Obstetrics and Gynaecology: An evidence-based text for MRCOG (2E)

906 Pages·2010·6.841 MB·English

by  Luesley, David M.

Obstetrics and
Gynaecology
An evidence-based text for MRCOG
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Obstetrics and
Gynaecology
An evidence-based text for MRCOG
SECOND EDITION
David M Luesley MA, MD, FRCOG
Professor of Gynaecological Oncology, University of Birmingham; and
Clinical Director, Pan-Birmingham Gynaecological Cancer Centre,
Birmingham, UK
Philip N Baker DM, BMedSci, BM, BS, FRCOG
Dean of the Faculty of Medicine and Dentistry, University of Alberta,
Edmonton, Canada
SECTION EDITORS
Linda Cardozo MD FRCOG
Professor of Urogynaecology; King’s College Hospital, London
James Drife MD FRCOG FRCPEd FRCSEd FCOGSA FFSRH
Emeritus Professor, Department of Obstetrics and Gynaecology, Leeds General
Infirmary, Leeds
Lucy Kean DM FRCOG
Consultant Obstetrician (Subspecialist in Maternal and Fetal Medicine)
University Hospitals, City Campus, Nottingham
Mark D Kilby MD FRCOG
Professor in Maternal and Fetal Medicine, Division of Reproduction and Child Health
Birmingham Women’s Hospital, University of Birmingham, Birmingham
Henry C Kitchener MD FRCOG FRCS (Glasgow)
Professor of Gynaecological Oncology and Head, Academic Unit of Obstetrics
and Gynaecology, University of Manchester, Manchester
William L Ledger MA DPhill (Oxon) MB ChB FRCOG
Head of Section of Reproductive and Developmental Medicine; and Professor of
Obstetrics and Gynaecology, Royal Hallamshire Hospital, Sheffield
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First published in Great Britain in 2004 by Arnold
This second edition published in 2010 by
Hodder Arnold, an imprint of Hodder Education, an Hachette UK Company,
338 Euston Road, London NW1 3BH
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© 2010 Edward Arnold (Publishers) Ltd
All rights reserved. Apart from any use permitted under UK copyright law, this publication may only
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Whilst the advice and information in this book are believed to be true and accurate at the date of going
to press, neither the authors nor the publisher can accept any legal responsibility or liability for any
errors or omissions that may be made. In particular but without limiting the generality of the
preceding disclaimer every effort has been made to check drug dosages; however it is still possible
that errors have been missed. Furthermore, dosage schedules are constantly being revised and new
side-effects recognized. For these reasons the reader is strongly urged to consult the drug companies’
printed instructions before administering any of the drugs recommended in this book.
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ISBN 978 0 340 99013 1
ISBN [ISE] 978 0 340 99052 0 International Students’ Edition, restricted territorial availability
1 2 3 4 5 6 7 8 9 10
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To my daughters, Alice and Megan (DL)
To my elder daughter, Charlotte (PB)
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Contents
CONTRIBUTORS xi
PREFACE xv
ACKNOWLEDGEMENTS xvii
LIST OF ABBREVIATIONS USED xix
HOW TO USE THIS BOOK xxv
PART ONE INTRODUCTORY/GENERAL Part Editor: James Drife
1 Evidence-based medicine and medical informatics Jane Thomas 3
2 The general principles of surgery Fiona M Reid and Anthony RB Smith 12
3 Communication and counselling Richard Porter 21
4 The law, medicine and women’s rights Sheila McLean 25
PART TWO OBSTETRICS Part Editor: Philip Baker
SECTION A Antenatal complications: maternal Section Editor: Philip Baker 33
ANTENATAL
5 Routine antenatal care: an overview John A D Spencer 35
6 Pre-existing
6.1 Chronic hypertension Andrew Shennan 45
6.2 Diabetes mellitus Clare L Tower 49
6.3 Cardiac disease Catherine Nelson-Piercy 59
6.4 Thyroid disease Andrew Shennan 64
6.5 Haematological conditions Joanna C Gilham 69
6.6 Renal disease Catherine Nelson-Piercy 87
6.7 Autoimmune conditions Catherine Nelson-Piercy 92
6.8 Liver and gastrointestinal disease Catherine Nelson-Piercy 98
6.9 Respiratory conditions Louise Kenny 104
6.10 Neurological conditions Louise Kenny 113
6.11 Dermatological conditions Louise Kenny 124
6.12 Drug and alcohol misuse Louise Kenny 128
6.13 Smoking Andrew Shennan 136
7 Arising in pregnancy
7.1 Anaemia Tracey A Johnston 139
7.2 Abdominal pain Clare L Tower 144
7.3 Malignancy Louise Kenny 151
7.4 Infection Joanna Gillham 160
7.5 Gestational diabetes Clare L Tower 178
7.6 Pre-eclampsia and non-proteinuric
pregnancy-induced hypertension Andrew Shennan 184
8 Medication in pregnancy Clare L Tower 192
9 Maternal mortality James Drife 198
Section B Antenatal complications: fetal conditions Section Editor: Mark Kilby 209
10 Fetal anomalies
10.1 Biochemical screening Michele P Mohajer 211
10.2 Ultrasound screening Michele P Mohajer 215
10.3 Invasive prenatal diagnosis Michele P Mohajer 221
