Pocket Obstetrics and Gynecology

325 Pages·2014·9.44 MB·English

by  K. Joseph Hurt

(c) 2015 Wolters Kluwer. All Rights Reserved.
P o c k e t
Notebook
Pocket
   Obstetrics
and
GynecOlOGy
Edited by
K. Joseph hurt, MD, phD
Assistant Professor
Department of obstetrics and Gynecology
University of Colorado School of Medicine
(c) 2015 Wolters Kluwer. All Rights Reserved.
LWBK1354-FM_i-xiv.indd 1 26/05/14 4:29 PM
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9 8 7 6 5 4 3 2 1
Printed in China
Library of congress cataloging-in-Publication Data 
Pocket obstetrics and gynecology / edited by k. Joseph Hurt.
p. ; cm. – (Pocket notebook series)
ISbN 978-1-4511-4605-9 (paperback)
I. Hurt, k. Joseph., editor. II. Series: Pocket notebook.
[DNLM: 1. Genital Diseases, Female–diagnosis–Handbooks. 2. Diagnosis, Differential–
Handbooks. 3. obstetrics–Handbooks. WP 39]
RG107
618.1′075–dc23
2014017349
Care has been taken to confirm the accuracy of the information presented and to
describe generally accepted practices. However, the author(s), editors, and publisher are
not responsible for errors or omissions or for any consequences from application of the
information in this book and make no warranty, expressed or implied, with respect to
the currency, completeness, or accuracy of the contents of the publication. Application of
this information in a particular situation remains the professional responsibility of the
practitioner; the clinical treatments described and recommended may not be considered
absolute and universal recommendations.
the author(s), editors, and publisher have exerted every effort to ensure that drug
selection and dosage set forth in this text are in accordance with the current recom-
mendations and practice at the time of publication. However, in view of ongoing research,
changes in government regulations, and the constant flow of information relating to drug
therapy and drug reactions, the reader is urged to check the package insert for each drug
for any change in indications and dosage and for added warnings and precautions. this is
particularly important when the recommended agent is a new or infrequently employed
drug.
Some drugs and medical devices presented in this publication have Food and Drug
Administration (FDA) clearance for limited use in restricted research settings. It is the
responsibility of the health care provider to ascertain the FDA status of each drug or
device planned for use in his or her clinical practice.
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CONTENTS
Contributing Authors ix
Preface xiii
Foreword xiv
Well Woman Visit and Primary Care
Shilpa Iyer, Kavita Shah Arora, Heather A. Walker, K. Joseph Hurt, and Maryam Guiahi
Well-woman (Annual) Exam 1-1
Benign Breast Disease 1-2
Breast Cancer 1-4
Cervical Cancer Screening 1-5
Lipids & Cholesterol 1-7
Obesity 1-8
Osteoporosis 1-9
Skin Cancer Screening 1-11
Domestic Violence 1-12
Substance Abuse 1-13
Depression and Psychiatric Disease Screening 1-14
Contraception and Sterilization 1-15
Emergency Contraception (EC) 1-17
Vaccinations 1-17
Women’s Health Epidemiology and Research 1-18
emergenCy room
Lauren May, Marguerite Palisoul, Caryn Dutton, and Roxanne Vrees
Imaging in OBGYN 2-1
Ultrasound in Early Pregnancy 2-2
Acute Pelvic Pain 2-2
Ectopic Pregnancy 2-3
Ovarian Cysts 2-5
Adnexal Torsion 2-6
Pelvic Inflammatory Disease (PID) 2-7
Acute Uterine Bleeding 2-8
Spontaneous Abortion (SAB) 2-8
Trauma in Pregnancy 2-10
oPeratiVe oB-gyn Considerations
Brett Einerson, Sherif El-Nashar, David Shalowitz, and Sarah L. Cohen
Perioperative Patient Management 3-1
Postoperative Fever 3-5
Surgical Site Infections (SSI) 3-5
Perioperative DVT/PE 3-6
Sepsis 3-7
Perioperative Oliguria 3-8
Postoperative Ileus 3-9
Bowel Obstruction 3-9
Complications of Laparoscopy 3-10
Complications of Hysteroscopy 3-11
oB anesthesia
Annalisa Post, Laura Goetzl
Gynecologic Anesthesia 4-1
Parenteral Analgesia in Obstetrics 4-1
Neuraxial Anesthesia in Obstetrics 4-2
(c) 2015 Wolters Kluwer. All Rights Reserved.
