Dewhursts Textbook of Obstetrics and Gynaecolog 9th Edition by Keith Edmonds, Christoph Lees, Tom Bourne 1119211425 9781119211426

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ISBN 10: 1119211425

ISBN 13: 9781119211426

Author: Keith Edmonds, Christoph Lees, Tom Bourne

This classic textbook continues to provide the basic knowledge relevant to the practice of obstetrics and gynaecology. Comprehensive in scope, Dewhurst’s Textbook of Obstetrics & Gynaecology offers contributions from a noted panel of experts and contains an integrated approach that is designed to help deliver the highest possible care to patients. Since the publication of the previous edition, there have been a number of obstetric breakthroughs that are addressed in this new edition.  Written for both students and professionals, Dewhurst’s Textbook of Obstetrics & Gynaecology is a straightforward, authoritative and practice-based guide to women’s reproductive health.

Dewhursts Textbook of Obstetrics and Gynaecolog 9th Table of contents:

Section 1 Obstetrics

Part 1 Basic Science

1 Maternal Physiology

Maternal response to pregnancy

The uterus

The cardiovascular system

The respiratory system

Haematology

The renal system

The cerebral circulation

The gastrointestinal system

Energy requirements

Endocrine systems

Conclusion

References

Further reading

2 The Placenta and Fetal Membranes

Structural characteristics of the human placenta

Macroscopic features of the term placenta

Placental development

Basic structure of villi

Fetal membranes

Ultrasound

References

Further reading

Part 2 Normal Pregnancy

3 Healthy Fetal Growth

Estimation of gestational age

Measurement of the fetus

Comparing the measurement to a standard or reference

International standards of fetal growth and newborn size

References

4 Pre‐conception Counselling

Purpose of pre‐conception counselling

Who needs pre‐conception counselling?

