Jaypee Brothers
In Current Chapter
In All Chapters
X
Clear
X
GO
Normal
Sepia
Dark
Default Style
Font Style 1
Font Style 2
Font Style 3
Less
Normal
More
Clinical Progress in Obstetrics & Gynecology
Duru Shah, Sudeshna Ray
CHAPTER 1:
Current Approaches to the Management of Fibroids
Introduction
Expectant Management
Surgical Management
Hysterectomy
Myomectomy
Conventional Abdominal Myomectomy
Laparoscopic Myomectomy
Laparoscopic-assisted Myomectomy
Vaginal Myomectomy
Hysteroscopic Myomectomy
Laparoscopic Thermomyolysis or Cryomyolysis
Laparoscopic Uterine Artery Occlusion
Temporary Transvaginal Uterine Artery Occlusion
Radiological Treatments
Uterine Artery Embolization (UAE)
MR Guided Focused Ultrasound (MRgFUS)
Medical Management
GnRH Agonists
Progesterone, the Progesterone Receptor and Receptor Antagonists/Modulators
Levonorgesterol Intrauterine Device (LNG-IUS)
Progesterone Receptor Modulators
Evidence for Effectiveness of PRMs in Treatment of Uterine Fibroids
Mifepristone (RU-486)
CDB-4124 (Telapristone)
J-867 (Asoprisnil)
CDB-2914 (Ulipristal Acetate or UA) (Fig. 1.2)
Adverse Effects and Limitations Associated with Long-term Use of PRMs
Gestrinone
Other Treatment Modalities
Endometrial Ablation
Image Guided Thermal Therapy
Cryotherapy
Radiofrequency Ablation
Acupuncture
Concluding Remarks
CHAPTER 2:
Tumor Markers in Gynecological Cancers
Serum Markers for Ovarian Cancer
Serum Markers in Epithelial Ovarian Cancer
Serum CA 125
Uses of CA 125
Other Markers for Ovarian Cancer
The Kallikrein Family
Osteopontin
Lysophosphatidic Acid (LPA)
Carcinoembryonic Antigen (CEA)
Plasminogen Activator Inhibitor-1 and -2 (PAI-1 and -2)
Interleukin-6 (IL-6)
Her-2/neu
Serum Tumor Markers in Non-epithelial Ovarian Cancer
Ovarian Germ Cell Tumors (OGCN)
Human Chorionic Gonadotropin (hCG)
Alpha Feto Protein (AFP)
Lactate Dehydrogenase (LDH)
Sex Cord Stromal Tumors
Inhibin
Estradiol
Mullerian Inhibiting Substance (MIS)
Serum Markers for Other Gynecological Cancers
Gestational Trophoblastic Disease (GTD)
Serum Markers for Cervical Cancer
Other Tumour Markers in Carcinoma Cervix
Conclusion
CHAPTER 3:
Emergency Contraception–Rational Use for Women's Health
History
Need for Emergency Contraception in India
Indications of Use of Emergency Contraception
Contraindications of Use of Emergency Contraception
Current Methods of Emergency Contraception
Yuzpe Regimen
Intrauterine Contraceptive Device
Mifepristone
Levonorgestrel—the Method of Choice
Ulipristal Acetate
Mechanism of Action of Emergency Contraception12
Effectiveness and Probability of Conception
Prescribing the Pill
Important Tips for Prescription
Follow-up
Initiating Regular Contraception after Emergency Contraception
Key Facts for Awareness
Warning and Precautions
Record Keeping for EC Use
Management of Side Effects
How Frequently can One Take it?
