Practical Management of Gynecological Problems Sulochana Gunasheela
INDEX
A
Abnormal
smear 182
smear prior to pregnancy 214
Absolute
contraindications 40
contraindications to HRT 62
Accuracy of pap-smear 182
Acid-fast bacilli (AFB) 167
Activated protein C resistance 62
Activin/inhibin system 94
Acute
deep venous thrombosis 70
thromboembolism 70
Adenocarcinoma in situ (AIS) 215
Adenomyosis 57
Adequate smear 181
Adolescent age group 41
Adrenal contribution 94
Advantages of
DMPA 42
UAE 131
Age and parity 111
Agonist in uterine leiomyoma (LM) 123
Alternative treatment 77
Alzheimer's disease 68
Amenorrhea 23
due to end organ failure 14
related to weight loss 9
Amenorrhea/oligomenorrhea 56
Androgen insensitivity syndrome (XY) 10
Anovulation and
infertility 100
menstrual irregularities in PCOS 102
Anterior compartment defect 152
Anticardiolipin antibody syndrome 62
Antifibrinolytics 27
and nonsteroidal anti-inflammation 27
Antioxidant activity 64
Applied anatomy 152
Archibald Mcindoe's operation 11
Arterial thrombosis 37
in postmenopausal women 185
B
Basic rules of HRT 61
Beneficial effects 35
of HRT in diabetics 64
Benefits of
oral contraceptives 35
UAE 131
Benign
breast disease 35
lesions 23
ovarian cyst 35
ovarian tumors 244
tumors 223
Bladder 151
injury 161
Bleeding and pain 52
Borderline tumors 223
Breakthrough bleeding 38
Breast
cancer 65
carcinoma 44
Bronchial asthma 68, 130
C
Ca cervix 228
Ca endometrium 228, 229
Carbon dioxide (CO2) 133
Carcinogenic effect 56
Carcinoma
cervix 67, 179, 209
endometrium 216
ovary 222
Catecholamines and other neuronal factors 94
Categories of hormonal contraceptives 32
Central defects 153
Cervical
cancer screening 179
intraepithelial neoplasia (CIN) 192, 209
neoplasia 44
Cervix or vault 151
Changes in intraovarian milieu 93
Chlamydia trachomatis 192
Classification of primary amenorrhea 6
Clear cell carcinoma 217
Clomiphene citrate (CC) 106
COC and
cancer risk 38
carcinoma of breast 39
carcinoma of ovary 39
other cancers 39
subsequent fertility 36
COC
pill 27
use and breast cancer 39
use and cervical cancer 38
Cold light source 77
Colposcopic punch biopsy 211
Combination of estrogen and progestogen 46
Combined oral
contraceptive (COC) and benign neoplasms 39
contraceptives (COCs) 32
Combined preparations 60
Common hypercoagulable states 62
Competitive
luminex immunoassay (CLIA) 193
radioimmunoassay (CRIA) 193
Complete blood count 63
Complications of
ovarian transposition 233
pregnancy 22
Conclusions from literature 79
Cone biopsy
methods 212
specimen 211
Congenital adrenal hyperplasia (CAH) 4, 18
Conisation of cervix 212
Contraceptive
benefits 35
efficacy 42
Controlled ovarian hyperstimulation (COH) 106
Cooper's ligament 160, 161
Copper impregnated devices 51
Cornual resection 77
Coronary artery disease 62
Criteria for patient selection 76
Cryopreservation of ovarian tissue for purpose 241
Cryptomenorrhea of
acute onset 8
chronic type 8
Curettage if problem continues 42
Cyclofem 32
Cytogenetics of complete moles 83
D
Danazol 47, 140
therapy 140
Decreases level of antithrombin 63
Deficiency of protein C 62
Degree of protection 182
Delaying administration of hCG 108
Dendritic cells and Langerhans' cells 190
Denonvillier's fascia 153
Depot medroxy progesterone acetate (DMPA) 41
Diabetes mellitus 63, 130
Diagnostic
dilemma 165
problems of tuberculosis 166
Dihydroepiandrosterone
DHEA 3
sulfate (DHEASO4) 3
Dilatation and curettage (D and C) 26
Disadvantages of GnRHa therapy 126
DMPA and neoplasia 44
Drugs used throughout cycle 28
Dysfunctional uterine bleeding 22, 23
Dysmenorrhea 57
E
Ectopic pregnancy 35, 53
and past IUCD 54
Effect of
chemotherapy in males 234
DMPA on fetus 45
dopamine agonist therapy on fetus 147
estrogen in pill 33
estrogen on coagulation 63
hyperandrogenism 96
pregnancy on prolactinomas 146
Effect on
benign tumors 44
coagulation systems 36
Effects of
estrogen deficiency 62
progestin in pill 34
radiation and chemotherapy 233