Timing of pre‐conception counselling

Healthcare professionals who should undertake pre‐conception counselling

General pre‐conception advice

Advice regarding medications

Advice related to maternal age

Genetic counselling

Advice regarding access to maternity care

Conditions where pregnancy is not recommended

Specific medical diseases

Previous poor obstetric history

References

5 Antenatal Care

Aims of antenatal care

Screening for maternal complications

Screening for fetal complications

Organization of antenatal care

References

6 First Trimester Antenatal Screening

First‐trimester Down’s syndrome screening

First‐trimester screening of aneuploidies other than Down’s syndrome

Diagnostic tests

Non‐invasive prenatal testing

First‐trimester screening of fetal structural anomalies

First‐trimester screening of late obstetric complications

First‐trimester screening of single gene disorders

Conclusion

References

Part 3 Maternal Medicine

7 Hypertensive Disorders

Pathophysiology

Defining hypertensive disease in pregnancy

Measuring blood pressure and proteinuria in pregnancy and pre‐eclampsia

Risk assessment and risk reduction

Chronic hypertension

Gestational hypertension

Pre‐eclampsia

Postnatal management

References

8 Heart Disease in Pregnancy

Physiological adaptations to pregnancy, labour and delivery

Cardiac investigations in pregnancy

General considerations in pregnant women with heart disease

Specific cardiac conditions

Mechanical heart valves

Coronary artery disease

Hypertrophic cardiomyopathy

Peripartum cardiomyopathy

Arrhythmias

Cardiac arrest

Endocarditis prophylaxis

References

9 Diabetes in Pregnancy

Classification of diabetes in pregnancy

Diagnosing diabetes and gestational diabetes

The significance of maternal type of diabetes

The principles of maternal glycaemic control

Screening for diabetic complications

Screening for non‐diabetic comorbidities

Risks to the fetus of a diabetic pregnancy

Managing diabetes in pregnancy

Birth

Postpartum care

The management of gestational diabetes

Neonatal and longer‐term consequences of a diabetic pregnancy

Conclusion

References

10 Liver and Endocrine Diseases in Pregnancy

LIVER DISEASE IN PREGNANCY

Normal physiological changes in pregnancy

Investigation of liver disease in pregnancy

Approach to the patient with suspected liver disease in pregnancy

Pregnancy‐related liver disease

Liver diseases incidental to pregnancy

Pregnancy following liver transplantation

ENDOCRINE DISORDERS IN PREGNANCY

Thyroid disease

Pituitary disease

Adrenal disease

Parathyroid disease

Conclusion

Acknowledgements

References

11 Renal Disease

Pre‐pregnancy assessment

Normal pregnancy

Chronic kidney disease

Patients on dialysis

Kidney transplant recipients

Summary

References

12 Haematological Problems in Pregnancy

Physiological changes to the blood in pregnancy

Anaemia in pregnancy

Thrombocytopenia in pregnancy

Sickle cell disorders

Thalassaemia

Prevention of haemolytic disease of the fetus and newborn

Fetal/neonatal thrombocytopenia

Haemostatic measures in obstetric haemorrhage

Thrombosis and thromboembolism

Inherited bleeding disorders

Myeloproliferative disorders in pregnancy

Haematological malignancy during pregnancy

References

13 Maternal Infection During Pregnancy

Human immunodeficiency virus

Hepatitis B

Rubella

Syphilis

Toxoplasmosis

Cytomegalovirus

Parvovirus B19

Herpesvirus

Varicella‐zoster virus

Zika virus

References

14 Psychiatric Problems in Pregnancy and Post Partum

Effects of untreated prenatal depression, anxiety and stress

Depression during pregnancy

Postpartum blues

Postpartum depression

Anxiety disorders

Antidepressant medications during pregnancy

Breastfeeding and antidepressants

Benzodiazepines

Non‐pharmacological treatments

Bipolar disorder

Psychotic disorders and postpartum psychosis

Mood stabilizers

Antipsychotics

Breastfeeding and mood stabilizers and antipsychotics

Conclusion

References

15 Autoimmune Rheumatic Diseases and Other Medical Disorders in Pregnancy

Background

Systemic lupus erythematosus

Rheumatoid arthritis and other inflammatory arthritides

Scleroderma and other connective tissue diseases

Ehlers–Danlos syndrome types III and IV

Vasculitides in pregnancy

Respiratory disorders

Neurological conditions

Acute abdominal complications

Malignant disease

Imaging in pregnancy

References

16 Obesity and Pregnancy

Contraception, fertility and conception

Pre‐pregnancy consultation

Maternal complications: gestational diabetes, pre‐eclampsia and pregnancy‐induced hypertension

Fetal complications: ultrasound, anomalies and intrauterine demise

Delivery issues

Postnatal care

Interventions

Summary

References

Part 4 Fetal Medicine

17 Fetal Growth Restriction

Definition

Consequences of growth restriction

Regulation of fetal growth

Assessment and investigation

Monitoring SGA

Timing of delivery

References

18 Third Trimester Fetal Assessment

Predicting preterm birth

Identifying placenta praevia, placenta accreta, vasa praevia and uterine scar

Predicting intrauterine growth restriction and intrapartum fetal hypoxia

Predicting fetal macrosomia, risk of failure to progress and shoulder dystocia in labour

Conclusion

References

19 Fetal Medical Conditions

Fetal thyroid function

Congenital adrenal hyperplasia

Fetal dysrhythmias

Fetal and neonatal alloimmune thrombocytopenia

Fetal anaemia

References

20 Fetal Anomalies

Timing and development of fetal malformations

Selected fetal anomalies in specific organ systems

Fetal tumours

Fetal hydrops [37,38]

