Hacker & Moore’s Essentials of Obstetrics and Gynecology

474 Pages·2015·24.856 MB·English

by  Neville F. Hacker, Joseph C. Gambone, Calvin J. Hobel

https://t.me/MedicalBooksStore
Hacker & Moore’s
E S S E N T I A L S O F
OBSTETRICS &
GYNECOLOGY
Hacker & Moore’s
E S S E N T I A L S O F
OBSTETRICS &
GYNECOLOGY
Neville F. Hacker, MD
Professor of Gynaecologic Oncology
Conjoint, University of New South Wales
Director, Gynaecological Cancer Centre
Royal Hospital for Women
Sydney, Australia
Joseph C. Gambone, DO, MPH, Executive Editor
Professor Emeritus of Obstetrics and Gynecology
David Geffen School of Medicine at UCLA
Attending Physician, Ronald Reagan UCLA Medical Center
Clinical Professor of Obstetrics and Gynecology
Western University of Health Sciences
College of Osteopathic Medicine of the Pacific
Private Infertility and Reproductive Endocrinology Practice, Durango, Colorado
Calvin J. Hobel, MD
Miriam Jacobs Chair in Maternal-Fetal Medicine
Cedars-Sinai Medical Center
Professor of Obstetrics and Gynecology
Professor of Pediatrics
David Geffen School of Medicine at UCLA
Los Angeles, California
Sixth Edition
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
HACKER & MOORE’S ESSENTIALS OF OBSTETRICS & GYNECOLOGY, ISBN: 978-1-4557-7558-3
SIXTH EDITION
INTERNATIONAL EDITION ISBN: 978-0-323-34053-3
Copyright © 2016 by Elsevier, Inc. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or
mechanical, including photocopying, recording, or any information storage and retrieval system, without
permission in writing from the publisher. Details on how to seek permission, further information about the
Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance
Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other
than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden
our understanding, changes in research methods, professional practices, or medical treatment may become
necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
using any information, methods, compounds, or experiments described herein. In using such information or
methods they should be mindful of their own safety and the safety of others, including parties for whom
they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most
current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be
administered, to verify the recommended dose or formula, the method and duration of administration, and
contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of
their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient,
and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any
liability for any injury and/or damage to persons or property as a matter of products liability, negligence or
otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the
material herein.
Previous editions copyrighted 2010, 2004, 1998, 1992, and 1986.
Library of Congress Cataloging-in-Publication Data
Hacker & Moore’s essentials of obstetrics & gynecology / [edited by] Neville F. Hacker, Joseph C. Gambone,
Calvin J. Hobel.—6th edition.
p. ; cm.
Hacker and Moore’s essentials of obstetrics and gynecology
Essentials of obstetrics and gynecology
Preceded by Hacker and Moore’s essentials of obstetrics and gynecology / [edited by] Neville F. Hacker, Joseph
C. Gambone, Calvin J. Hobel.
Includes bibliographical references and index.
ISBN 978-1-4557-7558-3 (pbk. : alk. paper)–ISBN 978-0-323-34053-3 (international edition)
I. Hacker, Neville F., editor. II. Gambone, Joseph C., editor. III. Hobel, Calvin J., editor. IV. Title: Hacker
and Moore’s essentials of obstetrics and gynecology. V. Title: Essentials of obstetrics and gynecology.
[DNLM: 1. Obstetrics–methods. 2. Genital Diseases, Female. 3. Pregnancy Complications. WQ 100]
RG101
618—dc23
2015035364
Acquisitions Editor: James Merritt
Developmental Editor: Julia Rose Roberts
Publishing Services Manager: Catherine Jackson
Project Manager: Rhoda Howell
Design Manager: Renee Duenow
Illustrations Manager: Nichole Beard
Marketing Manager: Melissa Darling
Printed in Canada
Last digit is the print number: 9 8 7 6 5 4 3 2 1
This edition is dedicated to our wives,
Estelle Hacker, Marge (Morris) Gambone, and Marsha Lynn Hobel.
Their understanding and support for the time and effort required
to complete this project was essential.
