113, 200, 202
severe pulmonary 201
Renal plasma flow 198
Renal scarring 774
Renal tract ultrasound 201
Reproductive system, anatomical defects of 339
Rescue cervical cerclage 271
Reserpine 374
Residual urine, assessment of 762
Resistance index 418
Resistant ovary syndrome 685
Respiratory diseases 119
Respiratory distress 105, 354, 567
syndrome 171, 271, 276, 568
aetiopathogenesis of 569t
complications of 569b
pathophysiology of 568f
X-ray appearance of 569f
Respiratory rate 23, 33, 102
Respiratory syncytial virus 226
Respiratory syndrome, severe acute 222
Respiratory system 119
Respiratory tracts 428
Resuscitation
cardiopulmonary 539, 540
maternal 538, 540
Reticuloendothelial system 215
Retinal assessment 172, 173
Retinal haemorrhage 500
Retinal screening 149
Retinitis 425
Retinoblastoma 74
Retinoids 370
Retrograde menstruation 662
Retroplacental clot 288f
Retropubic approach 765
Retropubic bladder neck colposuspension 768
Retropubic method 765
Reverse transcriptase-polymerase chain reaction 424
Rhesus
blood group 294
incompatibility 294
isoimmunisation 294
pathogenesis of 295f
Rheumatoid arthritis 733
Rhinitis, severe 120
Rhythm
disturbances 433
method 884
Rifampicin 371
Rilpivirine 211
Ring of fire appearance 383f
Ringer's lactate 94
Risedronate 609
Rituximab 114
Robertsonian translocation 72, 72f, 73f
Routine antenatal anti-D prophylaxis 298
Royal Australian and New Zealand College of Obstetricians and Gynaecologists 68
Royal College of Obstetricians and Gynaecologist 49, 68, 258, 336
Rubella 357
infection 45, 424, 431
congenital 424
treatment of 424
Rubin manoeuvre 506, 506f
Ruptured membranes, indicators of 451
S
Sac, empty 395
Sacral colpopexy, abdominal 753, 755f
Sacral segments 472
Sacrococcygeal teratoma 442
Sacroiliac joint, left 322
Sacrospinous colpopexy 752
Sacrospinous ligament 756f
S-adenosyl methionine 133
Salicylates 374
Saline infusion sonography 635, 642, 781
Salmonella 545, 546
Salpingectomy 386, 390
indications for 392b
partial 392
procedure of 392
Salpingitis 379, 853
Salpingo-oophorectomy, bilateral 658, 783
Salpingostomy 390, 391b, 392
laparoscopic 391
Salvage therapy
fifth-line 851
first-line 851
fourth-line 851
second-line 851
third-line 851
Scabies 862
Scaphoid 324
Scapula 317
Scar
disintegration of 349
integrity, assessment of 350
rupture, risk of 348
tenderness 348
Schauta vaginal hysterectomy 820
Sclerosis
amyotrophic lateral 589
multiple 128, 131, 761
Screening test 45, 57, 186
Second trimester complete hydatidiform mole, transvaginal sonogram of 406f
Secondary amenorrhoea 683, 688fc
causes of 685, 685t
management of 687
treatment of 685, 689
Secondary dysmenorrhoea 650, 653
alternative therapies for 653
causes of 650
Secondary sexual characteristics
development of 677
examination of 704
Sedation 25
Seizures 112
control of 126
epileptic 534
risk of 127
Selective oestrogen receptor modulators 608, 645, 656
Selective serotonin reuptake inhibitors 656
Semen analysis 694, 695t
interpretation of 695
normal parameters for 695t
parameters for 695t
Semen quality, abnormal 692
Semen sample 729
Sensorineural hearing loss 430
Sensory system, disorders of 438
Sepsis 361, 363, 401, 463, 489, 756
care bundle 545
diagnosis of 363b
management of 363b
neonatal 567
postpartum 543b
Septate uterus 396
Septic abortion 401, 703
Serial growth scan 126, 165
Serial human chorionic gonadotrophin assessment, role of 397
Serological tests 216, 425, 431
Serositis 111
Sertoli cells 677
Serum gonadotrophin levels
evaluation of 689
interpretation of 690
Serum lactate measurement 545
Serum progesterone
assay, role of 398
levels 382, 705
measurement of 398
Serum prolactin
levels 340, 602, 685
measurement of 688
Serum testosterone levels 602, 685
determination of 696
Serum thyroid stimulating hormone, measurement of 602
Several live-attenuated rubella vaccines 425
Severe hypoxic-ischaemic encephalopathy, diagnosis of 520b
Severe pre-eclampsia 86t, 90fc, 132, 177
symptoms of 88
Sex chromosomes 580
abnormal constitution of 582
normal constitution of 582
Sex cord
stromal tumours 789
tumour 189
Sex development, disorders of 580, 581t
Sex education 598
Sex hormone-binding globulin 718
levels of 721
Sexual abuse, victims of 622
Sexual arousal, disorders of 626, 627
Sexual assault 612, 620, 622
referral centres 624
Sexual aversion disorder 627
Sexual desire 627
disorders of 626
Sexual development, disorders of 690
Sexual dysfunction 605, 692, 734, 866
female 727t
Sexual function 586, 629
impaired 617, 735
Sexual health screening 615
Sexual history 702
Sexual intercourse 46, 475
Sexual pain, disorders of 626
Sexual partners, treatment of 856
Sexual transmission 215, 428
Sexually transmitted diseases 4, 248, 379, 430, 613, 703
screening for 854
Sexually transmitted infection 25, 839, 881
screening for 661
Sheehan's syndrome 318
Shirodkar's procedure 342, 343f
Shock 565
endotoxic 132
features suggestive of 544
haemorrhagic 638
septic 541
septicaemic 544b
treatment of 535
Short stature 588
Shoulder
delivery of 455
dystocia 472, 500, 503, 504, 505t, 508f, 509
diagnosis of 504
high 503
low 503
management of 504, 504fc, 505
risk factors for 503b
unilateral 503
Sialidosis 434
Siamese monozygotic twin pregnancy 257
Sick pregnant 366
Sickle cell
anaemia 148, 149f, 153
crisis 151, 177
disease 75, 148, 426
syndrome, clinical features of 149, 149b
Sim's speculum 897f
Single embryo 255
Single gene defects 74, 336
Single-blind trial 9
Single-dose methotrexate, protocol for 390b
Single-photon emission computed tomography 125
Singleton pregnancy 358
Sinusoidal pattern 513, 513f
Sjögren syndrome 733
Skeletal dysplasias, generalised 54
Skeleton, structural anomalies of 54t
Skin
changes over breast 182
closure 486
colour 565
examination of 704
incision
abdominal 482
low transverse 318
infection 545
oedema 435
preparation of 481
soreness of 786
Slapped cheek disease 426
Sleep
disorders 660
disturbances 657
Sling operations, types of 758
Sling surgery
abdominal 751
principle of 752
Sluggish pupil reaction 538
Smoking 237, 374, 702
adverse effect of 240t
cessation of 172
during pregnancy 46, 237
Snowballing 17
Social distance 228
maintenance of 228
Society for Maternal Foetal Medicine 458
Society of Gynecologic Oncologists 784
Sodium
bicarbonate 247, 563
citrate 200
hyaluronate 668
Soft tissue
infection 545
tumours 789
Solid heterogeneous cervical mass 815f
Solomon technique 264
Sonography 738
abdominal 285f
transabdominal 397, 815f
transvaginal 281, 386389, 397, 635b, 661, 662, 664, 686, 781f, 816f
Space of Retzius 767
Spacious pelvis 325
Spalding sign 331f
Spectroscopy, near-infrared 516
Speculum examination 273
Sperm
banking 738
cryopreservation 738
fertilisation of 594
injection 725
subzonal 725
morphology, normal 694
preparation 729
transport, disorders of 693
Spermatocytes, primary 677
Spermatogenesis 677
stages of 678f
Spermatozoa 677, 678
abnormal 244
Spermatozoon 725
Spermicides 886, 887
Spina bifida 442
in utero closure of 442
Spinal analgesia, continuous 469
Spinal cord
injury 628
surgery of 628
Spinal surgery, previous 467
Spinocerebellar ataxia 74
Spiramycin 426
Spironolactone 723, 723
Spleen 425
Spontaneous abortion 240, 267, 394
medical management of 400b
Spontaneous miscarriage 152, 394, 396t
causes of 399
risk of 206
Sporadic miscarriage 336
risk of 338
Sporozoite 425
Spotting 178
Squamocolumnar junction, identification of 801f
Squamous cell hyperplasia 859
Squamous intraepithelial lesion, low grade 801
Squamous papillomas 806
Staphylococcus aureus 543, 773
Staphylococcus saprophyticus 771
Stasis 159
Statins 371
Sterilisation 871, 872
female 871, 875
male 875
tubal ligation for 700