Conclusions

References

21 Multiple Pregnancy

Incidence

Perinatal loss

Chorionicity and zygosity

Miscarriage

Prenatal diagnosis

Maternal homeostatic responses

Intrauterine growth restriction

Preterm labour

Complications of monochorionic twinning

Labour and delivery of twins and multiple pregnancies

Higher‐order multiples

Conclusion

References

Part 5 Birth

22 Normal Mechanisms in Labour

Parturition

Mechanics of normal labour at term

Management of uncomplicated labour and delivery

Conclusions

Acknowledgements

References

23 Post‐term Pregnancy

Definitions

Incidence

Aetiology

Epidemiology

Risks associated with post‐term pregnancy

Management

Women’s views of induction for post‐term pregnancy

Post‐term pregnancy and home birth

Clinical guidelines for management of post‐term pregnancy

Practical management of post‐term pregnancy

References

24 Induction and Augmentation of Labour

Definition

Indications for induction of labour

Contraindications to induction of labour

Predicting success of induction of labour

Pharmacological and mechanical methods of induction of labour

Augmentation of labour

Complications of induction of labour

Monitoring and setting during induction of labour

Induction of labour at term (>37 weeks’ gestation): risks and benefits

Summary

References

25 Obstetric Emergencies

General principles for minimizing the risk of an emergency occurring

General principles for minimizing adverse consequences resulting from an emergency

Collapse

Haemorrhage

Obstetric causes of collapse

Emergency obstetric deliveries

Summary

References

26 Malpresentation, Malposition, Cephalopelvic Disproportion and Obstetric Procedures

Malpresentation, malposition and cephalopelvic disproportion

Instrumental vaginal deliveries

Caesarean section

Episiotomy and perineal lacerations

Conclusion

References

27 Fetal Monitoring During Labour

Fetal physiology

Labour

Detecting the fetus with hypoxia

The future

Summary

References

Further reading

28 Preterm Labour

Epidemiology

Neonatal outcomes after preterm birth

Endocrinology and biochemistry of labour

Causes of preterm labour

Prediction of preterm labour

Prevention of preterm labour

Preterm pre‐labour rupture of membranes

Management of symptomatic preterm labour

Management of inevitable preterm delivery

References

29 Stillbirth

Stillbirth rates

Classification of stillbirth

Aetiology

Diagnosis of intrauterine fetal demise and antepartum stillbirth

Management of antepartum stillbirth

Legal considerations following stillbirth

Lactation suppression

Psychological aspects

Follow‐up investigations

Management of a future pregnancy and prevention

References

30 Analgesia, Anaesthesia and Resuscitation

Pain

Non‐regional analgesia for labour

Regional analgesia

Anaesthesia for caesarean section

Cardiopulmonary resuscitation and critical care

Summary

References

Part 6 Postnatal Care

31 Puerperium and Lactation

Physiology of the puerperium

Management of puerperium

Complications of the puerperium

Infant feeding

Physiology of lactation

Management of breastfeeding

Suppression of lactation

References

32 Neonatal Care for Obstetricians

Anticipation and levels of neonatal care

Antenatal communication and care plans

Organization of neonatal services

Birth and postnatal adaptation: neonatal resuscitation

Antenatal and newborn screening

Neonatal outcome

Important clinical conditions in neonatology

Breastfeeding

Acknowledgement

References

Further reading

33 Perinatal Epidemiology and Statistics

Background

Study design

Statistics

Descriptive statistics

How we use statistics

References

Section 2 Gynaecology

Part 7 Basic Science

34 Clinical Anatomy of the Pelvis and Reproductive Tract

Surface anatomy

The anterior abdominal wall

The umbilicus

Epithelium of the genital tract

The peritoneum

Vulva

The clitoris

Bony pelvis

Pelvic floor

Pelvic organs (Fig. 34.11)

