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Contents
- Front matter
  - OXFORD MEDICAL PUBLICATIONS • • Oxford Handbook of Obstetrics and Gynaecology
  - Published and forthcoming Oxford Handbooks
  - Oxford Handbook of Obstetrics and Gynaecology
  - titleverso
  - Contents
  - Preface
  - Acknowledgements
  - Abbreviations
  - Contributors
- Chapter 1 Normal pregnancy
  - Obstetric history: current pregnancy
  - Obstetric history: other relevant features
  - Obstetric physical examination
  - Engagement of the fetal head
  - The female pelvis
  - Diameters of the female pelvis
  - Fetal head
  - Diameters and presenting parts of the fetal head
  - Placenta: early development
  - Placenta: later development
  - Placenta: circulation
  - Placenta: endocrine functions
  - Physiology of pregnancy: endocrine
  - Physiology of pregnancy: haemodynamics
  - Physiology of pregnancy: cardio-respiratory
  - Physiology of pregnancy: genital tract and breast
  - Physiology of pregnancy: other changes
  - Preparing for pregnancy
  - Supplements and lifestyle advice
  - General health check
  - Diagnosis of pregnancy
  - Dating of pregnancy
  - Ultrasound assessment of fetal growth
  - Booking visit
  - Antenatal care: planning
  - Antenatal care: routine blood tests
  - Antenatal care: specific blood tests
  - Antenatal care: preparing for delivery
- Chapter 2 Pregnancy complications
  - Minor symptoms of pregnancy: gastrointestinal
  - Minor symptoms of pregnancy: musculoskeletal and vascular
  - Minor symptoms of pregnancy: genitourinary and others
  - Antepartum haemorrhage: overview
  - Antepartum haemorrhage: assessment
  - Antepartum haemorrhage: management
  - Blood pressure in pregnancy: physiology
  - Blood pressure in pregnancy: hypertension
  - Pre-eclampsia: overview
  - Pre-eclampsia: clinical features and investigations
  - Pre-eclampsia: management
  - Severe pre-eclampsia: management
  - Eclampsia and HELLP syndrome
  - Multiple pregnancy: overview
  - Multiple pregnancy: types
  - Multiple pregnancy: antenatal care
  - Twin-to-twin transfusion syndrome (TTTS)
  - Multiple pregnancy: labour
  - Breech presentation: overview
  - External cephalic version (ECV)
  - Breech presentation: delivery
  - Transverse, oblique, and unstable lie
  - Abdominal pain in pregnancy: pregnancy related (<24 weeks)
  - Abdominal pain in pregnancy: pregnancy related (>24 weeks)
  - Abdominal pain in pregnancy: bowel related
  - Abdominal pain in pregnancy: other causes
  - Preterm labour: overview
  - Preterm labour: prediction and prevention
  - Preterm prelabour rupture of membranes (PPROM)
  - Preterm prelabour rupture of membranes (PPROM): management
  - Prolonged pregnancy: overview
  - Prolonged pregnancy: management
- Chapter 3 Fetal medicine
  - Prenatal diagnosis: overview
  - Trisomy 21 (Down's syndrome)
  - Other types of aneuploidy
  - Screening for chromosomal abnormalities
  - Combined and serum integrated tests
  - Integrated and other tests
  - Diagnosis of structural abnormalities
  - Neural tube defects
  - Cardiac defects (congenital heart disease)
  - Urinary tract defects
  - Lung defects
  - Gastrointestinal defects
  - Soft markers on ultrasound scan
  - Diagnostic tests
  - Fetal hydropes: overview
  - Non-immune hydrops: treatment
  - Rhesus isoimmunisation (immune hydrops)
  - Rhesus disease: management
  - Oligohydramnios
  - Polyhydramnios
  - Intrauterine growth restriction (IUGR): overview
  - Intrauterine growth restriction (IUGR): causes
  - Intrauterine growth restriction (IUGR): management and outcome
  - Antenatal fetal surveillance: overview
  - Identifying the high-risk fetus
  - Monitoring the high-risk fetus: Doppler ultrasound