Sternocleidomastoid muscle 315
Steroids 268
administration of 169
use of 127
Stillbirths 215, 340, 436, 573
intrapartum 573
medical certification of 334
rate 573
Stimulation 457
protocols 727
training 14
Stomach, empty 480
Stool softeners 475
Straight-cut scar 350
Streak gonads 587
Streak ovaries 687
Streptococcus pneumoniae 36, 543
Streptococcus pyogenes 543
Streptomycin 371
Stress 861
incontinence 761, 763, 764
confirmation of 764
management 775
urinary incontinence 761
Stroke 100, 364, 610, 761, 873
Stromal tumours 799
Stuck twin, formation of 264
Sturmdorf sutures, application of 810f
Subcutaneous space, closure of 486
Subdermal progestogen implants 875, 880, 892
Subfertility 735
Submucous fibroid 646f
hysteroscopic resection of 646f
Substance abuse 655
Suburethral sling 764, 765
Sulphonamides 371, 372, 374, 426
Superficial transverse perineal muscle 758f
Superficially invasive vulvar cancer 831
Superior iliac spines 483
Supernumerary embryos, cryostorage of 730
Supine hypotension 480
Supplemental oxygen 569
Suprapubic pressure 506
application of 506f
Surgery 820, 821, 827, 862, 866, 896
general principles of 21
history of 23
indications for 764
overview of 55, 894
primary 796
principles of 749
steps of 751, 889
types of 765
Surgical abortion 898
Surgical therapy 776
indications for 390b
Swabs, endocervical 651
Sweating 657
Swine flu vaccine 150
Swyer syndrome 581
Sympathetic fibres 472
Symphysiotomy 507
Symphysis pubis 503
Symphysis-fundal height 416
Symptothermal method 884
Synthetic progestogens 552
Syphilis 338, 357, 361, 430, 830, 844, 845
congenital 416, 430, 844
infection 430, 432
transmission of 430
latent 844
primary stage of 430
screening for 45
standard tests for 430
tertiary 844
Systematic opiates, administration of 249
Systemic lupus erythematosus 65, 111, 112, 118, 155, 157, 336, 733, 735, 874
aetiology 111, 114
classification 114
criteria 112
complications 113
diagnosis 111
management 116
Systemic lupus international collaborating clinics 111, 112
Systemic vascular resistance 233
T
T sign 260f
Tachyarrhythmia 434
Tachycardia 270
maternal 516
supraventricular 434
Tachypnoea, transient 485, 566
Tachyzoite 425
Talipes equinovarus 54
Tamoxifen 697, 712, 739
role of 779
Tamponade 537
Tanner stages 598t, 684f
Tay-Sachs disease 75
Tears
fourth-degree 476
third-degree 476
Teletherapy 822
Tenderness 160
upon pelvic examination 663
Tenofovir 211
Tensilon test 130
Tension pneumothorax 537
Tension-free obturator tape 766f
Tension-free vaginal tape
surgery 766f
use of 757
Teratogenesis 370
Teratogenic drugs 370
Teratogenic influence 370
Teratospermia 695
Teratozoospermia 695
Terconazole 850
Testes
acquired disorders of 693
developmental disorders of 693
Testicular disease 693
Testicular trauma, history of 692
Testosterone 600, 629, 658, 677, 714
influence of 579
replacement therapy 697
therapy, role of 629
Tetracycline 371, 372, 374, 849
derivatives 370
Tetrahydrocannabinol 247
Thalassaemia 145, 146f, 148, 153, 357
major 75
syndromes 145
Thalidomide 370, 373
Thanatophoric dysplasia 54
Theca cells 719
Thelarche 598
Thermal injury 31
Thiamine
deficiency of 137
supplementation 137
Thiazide diuretics 371, 372, 374
Thoracic malformations 53
Thoracoabdominal syndrome 434
Threatened abortion 394, 395, 399, 406
Threatened miscarriage 298
Three-dimensional power Doppler 286
Throat swabs 545
Thrombin 525
time 290
Thrombocytopenia 112, 115, 205, 271, 428
Thromboembolic disorders 154, 552
Thromboembolism 488
Thrombolytic therapy 163
Thrombophilia 163, 166, 343
inherited 343
screen 164
Thrombophilic disorders, history of 165
Thrombophlebitis 159, 160
Thromboprophylaxis 25, 137, 158, 481
regimes 117t
Thrombosis 541
prevention of 116
Thymomas 129
Thyroid 733
binding globulin 106
cancer 108
disease 106
disorders 106, 109f, 395, 733
management of 109, 109fc
screening for 173
dysfunction 22, 341, 690, 702
examination 23, 684, 703
function
abnormalities in 549
test 107, 135, 147, 340, 589, 600, 635, 685, 734
gland 106
functioning of 106
hormones, synthesis of 106f
stimulating hormone 106, 109, 331, 686689
Thyroiditis, postpartum 108
Thyrotropin-releasing hormone 687
Thyroxine 106, 109
Tibolone 606, 608
Tinea cruris 862
Tioconazole 850
Tiredness 786
Tissue 525
biopsy 815
drying 717
healing, abnormal signs of 476
hypoxia 717
Tocilizumab 114
Tocolysis 327
use of 316
Tocolytic drug 272
Tocolytic therapy 270, 285
Tolbutamide 374
Tolterodine 763
Topiramate 127
Torsion 648
Total complement haemolytic activity 112
Toxic shock syndrome 544, 545, 648, 887
Toxoplasma 425
gondii 425
Toxoplasmosis 357, 425, 432
infection, acquire 426
rubella, cytomegalovirus, herpes simplex 331, 338
Tracheal intubation 562f
Tramadol 466
Tranexamic acid 636, 643
Transcervical chorionic villus sampling 58
procedure for 58f
Transcutaneous electric nerve stimulation 39, 127, 465, 652, 653
Transdermal oestradiol patches 657
Transdermal skin patches 606, 607
Transformation zone, large loop excision of 810, 810f
Transient neonatal lateral rectus palsy 500
Transobturator cystocele repair, perigee system for 757f
Transobturator tension-free vaginal mesh techniques 757
Transplacental rubella 431
Transvaginal sacrospinous ligament fixation 756, 756f
Transversalis fascia 483
Transverse cerebellar diameter, measurement of 418f
Transverse incision 482
Transverse lie 316, 317f, 328
management of 317
positions of 316f
risk factors for 316
Trauma 29, 177, 488, 525, 612
neonatal 315
Treponema pallidum 806, 844
Treponemal infection, transplacental passage of 845
Treponemal tests 845
Trichomonas vaginalis 266
Trichomoniasis 847, 849
Tri-iodothyronine 106
Trilaminar germ disc, development of 681f
Trimethadione 370
Trimethoprim 370, 371
Triphasic pills 871
Triploidy 51, 136
Trisomy 13 79
Trisomy 18 51, 78
Trisomy 21 78, 136
Trophoblast lymphocyte 338
Tubal abortion 381
Tubal destruction 841
Tubal ectopic pregnancy, diagnosis of 383f
Tubal factors 698, 700
tests for 706
Tubal ligation 700, 889
Tubal lumen, hysteroscopic cannulation of 890f
Tubal obstruction, causes of 700
Tubal pathology, types of 707
Tubal sterilisation 888
Pomeroy's technique of 889f
Tube
delivery of 889
tubercular lesion of 827
Tubo-ovarian abscess 189, 853, 857
Tubo-ovarian mass 854f
Tumours 788
epithelial 789, 799
gestational trophoblastic 410t
inoperable primary 833
markers 191, 789
metastatic 789
mucinous 788
node and metastasis 794
secondary 789
serous 788
stage 833
Turner syndrome 79, 587, 588, 589, 602, 686, 687, 690
stigmata of 703
Turtle sign 504
Twins 255
breech, management of 307
gestation 262, 262t, 347
types of 255
locking of 265
peak sign 260f
pregnancy 263, 319, 434
presentation 479
reversed arterial perfusion syndrome 264
types of 261, 262
Twin-to twin transfusion,
treatment of 437
syndrome 257, 259, 262264, 330, 357
Two-cell-two-gonadotrophin theory 593f
Typhoid 545
U
Ulceration 756
Ulipristal acetate 636, 645, 887
Ultra-potent topical steroids 862
Ultrasonic gel 308
Ultrasound 123, 182, 457, 535
biometry 417
criteria 384
examination 45, 66, 258, 273, 317, 357
scanning 52, 147, 150
transabdominal 526
transvaginal 291f, 526, 781
Umbilical artery 418
blood flow patterns 420f
Doppler 419, 518
ultrasound waveforms, normal 420f
vasospasm 327
waveform analysis 421, 422
Umbilical cord 326f, 532f
compression, reduction of 516
Undescended testes 694
Unexplained infertility 707, 741, 742
treatment for 742
Unilateral lymphadenectomy, criteria for 832b
Unipolar diathermy 30
Unsafe abortion 361
practices 361
Unstable lie 318
causes for 318
Upper segment uterine scar 484
Uraemia 136
Ureaplasma 396
urealyticum 266, 775
Ureter 771
Urethra 771
neck of 471
obstruction of 768