Conclusion

Further reading

35 Normal and Abnormal Development of the Genital Tract

Development of the genital organs

Disorders of sexual development

Other anatomical anomalies

XY females

References

Further reading

36 Role of Imaging in Gynaecology

Ultrasound techniques

Imaging in common gynaecological conditions

Conclusion

References

37 Ambulatory Gynaecology, Hysteroscopy and Laparoscopy

Equipment common to hysteroscopy and laparoscopy

Equipment for hysteroscopy

Equipment for laparoscopy

Operating theatre organization

Diagnostic hysteroscopy

Operative hysteroscopy

Diagnostic laparoscopy

Operative laparoscopy

Training in endoscopic surgery

References

Part 8 Childhood and Adolescence

38 Puberty and Its Disorders

Control of the onset of puberty

Physical changes of puberty

Precocious puberty

Delayed puberty

Aetiology of primary amenorrhoea

References

39 Gynaecological Disorders of Childhood and Adolescence

Prepubertal child

Adolescence

Reference

Further reading

Part 9 Early Pregnancy Problems

40 Spontaneous Miscarriage

Definition

Aetiology

Diagnosis

Management

Rhesus status

Psychology and counselling

Conclusion

References

41 Recurrent Miscarriage

Definition

Epidemiology

Other associated factors and their management

Structural genetic factors

Anatomical factors

Prothrombotic factors

Endocrinological factors

Immunological factors

Endometrial factors

Idiopathic recurrent miscarriage

Conclusions

References

42 Gestational Trophoblast Neoplasia

Classification, demographics and risk factors

Premalignant pathology and presentation

Malignant pathology and presentation

Prognostic factors and treatment groups

Personal and psychological issues

Summary

References

Further reading

Websites

43 Ectopic Pregnancy

Risk factors

Types of ectopic pregnancy

Diagnosis

Management

Conclusion

References

44 Induced abortion

The law and abortion

Assessment for abortion

Choice of method

Surgical abortion

Medical abortion

Aftercare

Conclusions

References

45 Acute Pelvic Infection

Epidemiology and risk factors

Microbiology

Clinical presentation

Investigation

Treatment

Prognosis

Special circumstances

Prevention

References

Further reading

Part 10 Menstruation

46 The Menstrual Cycle

Step one: ensuring mono‐ovulation

Step two: ensuring maintenance of very early pregnancy

Menstruation

Conclusion

References

47 Polycystic Ovary Syndrome and Secondary Amenorrhoea

Defining polycystic ovary syndrome and secondary amenorrhoea

Examination and investigation of patients with polycystic ovary syndrome and secondary amenorrhoea

Polycystic ovary syndrome

Secondary amenorrhoea

References

Further reading

48 Heavy Menstrual Bleeding

Definition

Prevalence and impact

Aetiology

Clinical evaluation

Management

Severe acute heavy menstrual bleeding

Acknowledgements

References

49 Premenstrual Syndrome

Definitions

Symptoms and classification of PMS

Diagnosis

Aetiology

Treatment

Conclusion

References

50 Menopause and Postmenopausal Health

Consequences of the menopause

Advances in prediction of menopause

Patient assessment and ongoing monitoring

Premature ovarian insufficiency

Interventions

Future research

Conclusions

References

Further reading

Additional websites

Part 11 Reproductive Problems

51 Subfertility

Importance

Definition: what is infertility?

Aetiology

Principles of management

Prognosis

Funding

References

52 Assisted Reproduction

Investigations prior to assisted conception

Types of assisted conception

Results

Complications of assisted conception

Summary

References

Further reading

Part 12 Pelvic Pain

53 Endometriosis

Epidemiology

Natural history of endometriosis and associated comorbidities

Endometriosis phenotypes at laparoscopy

Classification systems

Symptoms of endometriosis

Diagnosis

General treatment issues

Treatment aims

Treatment for women with symptoms such as pain related to endometriosis

Treatment for women with endometriosis‐related infertility

Ongoing research

References

Further reading

54 Chronic Pelvic Pain

Clinical history

Examination

Investigations

Management

Pelvic congestion syndrome

Hysteroscopic sterilization

Myofascial pain

Conclusions

References

Part 13 Urogynaecology

55 Uterovaginal Prolapse

Incidence and epidemiology

Aetiology

Pelvic anatomy

Clinical presentation

Evaluation

Investigation

Management

The future

References

56 Urinary Incontinence

Clinical presentation of urinary incontinence

Investigations

Causes of urinary incontinence

Urodynamic stress incontinence

Detrusor overactivity

Mixed incontinence

Retention with overflow

Fistulae

Urethral diverticulum

General conservative measures

Oestrogens in the management of incontinence

Other lower urinary tract disorders

Conclusion

References

Part 14 Benign Gynaecological Disease

57 Benign Diseases of the Vulva

History‐taking

Examination

Investigations

Inflammatory diseases of the vulva

Bullous diseases

Vulval ulceration

Manifestations of underlying disease

Disorders of pigmentation

Benign tumours

Vascular lesions

Disorders of lymphatics

References

58 Benign Diseases of the Vagina, Cervix and Ovary

Vagina

Cervix

Ovaries

References

59 Benign Disease of the Uterus

Adenomyosis

Endometrial polyps

Uterine leiomyomata (fibroids)