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Local Anesthetics in obstetrics 4-5
Nonpharmacologic Analgesia in obstetrics 4-6
General Anesthesia in obstetrics 4-6
Postoperative Pain Management 4-6
generaL gynecoLogy
Alexis May Tran, Teresa M. Walsh, and Sarah Appleton
Vulvovaginitis 5-1
bartholin Gland Cyst and Abscess 5-2
Uterine Fibroids 5-2
Adenomyosis 5-4
endometriosis 5-4
Recurrent Abnormal Uterine bleeding (AUb) 5-6
Postmenopausal bleeding 5-7
Dysmenorrhea 5-8
Premenstrual Dysphoric Disorder (PMDD)
and Premenstrual Syndrome (PMS) 5-10
Chronic Pelvic Pain 5-10
Vestibulodynia 5-11
Female Sexual Dysfunction 5-12
Menopause 5-13
Hormone therapy 5-14
Pregnancy termination 5-16
PeDiatric anD aDoLescent gynecoLogy
Jessica Opoku-Anane, Emily Petersen, and Tricia Huguelet
Puberty 6-1
Precocious Puberty 6-2
Delayed Puberty 6-3
Amenorrhea 6-5
Androgen Insensitivity Syndrome 6-8
Congenital Adrenal Hyperplasia (CAH) 6-11
PeLVic surgery anD urogynecoLogy
Catherine Hudson, Emily Prendergast, Kathleen A. Connell,
and Lieschen H. Quiroz
Physiology and Mechanisms of Micturition 7-1
Physiology and Mechanisms of Defecation 7-1
Pelvic organ Prolapse (PoP) 7-1
Urinary Incontinence 7-4
overactive bladder and Urge Incontinence 7-5
Stress Incontinence 7-6
overflow Incontinence 7-6
bypass Incontinence and Urogenital Fistulae 7-7
Interstitial Cystitis 7-7
Anal Incontinence 7-8
infertiLity
Shweta Bhatt, Manuel Doblado, Laxmi A. Kondapalli, and Mary Ellen Pavone
Infertility evaluation 8-1
Premature ovarian Insufficiency (PoI) 8-2
Polycystic ovarian Syndrome (PCoS) 8-2
tubal Factor Infertility 8-3
Recurrent Pregnancy Loss (RPL) 8-4
(c) 2015 Wolters Kluwer. All Rights Reserved.
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Müllerian Anomalies 8-4
Male Factor Infertility 8-8
ovulation Induction and Assisted Reproduction 8-9
Fertility Preservation 8-10
Preimplantation Genetic testing 8-11
ovarian Hyperstimulation Syndrome (oHSS) 8-11
PrenataL care
Sarah Rae Easter, Julia Drose, Emily Todd, and Sharon Phelan
Routine Prenatal Visits 9-1
Nutrition in Pregnancy 9-3
Clinical Pelvimetry 9-4
Common Prenatal Complaints 9-5
Fetal Ultrasound: Anatomy and echocardiography 9-6
Congenital Anomalies 9-7
Genetic Screening 9-11
Amniocentesis and Chorionic Villus Sampling (CVS) 9-12
normaL LaBor anD DeLiVery
David Shalowitz, Amy Nacht, and Sara Mazzoni
Antenatal Fetal testing 10-1
Fetal Lung Maturity testing by Amniocentesis 10-2
Newborn Respiratory Distress 10-2
Group b Streptococcal Disease 10-3
Spontaneous Labor and Delivery 10-4
Induction of Labor (IoL) 10-5
Intrapartum Fetal Monitoring 10-7
operative Vaginal Delivery 10-11
Vaginal birth After Cesarean 10-12
Fetal Cord blood Gas Analysis 10-13
Routine Postpartum Care 10-13
breastfeeding 10-14
Affiliated obstetrical Providers 10-15
comPLicateD Pregnancy anD DeLiVery
Lisa Gill, Alexandria J. Hill, Paul Wexler, and Jamie Bastek
Gestational Hypertensive Disorders 11-1
Hydrops Fetalis 11-2
Intrauterine Growth Restriction 11-3
Multiple Gestation 11-4
Cervical Insufficiency/Short Cervix 11-5
Preterm Premature Rupture of Membranes 11-6
Preterm Labor 11-7
Postpartum Hemorrhage (PPH) 11-8
Placental Abruption 11-11
Placenta Previa 11-12
Vasa Previa 11-13
Placenta Accreta 11-13
Uterine Inversion 11-14
Amniotic Fluid embolism 11-14
Malpresentation 11-15
Fetal Meconium 11-15
Chorioamnionitis 11-16
endomyometritis 11-16
(c) 2015 Wolters Kluwer. All Rights Reserved.