Urethral bulking agents, injection of 764, 768
Urethral meatus, external 748
Urethral obstruction 356
Urethral sling 767
Urethritis 250
Urge incontinence 761, 763
Urinary bladder, non-visualisation of 264
Urinary catheter 481
Urinary dysfunction 786, 822
Urinary incontinence 756, 761
grading system for 762t
Urinary infection 36
Urinary obstruction 617
Urinary retention 36, 499, 842
Urinary stress test 764
Urinary symptoms 605
Urinary tract 428, 488, 769
complications 36, 617
infection 33, 136, 175, 198, 250, 544, 617, 769, 771, 776
complicated 772
lower recurrent 605
treatment of 773
uncomplicated 773
obstructive defects 442
symptoms, lower 762
Urinary tube defects 250
Urine
alkalinising agents 200
analysis 199, 664, 526
complete 25
culture 664
and sensitivity 762, 772
cytology 775
dipstick test 762
investigations 854
test 44, 45, 201
Urodynamic tests 762, 775
Urogenital atrophy
mild 607
moderate-to-severe 607
Urogenital diaphragm, muscles of 758f
Urogenital fistula 769
Urogenital malformations 53
Urogenital prolapse 747
Urogenital sinus
abnormalities 658
endodermal 580f
Urogenital tract, infection of 543
Urological Rusch balloon 527
Ursodeoxycholic acid 132
Ustekinumab 114
Uterine activity
monitoring 267
reduction of 516
Uterine anomalies 271, 316, 339
classification of 699f
Uterine artery 418, 436, 528, 532
blood flow
normal 419f
patterns 419f
Doppler 418
embolisation 636, 639, 641643, 646, 673
ligation 530f
Uterine biopsy 826
Uterine bleeding, abnormal 633, 633fc, 779, 780, 781f, 783
Uterine cavity 642
empty 384
irreparable distortion of 726
Uterine contractions 325, 451, 512, 516
Uterine curettage 671
Uterine cycle 591
Uterine dehiscence 350
Uterine endometrium 683, 688
Uterine enlargement 785
Uterine factor
infertility 698
tests for 706
treatment of 707
Uterine fibroids 258, 339, 637, 642
classification of 646f
treatment for 642
Uterine fundus 484
estimation of height of 450f
Uterine hyperactivity 650
Uterine hyperstimulation 463
Uterine hypertonicity 288
Uterine hypocontractility 458
Uterine incision 283, 484
closing 485
double-layered closure of 485
single-layered closure of 485
Uterine inertia 325
Uterine inversion 534, 535
degrees of 534f
reduction of 535f
Uterine leiomyomas 640
Uterine malformations 339
drug-induced 699
Uterine myomas 640
Uterine perforation 401, 785, 812, 882
diagnosis of 883f
Uterine prolapse 747, 748, 749b, 756
surgery for 757
Uterine rupture 177, 322, 347b, 349, 350, 458, 463, 488
lower risk of 348
risk of 269, 351
types of 349
Uterine scar 349
lower segment 484
previous 283
rupture 348b
Uterine segment, lower 484
Uterine sepsis 188
Uterine septum 339
resection 341
Uterine serosa 640
Uterine suspensions, types of 752
Uterine tenderness 288
Uterine trauma 670
Uterine tube 579f
ampulla of 679
Uterine vessels 283, 484
Utero-ovarian artery ligation 528
Uteroplacental apoplexy 289
Uteroplacental vascular ischemia 419
Uterosacral ligament 664, 704, 750
Uterotonic agent 462
Uterovaginal canal, mesoderm of 580f
Uterus 598, 605, 683
cancer of 23
dextrorotated 483
empty 381
formation of 579f
inversion 535
manual manipulation of 535
perforation of 612
ruptured 489
septate 396
unicornuate 726
V
Vacuum aspiration 896
procedure of 897f
Vacuum cup over foetal head, placement of 495, 497f
Vacuum delivery 501t
suction-cup devices, types of 492t
use of 491
Vacuum devices, types of 492
Vacuum extraction 491
steps of 495
Vacuum suction, creation of 498
Vagina 598, 605, 683
apical 748
development of 579
formation of 580f
suspension of 749, 750
upper third of 475
Vaginal atrophy 607, 612, 629
symptoms of 629
Vaginal birth after caesarean section 307, 345, 345b, 346, 347b, 348, 470
Vaginal bleeding 267, 288
abnormal 186
Vaginal breech deliveries 305, 309, 310
Vaginal cancer 824, 826, 828
aetiology 824
complications 826
diagnosis 824
differential diagnosis 825
early stage 826
management 825
staging for 825t
treatment of 825t
Vaginal contraceptive sponge 886
Vaginal culture 848
Vaginal delivery 129, 211, 233fc, 309, 347, 472, 504
normal 232
operative 500
spontaneous 321, 501
Vaginal dilatation 585
Vaginal dilators 865
Vaginal discharge 47, 178, 599, 846, 848fc, 849t
abnormal 186
aetiology 846
brownish 394
complications 851
diagnosis 846
history of 702
management 848
pathological 846t
causes of 846, 846t
physiological 846
Vaginal dissection 767
Vaginal dryness 605, 628, 667
Vaginal epithelial cells 629
Vaginal epithelium, thickness of 629
Vaginal examination 279, 288, 304, 317, 320322, 324, 405, 451, 475, 544, 864
internal 352
Vaginal incision, closure of 768
Vaginal injuries, repair of 529
Vaginal intraepithelial neoplasia 824
Vaginal introitus 627
infibulation of 616f
Vaginal irradiation, postoperative 785
Vaginal lubricants 611
Vaginal moisturizers 611
Vaginal mucosa 472f
Vaginal oestrogen 607
preparations 607
Vaginal progesterone 657
prophylactic 270
Vaginal radical trachelectomy 823
Vaginal rings 871
Vaginal routes 307
Vaginal spotting 667
Vaginal stenosis 786
Vaginal swab, high 526
Vaginal tears, repair of 473
Vaginal tissue 759t
Vaginal trichomoniasis 851
Vaginal vault suspension 752
Vaginal wall
adjacent 768
posterior 748
Vaginal-assisted delivery 491
Vaginismus 626628, 864
development of 628
Vaginitis 847t
emphysematous 851
Validation 5
Valproate 369, 370
Valvular heart disease 250
Varicella 203
infection 203
neonatal transmission of 206
neonatal 203
syndrome, congenital 203
vaccine 206
Varicella-zoster
immunoglobulin 204
virus 203, 204
immunoglobulin 204
infection 204fc
vaccination 205
Varicocele 694
Varicose ulceration 160
Varicose veins 47
Vasa praevia 291, 293
aetiology 291
complications 292
diagnosis 291, 291f
evidence-based medicine 292
investigations 291
management 292
risk factors for 291
Vascular endothelial growth factor 798
receptors 798
Vascular injury 159
Vasculitis 111
Vasectomy 871, 890
procedure of 890f
Vasomotor instability 734
Vasopressin analogues 763
Vena cava filters 160
Venereal Disease Research Laboratory 331, 844
Venlafaxine 763
Venous stress disorder 160
Venous thromboembolism 25, 154, 155, 155t, 156, 157, 165
prophylaxis against 281
Venous thrombosis 37, 115, 201
risk factors for 26b
Ventouse application 325
Ventricular septal defects 424
Verbal communication 5
Vermian agenesis 222
Vertex presentation 322
Vertical transmission 61
Vertical uterine incision 318, 319
Very-low-birth weight 560
Vesicoamniotic shunt 444f
Vestibulectomy 629
modified posterior 866f
Vestibulodynia 629
Vibroacoustic stimulation test 69
Vincristine 409
Viral pneumonia 226
Virilisation 584
signs of 684
Virus, identification of 429
Visceral infarcts 250
Visceral injury 769
Visceral origin 660
Visceral peritoneum, incision of 482f
Visible embryo 336
Visual analogue pain score 775
Visual fields
assessment of 684
fundoscopy of 684
Vital signs 565
Vitamin
B1 137
B12 144
isolated deficiency of 144
B6 136
C 144
D-dependent rickets 75
D-resistant rickets 77
K
administration of 127
analogues 374
deficiency 196
supplementation 46, 124
Vitiligo 733, 735
Vitrification 731
Voice, deepening of 667
Voiding dysfunction 769
Vomiting 47, 134, 135, 135fc, 178, 365, 544, 651, 713
von Willebrand disease 635
Vulva 605
microinvasive carcinoma of 829
non-neoplastic epithelial disorders of 859
Paget's disease 830
Vulval biopsy 861, 865
Vulval inspection 864
Vulval intraepithelial neoplasia 862
Vulval pain syndromes 859
Vulval pruritus 862t
Vulval tumours, lateral 832
Vulvar cancer 829, 833
aetiology 829
diagnosis 829
differential diagnosis 830
management 830
staging for 830, 830t
surgical treatment of 830
treatment for 833t
Vulvar intraepithelial neoplasia 829
Vulvar lesions, lymphatic spread of 832f