  - Monitoring the high-risk fetus: cardiotocography (CTG)
- Chapter 4 Infectious diseases in pregnancy
  - Rubella (German measles)
  - Cytomegalovirus (CMV)
  - Varicella (chickenpox)
  - Parvovirus B19
  - Toxoplasmosis
  - Herpes simplex
  - Hepatitis B
  - Group B streptococcus (GBS)
  - Other infections
  - HIV and pregnancy
  - HIV: antenatal care
  - HIV: mother-to-child transmission
  - HIV: perinatal and postnatal concerns
  - Vaccination and travel
- Chapter 5 Medical disorders in pregnancy
  - Epilepsy
  - Epilepsy: management in pregnancy
  - Cerebrovascular accident (CVA)
  - Cardiac disease: management in pregnancy
  - Artificial heart valves
  - Acquired heart disease
  - Myocardial infarction and cardiomyopathy
  - Congenital heart disease
  - Anaemia
  - Sickle cell disease
  - Thalassaemia
  - Haemophilia
  - Autoimmune idiopathic thrombocytopenic purpura (ITP)
  - Asthma
  - Cystic fibrosis (CF)
  - Respiratory infections
  - Inflammatory bowel disease (IBD)
  - Obstetric cholestasis
  - Acute fatty liver of pregnancy (AFLP)
  - Renal tract infections
  - Chronic renal disease
  - Pregnancy after renal transplantation
  - Acute renal failure
  - Systemic lupus erythematosus (SLE)
  - Anti-phospholipid antibody syndrome
  - Rheumatoid arthritis
  - Myasthenia gravis
  - Diabetes: established disease in pregnancy
  - Diabetes: antenatal management
  - Diabetes: labour and postpartum care
  - Gestational diabetes
  - Thyrotoxicosis
  - Hypothyroidism
  - Other thyroid diseases
  - Phaeochromocytoma
  - Congenital adrenal hyperplasia (CAH)
  - Addison's, Conn's, and Cushing's syndromes
  - Hyperprolactinaemia
  - Hypopituitarism
  - Obesity in pregnancy: maternal risks
  - Obesity in pregnancy: fetal risks
  - Drugs in pregnancy
- Chapter 6 Labour and delivery
  - Labour: overview
  - Labour: 1st stage
  - Labour: 2nd stage
  - Labour: 3rd stage
  - Induction of labour: indications
  - Cervical ripening
  - Induction of labour: methods
  - Induction of labour: special circumstances
  - Fetal surveillance in labour: overview
  - Fetal surveillance: CTG
  - Fetal surveillance: CTG abnormalities
  - Fetal surveillance: CTG classification
  - Meconium-stained liquor
  - Operative vaginal delivery: overview
  - Operative vaginal delivery: instruments
  - Operative vaginal delivery: criteria
  - Operative vaginal delivery: trial
  - Episiotomy
  - Perineal tears
  - Third- and fourth-degree tears
  - Caesarean section: overview
  - Caesarean section: indications
  - Caesarean section: types
  - Caesarean section: complications
  - Prelabour rupture of membranes (PROM) at term
  - Prelabour rupture of membranes (PROM): management
  - Abnormal lie: transverse and oblique
  - Malpresentations in labour: overview
  - Malpresentations: brow and face
  - Retained placenta and placenta accreta
  - Postpartum haemorrhage (PPH)
  - Home birth: overview
  - Home birth: risks and GP involvement
  - Home birth: the evidence
- Chapter 7 Obstetric anaesthesia
  - Pain relief in labour
  - Epidural analgesia: overview
  - Epidural analgesia: advantages and disadvantages
  - Anaesthetic techniques for Caesarean section: spinal
  - Anaesthetic techniques for Caesarean section: epidural
  - Anaesthetic techniques for Caesarean section: combined spinal epidural (CSE)
  - Anaesthetic techniques for Caesarean section: general anaesthesia
- Chapter 8 Neonatal resuscitation
  - Overview
  - Practical aspects
  - ABC
  - Drugs
  - Recent advances
  - Communication with parents
- Chapter 9 Postnatal care
  - Normal changes in the puerperium
  - Major postnatal problems
  - Puerperal pyrexia: genital causes
  - Puerperal pyrexia: non-genital causes
  - Puerperal pyrexia: management
  - Other postnatal problems