Social and Ethical Issues with Emergency Contraception Use
Future of Postcoital Contraceptives
EC: Useful Information
CHAPTER 4:
Current Management of Tubal Pregnancy
Incidence
Risk Factors for Tubal Ectopic Pregnancy
Pathogenesis
Diagnosis of Tubal Ectopic Pregnancy
Use of Transvaginal Ultrasonography and Serial Human Chorionic Gonadotropin Levels
Medical Treatment of Tubal Pregnancy
Predictors of Methotrexate Failure
Side Effects of Methotrexate
Heterophilic Antibodies
Surgical Treatment of Ectopic Pregnancy
Salpingectomy Versus Salpingostomy
Laparoscopic Salpingectomy
Laparoscopic Linear Salpingostomy
Adjunctive Use of MTX
Conclusion
CHAPTER 5:
Optimizing Ovulation Induction
Introduction
Ovarian Cycle and its Physiology
Ovulation Induction
The Choice of Treatment will depend on
Prediction of Ovarian Response/Reserve is based on following Tests
Markers of High Response
Markers of Low Response
Drugs Used for Ovulation Induction
Clomiphene Citrate
Tamoxifen Citrate
Aromatase Inhibitors
Letrozole
Anastrozole
Gonadotropins
Initial dose of GTs depends on
Regimens of Gonadotropin Therapy
Principle
Newer Gonadotropins
Disadvantages of Controlled Ovarian Hyperstimulation
Luteal Phase Support
Luteal Phase Support can be Given with the Following
GnRH Agonist
GnRH Antagonists
Growth Hormone (GH) Augmentation
GnRH for Anovulation Because of Hypothalamic Factor
Adjuncts to Ovulation inducing Drugs
Glucocorticoids
Prolactin Reducing Medications
Insulin Sensitizers
Ovulation Induction in Special Situations
Hypergonadotropic Hypogonadism
Natural Cycle IVF
Natural Cycle IVF with Minimal Stimulation (Fig. 5.20)
Mild Stimulation
Stimulation for In Vitro Maturation (IVM)
Protocols for In Vitro Maturation
Concerns of IVM
COH in Cancer Patients
Monitoring Ovulation Induction Cycles
What to Monitor?
Complications of Ovulation Induction
Premature Luteinization
Luteinized Unruptured Follicle (LUF)
Endogenous LH Surge Results
Poor Response
Ovarian Hyperstimulation Syndrome (OHSS)
Functional Cyst
Persistent Corpus Luteum (CL) or Retention Cyst
Conclusion
Case Studies
Case 1
Case 2
Case 3
Case 4
CHAPTER 6:
Third Party Reproduction
Introduction
Important Definitions
Historical Context
Reproductive Tourism in India
Advantages of Surrogacy in India
Surrogacy and Law
Clinics which should be Registered
Responsibilities of the Clinic
Information and Counseling to be given to Patients
Desirable Practices/Prohibited Scenarios
Requirements for a Sperm Donor
Requirements for an Oocyte Donor
How may Sperm and Oocyte Donors and Surrogate Mothers be Sourced?
Surrogacy: General Considerations
Preservation, Utilization and Destruction of Embryos
Rights of a Child Born through Various ART Technologies
Responsibilities of the Drug Industry
General Considerations
Responsibilities of the Accreditation Authority
Legal Issues
Institutional Ethics Committees
Egg (Ovum) Donation
Indications for use of Donor Oocytes16
Types of Ovum Donors
Preparation of the Donor for Egg Retrieval
Preparation of the Recipient for Embryo Transfer
Success Rates of Egg Donation
Sperm Donation
Indications for use of Donor Sperm16
Procedure
Success Rates
Embryo Donation
Number of Embryos to be Transferred
Types of Surrogacy
Indications for Gestational Surrogacy18
Selection of a Gestational Surrogate
Counseling of Gestational Surrogates and the Intended Parents
What is the Success Rate of Surrogacy in India?
Our Experience with Gestational Surrogacy
What is the Nine Months Journey like with the Gestational Surrogate?
What are the Different Ways Children Born through Surrogacy may Receive Breast Milk?
Surrogacy: A High-Risk Pregnancy
Conclusion
Glossary
CHAPTER 7:
A Clinical Approach to Female Sexual Pain
Introduction
Prevalence
Problem of Classification
Definitions
Vaginismus
Dyspareunia
Vulvar Vestibulitis Syndrome
Neurobiology of the Pelvis
Individual Psychological and Personality Characteristics in Women with Vaginismus
Individual Psychological and Personality Characteristics in Women with Dyspareunia (and/or Vestibulitis)
Mucous Membranes and Sexual Pain Disorders
Chronic Vulvar Dermatosis
Vulvar Vestibulitis Syndrome
Vulvodynias (Syn: Dysesthetic Vulvodynia)
Common Etiologies
Superficial
Deep
Clinical Approach to Sexual Pain
Questions Qualifying the Pain
Educational Gynecological Sexological Examination
Questionnaire Assessment of Patients with Sexual Pain
Female Sexual Function Index
Treatment
Dyspareunia
Vaginismus
CHAPTER 8:
Domestic Violence Against Women–A Universal Challenge
Introduction
Risk Factors
Scope of the Problem
Women's Rights are Human Rights4
Intimate Partners and Sexual Violence
Health Consequences
Social and Economic Costs
Prevention
WHO Response
Violence Against Women in Asia and India
Medical Complications Because of Violence Against Women
Economic Violence
Role of the Law
Role of Physician/Gynecologist
Screening
Conclusion
CHAPTER 9:
Metabolic Disorders after Menopause
Introduction
Menopause and Hyperlipidemia
Menopause and Hypertension
Menopause and Diabetes
Menopause and Endothelial Function
Menopause and Obesity
Menopause and Coronary Heart Disease
Metabolic Disorders and Vasomotor Symptoms
Hot Flushes and Cardiovascular Disease Risk
Menopause and Ethnicity
Conclusion
CHAPTER 10:
Use of Mesh in Urogynecology
Anatomy of the Pelvic Floor and the Functional Relationship to Pelvic Organ Prolapse
Why did Pelvic Floor Surgeons Feel the Need for Mesh?