Vulvar pain syndrome 863, 867
Vulvectomy, radical 786
Vulvodynia 627, 628, 863, 865t, 866
aetiology of 864fc
clinical pain in 863
diagnosis of 864
localised provoked 864, 865
unprovoked 864, 866
Vulvovaginal candidiasis 847, 849
Vulvovaginal thrush 862
W
Warfarin 370, 372
Warly-onset group B Streptococcus infection 571
Watery discharge per vaginum 272
Weak scar, causes of 488b
Weight control 172
Weight gain 88, 667, 881
maternal 122
Weight management 92
Weight record, maternal 352
Well's score 161
calculation of 162fc
Wernicke's encephalopathy 137
Wernicke-Korsakoff syndrome 137
Wertheim's hysterectomy 820
Wet mount preparation 847
Wharton's jelly 326
Wheel-spoke appearance 715f
Wheeziness 119
Wilson's disease 75
Wolff-Parkinson-White syndrome 434
Wood's screw manoeuvre 506, 506f, 507f
reverse 506, 507f
Woody subcutaneous tissues 250
World Medical Association 3
Worldwide maternal mortality rates 361f
Wound
breakdown 786, 834
care 34, 487
complications, rate of 490
dehiscence, risk of 475
infection 39, 769, 786
X
X chromosome, inactivation of 336
X-linked dominant
disorder, inheritance of 78f
porphyria 77
trait 78f
X-linked recessive
disorder 77f
inheritance pattern 76b
trait 77f
features of 77b, 78b
Y
Y chromosome 587
Yasmin® 876
Yuzpe's regimen 887
Z
Zavanelli manoeuvre 507, 508f
Zidovudine 211
Zika syndrome 221
Zika virus 219, 220
disease 220
infection 219, 221, 222t, 236
testing 219
transmission, risk of 221
Zoledronic acid 609
Zona dissection, partial 725
Zona pellucida 678
function of 678
Zona reaction 678
Zona-free hamster oocyte penetration test 696
Zygote 678
intrafallopian transfer 725
×
Chapter Notes

Save Clear


An Evidence-Based Clinical Textbook in Obstetrics & Gynaecology for MRCOG-2
An Evidence-Based Clinical Textbook in Obstetrics & Gynaecology for MRCOG-2
SECOND EDITION
Richa Saxena MBBS MD (Obstetrics and Gynaecology) PG Diploma in Clinical Research Obstetrician and Gynaecologist Course Mentor: Cracking MRCOG New Delhi, India
Jaypee Brothers Medical Publishers (P) Ltd.
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© 2021, 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) 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.
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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. The CD/DVD-ROM (if any) provided in the sealed envelope with this book is complimentary and free of cost. Not meant for sale.
Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com
An Evidence-Based Clinical Textbook in Obstetrics & Gynaecology for MRCOG-2
First Edition: 2017
Second Edition: 2021
9789390020645
Printed at
My mother Mrs Bharati Saxena for always being there…. .
“My mother is the most beautiful woman I have ever seen. All I am I owe to my mother. I attribute all my success in life to the moral, intellectual and physical education I received from her.”
George Washington
Preface to the Second Edition
“Twenty years from now you will be more disappointed by the things that you didn't do than by the ones you did do.”
—Mark Twain
Surely, none of the obstetrician gynaecologist would desire that not making an effort to acquire MRCOG degree becomes one of those things they did not do at a time when it would have been possible. Attaining the MRCOG degree has always been the dream of many doctors. Membership of the Royal College of Obstetricians and Gynaecologists (MRCOG) can be considered as a gold standard, international qualification in the field of obstetrics and gynaecology and is often thought to represent the zenith of one's career. The book “An Evidence-Based Clinical Textbook in Obstetrics and Gynaecology for MRCOG-2” is an attempt to bring together the fundamental topics related to clinical sciences, which are of prime importance for the doctors who are planning to appear in MRCOG Part 2 Examination and wish to pursue their specialisation in obstetrics and gynaecology in the UK.
Getting the MRCOG degree entails passing through a series of a three-part examination in which Part 1 is a written examination, testing the candidate's knowledge related to basic sciences. Part 2 examination is a written examination testing candidate's clinical knowledge pertaining to the speciality of obstetrics and gynaecology. Part 3 is a clinical skills examination based on Objective Structured Clinical Examination (OSCE). For more details related to the MRCOG examination, kindly refer to the Royal College of Obstetricians and Gynaecologists (RCOG) website, https://www.rcog.org.uk/.
“When you want to succeed as bad as you want to breathe, then you shall be successful.”
—Eric Thomas
There is no denying of the fact that the MRCOG, especially part 2 examination, is a difficult examination and requires a lot of hard work and dedication on the part of the candidate. A fact remains that no book can replace the hard work the candidate would be required to put in. However, this book would definitely help the candidate to study smartly by providing them with the right amount of knowledge and guide them through the various nuances and finer aspects of the examination, enabling them to emerge out successfully through the examination.
The second edition of the book “An Evidence-Based Clinical Textbook in Obstetrics and Gynaecology for MRCOG-2” has been primarily inspired by the success of the first edition. Similar to the previous edition, the second edition has also adopted an evidence-based approach, especially focussing on the current standards in health care. It helps in the amalgamation of clinical expertise, patient values, and the best research evidence so that it can be used in the decision-making process for patient care.
The second edition has been thoroughly updated as per the latest evidence-based guidelines as recommended by the National Institute for Health and Clinical Excellence (NICE), Royal College of Obstetricians and Gynaecologists (RCOG), Green-Top Guidelines, etc. in the field of obstetrics and gynaecology. The book also covers the updated figures for maternal and perinatal mortality as described by MBRRACE UK (2019).
The previous categorisation of the book into three parts: general, obstetrics, and gynaecology as well the pattern of previous sections have been retained in this comprehensive new edition. This new edition comprises of 98 chapters, distributed into 17 sections and is based as per the current MRCOG-2 curriculum available from the RCOG website. Nevertheless, there has been an addition of several new chapters such as thromboembolism in pregnancy, genetic disorders, postpartum collapse, Zika virus infection, etc. COVID-19 and its management during pregnancy has also been discussed at length in this new edition.
Addition of online content is another new value-adding feature of this book. The book buyers would get access to more than 250 questions (in form of EMQs and SBAs), which have been added in an interactive format on an online portal. This additional content can be redeemed by using the scratch code going inside the front cover of the book. Besides a detailed explanation, which is provided with each question, an 8–9-hour-long video discussing these questions and other tips and tricks for clearing the Part 2 examination has also been added. The references of each chapter can also be accessed online by scanning a QR code. In case the reader wants to obtain more information related to a specific online reference, it can be clicked to access the actual journal article. This would also enable the reader to access the Green-Top Guidelines available online and read them in its entirety.
