Index

Obstetric & Gynecological Emergencies Swaraj Batra, Deepti Goswami, Sangeeta Bhasin

SECTION I: OBSTETRIC EMERGENCIES
CHAPTER 1:Ectopic Pregnancy
- INTRODUCTION
  - Risk Factors for Ectopic Pregnancy4–6
  - Differential Diagnosis will Include
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- EXPECTANT MANAGEMENT
- MEDICAL MANAGEMENT
- SURGICAL MANAGEMENT
  - Indications for Laparotomy in a Case of Ectopic Pregnancy
  - Follow-up after Conservative Tubal Surgery for Ectopic Pregnancy
- PERSISTENT TROPHOBLAST
- HETEROTROPIC PREGNANCY
- NON-TUBAL ECTOPIC PREGNANCY
CHAPTER 2:Hydatidiform Mole
- INTRODUCTION
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- MANAGEMENT OF HYDATIDIFORM MOLE
- PREGNANCY AFTER HYDATIDIFORM MOLE
- CO EXISTENT FETUS AND HYDATIDIFORM MOLE
- FALSE POSITIVE HCG LEVELS – THE PHANTOM HCG
CHAPTER 3:Inevitable and Incomplete Abortion
- INTRODUCTION
  - Differential Diagnosis
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- TREATMENT
  - Definition
  - Differential Diagnosis
- NON-SURGICAL MANAGEMENT
- OTHER ASPECTS OF MANAGEMENT
- CONCLUSION
CHAPTER 4:Septic Abortion
- INTRODUCTION
  - Differential Diagnosis
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- TREATMENT
  - Differential Diagnosis
    - Proceed for History and Examination as Discussed in Case 1
  - Diagnosis
- IMMEDIATE TREATMENT IN SUCH CASES
  - Management of Shock8,9
- DEFINITIVE MANAGEMENT
- FURTHER MANAGEMENT IN SUCH CASES
- OTHER CLINICAL PRESENTATIONS
- PROGNOSIS
- PREVENTION
CHAPTER 5:Hyperemesis Gravidarum
- INTRODUCTION
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- TREATMENT
- PREVENTION
- PROGNOSIS
CHAPTER 6:Hypertensive Emergencies in Pregnancy
- INTRODUCTION
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
  - Diagnosis
  - Test for Proteinuria
- MANAGEMENT
- PREVENTION OF PRE ECLAMPSIA
- PATHOPHYSIOLOGY
CHAPTER 7:Cardiac Failure in Pregnancy
- INTRODUCTION
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- MANAGEMENT
- HYPERTROPHIC CARDIOMYOPATHY
  - Management
CHAPTER 8:Acute Asthmatic Attack in Pregnancy
- INTRODUCTION
  - Differential Diagnosis
- FIRST AID MEASURES
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- TREATMENT
- ACUTE EXACERBATION IN PREGNANCY
- LIFE-THREATENING ATTACK OF ASTHMA
- OBSTETRIC MANAGEMENT
CHAPTER 9:Jaundice in Pregnancy
- INTRODUCTION
  - Differential Diagnosis
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
  - Diagnosis
- MANAGEMENT
- PROGNOSIS
- PREVENTION
- TREATMENT
  - Postpartum Management
  - Diagnosis
- MANAGEMENT OF ACUTE LIVER FAILURE
CHAPTER 10:Antepartum Hemorrhage
- INTRODUCTION
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- IMMEDIATE MANAGEMENT
- INVESTIGATIONS
  - Final Diagnosis
- FURTHER MANAGEMENT
CHAPTER 11:Fetal Distress During Labor
- INTRODUCTION
- CAUSES OF FETAL DISTRESS
- MANAGEMENT OF PATHOLOGICAL CTG5
- MANAGEMENT OF MECONIUM STAINED LIQUOR
  - Risk Factors for Cord Prolapse15
- MANAGEMENT OF CORD PROLAPSE14,16
- PREVENTION14
CHAPTER 12:Shoulder Dystocia
- INTRODUCTION
- MANAGEMENT2,3,4,7
CHAPTER 13:Obstructed Labor and Rupture Uterus
- INTRODUCTION
  - Definition
  - Causes
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- MANAGEMENT
- COMPLICATIONS OF OBSTRUCTED LABOR
  - Immediate Complications
  - Late Complications
- PREVENTION OF OBSTRUCTED LABOR
  - Morbid Anatomy
  - Predisposing Factors
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
  - Diagnosis
- MANAGEMENT
CHAPTER 14:Atonic Postpartum Hemorrhage
- INTRODUCTION
- MANAGEMENT
- PPH PROTOCOL
CHAPTER 15:Morbidly Adherent Placenta and Retained Placenta
- INTRODUCTION
  - Adherent Placenta may be of Three Types
  - Risk Factors for Placenta Accreta
- RADIOLOGICAL FINDINGS IN PLACENTA ACCRETA4
- MANAGEMENT OF PLACENTA ACCRETA AND PERCRETA (Figure 15.1)
- MANAGEMENT OF RETAINED PLACENTA (Figure 15.2)