Effects on protein metabolism 36
Efficacy
of prophylactic vaccines 193
trial of bivalent vaccine 194
Embryo transfer (ET) 177
Emergency surgery in pregnancy 149
Endocervical curettage 211
Endometrial
cancer 38, 67, 218
carcinoma 44
hyperplasia 218
sampling 26
variants 217
Endometriosis 35, 68, 243
Endoscopic procedures 101
Enterocele 151
Enucleation of myoma 115
Epidemiology and transmission of genital HPV 187
Epilepsy 68
Estimated TB incidence and mortality 165
Estrogen
and progestins 32
component of OC 32
dependant 217
nondependant 217
replacement in eating disorders 69
employed for postcoital 46
Ethinylestradiol 32
Ethisterone derivative 140
Examination of biopsy specimens 210
Excisional and destructive methods of treatment 211
Expectant treatment 76
Expulsion rate 56
Extraglandular estrogens 96
F
Factors predicting onset of menarche 3
Familial hypertriglyceridemia 64
Fasting serum insulin levels 99
Fertility after
IUCD removal 55
myomectomy 119
Fertility sparing management of gynecological malignant 208
Fibroids 57
First generation of combined oral contraceptive 33
Follicle stimulating hormone (FSH) 1
Follicular
aspiration 109
stimulating hormone (FSH) 106
Frank technique or perineal dilation 13
Freezing of ovarian cortical strips 242
Full blood count (FBC) 25
Functional ovarian cysts 56
Future II trial 195
G
Gallbladder disease 41
Gallstones 64
Gamma-amino butyric acid (GABA) 145
Genesis of partial mole 83
Genital tuberculosis 166, 176
and infertility 165
Germ cell tumors of ovary 226
Gestational trophoblastic
disease (GTD) 82
tumor (GTT) 88
Global advisory committee on vaccine safety (GACVS) 196
GnRH 28
Gonadotoxicity of
chemotherapy 232
combined intensive chemotherapy 233
radiotherapy 232
Gonadotropin releasing hormone 14
analogs (GnRHa) 107
Gonadotropins (GTH) 1
Grisofulvin 34
Gross hematuria 161
Guidelines
for management of ovarian tumors 227
on fertility preservation 245
Gunasheela IVF center 175
H
Hemocoagulase injection 129
Hemostatic evaluation 63
Heterosexual development of SSC 18
High false negativity 181
High flow CO2 insufflator 77
High grade lesions (HGSIL) 185
Hirsutism and acne 100
Histogenetic classification of ovarian neoplasms 222
Histomorphological features of polycystic ovaries 92
Holding hCG 108
Hormonal
contraception 41
contraception in female: advantages and disadvantages 31
methods 46
Hormone
plants 32
releasing devices 51
releasing IUCD 32
Hormones
releasing IUCD 55
used 59
Hot flushes, night sweats 62
HPV
in etiology of cervical cancer 191
naïve 195
vaccine for prevention of cervical cancer 187
HRT in women “at risk” for breast cancer 67
Human chorionic gonadotrophin (hCG) 14
for ovulation trigger 108
Human
menopausal women's urine (HMG) 106
papillomavirus (HPV) 184, 187
Hydatidiform mole with a coexistent live fetus 82
Hydroxyethyl starch (HES) 108
Hyperandrogenemia in PCOS 94
Hyperandrogenism (HA) 91
Hyperandrogenism in PCOS 102
Hypergonadotropic situation 14
Hyperinsulinemic insulin resistance 103
Hypermobility SUI 159
Hyperprolactinemia (HPRL) 14, 145
Hypertension 64, 130
Hypoestrogenaemia in PCOS 95
Hypogonadotropic
hypogonadism 14
pathology 14
Hypomenorrhea 23
Hysterosalpingogram (HSG) 171
Hysteroscopy 26
I
Immunogenicity of prophylactic vaccines 193
Impact of chemotherapeutic agents on ovarian function 234
Impact on
infertility 113
obstetrical outcome 113
Impaired insulin secretion 63
Imperforate hymen 8
Improve smear quality 182
Inappropriate gonadotropin secretion 92
Increased risk
for CVD 98
of thromboembolism 63
Indications for ovarian drilling 102
Inert devices 51
Injectable contraceptives 41
Insertion technique 57
Insulin
resistance 63
resistance/hyperandrogenism in PCOS 96
Interaction with drugs 34
Intramural fibroids 129
Intrapartum care 149
Intrauterine
contraceptive devices (IUCDS) 51
Intravenous albumin 108
Intrinsic sphincter deficiency (ISD) 158
Invasive ovarian carcinoma 225
Investigation of delayed puberty 4
Isolated GnRH deficiency 14
L
Lactating women 56