The text in each chapter has been organised in the form of a predefined template, including headings such as introduction, aetiology/indications, diagnosis, differential diagnosis, management, complications, and evidence-based medicine. A new heading, titled ‘key features’, has been added to all the chapters in the new edition. This heading would help the reader in summarising the chapter. Important topics in each chapter have been delineated with help of a specific symbol so that the reader lays special emphasis on these topics. This style facilitates innovative learning and would enable the readers to quickly revise just before the examination by taking a glance at the key features and portions of the text indicated with an icon of a ‘pin’.
Writing a book is a colossal 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 Mr Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Ms Chetna Malhotra (Associate Director—Content Strategy), Ms Pooja Bhandari (Production Head), Kritika Dua (Senior Development Editor), Ashwani Singh (Assistant Manager), Yogeshwar Pal (Medical Editor and Coordinator), Raj Kumar (Typesetter), Nitin Bharadwaj (Graphic Designer), Sarvesh Singh (Proofreader), and Ms Seema Dogra (Cover Designer) for publishing the book.
I believe that writing a book involves a continuous learning process. Though extreme care has been taken to maintain the accuracy while writing this book, constructive criticism would be greatly appreciated.
Please e-mail me your comments at the e-mail address: richa@drrichasaxena.com. Also, please feel free to visit my website www.drrichasaxena.com for obtaining information related to various other books written by me and to make use of the free online resources available for the doctors attempting the MRCOG examination.
Richa Saxena
Preface to the First Edition (Extract)
Recently, there has been a growing consensus regarding the use of evidence-based approach for healthcare management. Evidence-based practice has been defined as follows:
“The conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.”
—Sackett D, 1996
This book, An Evidence-Based Clinical Textbook in Obstetrics and Gynaecology for MRCOG-2, an evidence-based approach, typically focusses on the current standards in health care. It helps in the amalgamation of clinical expertise, patient values, and the best research evidence so that it can be used in the decision-making process for patient care. It is intended for the doctors who are planning to appear in MRCOG examination and wish to pursue their specialisation in obstetrics and gynaecology in the UK. This comprehensive textbook comprises of 93 chapters, distributed into 17 sections and is based as per the current MRCOG-2 curriculum (available from: https://www.rcog.org.uk/en/careers-training/mrcog-exams/part-2-mrcog/syllabus). Designed into three parts, the textbook covers all the relevant topics related to general principles of medical practice, obstetrics, and gynaecology which are further segregated into sections like general principles, antenatal period, medical disorders during pregnancy, complications specific to pregnancy and those during early pregnancy, foetal complications (diagnosis and management), intrapartum period, delivery and its complications, postpartum period, the newborn infant, general gynaecology, abnormalities of menstruation, reproductive medicine, urogynaecological and pelvic floor abnormalities, gynaecological oncology, gynaecological infections as well as pregnancy prevention. To facilitate easy learning, the text is organised in accordance with a predefined template, including introduction, aetiology/indications, diagnosis, differential diagnosis, management, complications, clinical pearls, and evidence-based medicine. An effort has been made to incorporate all the recent most evidence-based guidelines (Green-top Guidelines, NICE Guidelines, etc.) in the text. Numerous flowcharts and diagrams have been incorporated in the text to make it more understandable for the students. The book also includes the latest statistics related to the causes of maternal and neonatal mortality in the UK as published by the MBRRACE UK in December 2016. It also includes details pertaining to the Green-top Guidelines (No. 52) for prevention and management of postpartum haemorrhage (published in December 2016).
The text aptly offers all the required information a specialist registrar or senior house officer requires during his/her training and while preparing for the MRCOG examination. In fact, this book would also assist all the applicants, especially overseas, preparing for MRCOG examination (part 1 as well as parts 2 and 3). It would equip them with the knowledge to answer the SBAs and EMQs asked during MRCOG-2 examination. It would also enhance their clinical knowledge to be able to attempt the OSCES in MRCOG-3 examination. Also, any healthcare professional in the UK interested in learning more about the health care of women is likely to benefit from this book. In a nutshell, this book would serve as an invaluable companion not only for the doctors aiming towards higher training in obstetrics and gynaecology, but would also serve as a useful source of ready reference for those in established practice.
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. I believe that writing a book involves a continuous learning process. Though extreme care has been taken to maintain the accuracy while writing this book, constructive criticism would be greatly appreciated. Please e-mail me your comments at the e-mail address: richa@drrichasaxena.com.
Richa Saxena
MRCOG Standards  
The New Core Curriculum and the MRCOG
As per the new course curriculum (2019) by the RCOG, the Capabilities in Practice (CiPs) are assessed by the different parts of the MRCOG examination. The Part 2 MRCOG, which covers the knowledge required during clinical practice, is used for the summative assessment of CiP 9, CiP 10, CiP 11, and CiP 12, along with elements of CiP 2 to demonstrate developing clinical expertise. Various CiPs as assessed by the MRCOG-2 examination are as follows:
 
Skill Assessed: Developing the Doctor (Generic)
CiP 2: The doctor is able to successfully work within health organisations
 
Skill Assessed: Developing the Obstetrician and Gynaecologist (Specialty-specific)
CiP 9: The doctor is competent in recognising, assessing, and managing emergencies in gynaecology and early pregnancy
CiP 10: The doctor is competent in recognising, assessing, and managing emergencies in obstetrics
CiP 11: The doctor is competent in recognising, assessing, and managing non-emergency gynaecology and early pregnancy care
CiP 12: The doctor is competent in recognising, assessing, and managing non-emergency obstetrics care.
This comprehensive textbook is based as per the current MRCOG-2 curriculum (available from: https://www.rcog.org.uk/globalassets/documents/careers-and-training/mrcog-exam/mrcog-syllabus-curriculum-2019.pdf). Described below are various CiPs and the various knowledge areas covered by them. Different knowledge areas on which different chapters of this textbook are based are also tabulated below:
 
CiP 2
Knowledge Areas
Book chapters covering the syllabus
Clinical skills
Teaching and research
Chapter 1: Principles of Clinical Practice in the NHS
Topics Covered
Knowledge Area 1: Clinical Skills
  • Understand the important elements in an obstetric and gynaecological history
  • Understand the principles and legal issues surrounding informed consent, with particular awareness of the implications for the unborn child, post-mortem examinations, consent to surgical procedures including sterilisation, parental consent, and Fraser guidelines and medical certification.
Knowledge Area 2: Teaching and Research
  • Identifying teaching strategies appropriate to adult learning like principles, needs, and styles relevant to medical education.
  • Understanding the difference between appraisal, assessment, and performance review.
  • Demonstrating appropriate skills in education, training, and continuing professional development.
  • Understanding quality improvement and management.
  • Understanding the production and application of clinical standards, guidelines, and care pathways and protocols.
  • Demonstrating working knowledge of the principles of risk management and their relationship to clinical governance and complaints procedures.
  • Understanding the difference between audit and research.
  • Learning how to plan and analyse a research project.
  • Demonstrating the skills required to critically appraise scientific trials and literature.
  • Gaining knowledge related to principles of screening, clinical trial design (multicentre, randomised controlled trials, etc.) and the statistical methods used in clinical research.
  • Comprehending levels of evidence, quantification of risk, power of study, level of significance, informed consent, and ethical and regulatory approvals in research.
  • Understanding principles of safe prescribing, quality control in medicine and the accuracy of tests.
 
CiP 9
Knowledge Areas
Book chapters covering the syllabus
Core surgical skills
Post-operative care
Chapter 2: General Principles of Surgery
Early pregnancy care
Chapter 37: Ectopic Pregnancy
Chapter 38: Spontaneous Miscarriage
Chapter 39: Gestational Trophoblastic Neoplasia
Chapter 98: Medical Termination of Pregnancy
Topics Covered
Knowledge Area 3: Core Surgical Skills
  • Understanding and demonstrating appropriate knowledge, skills, and attitudes in relation to basic surgical skills.
  • Comprehending legal issues surrounding informed consent, knowledge of complication rates, and risks.
  • Learning diagnostic methods and treatment of complications to increase success rates of different gynaecological surgeries.
  • Showing familiarity with surgery by discussing the common surgeries together with common surgical instruments and sutures.
  • Regional anatomy and histology.
  • Commonly encountered infections, including an understanding of the principles of infection control.