CHAPTER 16:Inversion Uterus
- INTRODUCTION
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- MANAGEMENT
- REPOSITIONING THE UTERUS: NONSURGICAL METHOD
- REPOSITIONING THE UTERUS: SURGICAL METHODS
- PREVENTION OF INVERSION UTERUS
- PROGNOSIS
- CONCLUSION
CHAPTER 17:Perineal Tear During Delivery
- INTRODUCTION
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- TREATMENT
- PREVENTION OF PERINEAL TEAR DURING DELIVERY
  - Antenatal Interventions
  - Intrapartum interventions to Reduce Perineal Trauma (NICE Guidelines 2007)10
- PROGNOSIS
CHAPTER 18:Vulval and Paravaginal Hematomas
- INTRODUCTION
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- TREATMENT
  - Differential Diagnosis
- POINTS TO BE NOTED IN HISTORY
  - Diagnosis
- INVESTIGATIONS
- MANAGEMENT
- SUBPERITONEAL HEMATOMAS
  - Surgical exploration
CHAPTER 19:Postpartum Collapse
- INTRODUCTION
  - Causes
- APPROACH TO DIAGNOSIS
- INVESTIGATIONS
- MANAGEMENT
- AIR EMBOLISM
- OBSTETRIC SHOCK
- UTERINE RUPTURE
  - Clinical Features and Diagnosis
  - Treatment
- BROAD LIGAMENT/RETROPERITONEAL HEMATOMA
- ACCIDENTS TO OVARIAN CYSTS
- ANESTHETIC ACCIDENTS
CHAPTER 20:Puerperal Sepsis
- INTRODUCTION
- POINTS TO BE NOTED IN THE HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- TREATMENT
  - Promotion of Drainage
- MEDICAL AND SURGICAL COMPLICATIONS OF PUERPERAL SEPSIS
- PREVENTION
CHAPTER 21:Abnormal Behavior in a Postpartum Patient
- INTRODUCTION
  - Differential Diagnosis of Postpartum Psychosis and Relevant Investigations
    - Psychiatric Disorders
    - Medical Causes
  - Diagnosis
- TREATMENT
CHAPTER 22:Resuscitation of the Depressed Neonate in Delivery Room
- INTRODUCTION
- BIRTH ASPHYXIA
- IDENTIFICATION OF NEWBORNS WHO NEED RESUSCITATION AT BIRTH
  - Initial Assessment and Intervention
- VENTILATION
- CHEST COMPRESSION
- MEDICATIONS
  - When to Discontinue Resuscitation
CHAPTER 23:Cardiopulmonary Resuscitation of a Pregnant Patient
- INTRODUCTION
- CARDIOPULMONARY RESUSCITATION
- BASIC LIFE SUPPORT
- C-A-B-D SEQUENCE OF ACTIONS
- EFFECTIVE ADVANCED CARDIOVASCULAR LIFE SUPPORT (ACLS)
- CONSIDER AND TREAT POTENTIALLY REVERSIBLE CAUSES
- ACCESS FOR PARENTERAL MEDICATIONS DURING CARDIAC ARREST
  - Medications during Cardiac Arrest
- MATERNAL CARDIAC ARREST NOT IMMEDIATELY REVERSED BY BLS/ACLS
  - Consider Emergency Cesarean Section
  - Potential Benefits of Perimortem Cesarean Section
- SUBSEQUENT RESPONDERS
  - Search for and Treat Possible Contributing Factors (BEAU-CHOPS)
- POSTCARDIAC ARREST CARE
SECTION II: GYNECOLOGICAL EMERGENCIES
CHAPTER 24:Acute Pelvic Inflammatory Disease
- INTRODUCTION
- CDC DIAGNOSTIC CRITERIA FOR THE DIAGNOSIS OF PID7
- POINTS TO BE NOTED IN THE HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- MANAGEMENT OF ACUTE PID
- SPECIAL CONSIDERATIONS
- PREVENTION
CHAPTER 25:Bartholin Abscess
- INTRODUCTION
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- TREATMENT
- BARTHOLIN ABSCESS IN A PREGNANT PATIENT
  - Pregnancy
  - Labor
CHAPTER 26:Abnormal Uterine Bleeding in Gynecology
- INTRODUCTION
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
  - Diagnosis
- MANAGEMENT
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- TREATMENT
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- TREATMENT
  - Common Causes of Bleeding in Children1
CHAPTER 27:Dysmenorrhea and Cryptomenorrhea
- INTRODUCTION
  - Differential Diagnosis
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- TREATMENT
- INVESTIGATIONS
- TREATMENT
- POINTS TO BE NOTED IN HISTORY AND EXAMINATION
- INVESTIGATIONS
- TREATMENT
CHAPTER 28:Ovarian Torsion
- INTRODUCTION
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- EMERGENT CARE
- INVESTIGATIONS
- DEFINITIVE TREATMENT
  - Complications
- PREVENTION OF RECURRENCE
  - Diagnosis
- MANAGEMENT
CHAPTER 29:Emergency Contraception
- INTRODUCTION
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- MANAGEMENT
