Blueprints Obstetrics and Gynecology

507 Pages·2012·35.65 MB·English

by  Tamara Callahan

BLUEPRINTS
OBSTETRICS &
GYNECOLOGY
Sixth Edition

BLUEPRINTS
OBSTETRICS &
GYNECOLOGY
Sixth Edition
Tamara Callahan, MD, MPP
Assistant Professor
Department of Obstetrics and Gynecology
Division of Gynecologic Specialties
Vanderbilt University Medical Center
Nashville, Tennessee
Aaron B. Caughey, MD, MPP, MPH, PhD
Professor and Chair
Department of Obstetrics and Gynecology
Oregon Health and Science University
Portland, Oregon
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relating to general principles of medical care that should not be construed as specific instructions for individual
patients. Manufacturers’ product information and package inserts should be reviewed for current information,
including contraindications, dosages, and precautions.
Library of Congress Cataloging-in-Publication Data
Callahan, Tamara L.
Blueprints obstetrics & gynecology / Tamara L. Callahan, Aaron B. Caughey. — 6th ed.
p. ; cm.
Obstetrics & gynecology
Blueprints obstetrics and gynecology
Includes bibliographical references and index.
ISBN 978-1-4511-1702-8 (alk. paper)
I. Caughey, Aaron B. II. Title. III. Title: Obstetrics & gynecology. IV. Title: Blueprints obstetrics and gynecology.
[DNLM: 1. Pregnancy Complications--Examination Questions. 2. Genital Diseases, Female--Examination
Questions. WQ 18.2]