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carDioLogy anD carDioVascuLar Disease
Catherine Albright, Meghan Donnelly
Cardiovascular Disease in Pregnancy 12-1
Cardiovascular Changes in Pregnancy 12-1
Chronic Hypertension (CHtN) 12-2
Hypertensive Crisis 12-4
Pregnancy-Related Hypertension 12-5
Coronary Artery Disease/Acute Coronary Syndrome 12-8
Pulmonary Hypertension 12-9
Valvular Heart Disease 12-10
Peripartum Cardiomyopathy 12-12
PuLmonary
David Shalowitz, Abdulrahman Sinno, and M. Camille Hoffman
Pulmonary Function testing 13-1
Respiratory Changes in Pregnancy 13-2
Arterial blood Gas (AbG) Analysis 13-3
Pneumonia 13-4
Pulmonary edema 13-5
Influenza in Pregnancy 13-5
Asthma and Pregnancy 13-6
Anaphylaxis 13-7
nePhroLogy anD urinary tract
Megan Barrett, Gina Northington
Urinary System Changes in Pregnancy 14-1
Acute Renal Failure (ARF) 14-1
Chronic Renal Failure 14-3
Urinary tract Infection (UtI) 14-4
Pyelonephritis 14-6
Nephrolithiasis 14-7
Fluids and electrolytes 14-8
gastroenteroLogy
Terri Huynh, Roxanne Vrees
Gastrointestinal Changes in Pregnancy 15-1
Cholelithiasis 15-1
Cholecystitis 15-1
Appendicitis 15-2
Pancreatitis 15-3
Irritable bowel Syndrome (IbS) 15-3
Inflammatory bowel Disease 15-4
Viral Hepatitis 15-6
Intrahepatic Cholestasis of Pregnancy (ICP) 15-8
HeLLP Syndrome 15-9
Acute Fatty Liver of Pregnancy (AFLP) 15-10
total Parenteral Nutrition (tPN) 15-10
hematoLogy
Todd J. Stanhope, Sasha Andrews
Hematologic Changes of Pregnancy 16-1
Anemia 16-1
Hemoglobinopathies 16-3
thrombocytopenia (Plt <150000/mL) 16-4
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Venous thromboembolic Disease 16-6
Perioperative Vte Prevention 16-9
thrombophilia evaluation 16-10
Coagulopathies 16-11
Antiphospholipid Antibody Syndrome (APS) 16-12
Alloimmunization 16-13
blood Products for Hemorrhage and Critical Care 16-15
enDocrinoLogy
Juan Alvarez, Amy Schutt, K. Joseph Hurt, and Terry Harper
Hormonal Regulation 17-1
type I Diabetes Mellitus 17-2
Diabetic ketoacidosis (DkA) 17-3
type II Diabetes Mellitus 17-4
Hyperosmolar Hyperglycemic State 17-5
Diabetes in Pregnancy 17-5
Gestational Diabetes (GDM) 17-7
Hypothyroidism 17-8
Hyperthyroidism 17-9
Adrenal Disorders 17-10
Hyperandrogenism 17-12
Hirsutism 17-13
Parathyroid Disorders 17-14
Pituitary Disorders 17-15
neuroLogy
Ponnila Marinescu, K. Joseph Hurt
Headache (HA) 18-1
Migraine 18-2
Seizure Disorders 18-3
eclampsia 18-5
Stroke in Pregnancy 18-6
Cerebral Venous thrombosis 18-6
Multiple Sclerosis in Pregnancy 18-7
Neuropathies in Pregnancy 18-8
DermatoLogy
Sumer Allensworth, K. Joseph Hurt, Crystal Adams
Dermatologic Changes in Pregnancy 19-1
Lichen Sclerosus 19-2
Lichen Simplex Chronicus 19-3
Lichen Planus 19-3
Seborrheic Dermatitis 19-4
Hidradenitis Suppurativa 19-5
Fox-Fordyce Disease 19-5
Gyn-Derm Cysts 19-6
Common Dermatologic Manifestations of Systemic Disease 19-6
infectious Disease
Leo Han, Michelle Khan
HIV/AIDS in Women 20-1
toRCH Infections 20-2