  • Knowledge of the NHS Improvement Programme Enhanced Recovery principles to enhance patient safety and optimise pre-, intra- and post-operative care.
  • Principles of nutrition, water; electrolyte and acid–base balance and cell biology.
  • Appropriate use of blood and blood products.
  • General pathological principles.
  • Prevention of complications related to surgery including venous thromboembolism, infection (wound, urinary tract, respiratory, intra-abdominal, and pelvic), and primary and secondary haemorrhage (intraoperative and post-operative).
  • Relevant clinical anatomy: Relevant bones, joints, muscles, blood vessels, lymphatics, nerve supply, and histology.
  • Characteristics, recognition, prevention, eradication and pathological effects of all commonly encountered bacteria, viruses, Rickettsia, fungi, protozoa, parasites and toxins, including an understanding of the principles of infection control.
  • Knowledge and awareness of anaesthesia: General anaesthetic, conscious sedation, regional and local.
  • General pathological principles including general, tissue and cellular responses to trauma, infection, inflammation, therapeutic intervention (especially by the use of irradiation, cytotoxic drugs, and hormones), disturbances in blood flow, loss of body fluids, hyperplasia, and neoplasia.
  • Knowledge and awareness of use in complications of diathermy and other energy sources.
  • Relevant basic sciences.
Knowledge Area 4: Post-operative Care
  • Understanding and demonstrating appropriate knowledge, skills, and attitudes in relation to post-operative care.
  • Knowing how to reach a diagnosis and assess a post-operative patient and deal with all aspects of post-operative care, including immediate, short-term and long-term.
  • Learning skills for prevention of common post-operative problems.
  • Understanding all aspects of surgery, complications, and follow-up.
Knowledge Area 13: Early Pregnancy Care
  • Understanding epidemiology, aetiology, pathogenesis, and clinical features related to miscarriage and other early pregnancy complications, including diagnosis, investigations, management, and psychological support in cases of miscarriage and ectopic pregnancy.
  • Ability to assess and manage these conditions both medically and surgically.
  • Attaining knowledge related to the use of ultrasound for diagnosis and management of complications in the early pregnancy, e.g., trophoblastic disease, ectopic pregnancy, etc.
 
CiP 12
Knowledge Areas
Book chapters covering the syllabus
Antenatal care
Chapter 3: Routine Antenatal Care
Chapter 4: Biochemical and Ultrasound Screening for Foetal Anomalies
Chapter 5: Invasive and Non-Invasive Prenatal Diagnosis
Chapter 6: Tests for Foetal Well-Being
Chapter 7: Genetic Disorders
Maternal medicine
Chapter 8: Hypertensive Disorders during Pregnancy
Chapter 9: Cardiac Disease in Pregnancy
Chapter 10: Thyroid Disorders during Pregnancy
Chapter 11: Connective Tissue Disorders (Autoimmune Disorders)
Chapter 12: Respiratory Diseases in Pregnancy
Chapter 13: Epilepsy and Other Neurological Disorders
Chapter 14: Hepatic and Gastrointestinal Diseases
Chapter 15: Anaemia and Other Haematological Abnormalities
Chapter 16: Thromboembolic Disorders in Pregnancy and Puerperium
Chapter 17: Diabetes Mellitus and Gestational Diabetes
Chapter 18: Abdominal Pain during Pregnancy
Chapter 19: Varied Malignancies during Pregnancy
Chapter 20: Dermatological Disorders during Pregnancy
Chapter 21: Renal Disease during Pregnancy
Chapter 22: Maternal Infection during Pregnancy
Chapter 23: Smoking during Pregnancy
Chapter 24: Alcohol and Drug Usage during Pregnancy
Chapter 40: Foetal Growth Restriction
Chapter 41: Foetal Infection
Chapter 42: Non-immune Foetal Hydrops
Chapter 43: Foetal Anomalies and their Management
Topics Covered
Knowledge Area 5: Antenatal Care
  • Having a better understanding of normal antenatal processes and progress.
  • Recognising and managing complications from preconceptual care through to delivery.
  • Dealing with the variety of maternal choices in antenatal and intrapartum care.
  • Developing skills in attending and in passing on complex information (e.g., concerning risk).
  • Demonstrating skills to communicate with midwives and other health professionals to optimise care of the woman thereby exhibiting empathic teamwork.
  • To be well acquainted with the principles of prenatal diagnosis and screening.
  • Understanding the ways in which problems may affect the foetus, and be able to interpret and act upon any appropriate investigations.
  • Learning how to be well trained in the use of ultrasound in the investigation and treatment of foetal disorders.
Knowledge Area 6: Maternal Medicine
  • Understanding the epidemiology, aetiology, pathophysiology, clinical characteristics, prognostic features, and management of common medical disorders and the effect that pregnancy may have on them, as well as the effect of such disorders on pregnancy (including both medical and obstetric problems). Some such disorders include hypertension, thyroid, epilepsy, neurological, dermatological, connective tissue as well as cardiac, respiratory, and renal diseases.
  • Developing the skills to liaise effectively with colleagues in other disciplines both clinical and non-clinical to assess and treat these conditions and know when more expert help is required.
 
CiP 10
Knowledge Areas
Book chapters covering the syllabus
Management of labour
Chapter 25: Multifoetal Gestation
Chapter 26: Preterm Labour and Premature Rupture of Membranes
Chapter 27: Antepartum Haemorrhage
Chapter 28: Rhesus Isoimmunisation
Chapter 29: Abnormal Presentation
Chapter 30: Intrauterine Death
Chapter 31: Recurrent Miscarriage
Chapter 32: Pregnancy after Previous Caesarean Delivery
Chapter 33: Post-term Pregnancy (Prolonged Pregnancy)
Chapter 34: Liquor Abnormalities
Chapter 35: Maternal Mortality
Chapter 36: Medications during Pregnancy
Chapter 44: Normal and Abnormal Progress of Labour
Chapter 45: Induction of Labour
Chapter 46: Anaesthesia and Analgesia in Labour
Chapter 47: Perineal Injuries
Management of delivery
Chapter 48: Caesarean Delivery
Chapter 49: Instrumental Vaginal Delivery
Chapter 50: Shoulder Dystocia
Chapter 51: Antepartum and Intrapartum Foetal Asphyxia
Postpartum complications
Chapter 52: Postpartum Haemorrhage
Chapter 53: Maternal Collapse during Pregnancy and Postpartum Period
Chapter 54: Puerperal Pyrexia
Chapter 55: Psychiatric Disorders in the Puerperium (Mood Disturbances)
Chapter 56: Problems with Breastfeeding
Chapter 57: Asphyxia Neonatorum
Chapter 58: Care of a Newborn Child
Chapter 59: Perinatal Mortality
Topics Covered
Knowledge Area 7: Management of Labour
  • Understanding and demonstrating appropriate knowledge, skills, and attitudes in relation to the normal progress of labour.
  • Attaining knowledge to demonstrate the appropriate use of protocols and guidelines.
  • Skilled initial management of intrapartum problems without direct supervision, including knowledge and understanding of mechanism of normal and abnormal labour and delivery.
  • Acquiring expertise in handling multifoetal gestation, preterm labour or premature rupture of membranes, antepartum and intrapartum haemorrhage, prolonged labour, intrauterine death, maternal mortality, etc.
  • Being aware of the causes and management of maternal collapse including massive haemorrhage, cardiac problems, pulmonary and amniotic embolism, drug reactions, trauma, etc.
  • Learning practical skills relating to normal and abnormal delivery.
  • Learning causes, management, and complications related to intrauterine death.
  • Acquiring expertise in assessment of foetal well-being using foetal heart rate monitoring, acid–base balance, and foetal scalp blood sampling.
  • Learning causes, mechanisms of action, and complications of foetal pulmonary maturity, infection risks, and foetal compromise including cord prolapse.
  • Understanding the mechanisms of normal and abnormal labour.
  • Attaining expertise in the methods of induction of labour, and understanding its indications, contraindications, and complications.
  • Getting acquainted with the types and methods of action of regional anaesthesia including epidural and spinal.
  • Learning types and methods of action of analgesia and sedation including narcotics, hypnotics, psychotropics, non-steroidal anti-inflammatory drugs, its indications and contraindications.
  • Being aware of complications of anaesthesia and analgesia.
Knowledge Area 8: Management of Delivery
  • Understanding the mechanism and making appropriate decisions in the choice of delivery in partnership with the mother at the same time respecting the views of other healthcare workers especially the midwives.