  - Other postnatal care issues
  - Breastfeeding: overview
  - Breastfeeding: benefits
  - Breastfeeding: potential problems
  - Drugs and breastfeeding
  - Viruses and breastfeeding
- Chapter 10 Obstetric emergencies
  - Sudden maternal collapse
  - Cord prolapse
  - Shoulder dystocia: overview
  - Shoulder dystocia: management
  - Fetal distress of second twin
  - Massive obstetric haemorrhage: causes
  - Massive obstetric haemorrhage: pathophysiology
  - Massive obstetric haemorrhage: resuscitation
  - Massive obstetric haemorrhage: medical management
  - Massive obstetric haemorrhage: surgical management
  - Venous thromboembolism: overview
  - Venous thromboembolism: prevention
  - Venous thromboembolism: diagnosis
  - Venous thromboembolism: treatment
  - Amniotic fluid embolism: overview
  - Amniotic fluid embolism: diagnosis and management
  - Uterine inversion
- Chapter 11 Miscellaneous obstetric issues
  - Fibroids in pregnancy
  - Ovarian cysts in pregnancy
  - Malignancy and premalignancy of the genital tract in pregnancy: overview
  - Cervical carcinoma in pregnancy: diagnosis
  - Cervical carcinoma in pregnancy: management and prognosis
  - Ovarian cancer
  - Vulval carcinoma
  - Perinatal mortality: overview
  - Perinatal mortality: key findings
  - Maternal mortality: definition
  - The Confidential Enquiry into Maternal Deaths (CEMACH)
  - CEMACH: direct deaths I
  - CEMACH: direct deaths II
  - CEMACH: indirect causes of death
  - CEMACH: psychiatric illness and domestic abuse
- Chapter 12 Substance abuse and psychiatric disorders
  - Substance abuse in pregnancy
  - Morbidity and mortality in substance abusers
  - Substance misuse in pregnancy: management
  - Alcohol abuse
  - Drugs of abuse: opiates
  - Drugs of abuse: cocaine
  - Drugs of abuse: other stimulants
  - Drugs of abuse: sedatives and cannabis
  - Other drugs of abuse
  - Antenatal psychiatric disorders: overview
  - Antenatal psychiatric disorders: specific disorders
  - Psychiatric medications
  - Postnatal depression
  - Puerperal psychosis
- Chapter 13 Gynaecological anatomy and development
  - Gynaecological history: overview
  - Gynaecological history: other relevant details
  - Gynaecological examination
  - Anatomy: female reproductive organs
  - Anatomy: blood supply and relationship to other structures
  - Anatomy: external genitalia
  - Malformations of the genital tract: overview
  - Malformations of the genital tract: management
  - Disorders of sex development (DSD)
  - Ambiguous genitalia at birth
  - Congenital adrenal hyperplasia (CAH)
  - Androgen insensitivity syndrome (AIS)
  - Disorders of growth and puberty
  - Delayed puberty and 1° amenorrhoea
  - Vaginal discharge: in childhood
  - Vaginal discharge: in adolescence
  - Dermatological conditions in children and adolescents
  - Gynaecological disorders: in adolescence
  - Gynaecological cancers: in childhood
  - Fertility implications of childhood cancer
- Chapter 14 Normal menstruation and its disorders
  - Physiology of the menstrual cycle
  - Menstrual disorders: amenorrhoea
  - Menstrual disorders: oligomenorrhoea
  - Menstrual disorders: dysmenorrhoea
  - Dysfunctional uterine bleeding (DUB): aetiology
  - Dysfunctional uterine bleeding (DUB): diagnosis and investigations
  - Dysfunctional uterine bleeding (DUB): medical management
  - Dysfunctional uterine bleeding (DUB): surgical management
  - Premenstrual syndrome (PMS): overview
  - Premenstrual syndrome (PMS): management
- Chapter 15 Early pregnancy problems
  - Termination of pregnancy (TOP): overview
  - Termination of pregnancy (TOP): methods
  - Termination of pregnancy (TOP): management
  - Bleeding in early pregnancy and miscarriage
  - Miscarriage: management