CHAPTER 30:Acute Complications of Intrauterine Contraceptive Device
- INTRODUCTION
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- MANAGEMENT
  - Outpatient Treatment of PID following IUCD Insertion
  - Recommended Regimen (CDC)2
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- MANAGEMENT
CHAPTER 31:Ovarian Hyperstimulation Syndrome
- INTRODUCTION
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- MANAGEMENT
- MILD AND MODERATE OHSS
  - Criteria for Hospitalization1
- SEVERE OHSS
- COMPLICATIONS OF OHSS
- PREVENTION
CHAPTER 32:Sexual Assault
- INTRODUCTION
  - Goals of Examination
  - Examination of the Survivor
- INITIAL CARE
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
  - Precautions while Handling the Samples
  - Special Tests
- TREATMENT
- SAFE (SEXUAL ASSAULT CARE AND FORENSIC EVIDENCE COLLECTION) KIT
- ORGANIZATIONS DEALING WITH THE SURVIVORS OF SEXUAL ASSAULT
CHAPTER 33:Emergencies of Gynecologic Oncology
- INTRODUCTION
  - Predisposing Factors of Hemorrhage in Carcinoma Cervix are:
  - Differential Diagnosis
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
  - General Examination
  - Cardiovascular and Respiratory System Examination
  - Abdominal Examination (P/A)
  - Pelvic Examination
  - Diagnosis
- INVESTIGATIONS
- MANAGEMENT
  - Differential Diagnosis
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
  - Diagnosis
- MANAGEMENT
  - Initial Management
  - Definitive Treatment
  - Differential Diagnosis
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- MANAGEMENT
  - Emergency Hysterectomy
  - Embolization
  - Conservative Myometrial Resection
  - Primary Uterine Oversewing
  - Differential Diagnosis
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
  - Diagnosis
- MANAGEMENT
- MALIGNANT PLEURAL EFFUSION
- GASTROINTESTINAL OBSTRUCTION
  - History
  - Management
- COLONIC OBSTRUCTION
- THROMBOEMBOLISM
- UNUSUAL ACUTE PRESENTATIONS OF OVARIAN MALIGNANCIES
- NEUTROPENIA
  - Management
- HEMORRHAGIC CYSTITIS
- POSTRADIATION HEMORRHAGIC PROCTITIS
  - Management
- POSTRADIATION BOWEL PERFORATION
CHAPTER 34:Postoperative Complications
- INTRODUCTION
  - General Complications
  - Complications Specific to Gynae Surgery
- REACTIONARY HEMORRHAGE OR DELAYED PRIMARY HEMORRHAGE
- SECONDARY HEMORRHAGE
- PULMONARY EMBOLISM
- PARALYTIC ILEUS
- BOWEL INJURY
SECTION III: EMERGENCIES COMMON TO OBSTETRICS AND GYNECOLOGY
CHAPTER 35:Acute Urinary Retention
- INTRODUCTION
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- MANAGEMENT
- URINARY RETENTION DUE TO FIBROID UTERUS
  - Differential Diagnosis
  - Diagnosis
- POSTOPERATIVE URINARY RETENTION
- FOWLER'S SYNDROME
- CONCLUSION
CHAPTER 36:Nonobstetric Trauma to the Genital Tract
- INTRODUCTION
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS
- TREATMENT
- PROGNOSIS
- MANAGEMENT
- PROGNOSIS
- MANAGEMENT
- PROGNOSIS
CHAPTER 37:Postexposure Prophylaxis to HIV and Hepatitis B
- INTRODUCTION
- FIRST AID
- DECIDING WHETHER PEP SHOULD BE INITIATED OR NOT
- INVESTIGATIONS
- BASIC REGIMEN VERSUS EXPANDED REGIMEN
  - Type of Exposure or Source Factor
  - Source of the Blood, Body Fluids or Tissue
- STARTING THE REQUIRED PEP FOR HIV TO THE ELIGIBLE EXPOSED PERSON
- FOLLOW-UP
CHAPTER 38:Endotoxic Shock
- DEFINING SEPSIS AND ITS CLINICAL MANIFESTATIONS
- POINTS TO BE NOTED IN HISTORY
- POINTS TO BE NOTED IN EXAMINATION
- INVESTIGATIONS AND MONITORING
  - Monitor the following Parameters
  - Rationale for using Swan-Ganz Catheter
- TREATMENT OF SEPSIS AND ENDOTOXIC SHOCK2,5,8,9,10
- PREVENTION
- CONCLUSION13,14
CHAPTER 39:Management of Hyperglycemic and Normoglycemic Ketoacidosis in Diabetes Mellitus
- INTRODUCTION
- INVESTIGATIONS
- MANAGEMENT
- START IV INSULIN THERAPY
- CONCLUSION
CHAPTER 40:Acid Base Balance and Common Electrolyte Abnormalities
- INTRODUCTION
  - Why do we order an ABG?