  • Attaining expertise in indications, contraindications, and complications related to labour and delivery.
  • Learning types and methods of different types of deliveries like caesarean, instrumental vaginal as well as management of complications such as shoulder dystocia.
  • Understanding perineal trauma and its repair as well as management of complications such as antepartum and intrapartum foetal asphyxia.
Knowledge Area 9: Postpartum Problems (The Puerperium)
  • Understanding and demonstrating proper knowledge, skills, and attitudes in management of postpartum problems, including resuscitation of both mother and baby and the ability to manage birth trauma and other birth complications.
  • Learning techniques for the control of postpartum haemorrhage.
  • Showing empathy and developing good counselling skills and an understanding about the role of other professionals.
  • Awareness of the breast-feeding initiative.
  • Understanding and demonstrating appropriate knowledge, skills, and attitudes in relation to the neonatal problems.
  • Ability to manage neonatal problems at birth like resuscitation of newborn and other neonatal complications.
  • Developing counselling skills regarding the patients who have faced perinatal loss or intrauterine death.
 
CiP 11
Knowledge Areas
Book chapters covering the syllabus
Gynaecological problems
Chapter 60: Normal and Abnormal Embryological Development
Chapter 61: Karyotypic Abnormalities
Chapter 62: Menstrual Cycle
Chapter 63: Adolescent and Paediatric Gynaecology
Chapter 64: Menopause and Hormone Therapy
Chapter 65: Injuries of the Female Genital Tract and Female Genital Mutilation
Chapter 66: Child Abuse, Sexual Assault, and Rape
Chapter 67: Dyspareunia and Other Psychosexual Problems
Chapter 68: Abnormal Uterine Bleeding
Chapter 69: Uterine Leiomyoma
Chapter 70: Dysmenorrhoea and Pelvic pain
Chapter 71: Premenstrual Syndrome
Chapter 72: Chronic Pelvic Pain and Endometriosis
Chapter 73: Adenomyosis
Subfertility
Chapter 74: Normal Conception
Chapter 75: Primary and Secondary Amenorrhoea
Chapter 76: Male Infertility
Chapter 77: Female Infertility
Chapter 78: Polycystic Ovarian Disease
Chapter 79: Hirsutism
Chapter 80: Assisted Reproductive Techniques
Chapter 81: Primary Ovarian Insufficiency
Chapter 82: Fertility Preservation
Chapter 83: Unexplained Infertility
Sexual and reproductive health
Chapter 93: Sexually Transmitted Infections
Chapter 94: Vaginal Discharge
Chapter 95: Pelvic Inflammatory Disease
Chapter 96: Benign Vulvar Problems and Vulval Pain Syndromes
Chapter 97: Contraception (Temporary and Permanent)
Gynaecological oncology
Chapter 87: Endometrial Cancer
Chapter 88: Ovarian Neoplasia (Benign and Malignant)
Chapter 89: Cervical Intraepithelial Neoplasia
Chapter 90: Invasive Cervical Cancer
Chapter 91: Rare Cancers of the Female Genital Organs
Chapter 92: Vulvar Cancer
Urogynaecology and pelvic floor problems
Chapter 84: Urogenital Prolapse
Chapter 85: Urinary Incontinence
Chapter 86: Urinary Tract Infection and Bladder Pain Syndrome
Topics Covered
Knowledge Area 10: Gynaecological Problems
  • Understanding and demonstrating appropriate knowledge, skills, and attitudes in relation to common gynaecological disorders such as menstrual disorders, menopause, and hormone replacement therapy.
  • Demonstrating knowledge of the aetiology, signs, symptoms, investigation, and treatment of common gynaecological problems like congenital abnormalities of the genital tract, paediatric gynaecology, and puberty-related abnormalities.
  • Appreciating the influence of psychosocial factors on the presentation and management of gynaecological problems using a patient-centred approach.
  • Being familiar with the laws related to child protection.
  • Understanding the epidemiology, aetiology, biological behaviour, pathophysiology, clinical characteristics, prognostic features, and management of menstrual and endocrine disorders, pelvic pain, dysmenorrhoea as well as premenstrual syndrome and problems of the climacteric like abnormal and postmenopausal bleeding.
Knowledge Area 11: Subfertility
  • Demonstrating appropriate knowledge, skills, and attitudes in relation to subfertility, including an understanding of the epidemiology, aetiology, pathogenesis, clinical treatment, and prognosis of all aspects of male and female fertility problems.
  • Gaining knowledge of indications, limitations, and interpretation of relative investigations and treatments in relation to both males and females, including disorders of fertility development and endometriosis.
  • Learning broad-based and up-to-date knowledge of assisted reproductive technologies, including ovulation induction, in vitro fertilisation, intracytoplasmic sperm injection, gamete donation and surrogacy, and the legal and ethical implications of these procedures.
Knowledge Area 12: Sexual and Reproductive Health
  • Understanding and demonstrating appropriate knowledge, skills, and attitudes in relation to the diagnosis and management of sexually transmitted infections (including HIV) and sexual dysfunction.
  • Demonstrating broad-based recognition of management techniques relating to the sexual health of vulnerable groups, such as young people, asylum seekers, commercial sex workers, drug users, and prisoners.
  • Learning the basis of national screening programmes and their implementation through local care pathways.
  • Attaining knowledge regarding reversible, irreversible and emergency contraception and abortion, mode of action, efficacy, indications, contraindications, and complications of various contraceptive methods.
  • Being familiar with the laws relating to abortion, sexually transmitted infections and consent and child protection.
Knowledge Area 14: Gynaecological Oncology
  • Developing detailed understanding related to the aetiology and screening involved in gynaecological oncology, including the international perspective.
  • Understanding presenting symptoms of various gynaecological malignancies and their management and have the appropriate competencies for each stage of the diagnostic process, including comprehension of the different roles and skills required at the district lead and gynae oncologist.
  • Know the prognosis and treatment options for various gynaecological cancers like vulvar, cervical, endometrial, ovarian, etc.
Knowledge Area 15: Urogynaecology and Pelvic Floor Problems
  • Understanding and demonstrating appropriate knowledge, skills, and attitudes in the management of urogynaecology and pelvic floor problems like urinary and faecal incontinence, benign bladder conditions and urogenital prolapse.
  • Demonstrating an understanding of the anatomy, pathophysiology, epidemiology, aetiology, and investigation of these conditions.
 
Reference:
Royal College of Obstetricians and Gynaecologists. (2019). MRCOG Syllabus and Knowledge Requirements for Core Curriculum 2019. [Online] Available from: https://www.rcog.org.uk/globalassets/documents/careers-and-training/mrcog-exam/mrcog-syllabus-curriculum-2019.pdf [Accessed November 2020].
Introduction to the Symbols Used in the Textbook
Promoting evidence-based medicine is the basic purpose of this book. Assembled into three parts, General, Obstetrics, and Gynaecology, the comprehensive textbook is divided into 17 sections and 98 chapters that are written as per the current MRCOG-2 curriculum. All the chapters have been organised into various subparts with the help of the symbols as described below.
