Editor
Pankaj Desai
MD FICM CH FICOG
Consultant Obstetrics and Gynecology Specialist Janani Maternity Hospital
Baroda, India
Formerly
President—FOGSI (2007) Dean of Students, Medical College,
Baroda, India
Associate Professor and Unit Chief Department of Obstetrics and Gynecology Medical College and SSG Hospital
Baroda, India
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
Corporate Office
4838/24 Ansari Road, Daryaganj, New Delhi - 110002, India, +91-11-43574357 (20 lines)
Registered Office
B-3 EMCA House, 23/23B Ansari Road, Daryaganj, New Delhi 110 002, India
Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021,
+91-11-23245672, Rel: +91-11-32558559, Fax: +91-11-23276490, +91-11-23245683
e-mail: jaypee@jaypeebrothers.com, Website: www.jaypeebrothers.com
Branches
- 2/B, Akruti Society, Jodhpur Gam Road SatelliteAhmedabad 380 015, Phones: +91-79-26926233, Rel: +91-79-32988717Fax: +91-79-26927094, e-mail: ahmedabad@jaypeebrothers.com
- 202 Batavia Chambers, 8 Kumara Krupa Road, Kumara Park EastBengaluru 560 001, Phones: +91-80-22285971, +91-80-22382956, +91-80-22372664Rel: +91-80-32714073, Fax: +91-80-22281761, e-mail: bangalore@jaypeebrothers.com
- 282 IIIrd Floor, Khaleel Shirazi Estate, Fountain Plaza, Pantheon RoadChennai 600 008, Phones: +91-44-28193265, +91-44-28194897,Rel: +91-44-32972089, Fax: +91-44-28193231, e-mail: chennai@jaypeebrothers.com
- 4-2-1067/1-3, 1st Floor, Balaji Building, Ramkote Cross RoadHyderabad 500 095, Phones: +91-40-66610020, +91-40-24758498, Rel:+91-40-32940929Fax:+91-40-24758499, e-mail: hyderabad@jaypeebrothers.com
- No. 41/3098, B & B1, Kuruvi Building, St. Vincent RoadKochi 682 018, Kerala, Phones: +91-484-4036109, +91-484-2395739, +91-484-2395740e-mail: kochi@jaypeebrothers.com
- 1-A Indian Mirror Street, Wellington SquareKolkata 700 013, Phones: +91-33-22651926, +91-33-22276404, +91-33-22276415Rel: +91-33-32901926, Fax: +91-33-22656075, e-mail: kolkata@jaypeebrothers.com
- Lekhraj Market III, B-2, Sector-4, Faizabad Road, Indira NagarLucknow 226016, Phones: +91-522-3040553, +91-522-3040554e-mail: lucknow@jaypeebrothers.com
- 106 Amit Industrial Estate, 61 Dr SS Rao Road, Near MGM Hospital, ParelMumbai 400012, Phones: +91-22-24124863, +91-22-24104532, Rel: +91-22-32926896Fax: +91-22-24160828, e-mail: mumbai@jaypeebrothers.com
- “KAMALPUSHPA” 38, Reshimbag, Opp. Mohota Science College, Umred RoadNagpur 440 009 (MS), Phone: Rel: +91-712-3245220Fax: +91-712-2704275, e-mail: nagpur@jaypeebrothers.com
USA Office
1745, Pheasant Run Drive, Maryland Heights (Missouri), MO 63043, USA, Ph: 001-636-6279734
Current Practice in Obstetrics and Gynecology—2
© 2009, Pankaj Desai
All rights reserved. No part of this publication 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 editor and the publisher.
