Obstetrics and Gynecology Board Review PDF
Preview Obstetrics and Gynecology Board Review
Obstetrics and Gynecology Board review Fourth edition Stephen G. Somkuti, MD, PhD Associate Professor Department of Obstetrics and Gynecology and Reproductive Sciences Temple University School of Medicine School Philadelphia, Pennsylvania Director, The Toll Center for Reproductive Sciences Division of Reproductive Endocrinology Department of Obstetrics and Gynecology Abington Memorial Hospital Abington Reproductive Medicine Abington, Pennsylvania New York Chicago San Francisco Athens London Madrid Mexico City Milan New Delhi Singapore Sydney Toronto Copyright © 2014 by McGraw-Hill Education. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. 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Neither McGraw-Hill Education nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom. McGraw-Hill Education has no responsibility for the content of any information accessed through the work. Under no circumstances shall McGraw-Hill Education and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise. COntents Contributors ..................................................................vi Introduction ...................................................................xi 1. Anatomy of the Pelvis and Reproductive Tract .....................................1 2. Embryology of the Genital Tract .............................................. 15 3. Physiology of Normal Pregnancy ..............................................23 4. Antepartum Management and Fetal Surveillance ..................................41 5. Labor and Delivery .........................................................53 6. Operative Obstetrics Pearls ...................................................61 7. Multiple Gestations ........................................................ 77 8. Breech ..................................................................83 9. Postdates Pregnancy and Fetal Demise ..........................................91 10. Labor Abnormalities ........................................................97 11. The Puerperium ..........................................................103 12. Obstetric Complications ...................................................111 13. Hypertension and Pregnancy ................................................ 117 14. Management of Medical and Surgical Conditions in Pregnancy ...................... 131 15. Gastrointestinal Disorders in Pregnancy ........................................ 159 16. First Trimester Ultrasound ..................................................169 17. Obstetrical Ultrasound and Fetal Abnormalities .................................. 179 18. Amniotic Fluid ...........................................................185 19. The Placenta and Umbilical Cord ............................................193 iii iv Contents • • • 20. Rh Alloimmunization ......................................................205 21. Genetics for the Obstetrician ................................................215 22. Lactation ............................................................... 223 23. Primary and Preventative Care ................................ ............... 231 24. Functional and Dysfunctional Uterine Bleeding ..................................239 25. Adenomyosis and Endometriosis ............................................. 249 26. Benign Disorders of the Upper Genital Tract ....................................257 27. Dysmenorrhea and Premenstrual Syndrome .....................................269 28. Vulvodynia .............................................................. 275 29. Ectopic Pregnancy ........................................................ 277 30. Genital Tract Infections and PID .............................................289 31. Benign Vulvar and Vaginal Lesions ................................ ............ 297 32. Hysterectomy ........................................... .................303 33. Menopause ............................................................. 315 34. Preoperative Evaluation and Preparation of Gynecologic Surgery ........ ............. 339 35. Postoperative Care of the Gynecologic Patient ................................... 349 36. Robotic Systems and Infertility Surgery ........................................361 37. Lower Urinary Tract Injuries During Gynecologic Surgery ..........................369 38. Pelvic Organ Prolapse ......................................................375 39. Urinary Incontinence and Urodynamics ........................................385 40. Pediatric and Adolescent Gynecology ..........................................391 41. Breast Disorders ..........................................................403 42. Ethics, Psychosocial, and Psychiatric Pearls ......................................419 43. Cervical Lesions and Cancer ................................................. 