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Advances in Obstetrics and Gynecology (Volume 3)
Shalini Rajaram, Neerja Goel, Sumita Mehta
SECTION 1: OBSTETRICS
1:
Anemia Update in Pregnancy
INTRODUCTION
PREVALENCE OF ANEMIA IN PREGNANCY
ERYTHROPOIESIS IN PREGNANCY8
Causes of Anemia
Physiological Anemia
Iron Deficiency Anemia
Prevention of Iron Deficiency
Effects of Anemia on Pregnancy
Clinical Features of IDA
Diagnosis
Management of IDA
Response to Therapy
Newer Iron Preparations
Parenteral Iron Therapy
Technique of Giving Parenteral Iron
Recombinant Erythropoietin
Dosage Regimen Erythropoietin (Epofer)
Antenatal Care
Management of Labor in Anemic Patient
Puerperium
Contraception
MEGALOBLASTIC ANEMIA IN PREGNANCY
Criteria for Megaloblastic Anemia
Folate Deficiency
Effects on Pregnancy
Effects on Fetus
Investigations
Prophylaxis
Treatment
Vitamin B12 Deficiency
Investigations
Treatment
Hemolytic Anemias
Microangiopathic Hemolytic Anemia
Hemolytic Anemias Associated with Hemoglobinopathies
Sickle Cell Trait
Prenatal Diagnosis
Antepartum Care
Labor and Delivery
Postpartum Management
Contraception
Thalassemia
Immune Hemolytic Anemia
2:
Pregnancy after Corrected Heart Disease
INTRODUCTION
MATERNAL RISKS
FETAL RISKS
SPECIFIC HEART CONDITIONS
Left to Right Shunts
Right to left Shunts
Acquired Valvular Heart Disease
PROSTHETIC VALVES
Bioprosthetic Valves
Advantages
Disadvantages
Mechanical Valves
Dosage and Schedule of Anticoagulation
GENERAL PRINCIPLES OF MANAGEMENT OF DELIVERY AND POSTPARTUM
Antibiotic Regimen
3:
An Update on Viral Infections in Pregnancy
INTRODUCTION
TOXOPLASMOSIS
Congenital Toxoplasmosis
Diagnosis
Maternal Treatment
Treatment of Neonatal Infection
CYTOMEGALOVIRUS (CMV)
Introdution
Cytomegalovirus Inclusion Disease (CID)
Asymptomatic Congenital CMV
Diagnosis
Congenital Infection
Treatment
Congenital Infection
Prevention
Active Immunization
HERPES SIMPLEX VIRUS (HSV)
Clinical Features
Congenital Herpes
Management of Women with First Episode of Genital Herpes
Management of Women with Recurrent Herpes
Management of HIV Positive Women with Recurrent HSV Infection (IV)
Neonatal Care
Level B Recommendations (based on limited or inconsistent scientific evidence)
Level C Recommendations (based on consensus or expert opinion)
PARVOVIRUS
Clinical Presentation
Parvovirus B19 Infection in Pregnancy
Fetal Effects of Parvovirus B19 Infection
Diagnosis of Fetal Infections
Management of Fetal Hydrops
RUBELLA
Clinical Features
Congenital Rubella Syndrome (CRS)
Diagnosis of Maternal Infection
Diagnosis of Fetal Infection
Management of Rubella Exposure/Infection in Pregnant Women
Recommendation
Treatment
Rubella Vaccine
SYPHILIS
Diagnosis
Serological Tests for Syphilis
Screening and Testing of Pregnant Woman
4:
Obstetric Admissions to ICU
INTRODUCTION
INCIDENCE OF ICU ADMISSION
INDICATION OF ICU ADMISSION
INDIAN SCENARIO
GENERAL PRINCIPLES OF CARDIOVASCULAR AND RESPIRATORY SUPPORT 9
Cardiovascular Monitoring12–14
Respiratory Support on the Delivery Suite15,16