Surgical Technique
Stepwise Approach to Any Type of Vaginal Repair Surgery
Perigeetm (American Medical Systems, MN)
Anterior Elevate (American Medical Systems, MN)
Upholdtm (Boston Scientific, MA)
Prosimatm(Johnson and Johnson, NJ)
Tips and Pearls
Postoperative Orders and Management
Change in Practice Following the FDA Notifications
Patient Document 1: Use of Mesh in Pelvic Organ Prolapse by the Transvaginal Route
Patient Document 2: Questions that Patients Need to Ask
The Future of Mesh in Urogynecology
CHAPTER 11:
Intrapartum Fetal Monitoring towards Improved Perinatal Outcome
Introduction
Prognosis
Clinical Surveillance
Maternal History
Risk Assessment
Meconium in Liquor
Intermittent Auscultation
Shortfalls with Intermittent Auscultation
Admission Test
Shortfalls with Admission Test
Biophysical Methods of Fetal Surveillance
Continuous Electronic Fetal Monitoring (CEFM)
Shortfalls of Electronic Fetal Monitoring Using Cardiotocography
Fetal ECG for Intrapartum Fetal Monitoring
Shortfalls of Fetal ECG
Fetal Pulse Oximetry
Shortfalls of Fetal Pulse Oximetry
Biochemical Means of Fetal Surveillance
Fetal Blood Sampling
pH and Base Excess
Fetal Blood Lactate Measurements
Shortfalls of Fetal Blood Sampling
Summary
CHAPTER 12:
Gestational Diabetes Mellitus–A Growing Concern
Gestational Diabetes Mellitus Pathogenesis
Etiopathogenesis of Gestational Diabetes Mellitus Possible Explanations
Screening and Diagnosis
World Health Organization Diagnostic Criterion13
American Diabetes Association Criterion-Evolution
ADA Diagnostic Criteria
One-Step Approach
Two-Step Approach
Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study
International Association of Diabetes and Pregnancy Study Groups (IADPSG) Recommendations
Pharmacotherapy
Glibenclamide (Category C in Pregnancy)
Metformin (Category B Medication in Pregnancy)
Insulin
Continuous Glucose Monitoring
Labor and Delivery
Fetal Monitoring
Puerperal and Neonatal Care
Prevention and Assessment of Neonatal Hypoglycemia
Assessment of Other Complications
Breastfeeding
Contraception or Pregnancy Planning
Barrier Methods
The Intrauterine Device
Hormonal Contraceptives
Combination Oral Contraceptives
Progesterone only Oral Contraceptives (POCs)
Implanon is also a Suitable Contraceptive Option for Diabetic Women
Long-term Risks for Baby
Diabetes Prevention
Cardiovascular Disease Risk Factor Assessment
Lifestyle Modification
CHAPTER 13:
Tuberculosis in Pregnancy
Epidemiology in the Female Population1–3
TB infection and TB Disease in Pregnancy
Factors Predisposing to Development of Active TB
Etiology
Pathology
Clinical Features
Clinical Features in the Pregnant Patient
TB and Female Factor Infertility19,20
Clinical Interaction of TB and Pregnancy
Effect on the Fetus24–30
Latent TB Infection in Pregnancy
Diagnosis
Microbiology
Molecular Methods
Treatment of Tuberculosis
General Principles
Chemotherapy
Surgical Treatment
INDEX
TOC
Index
×
Chapter Notes
Save
Clear
