Essentials of Obstetrics Sabaratnam Arulkumaran, V Sivanesaratnam, Alokendu Chatterjee, Pratap Kumar
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1Essentials of Obstetrics
2Essentials of Obstetrics
Sabaratnam Arulkumaran DCH FRCS FRCOG FAMS MD PhD FACOG FSLCOG FSOGC Hon. Professor and Head Division of Obstetrics and Gynaecology St. George's Hospital Medical School, London, UK V Sivanesaratnam MBBS (S'pore) FRCOG FICS FACS FAMM Professor, Department of Obstetrics and Gynaecology Faculty of Medicine University of Malaya Kuala Lumpur, Malaysia Alokendu Chatterjee FRCOG FICS Formely, Professor and Head Department of Obstetrics and Gynaecology NRS Medical College and Hospital, Calcutta Salt Lake City, Kolkata Pratap Kumar MD DGO FICS FICOG FICMCH Professor and Head Department of Obstetrics and Gynaecology Kasturba Medical College, Manipal
3Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
EMCA House, 23/23B Ansari Road, Daryaganj
New Delhi 110 002, India
Phones: 23272143, 23272703, 23282021, 23245672
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Essentials of Obstetrics
© 2004, Editors
All rights reserved. No part of this publication and CD ROM of illustrations should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the authors and the publisher.
First Edition: 2004
9788180613623
Typeset at JPBMP typesetting unit
Printed at Gopsons Papers Ltd., A-14, Sector 60, Noida
4Foreword
This book rightly focuses on undergraduates since the future truly rests on them.
We live in an era of hope with awesome scientific advances, with an ever-growing need to identify fetal well-being and obstetric aberrations. This book is truly the work of select obstetricians who have a deep concern for women's health and in these chapters, they have dealt with practical aspects, with utmost care to provide a crystal clear pathway to obstetric management for the undergraduates.
The greatest benchmark for the disparity in medical care between rich and poor countries is their obstetric outcome—their reproductive status. The Editors deep concern for this problem is easily visualized through a comprehensive chapter on Safe Motherhood and the emphasis on fundamentals of reproduction as an opening chapter, at the same time not ignoring important players like endocrinal and immunological components.
I feel privileged and happy to welcome this addition to our literature and look forward to it becoming a boon to all hues of obs-Gyn. practitioners. Its rich contents should please every undergraduate as well as his teachers.
Shirish S Sheth
Past President
FIGO
27th April, 2004
5Preface
The knowledge in obstetrics is expanding and one finds it difficult to keep pace with recent research. Research findings of today form the basis of practice in years to come. The core knowledge keeps changing and forms the basis of understanding of the disease process and management and is covered in this book. One may think of obstetrics as childbirth and its complications, but the expansion of knowledge in this area is exemplified by 46 chapters under 2 subsections. The book starts with issues related to conception, implantation and growth of the fetus and placenta. From this point, it expands to the knowledge needed for prenatal care followed by normal pregnancy and childbirth. The various obstetric and medical complications in the antenatal period are covered followed by normal and abnormal labor including operative deliveries. It ends with normal and complicated puerperium.
This book is multi-authored and hence the tendency for some overlap and repetition of knowledge. The editors have taken great effort in avoiding such duplications, but where it is felt that it may enhance continuity of reading an individual chapter, little change has been made. The authors have been selected based on their individual expertise, which has been useful to provide the best knowledge. This has led to the standards set high for many chapters. The knowledge provided straddles between what is needed for an undergraduate and a postgraduate. The editors had the difficult task of trimming down many chapters to make this book a reference source for undergraduates. In addition, it will form a basic reading book for postgraduates. The authors are from a variety of backgrounds and countries. This has led to some differences in the style and reporting of incidence of disease, but it does not alter the subject material.
We believe that this will be a good reference source for undergraduates and would welcome any comments or criticism that will help us to make this book better in the next edition. Your suggestions can be sent to any one of the editors or the publishers.
Sabaratnam Arulkumaran
V Sivanesaratnam
Alokendu Chatterjee
Pratap Kumar
6Acknowledgements
The editors would like to sincerely thank the contributors to this book. It had a long conception period due to some chapters arriving late and the need to have an extensive editorial process to make the chapters uniform, avoid duplication and step down postgraduate into undergraduate knowledge. The latter process has made some chapters so different from the original submission by authors. We ask the authors for their understanding and acceptance of this process. The principal editor collated the chapters from the other editors to streamline the publication and would like to acknowledge the help and advice provided by Mrs. Sue Cunningham at St. George's Hospital Medical School, University of London. We are grateful to the authors and publishers for their patience in the production of this book. Mr. JP Vij, Chairman and Managing Director and his team from Jaypee Brothers Medical Publishers (P) Ltd. need special commendation for the constant encouragement, in-house editorial work and production of the vast number of figures in the book. We would like to thank Dr. Shirish Sheth, past President of FIGO and an internationally renowned Obstetrician and Gynaecologist for writing the foreword for this book.
7Contributors