- PROPER SAMPLING AND HANDLING FOR ABG
- APPROACH FOR INTERPRETATION OF ABG
- CAUSES OF RESPIRATORY ACIDOSIS
- CAUSES OF RESPIRATORY ALKALOSIS
- METABOLIC ACIDOSIS
- METABOLIC ALKALOSIS
  - Causes of Metabolic Alkalosis (Table 40.5)
  - Compensation in Metabolic Alkalosis
- LOOK AT PH
- HYPONATREMIA
- HYPERNATREMIA
- DIABETES INSIPIDUS
- HYPOKALEMIA
- HYPERKALEMIA
- HYPOCALCEMIA
  - Diagnostic Approach
    - Symptoms of Hypocalcemia
    - Signs of Hypocalcemia
  - Treatment of Hypocalcemia
- HYPERCALCEMIA
  - Diagnostic Approach
  - Treatment of Hypercalcemia
- CLINICAL USES OF MAGNESIUM
- HYPOMAGNESEMIA
  - Diagnostic Approach
  - Treatment of Hypomagnesemia
- HYPERMAGNESEMIA
  - Causes of Hypermagnesemia
  - Treatment of Hypermagnesemia
CHAPTER 41:Rational use of Blood Components in Hemorrhage and Disseminated Intravascular Coagulation
- INTRODUCTION
  - Use of Blood Products is Common in the following Obstetric Conditions
- WHOLE BLOOD
  - Types of Blood Components
- PACKED RED BLOOD CELLS4,5,6,8,9,10
- PLATELETS4,5,6,8,9,10
- FRESH FROZEN PLASMA4,5,6,8,9,10
- CRYOPRECIPITATED ANTIHEMOPHILIC FACTOR (AHF)
- FIBRINOGEN
- DISSEMINATED INTRAVASCULAR COAGULATION
- MASSIVE BLOOD TRANSFUSION
  - Complications of Massive Blood/Blood Components Transfusions
- AUTOLOGOUS TRANSFUSION
- GENERAL INSTRUCTION FOR BLOOD/BLOOD PRODUCTS TRANSFUSION10,11
- SIDE EFFECTS OF BLOOD/BLOOD PRODUCTS TRANSFUSION
CHAPTER 42:Medicolegal and Ethical Issues in Obstetric and Gynecological Emergencies
- INTRODUCTION
- ISSUES RELATED TO CONSENT
- DEATH OF THE PATIENT
  - Certifying Death
  - Patient Brought Dead
- OFF-LABEL USE OF DRUGS
- QUALITY OF CARE ISSUES
- SEXUAL ASSAULT
  - The Goals of Management
  - Management of a Sexual Assault Victim
- UNNATURAL DEATH
- MEDICOLEGAL CASES
- WHEN PATIENT'S WISHES ARE IN CONTRADICTION WITH STANDARD MEDICAL CARE
  - Cesarean on Demand
- RIGHTS OF THE FETUS
- CONTRACEPTION IN A TEENAGER
- DISCLOSURE OF INFORMATION
- CONCLUSION
  - Acknowledgments
CHAPTER 43:Emergency Laboratory Investigations and Basic Medical Devices
- INTRODUCTION
- COLLECTION OF BLOOD SAMPLE
- COLLECTION OF URINE SAMPLE
- THE SI UNITS OF MEASUREMENT
- LAB INVESTIGATIONS IN SOME COMMON OBSTETRIC CONDITIONS

INDEX

TOC
Index

Chapter Notes