Contributors
Carolyn J. Alexander, MD Brian J. Koos, MD, DPhil
Southern California Reproductive Center Professor, Department of Obstetrics and Gynecology
Beverly Hills, California; David Geffen School of Medicine at UCLA
Clinical Associate Professor University of California, Los Angeles
David Geffen School of Medicine at UCLA Los Angeles, California
University of California, Los Angeles
Los Angeles, California Amy R. Lamb, PhD, CNM
Nurse-Midwife and Researcher
Jonathan S. Berek, MD, MMS Obstetrics and Gynecology
Laurie Kraus Lacob Professor Cedars-Sinai Medical Center
Chair, Department of Obstetrics and Gynecology Los Angeles, California
Stanford University School of Medicine
Director, Stanford Women’s Cancer Center Anita L. Nelson, MD
Director, Stanford Health Care Communication Professor, Department of Obstetrics and Gynecology
Program David Geffen School of Medicine at UCLA
Stanford, California University of California, Los Angeles
Los Angeles, California;
Lony C. Castro, MD, FACOG Medical Director, Research Division
Specialist, Maternal-Fetal Medicine California Family Health Council
Professor and Chair, Department of Obstetrics and Los Angeles, California
Gynecology
COMP/Western University of Health Sciences William H. Parker, MD
Pomona, California Health Sciences Clinical Professor
Department of Obstetrics and Gynecology
Sara Churchill, MD UCLA School of Medicine
Resident Physician Santa Monica, California
Department of Obstetrics and Gynecology
Cedars Sinai Medical Center Andrea J. Rapkin, MD
Los Angeles, California Professor of Obstetrics and Gynecology
David Geffen School of Medicine at UCLA
Daniel A. Dumesic, MD University of California, Los Angeles
Professor, Department of Obstetrics and Gynecology Los Angeles, California
Division Chief, Reproductive Endocrinology and
Infertility Bassam H. Rimawi, MD, FACOG
David Geffen School of Medicine at UCLA Department of Gynecology and Obstetrics
University of California, Los Angeles Division of Reproductive Infectious Diseases and
Los Angeles, California Maternal Fetal Medicine
Emory University School of Medicine
Michael L. Friedlander, PhD, FRACP Atlanta, Georgia
Conjoint Professor of Medicine
Prince of Wales Clinical School
University of New South Wales
Sydney, Australia
vii
vviiiiii CONTRIBUTORS
Ingrid A. Rodi, MD John Williams III, MD
Health Sciences Clinical Professor Clinical Professor
Director, Fertility Services Department of Obstetrics and Gynecology
UCLA Medical Center David Geffen School of Medicine at UCLA
Santa Monica, California University of California, Los Angeles
Director of Reproductive Genetics
Amy E. Rosenman, MD, FACOG, FPMRS Department of Obstetrics and Gynecology
Health Sciences Clinical Professor of Obstetrics and Cedars-Sinai Medical Center
Gynecology Los Angeles, California
David Geffen School of Medicine at UCLA
University of California, Los Angeles Mark Zakowski, MD
Los Angeles, California Associate Professor of Anesthesiology
Adjunct, Charles Drew University of Medicine and
David E. Soper, MD Science
J. Marion Sims Professor Chief, Obstetric Anesthesiology, Cedars-Sinai Medical
Department of Obstetrics and Gynecology Center
Medical University of South Carolina Los Angeles, California
Charleston, South Carolina
Preface
It has been thirty years since the first edition of Essen- seminar, with classroom time now increasingly devoted
tials of Obstetrics and Gynecology was published. As to discussions and problem solving by teams of stu-
stated in the Preface to the First Edition, there was dents supported by diverse faculty mentors. This is
then, and continues to be today, a need for a textbook appropriate, because health care is increasingly being
that covers the essential aspects of the specialty of delivered by multidisciplinary teams of professionals
Obstetrics and Gynecology, which is written primarily rather than by individual practitioners. With the ever-
for the student and resident physician training in the increasing complexity of medical and surgical care, this
field. The text has become known as ”Hacker and trend is expected to continue.