431 • • • Contents v 44. Endometrial Hyperplasia and Carcinoma .......................................441 45. Uterine Sarcomas .........................................................451 46. Epithelial and Nonepithelial Ovarian Tumors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 457 47. Fallopian Tube Neoplasms ..................................................463 48. Vulvar and Vaginal Carcinoma ...............................................467 49. Radiation Therapy, Chemotherapy, Immunotherapy, and Tumor Markers .............477 50. Gestational Trophoblastic Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 493 51. Gynecologic Pathology .....................................................501 52. Hypothalamic-Pituitary-Ovarian-Uterine Axis ................................... 519 53. Amenorrhea .............................................................527 54. Infertility ...............................................................539 55. Assisted Reproductive Technology ............................................553 56. GnRH and GnRH Analogs ................................................. 559 57. Laparoscopy and Infertility Surgery ........................................... 567 58. Hyperandrogenism ........................................................575 59. Disorders of Prolactin Secretion .............................................. 589 60. Miscarriage, Recurrent Miscarriage, and Pregnancy Termination .....................601 61. Family Planning and Sterilization .............................................607 62. Lesbian, Gay, Bisexual, and Transgender Health ..................................621 63. Reproductive Toxicology ...................................................627 64. Basic Epidemiology and Clinical Biostatistics ....................................639 65. ACOG Screening Guidelines Since 2007 .......................................651 COntributOrs Lauren Abern, MD Cari Brown, MD Department of Obstetrics and Gynecology Resident Physician Abington Memorial Hospital Department of Obstetrics and Gynecology Abington, Pennsylvania Abington Memorial Hospital Breast Disorders Abington, Pennsylvania Lesbian, Gay, Bisexual, and Transgender Health Primary and Preventative Care Vulvar and Vaginal Carcinoma The Puerperium Aroti Achari, MD Justin Chura, MD, MBA Advocare Magness & Stafford OBGYN Director, Robotic Surgery and Gynecologic Associates Oncology Department of Obstetrics and Gynecology Cancer Treatment Centers of America Virtua Voorhees Hospital Eastern Regional Medical Center Voorhees, New Jersey Philadelphia, Pennsylvania Hysterectomy Anatomy of the Pelvis and Reproductive Tract U terine Sarcomas Larry I. Barmat, MD Assistant Professor Frank J. Craparo, MD Department of Obstetrics and Gynecology Associate Professor Temple University Drexel University College of Medicine Abington Reproductive Medicine Philadelphia, Pennsylvania Abington Memorial Hospital Chief, Division of Maternal Fetal Medicine Abington, Pennsylvania Director, Fetal Diagnostic Center Robotic Systems and Infertility Surgery Department of Obstetrics and Gynecology Abington Memorial Hospital Katherine Bohnert, DO Abington, Pennsylvania Department of Obstetrics and Gynecology Breech Einstein Hospital Medical Center Labor and Delivery Philadelphia, Pennsylvania First Trimester Ultrasound Lindsay Curtis, MD Erica L. Borman, DO Abington Memorial Hospital Psychiatry Resident Abington, Pennsylvania Rowan University School of Osteopathic Medicine Ectopic Pregnancy Stratford, New Jersey Postoperative Care of the Gynecologic Patient Amenorrhea Preoperative Evaluation and Preparation of Hyperandrogenism Gynecologic Surgery vi • • • Contributors vii Glen de Guzman, MD Emily R. Goldenthal, DO Department of Obstetrics and Gynecology Department of Obstetrics and Gynecology Abington Memorial Hospital Albert Einstein Medical Center Abington, Pennsylvania Philadelphia, Pennsylvania Gastrointestinal Disorders in Pregnancy Anatomy of the Pelvis and Reproductive Tract Jennifer Deirmengian, MD Remington Horesh, OMSII Obstetrics Faculty Teaching Group Osteopathic Medical Student Abington Memorial Hospital Class of 2015 Abington, Pennsylvania Lake Erie College of Medicine Lactation Bradenton, Florida Rh Alloimmunization Physiology of Normal Pregnancy Mitchell I. Edelson, MD Lisa Jambusaria, MD Associate Professor Resident, Department of Obstetrics and Department of Obstetrics, Gynecolgy, and Gynecology Reproductive Sciences Abington Memorial Hospital Temple University School of Medicine Abington, Pennsylvania Hanjani Institute for Gynecologic Oncology Benign Vulvar and Vaginal Lesions Abington Memorial Hospital Genital Tract Infections and PID Abington, Pennsylvania Pelvic Organ Prolapse Epithelial and Nonepithelial Ovarian Tumors Urinary Incontinence and Urodynamics Fallopian Tube Neoplasms Vulvodynia Gestational Trophoblastic Disease Gynecologic Pathology Jacqueline Kohl, MD, MPH Radiation Therapy, Chemotherapy, Resident, Department of Obstetrics and Immunotherapy, and Tumor