10.4 Management of fetal anomalies Michele P Mohajer 225
11 Previous history of fetal loss Arri Coomarasamy 229
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viii Contents
12 Multiple pregnancy Bill Martin 235
13 Fetal infections Sailesh Kumar 240
14 Tests of fetal well-being Linda Watkins and Murray Luckas 247
15 Fetal growth restriction Linda Watkins and Murray Luckas 252
16 Aberrant liquor volume Sailesh Kumar 260
17 Fetal hydrops Sailesh Kumar 265
18 Malpresentation Ellen Knox 272
19 Prolonged pregnancy Devender Roberts 282
INTRAPARTUM
20 Routine intrapartum care: an overview Harold Gee 287
Section C Late pregnancy/intrapartum events Section Editor: Lucy Kean 297
21 Preterm labour Myles Taylor 299
22 Pre-labour rupture of the membranes Myles Taylor 309
23 Antepartum haemorrhage Lucy Kean 315
24 Intrauterine fetal death Lucy Kean 329
Section D First stage of labour Section Editor: Lucy Kean 339
25 Induction of labour Richard Hayman 341
26 Management after previous caesarean section Lucy Kean 355
27 Poor progress in labour Richard Hayman 364
28 Meconium Andrew Currie 374
29 Fetal compromise in the first stage of labour Myles Taylor 379
30 Obstetric anaesthesia and analgesia David M Levy 389
31 Caesarean section Richard Hayman 401
Section E Second stage of labour Section Editor: Lucy Kean 413
32 Fetal compromise in the second stage of labour Myles Taylor 415
33 Shoulder dystocia Myles Taylor 419
34 Instrumental vaginal delivery Richard Hayman 424
35 Breech presentation Richard Hayman 436
36 Perineal trauma Lucy Kean 447
POST-DELIVERY
Section F Postpartum complications: neonatal Section Editor: Lucy Kean 457
37 Perinatal asphyxia Andrew Currie 459
38 Neonatal resuscitation Andrew Currie 464
39 Common neonatal complications Andrew Currie 473
40 Perinatal mortality James Drife 481
Section G Postpartum complications: maternal Section Editor: Mark Kilby 489
41 Postpartum collapse Peter J Thompson 491
42 Postpartum haemorrhage Peter J Thompson 496
43 Postpartum pyrexia Peter J Thompson 501
44 Disturbed mood Peter J Thompson 504
45 Problems with breastfeeding Peter J Thompson 508
PART THREE GYNAECOLOGY Part Editor: David Luesley
Section A Reproductive medicine Section Editor: Bill Ledger 513
46 Normal and abnormal development of the genitalia Rebecca Deans, Catherine Minto and Sarah M Creighton 515
47 Karyotypic abnormalities Diana Fothergill 526
48 Menarche and adolescent gynaecology Diana Fothergill 529
49 Ovarian and menstrual cycles William L Ledger 533
50 Contraception, sterilization and termination of pregnancy Kulsum Jaffer 539
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Contents ix
51 Disorders of menstruation
51.1 Endometrial function Hilary OD Critchley and Christine P West 558
51.2 Uterine fibroids and heavy menstrual bleeding Christine P West 561
51.3 Heavy and irregular menstruation Christine P West 567
51.4 Dysmenorrhoea Christine P West 575
51.5 Endometriosis and gonadotrophin-releasing
hormone analogues Christine P West 581
51.6 Adenomyosis Christine P West 588
51.7 Premenstrual syndrome Christine P West 591
52 Fertility and conception
52.1 Normal conception Yakoub Khalaf 598
52.2 Female infertility Yakoub Khalaf 602
52.3 Male infertility Yakoub Khalaf 611
52.4 Assisted reproduction Yakoub Khalaf 616
53 Polycystic ovarian syndrome Mostafa Metwally and William Ledger 626
54 Hirsutism and virilism Mostafa Metwally and William Ledger 633
55 Amenorrhoea and oligomenorrhoea Mostafa Metwally and William Ledger 638
56 Menopause and hormone replacement therapy Michael Paterson 642
57 Problems in early pregnancy Ying Cheong and Aarti Umranikar 649
58 Reproductive ageing and ovarian reserve Dimitrios Nikolaou 657
Section B Pelvic floor and lower urinary tract dysfunction Section Editor: Linda Cardozo 669
59 Assessment of lower urinary tract function Angie Rantell 671
60 Urinary incontinence Dudley Robinson and Jane Rufford 687
61 Other lower urinary tract disorders Arasee Renganathan 711
62 Lower urinary tract infections Ismaiel A Mahfouz and Dudley Robinson 718
63 Urogenital prolapse Sushma Srikrishna and Dudley Robinson 725
64 Sexual problems in gynaecology
64.1 Infection and sexual health Melanie Mann 735
64.2 Dyspareunia and other psychosexual problems Melanie Mann 753
64.3 Child sex abuse Melanie Mann 759
64.4 Rape and rape counselling Susan J Houghton 762
Section C Lower genital tract Section Editor: David Luesley 769
65 Benign vulval problems Elias Tzakas and Charles Redman 771
66 Vulval pain syndromes David Nunns 781
67 Pre-invasive disease Gabrielle Downey 786
Section D Gynaecological oncology Section Editor: Henry Kitchener 797
68 Endometrial cancer Margaret E Cruickshank 799
69 Cervical cancer Pierre L Martin-Hirsch 808
70 Benign and malignant ovarian masses Sudha Sundar and Karina Reynolds 814
71 Vulval and vaginal cancer John Tidy 830
72 Gestational trophoblastic disease Barry W Hancock 837
INDEX 845
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