Abbreviations +ssRNA
Positive Sense Single-stranded RNA Virus
2019-nCoV
Novel Coronavirus
ACE
Angiotensin-converting Enzyme
ACOG
American College of Obstetricians and Gynecologists
ADPKD
Autosomal Dominant Polycystic Kidney Disease
AED
Antiepileptic Drug
AFI
Amniotic Fluid Index
AFV
Amniotic Fluid Volume
AIDS
Acquired Immune Deficiency Syndrome
ALT
Alanine Aminotransferase
ANA
Antinuclear Antibodies
ANC
Antenatal Care
Anti-Sm
Anti-Smith Antibodies
AP
Anteroposterior
APGAR
Appearance, Pulse, Grimace, Activity and Respiration
APLS/APS
Antiphospholipid Antibody Syndrome/Antiphospholipid Syndrome
aPTT/APTT
Activated Partial Thromboplastin Time
ARB
Angiotensin II Receptor Blockers
ARDS
Acute Respiratory Distress Syndrome
ARM
Artificial Rupture of Membranes
ASD
Atrial Septal Defect
AST
Aspartate Aminotransferase
BCSH
British Committee for Standards in Haematology
BMI
Body Mass Index
BP
Blood Pressure
BPM
Beats Per Minute
BPP
Biophysical Profile
BPS
Bladder Pain Syndrome
CA-MRSA
Community-acquired Methicillin-resistant Staphylococcus aureus
cART
Combined Antiretroviral Therapy
CBC
Complete Blood Count
CDC
Center of Disease Control and Prevention
CEMACH
Confidential Enquiries into Maternal and Child Health
CEMD
Confidential Enquiries into Maternal Deaths
CESDI
Confidential Enquiries into Stillbirths and Deaths in Infancy
cffDNA
Cell-free Foetal DNA
CI
Confidence Interval
CMACE
Centre for Maternal and Child Enquiries
CNS
Central Nervous System
CO
Carbon Monoxide
COMA
Committee on Medical Aspects for Food and Nutrition Policy
CoV
Coronavirus
COVID-19
Coronavirus Disease 2019
CPR
Cardiopulmonary Resuscitation
CRP
C-reactive protein
CS
Caesarean Section
CST
Contraction Stress Test
CT
Computed Tomography
CTG
Cardiotocography
CTPA
Computerised Tomography Pulmonary Angiography
CVS
Chorionic Villus Sampling
CZS
Congenital Zika syndrome
D&C
Dilatation and Curettage
DAD
Diffuse Alveolar Damage
DFMC
Daily Foetal Movement Count
DIC
Disseminated Intravascular Coagulation
DLC
Differential Leucocyte Count
Ds
Double-stranded
DVT
Deep Vein Thrombosis
ECG
Electrocardiogram
ELISA
Enzyme-linked Immunosorbent Assay
ERCS
Elective Repeat Caesarean Section
ESHRE
European Society of Human Reproduction and Embryology
ESR
Erythrocyte Sedimentation Rate
ESSIC
European Society for the Study of Interstitial Cystitis
FDA
Food and Drug Administration
FDP
Fibrin Degradation Products
FEV1
Forced Expiratory Volume in 1 Second
ffDNA
Free-foetal Deoxyribonucleic Acid
fFN
Foetal Fibronectin
FFP
Fresh Frozen Plasma
FH
Familial Hypercholesterolaemia
FHR
Foetal Heart Rate
FHS
Foetal Heart Sound
FIGO
International Federation of Gynecology and Obstetrics
FISH
Fluorescent In-Situ Hybridisation
FMH
Foetomaternal Haemorrhage
FNAC
Fine-needle Aspiration Cytology
FSH
Follicle-stimulating Hormone
FVL
Factor V Leiden
FVS
Foetal Varicella Syndrome
G6PD
Glucose-6-Phosphate Dehydrogenase
GBS
Group B Streptococcus
GDG
Guideline Development Group
GFR
Glomerular Filtration Rate
GI
Gastrointestinal
GnRH
Gonadotrophin-releasing Hormone
GP
General Practitioner
GTG
Green-top Guideline
GUM
Genitourinary Medicine
HAART
Highly Active Antiretroviral Therapy
HAV
Hepatitis A Virus
HBIG
Hepatitis B Immunoglobulin
HBsAg
Hepatitis B Surface Antigen
HBV
Hepatitis B Virus
hCG
Human Chorionic Gonadotrophin
HCV
Hepatitis C Virus
HDV
Hepatitis D Virus
HELLP
Haemolysis, Elevated Liver Enzymes and Low Platelet count
HEV
Hepatitis E Virus
HG
Hyperemesis Gravidarum
HGV
Hepatitis G Virus
HIV
Human Immunodeficiency Virus
HLA
Human Leucocyte Antigen
HPV
Human Papillomavirus
HR
Heart Rate
HRT
Hormone Replacement Therapy
HSV
Herpes Simplex Virus
ICU
Intensive Care Unit
Ig
Immunoglobulin
IM
Intramuscular
INR
International Normalised Ratio
ISSHP
International Society for the Study of Hypertension in Pregnancy
IUCD
Intrauterine Contraceptive Device
IUGR
Intrauterine Growth Restriction/Retardation
IV
Intravenous
IVF
In Vitro Fertilisation
L:S ratio
Lecithin:Sphingomyelin ratio
LDA
Low-dose Aspirin
LFT
Liver Function Test
LH
Luteinising Hormone
LMWH
Low-Molecular-Weight Heparin
MAP
Morbidly Adherent Placenta
MAS
Meconium Aspiration Syndrome
MC
Monochorionic
MCH
Mean Corpuscular Haemoglobin
MCHC
Mean Corpuscular Haemoglobin Concentration
MCV
Mean Corpuscular Volume
MEN
Multiple Endocrine Neoplasia
MERS
Middle East Respiratory Syndrome
MEWS
Modified Early Warning Score
MOD
Multiple Organ Dysfunction
MOF
Multiple Organ Failure
MRI
Magnetic Resonance Imaging
MS
Multiple Sclerosis
MTC
Mother-to-Child
NCEPOD
National Confidential Enquiry into Patient Outcome and Death
NEC
Necrotising Enterocolitis
NHS
National Health Service
NICE
National Institute for Health and Clinical Excellence/National Institute for Clinical Excellence
NICU
Neonatal Intensive Care Unit
NIPD
Non-invasive Prenatal Diagnosis
NOACs
Non-vitamin K Antagonist Oral Anticoagulants
NPEU
National Perinatal Epidemiology Unit
NRTIs
Non-reverse Transcriptase Inhibitors
NSAIDs
Non-steroidal Anti-inflammatory Drugs
NST
Non-stress Test
OC
Obstetric Cholestasis
OCPs
Oral Contraceptive Pills
OPD
Outpatient Department
OR
Odds Ratio
PAPR
Powered Air-purifying Respirator
PC
Platelet Count
PCOS/PCOD
Polycystic Ovarian Syndrome/Polycystic Ovarian Disease
PCP
Pneumocystis carinii Pneumonia
PCR
Polymerase Chain Reaction
PE
Pulmonary Embolism
PEFR
Peak Expiratory Flow Rate
PET
Positron Emission Tomography
PFT
Pulmonary Function Test
PGI2
Prostacyclin/Prostaglandin I2
PID
Pelvic Inflammatory Disease
PIH
Pregnancy-induced Hypertension
PO
Per orally or per os
POF
Premature Ovarian Failure
POG
Period of Gestation
PPH
Postpartum Haemorrhage
PROM
Premature Rupture of Membranes
PT
Prothrombin Time
PV
Per Vaginally
QF-PCR
Quantitative Fluorescence Polymerase Chain Reaction
RBC
Red Blood Cell
RCOG
Royal College of Obstetricians and Gynaecologists
RCT
Randomised Controlled Trial
RDS
Respiratory Distress Syndrome
RIA
Radioimmunoassay
ROM
Rupture of Membranes
ROS
Reactive Oxygen Species
RPF
Renal Plasma Flow
RT-PCR
Reverse Transcription Polymerase Chain Reaction
SARS CoV-2
Severe Acute Respiratory Syndrome Coronavirus 2
SARS
Severe Acute Respiratory Syndrome
SC
Subcutaneous
SLE
Systemic Lupus Erythematosus
SNP
Single Nucleotide Polymorphism
SOGC
Society of Obstetricians and Gynaecologists of Canada
SPF
Sun Protection Factor
SSCP
Single Strand Conformation Polymorphism
STD
Sexually Transmitted Disease
T3
Tri-iodothyronine
T4
Thyroxine
TAS
Transabdominal Scan or Sonography
TENS
Transcutaneous Electrical Nerve Stimulation
TLC
Total Leucocyte Count
TORCH
Toxoplasmosis, Other Infections, Rubella, Cytomegalovirus, Herpes Simplex Virus
TSH
Thyroid-stimulating Hormone
TT
Thrombin Time
TTN
Transient Tachypnoea of the Newborn
TTTS
Twin-to-Twin Transfusion Syndrome
TVCL
Transvaginal Cervical Length
TVS
Transvaginal Scan or Sonography
TVT
Tension-free Vaginal Tape
TXA2
Thromboxane A2
UDCA
Ursodeoxycholic Acid
UFH
Unfractionated Heparin
UKOSS
UK Obstetric Surveillance System
UNICEF
United Nations Children's Fund
US
Ultrasonography
UTI
Urinary Tract Infection
UV
Ultraviolet
VBAC
Vaginal Birth after Caesarean
VDRL
Venereal Disease Research Laboratory
VTE
Venous Thromboembolism
VZIG
Varicella-Zoster Immunoglobulin
VZV
Varicella-Zoster Virus
WBC
White Blood Cell
WHO
World Health Organization
WY
Women Years
ZDV
Zidovudine
ZIKV
Zika Virus