other Infections in Pregnancy 20-4
Human Papilloma Virus (HPV) 20-5
Syphilis 20-7
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Molluscum Contagiosum 20-8
Chancroid 20-9
Pubic Lice 20-9
Genital Ulcers 20-10
gynecoLogic oncoLogy
Mariam Al-Hilli, Erin Medlin, Kari Ring, Leigh A. Cantrell, and Ritu Salani
types of Hysterectomy 21-1
Cervical Cancer 21-2
Uterine Cancer 21-4
epithelial ovarian Cancer (eoC) 21-7
Germ Cell tumors 21-8
Sex Cord-Stromal tumors 21-10
Vaginal Cancer 21-11
Vulvar Cancer 21-12
Gestational trophoblastic Neoplasia 21-14
Chemotherapy 21-17
Radiation therapy 21-18
aPPenDix: oB-gyn anatomy Primer  22-1
Sherif El-Nashar
aPPenDix: common ProceDures anD 
surgeries  23-1
Sherif El-Nashar, David Shalowitz
aPPenDix: Drug reference  24-1
Natalie Karp
aPPenDix: acLs aLgorithms  25-1
aPPenDix: nrP aLgorithm  26-1
aBBreViations  27-1
inDex  I-1
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CONTRIBUTING AUTHORS
crystal adams, mD Jamie Bastek, mD, msce
Assistant Professor Assistant Professor
obstetrics & Gynecology Maternal Fetal Medicine
University of Colorado obstetrics & Gynecology
Aurora, Colorado University of Pennsylvania
Philadelphia, Pennsylvania
catherine m. albright, mD
Section Editor shweta Bhatt, mD
Resident, obstetrics & Gynecology Resident, obstetrics & Gynecology
brown University Northwestern University
Providence, Rhode Island Chicago, Illinois
mariam al-hilli, mD Leigh a. cantrell, mD, msPh
Resident, obstetrics & Gynecology Assistant Professor
Mayo Clinic Gynecologic oncology
Rochester, Minnesota obstetrics & Gynecology
University of Virginia
sumer k. allensworth, mD Charlottesville, Virginia
Resident, obstetrics & Gynecology
University of Colorado sarah L. cohen, mD, mPh
Aurora, Colorado Instructor
Minimally Invasive Surgery
Juan P. alvarez, mD obstetrics & Gynecology
Resident, Gynecology & obstetrics Harvard Medical School
emory University boston, Massachusetts
Atlanta, Georgia
kathleen a. connell, mD
sasha e. andrews, mD Associate Professor
Fellow Female Pelvic Medicine &
Maternal Fetal Medicine Reconstructive Surgery
obstetrics & Gynecology obstetrics & Gynecology
University of Colorado University of Colorado
Aurora, Colorado Aurora, Colorado
sarah appleton, mD manuel a. Doblado, mD, ma
Senior Instructor Resident, obstetrics & Gynecology
obstetrics & Gynecology University of Colorado
University of Colorado Aurora, Colorado
Aurora, Colorado
meghan Donnelly, mD
kavita shah arora, mD, mBe Assistant Professor
Section Editor Maternal Fetal Medicine
Resident, obstetrics & Gynecology obstetrics & Gynecology
Northwestern University University of Colorado
Chicago, Illinois Aurora, Colorado
megan r. Barrett, mD Julia a. Drose, rDms, rDcs, 
Section Editor rVt
Resident, obstetrics & Gynecology Associate Professor, Radiology
University of Virginia University of Colorado
Charlottesville, Virginia Aurora, Colorado
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