THE CERVIX
THE CERVIX
Editor
SN Tripathy MD FICOG
Ex-Professor and Head Department of Obstetrics and Gynecology Shriram Chandra Bhanj (SCB) Medical College, Cuttack Odisha, India
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The Cervix
First Edition: 2018
9789352702091
Printed at: Sanat Printers
My husband, Prof Satchidananda Tripathy
My Guru and Marg Darshak
- Abha Rani Sinha DGO MS PGDMCH
- Assistant Professor
- Department of Obstetrics and Gynecology
- Patna Medical College Hospital
- Patna, Bihar, India
- Ambuja Chounar MD
- Consultant Obstetrician and Gynecologist
- Ex-Professor in Obstetrics and Gynecology
- Osmania Medical College
- Telangana, India
- Anupma singh MS (Obst & Gyne)
- Institute of Medical Sciences
- Banaras Hindu University
- Varanasi Uttar Pradesh, India
- Ex-Senior Resident
- All India Institute of Medical Sciences
- Senior Resident
- Nalanda Medical College
- Patna, Bihar, India
- Bharati Misra MD FICOG
- Professor, Department of Obstetrics and Gynecology
- MKCG Medical College
- Berhampur, Odisha, India
- GN Dash MD
- Consultant Obstetrics and Gynecology
- Ex-Joint Director
- Department of Health and Family Welfare
- Government of Odisha, Sambalpur, Odisha, India
- Gangadhar Sahoo MD
- Professor, Department of Obstetrics and Gynecology
- Institute of Medical Sciences and Sum Hospital
- Bhubaneswar, Odisha, India
- Garima Gupta MD
- Assistant Professor,
- CMC, Ludhiana, India
- Gayatri Satpathy MD
- Senior Resident (Obst & Gyne)
- Banaras Hindu University (BHU), Varanasi
- Uttar Pradesh, India
- H Pattnaik MD
- Obstetrician and Gynecologist
- Joint Director
- Department of Health and Family Welfare
- Government of Odisha, City Hospital
- Cuttack, Odisha, India
- Formerly Vice President, FOGSI
- Organizing Secretary, AICOG, 2017
- Hema J Shobhane MD FICMCH FICOG
- Associate Professor
- Maharani Laxmi Bai Medical College
- Jhansi, Uttar Pradesh, India
- Indrani Ganguli
- Head of the Department and Chairperson
- Institute of Obstetrics and Gynecology
- Sir Ganga Ram Hospital, New Delhi, India
- Ishita Priyam Singh
- 3rd Year PG, MKCG Medical College
- Berhampur, Odisha, India
- Kusum G Kapoor MS DGO
- Ex -Professor
- Department of Obstetrics and Gynecology
- Pataliputra Medical College
- Dhanbad, Jharkhand, India
- LK Pandey MS FICOG
- Professor
- Department of Obstetrics and Gynecology
- Institute of Medical Sciences
- Banaras Hindu University (BHU)
- Varanasi, Uttar Pradesh, India
- Manju Gita Mishra DGO MS FICS FICOG FIAMS FICMCH
- Formerly Professor and
- Head, Department of Obstetrics and Gynecology
- Patna Medical College, Patna, Bihar, India
- Formerly President
- Indian Society of Perinatology and Reproductive Biology
- Ojaswini Patel
- Associate Professor
- Department of Obstetrics and Gynecology
- VSS Institute of Medical Sciences and Research
- Odisha, India
- P Sujata MD
- Associate Professor
- Department of Obstetrics and Gynecology
- Institute of Medical Sciences and Sum Hospital
- Bhubaneswar, Odisha, India
- Pragya Mishra Choudhary MBBS DFFP (LOND) PhD
- MRCOG (LOND) PLAB (UK)
- Consultant Obstetrician and Gynecologist
- Fetal Medicine, Patna, Bihar, India
- Chair person, FOGSI
- SN Tripatby MD TDD FNCCP FICA
- Ex-Professor and Head
- Department of Pulmonary Medicine
- SCB Medical College
- Cuttack, Odisha, India
- (Mrs) SN Tripatby MD FICOG
- Ex-Professor and Head
- Department of Obstetrics and Gynecology
- SCB Medical College
- Cuttack, Odisha, India
- Sadhana Gupta MS MNAMS FICOG FIMACH FICMU
- Senior Consultant Obstetrician and Gynecologist
- Jeeevan Jyoti Hospital and Medical Research Centre
- Gorakhpur, Uttar Pradesh, India
- Vice President 2016 (FOGSI)
- Member
- ICOG Governing Council (2015-2016)
- Chairperson
- FOGSI Safe Motherhood Committee (2011-2013)
- Sankarsan Gan MD
- Department of Obstetrics and Gynecology
- MKCG Medical College
- Berhampur, Odisha, India
- Saswati Sanyal Choudhury MD FICOG FICMCH
- Associate Professor
- Department of Obstetrics and Gynecology
- Gauhati Medical College
- Guwahati, Assam, India
- Saubhagya Kumar Jena MD
- Additional Professor and Head
- Department of Obstetrics and Gynecology