Markers Gynecology Vulvar and Vaginal Carcinoma Abington Memorial Hospital Abington, Pennsylvania Stephanie J. Estes, MD, FACOG Dysmenorrhea and Premenstrual Syndrome Associate Professor Laparoscopy and Infertility Surgery Division of Reproductive Endocrinology and Infertility Kuhali Kundu, DO Department of Obstetrics and Gynecology Obstetrics and Gynecology Resident Penn State Hershey Medical Center Albert Einstein Medical Center Hershey, Pennsylvania Philadelphia, Pennsylvania Disorders of Prolactin Secretion Postdates Pregnancy and Fetal Demise GnRH and GnRH Analogs Karen T. Feisullin, MD Richard A. Latta, MD Department of Obstetrics and Gynecology Maternal-Fetal Medicine Abington Memorial Hospital Abington Memorial Hospital Abington, Pennsylvania Abington, Pennsylvania Family Planning and Sterilization Operative Obstetrics Pearls viii Contributors • • • Vincent Lucente, MD, MBA Amelia McLennan, MD Clinical Professor Resident, Department of Obstetrics and Department of Obstetrics and Gynecology Gynecology Temple University Abington Memorial Hospital Chief of Gynecology Abington, Pennsylvania St. Luke’s University Health Network Genetics for the Obstetrician Allentown, Pennsylvania Obstetrical Ultrasound and Lower Urinary Tract Injuries During Gynecologic Fetal Abnormalities Surgery Urinary Incontinence and Urodynamics Marlesa R. Moore, DO Resident Physician Rahil Malik, MD Department of Obstetrics and Gynecology Senior Resident Abington Memorial Hospital Department of Obstetrics and Gynecology Abington, Pennsylvania Jackson Memorial Hospital Pediatric and Adolescent Gynecology University of Miami Miami, Florida Erin M. Murphy, MD Adenomyosis and Endometriosis Center for Reproductive Medicine and Infertility Brielle A. Marks, BA Weill Cornell Medical College Student, Abington Reproductive Medicine New York, New York Holland, Pennsylvania Assisted Reproductive Technology Robotic Systems and Infertility Surgery Embryology of the Genital Tract Laura E. Martin, DO Victoria Myers, MD Resident, Department of Obstetrics and Faculty Tech Group Gynecology Abington Memorial Hospital Albert Einstein Medical Center Abington, Pennsylvania Philadelphia, Pennsylvania Miscarriage, Recurrent Miscarriage, and ACOG Screening Guidelines Since 2007 Pregnancy Termination Jennifer McClarren, MS, CGC Mary C. Naglak, PhD, RD Genetic Counselor, Integrated Genetics Academic Research Specialist Philadelphia, Pennsylvania Department of Medicine Genetics for the Obstetrician Abington Memorial Hospital Abington, Pennsylvania Alison B. McGrorty, MD Basic Epidemiology and Clinical Biostatistics Pediatric Resident Nemours-AI duPont Hospital for Ashwinee Natu Children Medical Student, Class of 2014 Thomas Jefferson University Hospital Drexel University College of Medicine Philadelphia, Pennsylvania Philadelphia, PA Ethics, Psychosocial, and Psychiatric Pearls Hypertension and Pregnancy • • • Contributors ix Neely N. Nelson, MD Stephen J. Smith, MD Resident, Department of Obstetrics and Vice Chair and Associate Program Director Gynecology Associate Professor Abington Memorial Hospital Department of Obstetrics and Gynecology Abington, Pennsylvania Abington Memorial Hospital and Infertility Temple University School of Medicine Abington, Pennsylvania Labor Abnormalities Jordana I. Reina-Fernandez, MD Postdates Pregnancy and Fetal Demise Resident, Department of Obstetrics and Gynecology Stephen G. Somkuti, MD, PhD Albert Einstein Medical Center Associate Professor Philadelphia, Pennsylvania Department of Obstetrics and Gynecology and Antepartum Management and Fetal Reproductive Sciences Surveillance Temple University School of Medicine School Philadelphia, Pennsylvania Amanda M. Rhodes, MD Director, The Toll Center for Reproductive Resident, Department of Obstetrics and Sciences Gynecology Division of Reproductive Endocrinology Abington Memorial Hospital Department of Obstetrics and Gynecology Abington, Pennsylvania Abington Memorial Hospital Labor Abnormalities Abington Reproductive Medicine Abington, Pennsylvania Cristina M. Saiz, MD, FACOG Hyperandrogenism Female Pelvic Medicine and Reconstructive Pediatric and Adolescent Gynecology Surgery Physician Maria A. Suescum, MD The Institute for Female Pelvic Medicine and Chief Resident, Department of Obstetrics and Reconstructive Surgery Gynecology Allentown, Pennsylvania Albert Einstein Medical Center Lower Urinary Tract Injuries During Gynecologic Philadelphia, Pennsylvania Surgery Uterine Sarcomas Meike Schuster, DO Janos L. Tanyi, MD, PhD Obstetrics and Gynecology Resident Assistant Professor Abington Memorial Hospital Division of Gynecologic Oncology Abington, Pennsylvania Department of Obstetrics and Gynecology Maternal Fetal Medicine Fellow University of Pennsylvania Health System Geisinger Medical Center Philadelphia, Pennsylvania Danville, Pennsylvania Cervical Lesions and Cancer Obstetric Complications Endometrial Hyperplasia and Carcinoma
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