First Edition: 2009
9788184485578
Typeset at JPBMP typesetting unit
Printed at
4Contributors
- Atul Munshi
- Professor of Obstetrics and Gynecology
- Smt NHL Municipal Medical College
- Ahmedabad
- Bhavin Kataria
- Consultant Pharmacologist
- Brand Leader
- Astra Zeneca Pharma
- Bengaluru
- Deepika Deka
- Professor of Obstetrics and Gynecology
- All India Institute of Medical Sciences
- Ansari Nagar, New Delhi
- Dilip B Walke
- Chairman
- Ethics and Medicolegal Committee
- FOGSI
- Pune
- Evita Fernandez
- Consultant Obstetrics and Gynecology Specialist and Director
- Fernandez Hospital
- Hyderabad
- Fessy Louis
- Consultant Infertility Specialist
- Thrissur (Kerala)
- Harshad Parasnis
- Hon Associate Professor
- Bharati Vidyapeeth's Medical College
- Pune
- KK Das
- Consultant Obstetrics and Gynecology Specialist
- Bokaro
- Kuldeep Singh
- Dr Kuldeep's Ultrasound and Color
- Doppler Clinic,
- D-80, East of Kailash,
- New Delhi-110 065
- Prakash Bhatt
- Consultant Obstetrics and Gynecology Specialist
- Varachha, Surat
- Prakash Trivedi
- Professor and Head of Obstetrics and Gynecology Department
- Rajawadi Hospital
- Mumbai
- Rajesh Modi
- Gynecologist and Endoscopy Surgeon
- Akola Endoscopy Centre
- Alsi Plots, Near NCC Office
- Akola
- Reva Tripathi
- Department of Obstetrics and Gynecology
- Maulana Azad Medical College
- New Delhi
- Sarbani Ghosh
- Consultant Obstetrics and Gynecology Specialist
- Bhagirathi Neotia Hospital
- Uma Singh
- Professor
- Department of Obstetrics and Gynecology
- CSM Medical University
- Lucknow
- Vandana Walvekar
- Retd Dean
- Nowrosjee Wadia Hospital for Women
- Parel, Mumbai
Following an encouraging success of Volume 1 of this series, I have embarked upon editing Volume 2. The demand for this update was palpable for nearly two years now. However, the presidential responsibilities at FOGSI tied me down. As soon as I was free, the current mission was activated. As has been with the previous volume, I have tried to select topics that are either current or controversial. The contributors have been handpicked in view of their expertise in the field and standing in the subject. I would like to thank them whole-heartedly for the hard work that they have put into each of their contributions. They have strived to give the most up-to-date knowledge to the readers.
Introduction of a new concept: Two Perspectives on One Topic. As a student and a teacher, I am aware of the fact that every teacher has his or her own perspective of any aspect of the subject. Though the basics remain common but the approach and understanding differ. This makes the student desirous of knowing the other perspective from some other teacher. So as to meet this need, in this volume we have introduced two perspectives of the topic—Conservative Surgery for Menorrhagia. Both the authors are very renowned in their subject and both have a unique approach. Different perspectives need not necessarily mean a debate— in fact it is away from any controversy. Both are coupling each other and thereby making the subject complete.
The controversy of supplements in I-Trimester for supporting the pregnancy has seen the pendulum swinging to and fro. Therefore, aptly titled Sense and Nonsense of Hormonal Support in I-Trimester is an evidence-based stand taken on different hormones used in I-Trimester of pregnancy. Investigating for genetic markers and problems in II-Trimester is a very fast developing science. This has been covered in this volume. Vesicular mole shows many different approaches rising and falling. This is more so in relation to its most dreaded complication of choriocarcinoma. It is imperative now to evaluate every woman who has a mole for administering prophylactic chemotherapy. All these aspects get covered in the chapter Prevention and Treatment of Choriocarcinoma. Amongst the medical disorders, epilepsy treatment still makes a clinician sit up and read every time as he has such a subject to treat. Epilepsy in 6Pregnancy is a chapter that covers the latest in approach to this challenge. Iron and calcium are the most commonly prescribed agents in pregnancy. No wonder most companies market them. The clinician then is at a disadvantage - what to prescribe and when? This is covered succinctly in two relevant chapters. Color Doppler is one more weapon in the armamentarium of the obstetrician. Though we all may not be able to do it, we all must be able to interpret the results. Therefore, a chapter on Decision Making through Color Doppler has been added. Induction of labour when, how and why has many new understandings. These get covered in the current volume. Babies born of ART are now on the surface of the earth for decades. It is time to pause and review the obstetric and perinatal outcome following ART. There is a chapter exclusively reviewing it.
Oligospermia is intriguing and managing it, is all the more challenging. The chapter covering this aspect, tries to cover this current approach to the topic. What is new in fibroid? Well, many advances have come, some have stayed, others have blown away. The topic on this has been authored by the authority that has done unique and outstanding work on this aspect. It is scary to imagine handling hysterectomy on a “Day Care” basis. But when you think something is impossible, someone else is already doing it elsewhere. There is a chapter on this aspect of laparoscopic hysterectomy being handled in a day care clinic. As in Volume 1, we have covered two allied aspects which I am sure will enrich the reader all the more.
As I place this volume in the hands of the reader—a student or a teacher or a practitioner of the subject, I feel satisfied that whatever was envisaged at the commencement of this volume could be accomplished. I now pray to Goddess Saraswati (Aetheus) of learning to make these pages most useful to the reader and help him/her serve humanity and making to the best of his/her ability.
Pankaj Desai