- AIIMS, Bhubaneswar, Odisha, India
- Sulekha Pandey MS
- Professor
- Institute of Medical Sciences
- Banaras Hindu University
- Varanasi, Uttar Pradesh, India
- Susandhya Devadarsini MD
- Senior Medical Officer
- Department of Health and Family Welfare
- Government of Odisha, Capital Hospital
- Bhubeneswar, Odisha, India
- Triptl Sinha MD FRCOG (London)
- Assistant Professor
- Department of Obstetrics and Gynecology
- Sri Krishna Medical College
- Muzaffarpur, Bihar, India
- Tusar Mahapatra
- 3rd Year PG, Department of Obstetrics and Gynecology
- VSS Institute of Medical Sciences and Research
- Odisha, India
I always wonder about the Cervix, how an organ can function so diametrically oppositely in pregnancy and later in life, becomes the woo of millions of women. Cervix fascinated me from the very beginning of my carrier and still I go on wondering about it. It is the most mystic organ of the body, and I tell it, ‘The Mystic Cervix.’
Whatever and whenever we desired a function from it, it complies. For example, in pregnancy, we want that the organ should remain closed, it remains so, as soon as labour starts we want, it should dilate as quickly as possible and we desire that it should forego its identity, it does so, it completely dilates and merges with the uterus. We want that it should come back to its former form in puerpureim, it comes back to its original state. Gone are the days when only we relied on Bishops score to know the same. On the other hand we expect it should not allow any organisms to pass through it, but allow only the sperm so that it can fertilize the ovum. Strangely it complies to this wish too. What a strange organ !!!. Remodeling of the cervix has gone a sea change due to advancement of molecular biology of the cervix. Similarly our understanding of cancer cervix has made a somersault. For the last so many decades, we are proving that it is an infective condition caused by a sexually transmitted virus, the HPV virus. What baffled me while editing the book is that I was ignorant about so many aspects of cervix. The molecular biology of cervix during pregnancy and labour is progressing in a tremendous rate. We are rewriting cancer cervix. First it was known that it is an infective viral disease, then the preventing vaccines are coming one by one. Now there are so many therapeutic vaccines in several phases of trials to treat the disease along with surgery, radiotherapy and chemotherapy. It is difficult to keep pace with the developments. I have tried my best to incorporate all the advancement in the cervix to a certain point of time. Please bear with me if there is some lacunae somewhere.
This text spans everything from embryology to the emotional trauma women undergo when their cervix is removed at hysterectomy. Essential for gynecologists, oncologists, basic scientists, GPs, nurses, colposcopy practitioners. This is the only definitive major clinical reference book published on the cervix.
I hope and believe that like our previous books, The Uterus, The Fallopian Tubes, Tuberculosis Manual for Obstreticians and Gynaecologists, this book will be liked by all of you, whatever you wanted to know is under one cover. Happy reading !
SN Tripathy
Acknowledgments
‘When you steal from one author, it is plagiarism, if you steal from many it is research.’ Time and time again we have drawn inspiration from the workers of the bygone era, and umpteen times we have utilized the work of various research workers. We are grateful to all of them.
I am very grateful to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), Ms Ritu Sharma (Director-Contents Strategy), Ms Chetna Malhotra (Associate Director-Contents Strategy), Ms Sunita Katla (PA to Group Chairman and Publishing Manager), Mr KK Raman (Production Manager) and the whole team of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for their excellent professionalism, and presentation of the book. I am also thankful to my daughters Susandhya and Susnigdha, son–in-law Abhisek and brother Srikrishna, for their constant help and tolerance, the time I spent, is their time.