Moore” over the years, as a tribute to the pioneering Textbooks have the recognized disadvantage of not
work of the original editors. The late J. George “Jerry” always containing the latest information on a topic and
Moore was the Professor and Chairman of Obstetrics of having a limited “shelf life.” But just as newspapers
and Gynecology at the University of California at Los and periodicals (printed or electronic) provide a “first
Angeles (UCLA), and the concept for the book was his. and early draft” of human history and require frequent
Neville Hacker was then an Assistant Professor in the correction over time, medical texts should contain and
Department and was in charge of the Student Clerk- document the time-tested facts of a discipline, along
ship. He was co-opted by Jerry to co-edit the book, after with newer information viewed through the prism of
the entire UCLA faculty had agreed to participate in its evidence-based and safe practice. It is our belief that
writing. textbooks will continue to provide the reliable essen-
The first edition of any textbook contains the vision tials of all clinical practice, including the practice of
and forms the foundation of the intent of the work, as obstetrics and gynecology.
outlined in the original preface. The editors have always All of the 42 chapters in this edition have been
felt that a new edition should be published only when updated. Some chapters have been completely rewrit-
there was significant new clinical information to report. ten. Others have been modified due to changes in clini-
Based on that standard, we believe it is now time for cal practice. As was the case in previous editions of this
the sixth and latest edition of “Hacker and Moore” to text, we have worked to include only the “essentials” of
be published. obstetrics and gynecology, making difficult choices
Medical education is continuously evolving, and has about the breadth and depth of the material presented.
changed significantly since the first edition of this text- Every attempt has been made to include material con-
book was published in 1986. The internet with its sistent with the learning objectives and goals proposed
world-wide web and other technologies have made by the Association of Professors in Gynecology and
information instantly available to students and resi- Obstetrics (APGO), available on their website at www.
dents on a mobile phone or tablet during a clinical apgo.org.
meeting. They are being taught to be life-long learners In addition to the authors and editors of this current
and information seekers. The classroom dynamics edition, we wish to acknowledge and thank those who
have been flipped in the past decade, in the sense that have contributed to all previous editions.* Their knowl-
information transfer and gathering occurs before a edge and wisdom contained in their words, some of
*Contributors from all previous editions: Juan J. Arce, Carol L. Archie, Ricardo Azziz, Martha J. Baird, Richard A. Bashore, A. David Barnes,
Michael J. Bennett, Narender N. Bhatia, Jennifer Blake, Clifford Bochner, J. Robert Bragonier, Charles R. Brinkman III, Michael S. Broder,
Philip G. Brooks, John E. Buster, Maria Bustillo, Richard P. Buyalos, Mary E. Carsten (deceased), Anita Bachus Chang, R. Jeffrey Chang,
George Chapman, Ramen H. Chmait, Gautam Chaudhuri, Kenneth A. Conklin, Irvin M. Cushner (deceased), Alan H. DeCherney, Cath-
erine Marin DeUgarte, William J. Dignam (deceased), John A. Eden, Bruce B. Ettinger, Ozlem Equils, Robin Farias-Eisner, Larry C. Ford
(deceased), Michelle Fox, Janice I. French, Ann Garber, Anne D.M. Graham, Paul A. Gluck, William A. Growdon, John Gunning (deceased),
Lewis A. Hamilton, Hunter A. Hammill, George S. Harris, Robert H. Hayashi, James M. Heaps, Howard L. Judd (deceased),
Continued
ix
xx PREFACE
which remain in this edition, form the foundation of Elsevier. We hope that the knowledge acquired from
this work and will continue to enlighten future stu- this book will encourage many to pursue a more in
dents of obstetrics and gynecology. depth study of the specialty.
We greatly appreciate, and wish to acknowledge, the
support and professionalism of James Merritt and his Joseph C. Gambone (Executive Editor)
excellent production staff, particularly Rhoda Howell, Neville F. Hacker
Rachel McMullen, Amy Meros, and Julia Roberts at Calvin J. Hobel
Daniel A. Kahn, Samir Khalife, Ali Khraibi, Matthew Kim, Oscar A. Kletzky (deceased), Grace Elizabeth Kong, Larry R. Laufer, Thomas
B. Lebherz (deceased), Joel B. Lench, Ronald S. Leuchter, John K.H. Lu, Michael C. Lu, Donald E. Marsden, John Marshall, Ruchi Mathur,
James A. McGregor, Arnold L. Medearis deceased) David R. Meldrum, Robert Monoson, J. George Moore (deceased), Thomas R. Moore,
John Morris (deceased), Suha H.N. Murad, Sathima Natarajan, Lauren Nathan, John Newnham, Tuan Nguyen, Bahij S. Nuwayhid, Gary
Oakes, Dotun Ogunyemi, Aldo Palmieri, Groesbeck P. Parham, Ketan S. Patel, Margareta D. Pisarska, Gladys A. Ramos, Anthony E.