Critical Care for Special Obstetric Emergencies
Massive Obstetric Hemorrhage
Maternal Collapse
Septic Shock19
Disseminated Intravascular Coagulation (DIC)
Preeclampsia20
Maternal Complications in ICU
Prognostic Scoring in Obstetrics
Measures Towards Reduction of ICU Admission
High Dependency Unit
CONCLUSIONS
5:
Liver Disorders in Pregnancy: Current Evidence for Management
INTRODUCTION
HYPEREMESIS GRAVIDARUM
Etiopathogenesis
Complications
Maternal
Fetal
Management
HEMOLYSIS, ELEVATED LIVER ENZYMES AND LOW PLATELETS (HELLP)
Mississippi Classification
Tennessee Classification
Pathogenesis
Clinical Presentation
Laboratory Findings
Management
Complications
ACUTE FATTY LIVER OF PREGNANCY
Etiopathogenesis
Clinical Features
Diagnosis
Management
INTRAHEPATIC CHOLESTASIS OF PREGNANCY
Etiopathogenesis
Clinical Features
Investigations
Management
HEPATITIS A
Clinical Presentation
Investigations
Treatment
HEPATITIS E
HEPATITIS B
Clinical Presentation
HEPATITIS C (HCV)
LIVER CIRRHOSIS
PRIMARY SCLEROSING CHOLANGITIS
PORTAL HYPERTENSION
BUDD-CHIARI SYNDROME (BCS)
WILSON'S DISEASE
6:
Changing Scenario in the Management of Placenta Previa/Accreta
INTRODUCTION
PLACENTA PREVIA
Risk Factors
Clinical Presentation
Localization of the Placenta
Management
Delivery of the Fetus
Maternal and Perinatal Outcome
PLACENTA ACCRETA
Risk Factors
Diagnosis
Treatment
Conservative Management
Cesarean Scar Pregnancy
Prevention Strategies
7:
Postpartum Complications
INTRODUCTION
PUERPERAL INFECTIONS
Etiology
Risk Factors for Puerperal Sepsis
Causal Organisms
Clinical Course
Investigations
Management of Puerperal Sepsis
General Management
BREAST COMPLICATIONS
Risk Factors for Mastitis
Causal Organisms
Complications
Treatment
DEEP VEIN THROMBOSIS AND VENOUS THROMBOEMBOLISM (VTE)
Risk Factors for Peripartum Venous Thromboembolism
Deep Vein Thrombosis (DVT)
Clinical Presentation
Pulmonary Thromboembolism (PE)
Imaging Modalities
Treatment of VTE
PERIPARTUM CARDIOMYOPATHY
Diagnosis
Treatment
POSTPARTUM THYROIDITIS (PPT)
Pathogenesis
Clinical Symptoms
Treatment
Follow-up
POSTPARTUM DEPRESSION (PPD)
Treatment
POSTPARTUM PSYCHOSIS
Treatment
GAPED EPISIOTOMY
During Labor
Care at Home
Treatment
8:
Anesthetic Considerations and Obstetric Outcomes
INTRODUCTION
PHYSIOLOGIC CHANGES OF PREGNANCY
Cardiovascular System
Respiratory System
Gastrointestinal System
Central Nervous System
Other Changes
ANALGESIA FOR LABOR AND VAGINAL DELIVERY
Regional Analgesia
Epidural Analgesia
Combined Spinal-epidural Analgesia
Continuous Epidural Infusion
Patient-controlled Epidural Analgesia
Anesthesia for Cesarean Section
Spinal Anesthesia
General Anesthesia
Problems with General Anesthesia
Preparation for General Anesthesia in a Pregnant Patient
Mendelson Syndrome
Treatment
Postdural Puncture Headache (PDPH)
Symptoms
Pathophysiology
Epidemiology
9:
Ultrasonography: Special Situations
LEIOMYOMA
ENDOMETRIAL CARCINOMA
ENDOMETRIOSIS
DERMOID CYST
BICORNUATE UTERUS WITH PREGNANCY (FIGURE 9-5).