Laparoscopic
colposuspension 160
cystocele repair 154
enterocele repair 155
sacrospinous ligament suspension 156
vaginal vault suspension 156
Lateral defects 153
Leiden
mutation and COC 33
mutation homozygous 33
Leiomyoma uteri 68
Levels of FSH and LH hormones 1
Levonorgestrel releasing IUCD 28, 56
Linear salpingostomy 77
Lipid profile 99
Liver and COC users 37
Lletz specimen and cone biopsy 211
LN biodegradable 32
Long-term health risks 103
Looking to the future 70
Loop excision of transformation zone (LLETZ) 212
Low
dose oral contraceptive agents 102
grade lesions (LGSIL) 185
Löwenstein-Jensen (LJ) 167
Luteinizing hormone (LH) 1, 107
M
Magnetic resonance imaging (MRI) 129
Major complications of conisation 212
Malignancy 65
Malignant
lesions 23
melanoma 67
Management of
androgen insensitivity syndrome 17
CIN and microinvasive disease 213
hypogonadotropic amenorrhea 15
low grade lesions 185
myomas 113
PCOS in young unmarried girls 99
Mayer-Rokitansky syndrome (MRS) 10
Mechanism of
action of COCs 33
menstruation 24
Medical treatment 27, 76
of endometriosis 138, 139
Medroxy progesterone actate 32
Medroxyprogesterone acetate 41, 139
Menorrhagia 23, 57, 123
Menstrual
cycle 35
dysfunction during the use of DMPA 42
history 220
irregularities 100
Metabolic effects of DMPA 44
Method of evacuation 88
Methodology of smear taking 180
Microadenomas 149
Middle compartment defect 152
Migraine 68
Minor effects with COC 38
Miscarriage rate 101
Macroadenomas 149
Mode of action of GnRH agonist 235
Molar pregnancy with coexistent normal fetus 85
Monitoring during pregnancy 148
Morcellation of myoma 118
Multiple pregnancy 101
Mycobacterium tuberculosis (MTB) 167, 168
in liquid culture 167
Myocardial infarction 65
Myomas and laparoscopic myomectomy 110
Myomectomy 114
N
National family welfare program 32
Native GnRH 122
Natural history of HPV infection 189
Needle bladder neck suspension 159
Neoplasms derived from
coelomic epithelum 223
germ cells 222
Neoplasms metastatic to ovary 222
Noncontraceptive benefits 35, 42
Nonhormonal methods 47
Nonspecific hemostatic agents 42
Norethisterone enanthate 32
Norethyndrone enanthate (NET EN) 41
Noristerat 41
Normal
menstruation 23
myometrium (MM) 123
Pap-smear 182
tissue 217
Norplant and norplant II systems 32
O
Obstetric history 220
Oligomenorrhagia 23
Oligomenorrhea 23
One month after delivery 150
Open reading frame (ORF) 187
Operative technique 114
Oral contraceptive (OC) for fertility preservation 235
Oral contraceptives 32
Osteoporosis 62
Outcome after ovarian diathermy 101
Ovarian
carcinoma 44, 67, 201
contribution 94
drilling work 101
estrogens 95
hyperstimulation syndrome (OHSS) 106
neoplasms in PCOS 103
P
Papillary (high grade) serous carcinoma 217
Pap-smear 179
after hysterectomy 185
reporting 182
Paravaginal suspension 154
Pathogenesis of PCOS 92
Patient with macroprolactinomas 147
Patricia trial 194
PCOS an inherited disorder 98
Pelvic
inflammatory disease 35, 57
pain 125
Per
speculum 220
vagina 221
Perimenopausal age group 41
Persistent ectopic pregnancy 79
Pharmacology of combined oral contraceptives 32
Phase III efficacy trial of
bivalent vaccine 194
quadrivalent vaccine 195
Phytoestrogens 70
Pif–prolactin inhibiting factor 145
Pitfalls in ultrasound scan 75
Placement of adhesion barrier 119
Plasminogen activation inhibitor 98
Polycystic ovarian syndrome (PCOS) 91, 104
Polycystic ovarian syndrome 91
Polymenorrhagia 23
Polymenorrhea 23
Polymerase chain reaction (PCR) 168
for DNA tuberculos 168
Population reports 45
Port placement 115
Postcoital contraception 46
Posterior compartment defect 152
Postmenopausal women 185
Postpartum
care 150
contraception 41
hemorrhage (PPH) 129
insertion 55
Postponement of embryo transfer (ET) 108
Pouch of Douglas 138
Precancerous conditions 23
Pregnancy
after myomectomy 119
in patients with prolactinomas 145
rate 56
with IUCD 53
Premature
adrenarche 100
ovarian failure (POF) 69
Preoperative
evaluation of pelvic floor suppor 152