Reading, Robert C. Reiter, Jean M. Ricci (Goodman), Michael G. Ross, Edward W. Savage, William D. Schlaff, Mousa Shamonki, James R.
Shields, Klaus J. Staisch (deceased), Eric Surrey, Khalil Tabsh, Christopher M. Tarnay, Maryam Tarsa, Nancy Theroux, Paul J. Toot, Maclyn
E. Wade (deceased), Nathan Wasserstrum, Barry G. Wren, and Linda Yielding.
1 
R
E
T
P
A
H
C
A Life-Course Perspective for
Women’s Health Care
Safe, Ethical, Value-Based Practice with a
Focus on Prevention
CALVIN J. HOBEL • JOSEPH C. GAMBONE
CLINICAL KEYS FOR THIS CHAPTER
■ Clinical practice in obstetrics and gynecology, based  and  ideals  of  confidentiality  and  multidisciplinary 
upon the principles of safe, ethical and value-based care,  collaboration.
is facilitated by viewing wellness and sickness in the  ■ Regulatory, economic, and public pressure make assess-
context of a life-course perspective. Effective clinical  ment and improvement of safety and value essential  
care of mother and child must begin early, even before  in the delivery of women’s health care. Optimal health 
conception, and continue throughout life. outcomes can only be achieved when principles from 
■ Adaptive developmental plasticity and epigenetic modi- continuous quality assessment and high reliability orga-
fication of genes during and after pregnancy can have a  nizations are combined with the systematic approach of 
significant impact on chronic diseases later in life. safety science and evidence-based medicine.
■ Clinicians should incorporate the major ethical princi- ■ The promising area of clinical preventive services in 
ples of nonmaleficence, beneficence, autonomy, and  obstetrics and gynecology, as in all heath care, is trans-
justice  into  their  practices,  along  with  the  duties   forming the practice of medicine in a very positive way.
This chapter of Essentials of Obstetrics and Gynecology  number of significant opportunities for improvement 
is being revised at a time when the health and wellness  such as infant and maternal mortality. The specialty 
of the population of the United States and some other  provides students and young physicians in training 
developed countries of the world are being evaluated  with the knowledge and skills necessary to improve  
and questioned. A recent study by the Harvard Busi- the health of women and their children very early in 
ness School conducted by Professor Michael Porter  their lives. In this first chapter of the book, some basic 
and his team ranked the United States only 70th in the  principles and guidelines for improving health care are 
world in terms of overall health and wellness. Despite provided, and several important factors that are influ-
the fact that the United States spends far more on encing the health of women and their children are 
health care (nearly 18% of gross domestic product or  suggested.
GDP) than any other nation, it continues to be ranked
only about 37th out of 191 nations for health status Principles of Practice
and health system performance. Further, the United 
States is ranked only 46th for average life-expectancy  There are four basic principles for practicing and
and 42nd for infant mortality by the World Health  improving health care. First, the safety of our patients
Organization (WHO). Clearly, the United States must  must always be paramount. In recent years we have 
strive to improve its standing on these and other mea- made major improvements in patient safety, in large 
sures of performance. This is especially important at a  part  by  emphasizing  teamwork  and  implementing 
time when the health care delivery system enters the  practices proven to be effective in the airline industry. 
era of the Affordable Care Act (ACA), and efforts to  Second, we must be true to our personal pledge made
provide care to all citizens at a reasonable cost are  when taking the Hippocratic Oath—to adhere to
underway. ethical practices. Third, we must transform to a value-
Obstetrics  and  gynecology  is  one  of  the  most   based system of health care delivery. Because medi-
exciting and challenging areas of health care, with a  cine has become very complex, we must be open to a 
2