Rh ISOIMMUNIZATION
OMPHALOCELE
HYDROCEPHALUS
SPINA BIFIDA
CEPHALOCELE
HYDATIDIFORM MOLE
OVARIAN NEOPLASMS
SECTION 2: GYNECOLOGY
10:
Menstrual Disorders in Adolescents
PREMENSTRUAL SYNDROME
Etiology
Symptoms
Diagnosis
Management
Lifestyle Changes
Medical Management
Miscellaneous Therapies
DYSMENORRHEA
Prevalence
Etiology of Primary Dysmenorrhea
Secondary Dysmenorrhea
Clinical Evaluation
Treatment
Nonsteroidal Anti-inflammatory Drugs
Oral Contraceptives
Other Pharmacologic Treatment
Newer Treatment Modalities
Treatment of Secondary Dysmenorrhea
ABNORMAL UTERINE BLEEDING
Assessment and Diagnosis
Laboratory Investigations
Treatment
11:
Evaluation of Postmenopausal Bleeding
IMAGING STUDIES
Ultrasonography
Doppler Studies
Saline Infusion Hysterosonography
MRI/CT
ENDOMETRIAL SAMPLING
Fractional Curettage
Endometrial Aspiration
HYSTEROSCOPY
SPECIAL SITUATIONS
Women on Tamoxifen
Hormone Therapy in Menopause
12:
HPV Carcinogenesis in Cancer Cervix
INTRODUCTION
Low Risk HPV
High Risk HPV
Risk Factors for Acquiring HPV Infection
Genome of HPV
Long Control Region
Early Region (E)
Late Region
Mechanism of Carcinogenesis by HPV
HPV Infection
Establishment of Infection
Viral Multiplication
Host Cell Proliferation and Malignant Transformation
Viral Persistence
Development of Precancer and Cancer
Clinical Implications of HPV Oncogenesis
Role of HPV detection in Screening and follow-up in Cancer Cervix
HPV Vaccine
CONCLUSION
13:
Alternative Therapies for Menopause
INTRODUCTION
PHARMOKINETICS
TYPES OF PHYTOESTROGEN
Physiological Effects
VARIOUS STUDIES
Herbalism
Complementary Interventions
PRESCRIBING NOTES
14:
Recent Concepts in Management of Urinary Incontinence in Women
DEFINITION
CONTINENCE AND PHYSIOLOGY OF MICTURITION
Causes of Urinary Incontinence2–12
Neural Pathways
Sphincteric Mechanism and Anatomic Support
DIAGNOSTIC EVALUATION
I. Physical Examination
II. Investigations
Eyeball Urodynamics
Multichannel Urodynamics
Filling/Storage Phase
MANAGEMENT OF STRESS INCONTINENCE
Conservative Techniques
Behavioral Therapy
PFMT
Regimen for PFMT
Electrical Stimulation
Pharmacologic Treatment3,19
Surgery for Stress Incontinence
Traditional Procedures
Newer Procedures
Traditional Procedures
Newer Procedures
15:
Management of Adolescent PCOS
INTRODUCTION
PHYSICAL EXAMINATION
INVESTIGATIONS
For Hyperandrogenism
Ovarian Morphology
Insulin Resistance
Ovulatory Functions
Metabolic Dysfunction
TREATMENT
Management of Hyperandrogenism
Treatment for Oligomenorrhea
Oral Contraceptive Pills
Treatment of Metabolic Correction
Long-term Health Consequences of PCOS
16:
Troubleshooting in Laparoscopy
TROUBLESHOOTING IN SPECIFIC SURGERIES
Adenexal Surgery
Laparoscopic Management of Ectopic Pregnancy
Extraluminal Ectopic Pregnancy
Laparoscopic Hysterectomy
Patient
Uterine Manipulator
Procedure
Laparoscopic Surgery for Symptomatic Endometriosis24
Ovarian Endometriosis
Adhesiolysis
Laparoscopic Management of Dermoid (Ovarian Cyst)25
Laparoscopic Adhesiolysis
Effective and Safe Adhesiolysis
Laparoscopic Myomectomy
Technique
17:
Intractable Chronic Malignant Pelvic and Perineal Pain
INTRODUCTION
SUPERIOR HYPOGASTRIC PLEXUS BLOCK: A NEW TREATMENT MODALITY FOR CHRONIC MALIGNANT PELVIC PAIN
Technique
GANGLION IMPAR (GANGLION OF WALTHER) BLOCK FOR INTRACTABLE PELVIC PAIN
Technique
Invasive Neurosurgical Approach
Psychological Supportive Adjuncts
CONCLUSION
INDEX
TOC
Index
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