preparation 114
Preparation of vaginal mould 11
Pressure effects on other organs 125
Prevention of ovarian
destruction before irradiation 232
hyperstimulation syndrome 106
Preventive management of
carcinoma of cervix 209
infertility 231
Primary amenorrhea 1
due to physiological delay 9
Principles of
hysteroscopy 133
management of primary
amenorrhea 1
Progesterone (P4) 238
only therapy 139
Progestins 32
alone 47, 102
Progestogens 28
Prognostic factors 218
Progressive potential of CIN 210
Prophylactic vaccine 197
Protegen sling 162
Protocol for multidose therapy 76
R
Raised HDL level 64
Receptors in endometrium 217
Re-construction of vagina 11
Rectocele and perineum 151
Recurrent
abortions and fetal loss 124
urinary tract infection 62
Regarding HRT 62
Related
to insertion 54
risk (RR) 201
Relevance of hormonal assay in evaluation 99
Resistant ovarian syndrome (XX) 15
Responsibility of treating oncologist 228
Retropubic urethropexy 159
Return of fertility after
removal 56
use of DMPA 44
Rokitansky-Mayer-Huffner-Kauser syndrome 8, 10
Role of
genetics 98
GnRH analogs 113
hyperprolactinemia in PCOS 93
obesity in PCOS 98
prostaglandins 24
S
Sacral colpopexy 156
Sacrospinous vaginal vault suspension 156
Safety concerns with ovarian transplantation 244
Safety of the prophylactic vaccines 196
Salpingectomy 77
Second generation of combined oral contraceptive 33
Secondary sexual characteristics (SSC) 3
Segmental resection 77
Selective
estrogen receptor modulators 70
transphenoidal adenectomy 148
Separation of crux levators 155
Serum DHEAs/DHEA 99
Seven-step approach for decisions 62
Sex cord stromal tumors 226
Sexually transmitted diseases 180
Side effects of danazol therapy 140
Smear interpretation 181
Squamous intraepithelial lesions (SIL) 209
SSC present—true amenorrhea 9
Stein Leventhal syndrome 91
Stimulating hormone (FSH) 122
Strategies for prevention of OHSS 107
Submucosal fibroids 128
Subserosal fibroids 129
Suppresses FSH 34
Surgery for stress urinary incontinence (SUI) 152
Surgical management 29
of anovulation/infertility 101
of laparoscopy vs. laparotomy 76
T
Tamoxifen for induction of ovulation 236
Target group for vaccination 197
Technique of
laparoscopic paravaginal suspension 154
UAE 130
Tension-free vaginal tape (TVT) 162
Teratogenic effect 56
Testicular feminizing syndrome 15
Testosterone in use 60
Th1 immune response 191
Th2 immune response 191
Third generation of combined oral contraceptive 33
Thrombosis and/or phlebitis 62
Thyroid function tests (TFTS) 25
Thyrotropin releasing hormone (TRH) 145
Time of insertion of IUCD 55
Transverse
defects 153
vaginal septum 8
Treatment of
acute bleeding 27
microinvasive carcinoma cervix 214
Trichomonas vaginalis 192
Trouble shooting during hysteroscopy 136
Tuberculosis (TB) 165
Turner's
mosaic 16
or Turner's mosaic 15
syndrome 4, 10, 16
U
Ultrasonography 26
Ultrasound scan 75
Undetermined vaginal bleeding 70
Unwanted side effects 42
Urethra 151
Urinary
assays 75
incontinence 62
retention 161
Urodynamic study 159
Use of 1.5% glycine 135
aromatase inhibitor (letrozole) for inducti 237
carbon dioxide 133
crystalloid and dextrose solution 134
GnRH analog
along with chemoadjuvant therapy 235
in treatment of myoma 122
GnRH therapy in endometriosis 141
IVF and embryo transfer 165
ovarian grafts in non-cancerous conditions 243
uterine arterial embolization in treatment 128
Viscous media 135
Uterine artery
embolization (UAE) 114, 129, 130, 132
ligation 116
Uterine
fibroids 35
leiomyomas (fibroids) 128
leiomyomas (myomas) 110
rupture after laparoscopic myomectomy 119
V
Vaginal dryness dyspareunia 62
Vasoactive intestinal peptide (VIP) 145
Venous
thromboembolism (VTE) 31
thrombosis and COC 36
Viral
changes 184
subtype 184
Virus like particles (VLPS) 187
Viscous media 133
Voiding dairy 159
W
Whom to screen 179
Williams vaginoplasty 13
Wolffian ducts 138
Women with symptomatic myomata 125
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