Conclusions

References

Part 15 Gynaecological Cancer

60 Malignant Disease of the Vulva and the Vagina

Background

Risk factors

Aetiology

Histology

Presentation

Assessment

Surgical management of the primary vulvar lesion

Management of the lymph nodes

Complications of surgical treatment

Radiotherapy and chemotherapy

Recurrent disease

Vaginal cancer

Uncommon vaginal tumours

References

61 Premalignant and Malignant Disease of the Cervix

Premalignant disease of the cervix

Malignant disease of the cervix

References

62 Endometrial Cancer

Aetiology

Clinical presentation

Types of endometrial cancer

Management

Relapsed endometrial cancer

Conclusion

References

63 Surgical and Medical Management of Epithelial Ovarian Cancer

Aetiology, epidemiology and genetics

Subclassification of ovarian cancer

Clinical presentation

CA125: ovarian cancer tumour marker

EOC precursor lesions

Screening and prophylactic oophorectomy

Staging of EOC

Patterns of spread of ovarian cancer

Histopathological diagnosis of EOC

Prognostic factors

Treatment of newly diagnosed ovarian cancer

Advanced ovarian cancer

The BRCA‐positive patient

Recurrent ovarian cancer

Future developments

Summary

References

Part 16 Sexual Health

64 Sexually Transmitted Infections

Epidemiology

Integrated approach to STIs in gynaecology

Diagnostic advances

STI in pregnancy

Chlamydia

Gonorrhoea

Mycoplasma genitalium

Trichomoniasis

Recurrent vulvo‐vaginal infections

Genital herpes

Genital warts

Syphilis

Conclusion

References

Further reading

65 Contraception and Sterilization

Effectiveness

Medical eligibility for contraception

Contraceptive choice

Intrauterine contraception

Progestogen‐only contraception

Combined hormonal contraception

Emergency contraception

Female sterilization

Barrier methods

Fertility awareness methods

Lactational amenorrhoea method

Non‐contraceptive benefits of contraception

Conclusion

References

66 Sexual Dysfunction

Changing attitudes towards sex

Sexual response: models of sexual function

Sexual response: anatomy and physiology

Sexual diversity

Sexual dysfunction

Psychosocial and psychosexual factors contributing to sexual well‐being

Physical factors contributing to sexual well‐being

Overview of psychosocial and psychosexual interventions

Sexual desire disorder

Sexual arousal disorder

Orgasmic disorder

Genitopelvic pain/penetration disorder

Conclusions

References

67 Rape and Sexual Assault and Female Genital Mutilation

The Law

Prevalence

Presentation

Management of a victim who presents acutely

Capacity and consent

History

Examination

Emergency contraception

Post‐exposure prophylaxis following sexual exposure

Safeguarding

Domestic violence

Honour‐based crimes

Statements

Giving evidence in court

Long‐term health consequences of sexual violence

Vicarious trauma

Child sexual exploitation

Female genital mutilation

References

Part 17 Miscellaneous Topics

68 Ethical Dilemmas in Obstetrics and Gynaecology

Abortion

The management of pregnancy and childbirth

Fertility treatment

Conclusion

References

69 The Law and the Obstetrician and Gynaecologist

The rise of autonomy

Abortion

Professional discipline

Postgraduate training

Cerebral palsy

References

70 Evidence‐based Medicine in Obstetrics and Gynaecology

Practical evidence‐based medicine

Conclusion

References

Index

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