618.0076--dc23
2012028782
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Contents
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .x
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xii
PART I: Obstetrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1 Pregnancy and Prenatal Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
2 Early Pregnancy Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
3 Prenatal Screening, Diagnosis, and Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
4 Normal Labor and Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40
5 Antepartum Hemorrhage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .62
6 Complications of Labor and Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78
7 Fetal Complications of Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .94
8 Hypertension and Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .111
9 Diabetes During Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121
10 Infectious Diseases in Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .131
11 Other Medical Complications of Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .147
12 Postpartum Care and Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .161
PART II: Gynecology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .174
13 Benign Disorders of the Lower Genital Tract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .174
14 Benign Disorders of the Upper Genital Tract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .187
15 Endometriosis and Adenomyosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .204
16 Infections of the Lower Female Reproductive Tract . . . . . . . . . . . . . . . . . . . . . . .215
17 Upper Female Reproductive Tract and Systemic Infections . . . . . . . . . . . . . . .230
18 Pelvic Organ Prolapse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .239
19 Urinary Incontinence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .250
20 Puberty, the Menstrual Cycle, and Menopause . . . . . . . . . . . . . . . . . . . . . . . . . . . .267
21 Amenorrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .281
22 Abnormalities of the Menstrual Cycle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .293
23 Hirsutism and Virilism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .306
24 Contraception and Sterilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .316
v
vi • Contents
25 Elective Termination of Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .337
26 Infertility and Assisted Reproductive Technologies . . . . . . . . . . . . . . . . . . . . . . .346
27 Neoplastic Disease of the Vulva and Vagina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .360
28 Cervical Neoplasia and Cervical Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .369
29 Endometrial Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .383
30 Ovarian and Fallopian Tube Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .392
31 Gestational Trophoblastic Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .404
32 Benign Breast Disease and Breast Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .416
Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .434
Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .450
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .466
Contributors
Jeff Andrews, MD, FRCSC Sharon Engel, MD
Associate Professor Resident, Obstetrics and Gynecology
Department of Obstetrics and Gynecology Oregon Health & Science University
Division of General Obstetrics and Gynecology Portland, Oregon
Vanderbilt University School of Medicine
Nashville, Tennessee Abby Furukawa, MD
Resident, Obstetrics and Gynecology
Suzanne Barakat Oregon Health & Science University
Medical student Portland, Oregon
University of North Carolina
Chapel Hill, North Carolina Karen Gold, MD, MSCI
Assistant Professor
Alison Barlow, WHNP Director of Resident Education
Assistant Professor Department of Obstetrics and Gynecology
Department of Obstetrics and Gynecology Division of Female Pelvic Medicine and Reconstructive
Division of Midwifery and Advanced Practice Nursing Surgery
Vanderbilt University School of Medicine University of Oklahoma - Tulsa
Nashville, Tennessee Tulsa, Oklahoma
Lisa Bayer, MD Meghana Gowda, MD
Fellow, Family Planning Clinical Instructor
Oregon Health & Science University Department of Obstetrics and Gynecology
Portland, Oregon Division of Female Pelvic Medicine and Reconstructive
Surgery
Daniel H. Biller, MD Vanderbilt University School of Medicine
Assistant Professor Nashville, Tennessee
Department of Obstetrics and Gynecology
Division of Female Pelvic Medicine and Reconstructive William J. Kellett, DO
Surgery Assistant Professor
Vanderbilt University School of Medicine Department of Obstetrics and Gynecology
Nashville, Tennessee Division of General Obstetrics and Gynecology
Vanderbilt University School of Medicine
Yvonne W. Cheng, MD, PhD Nashville, Tennessee
Assistant Professor
University of California, San Francisco Tamara Keown, MSN, WHNP-BC
San Francisco, California Assistant Professor
Department of Obstetrics and Gynecology
Howard Curlin, MD Division of Midwifery and Advanced Practice Nursing
Department of Obstetrics and Gynecology Vanderbilt University School of Medicine
Madigan Army Medical Center Nashville, Tennessee
Tacoma, Washington
Amy Doss, MD
Fellow, Maternal-Fetal Medicine
Oregon Health & Science University
Portland, Oregon
vii
viii • Contributors
Dineo Khabele, MD, FACOG, FACS Stacey Scheib, MD
Assistant Professor Assistant Professor
Department of Obstetrics and Gynecology Department of Gynecology and Obstetrics
Division of Gynecologic Oncology Division of Minimally Invasive Gynecology
Vanderbilt University School of Medicine Johns Hopkins Hospital
Nashville, Tennessee Baltimore, Maryland
John Lucas, MD Brian L. Shaffer, MD
Assistant Professor Director, Fetal Diagnosis & Treatment Center
Department of Obstetrics and Gynecology Oregon Health & Science University
Division of Reproductive Endocrinology and Infertility Portland, Oregon
Vanderbilt University School of Medicine
Nashville, Tennessee Jonas Swartz, MD
Resident, Obstetrics and Gynecology
Lucy Koroma, MSN, WHNP-BC Oregon Health & Science University
Department of Obstetrics and Gynecology Portland, Oregon
Divisions of Reproductive Endocrinology and
Gynecology May Thomassee, MD
Vanderbilt University School of Medicine Clinical Instructor
Nashville, Tennessee Department of Obstetrics and Gynecology
Division of Minimally Invasive Gynecology
Erica Marsh, MD Vanderbilt University School of Medicine
Assistant Professor Nashville, Tennessee
Department of Obstetrics and Gynecology
Divisions of Reproductive Endocrinology and Susan H. Tran, MD
Infertility and Reproductive Biology Research Assistant Professor, Maternal-Fetal Medicine
Feinberg School of Medicine - Northwestern University Oregon Health & Science University
Evanston, Illinois Portland, Oregon
John Mission, MD Ashlie Tronnes, MD
Resident Fellow, Maternal-Fetal Medicine
Obstetrics and Gynecology University of Washington
Oregon Health and Science University Seattle, Washington
Portland, Oregon
Gina Westhoff, MD
Melinda New, MD Fellow, Gynecologic Oncology
Assistant Professor University of California, San Francisco
Director of Resident Education
Department of Obstetrics and Gynecology Keenan Yanit, MD
Division of Gynecology Resident, Obstetrics and Gynecology
Vanderbilt University School of Medicine Oregon Health & Science University
Nashville, Tennessee Portland, Oregon
Brian Nguyen, MD Jessica L. Young, MD
Resident, Obstetrics and Gynecology Assistant Professor
Oregon Health & Science University Department of Obstetrics and Gynecology
Portland, Oregon Division of General Obstetrics and Gynecology
Vanderbilt University School of Medicine
Rachel Pilliod, MD Nashville, Tennessee
Resident, Obstetrics and Gynecology
Brigham & Women’s Hospital Amanda Yunker, DO
Boston, Massachusetts Assistant Professor
Department of Obstetrics and Gynecology
Division of Minimally Invasive Gynecology
Vanderbilt University School of Medicine
Nashville, Tennessee