Essentials of Obstetrics and Gynaecology, 2e

339 Pages·2012·4.43 MB·English

by  Barry O'Reilly MD MRCOG FRANZCOG

Essentials of
Obstetrics and
Gynaecology
Pocket Essentials
Series Editors
Professor Parveen Kumar
Professor of Medicine and Education, Barts and The London
School of Medicine and Dentistry, Queen Mary University
of London, and Honorary Consultant Physician and
Gastroenterologist, Barts and the London NHS Trust and
Homerton University Hospital NHS Foundation Trust,
London, UK
and
Dr Michael Clark
Honorary Senior Lecturer, Barts and the London, Queen Mary’s
School of Medicine and Dentistry, University of London, UK
For Elsevier
Commissioning Editor: Pauline Graham
Development Editor: Catherine Jackson
Project Manager: Sukanthi Sukumar
Designers: Stewart Larking, Miles Hitchen
Illustration Manager: Bruce Hogarth
Illustrator: EPS Inc.
Essentials of
Obstetrics and
Gynaecology
SECOND EDITION
Barry O’Reilly
MD FRCOG FRANZCOG
Consultant Obstetrician and Gynaecologist, Cork University Maternity
Hospital, Cork, Ireland
Cecilia Bottomley
MA MB BChir MRCOG
Specialist Registrar in Obstetrics and Gynaecology, Guy’s
and St Thomas’ Hospital Trust, London, UK
Janice Rymer
MD MRCOG FRANZCOG ILTM
Senior Lecturer and Honorary Consultant in Obstetrics
and Gynaecology, Guy’s, Kings’ and St Thomas’ Hospital Trust,
London, UK
EDINBURGH LONDON NEW YORK OXFORD
PHILADELPHIA ST LOUIS SYDNEY TORONTO 2012
© 2012, Elsevier Ltd. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by
any means, electronic or mechanical, including photocopying, recording, or any
information storage and retrieval system, without permission in writing from
the publisher. Details on how to seek permission, further information about the
Publisher’s permissions policies and our arrangements with organizations such as
the Copyright Clearance Centre and the Copyright Licensing Agency, can be found
at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under
copyright by the Publisher (other than as may be noted herein).
First edition 2005
Second edition 2012
ISBN 978 0 7020 4361 1
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalogue record for this book is available from the Library of Congress
Notices
Knowledge and best practice in this field are constantly changing. As new research
and experience broaden our understanding, changes in research methods, professional
practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge
in evaluating and using any information, methods, compounds, or experiments
described herein. In using such information or methods they should be mindful of their
own safety and the safety of others, including parties for whom they have a professional
responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to
check the most current information provided (i) on procedures featured or (ii) by the
manufacturer of each product to be administered, to verify the recommended dose or
formula, the method and duration of administration, and contraindications. It is the
responsibility of practitioners, relying on their own experience and knowledge of their
patients, to make diagnoses, to determine dosages and the best treatment for each
individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or
editors assume any liability for any injury and/or damage to persons or property as a
matter of products liability, negligence or otherwise, or from any use or operation of
any methods, products, instructions, or ideas contained in the material herein.
The
Publisher's
policy is to use
paper manufactured
from sustainable forests
Printed in China
Series preface
Medical students and doctors in training are expected to travel to different
hospitals and community health centres as part of their education. Many
books are too large to carry around, but the information they contain is
often vital for the basic understanding of disease processes.
The Pocket Essentials series is designed to provide portable, pocket-
sized companions to larger texts, such as our own Kumar & Clark’s Clinical
Medicine. They are most useful for clinical practice, whether in hospital or
the community, and for exam revision.
All the books in the series have the same helpful features:
l succinct text
l simple line drawings
l emergency and other boxes
l tables that summarize causes and clinical features of disease
l exam questions and answers.
They contain core material for quick revision, easy reference and practical
management. The format makes them easy to read, providing an indis-
pensable ’pocket essential’.
Parveen Kumar and Michael Clark
Series Editors
v
This page intentionally left blank
Preface
This is the second edition of the very successful Essentials of Obstetrics and
Gynaecology.
This book continues to fill the gap for a compact textbook that gives a
concise yet comprehensive account of all topics covered by undergraduate
and postgraduate curricula. It has a strong emphasis on obstetric and
gynaecological management, in particular through the use of management
flow charts and in the emergency and procedures section.
This book has three strengths – it is a pocket book and therefore easy to
carry around with you at all times, it is a part of a well-recognized series,
and it is written by three authors who have been actively practising obstet-
rics and gynaecology at consultant level for many years, and are actively
involved in undergraduate and postgraduate education.
The information is easy to access, easy to read, evidence-based and very
up to date.
The information available on the web and the Cochrane database, as
well as college guidelines, have been the lynchpin of our information but
we have collated it to provide a comprehensive cover of obstetrics and gyn-
aecology, concentrating on the core curriculum.
In addition we have included sample examination questions, which
inevitably assist learning. In this latest edition we have modified the ques-
tion section to the newer exam format of ‘single best answer’ and ‘extended
matching’ questions, which will be invaluable to all those taking examina-
tions in obstetrics and gynaecology.
We would like to thank Mike Clark and Parveen Kumar for their
support in the preparation of this latest in the Pocket Essentials series.
Barry O’Reilly
Janice Rymer
Cecilia Bottomley
vii
This page intentionally left blank
Contents
Section 1 – History-taking and examination in obstetrics and
gynaecology
1 Gynaecology history-taking 3
2 Gynaecological examination 7
3 Obstetric history-taking 11
4 Obstetric examination 13
Section 2 – Gynaecology
5 The menstrual cycle, menstrual disorders, 19
infertility and the menopause
6 Pelvic pain, endometriosis and minimal-access 53
surgery
7 Problems of the female genital tract 69
8 Uterovaginal prolapse and urinary incontinence 87
9 Family planning and sexual health 101
10 Bleeding in early pregnancy 137
Section 3 – Obstetrics
11 Prepregnancy counselling, prenatal diagnosis 153
and antenatal care
12 Physiology of pregnancy and pregnancy problems 169
13 Multiple pregnancy, breech and abnormal presentations 215
14 Labour 223
15 The puerperium 255
16 Neonatal medicine 265
ix