  - Ectopic pregnancy: diagnosis
  - Ectopic pregnancy: management
  - Pregnancy of unknown location (PUL)
  - Recurrent miscarriage: overview
  - Recurrent miscarriage: management
  - Hyperemesis gravidarum
- Chapter 16 Genital tract infections, and pelvic pain
  - Vaginal discharge
  - Sexually transmitted infections (STIs)
  - Chlamydia
  - Herpes simplex
  - Gonorrhoea
  - Syphilis
  - Trichomonas
  - Human papillomavirus (HPV)
  - Bacterial vaginosis (BV)
  - Candidiasis (thrush)
  - Pelvic inflammatory disease (PID): overview
  - Pelvic inflammatory disease (PID): diagnosis and treatment
  - Acute pelvic pain
  - Chronic pelvic pain (CPP): gynaecological causes
  - Chronic pelvic pain (CPP): non-gynaecological causes
  - Chronic pelvic pain (CPP): diagnosis
  - Chronic pelvic pain (CPP): treatment
- Chapter 17 Subfertility and reproductive medicine
  - Polycystic ovarian syndrome (PCOS): overview
  - Polycystic ovarian syndrome (PCOS): management
  - Hirsutism and virilization: overview
  - Hirsutism and virilization: clinical appearance and investigations
  - Hirsutism: first-line treatment
  - Hirsutism: second-line treatment
  - Endometriosis: overview
  - Endometriosis: diagnosis
  - Endometriosis: treatment
  - Gonadotrophin releasing hormone (GnRH) in health and disease
  - Gonadotrophin releasing hormone (GnRH) agonists and antagonists
  - Female subfertility: overview
  - Female subfertility: diagnosis
  - Female subfertility: management
  - Male subfertility
  - Assisted reproduction: IVF and ICSI
  - Assisted reproduction: other techniques
  - Ovarian hyperstimulation syndrome (OHSS)
  - Sexual dysfunction: overview
  - Sexual dysfunction: classification of disorders
  - Sexual dysfunction: treatment
  - Sexual dysfunction: male disorders
- Chapter 18 Sexual assault
  - Sexual assault: overview
  - Sexual assault: history and examination
  - Sexual assault: management
- Chapter 19 Contraception
  - Combined oral contraceptive pill (COCP): overview
  - Combined oral contraceptive pill (COCP): regimes
  - Progestogen-only pill (POP)
  - Other forms of contraception
  - Emergency contraception (EC)
  - Female sterilization: preoperative considerations
  - Female sterilization: the procedure
- Chapter 20 Menopause
  - Menopause: overview
  - Menopause: short-term consequences
  - Menopause: long-term consequences
  - Menopause: history taking and investigations
  - Premature menopause
  - Hormone replacement therapy(HRT): overview
  - Hormone replacement therapy (HRT): benefits
  - Hormone replacement therapy (HRT): risks
  - Hormone replacement therapy (HRT): uncertainties
- Chapter 21 Urogynaecology
  - Classification of urinary incontinence
  - Urinary symptoms
  - Assessment of the lower urinary tract: history and examination
  - Assessment of the lower urinary tract: investigations
  - Assessment of the lower urinary tract: imaging
  - Assessment of the lower urinary tract: urodynamic investigations
  - Stress urinary incontinence: overview
  - Stress urinary incontinence: conservative management
  - Stress urinary incontinence: surgical management
  - Overactive bladder syndrome (OAB): overview
  - Overactive bladder syndrome (OAB): management
  - Anatomy of the pelvic floor
  - Prolapse: classification
  - Prolapse: clinical assessment
  - Prolapse: conservative management
  - Prolapse: surgical management; anterior and posterior compartments
  - Prolapse: surgical management; uterovaginal and vault
- Chapter 22 Benign and malignant gynaecological conditions
  - Benign neoplasms of the lower genital tract
  - Benign neoplasms of the uterus
  - Benign ovarian tumours: diagnosis
  - Benign ovarian tumours: histology
  - Benign ovarian tumours: management
  - Vulval dermatoses: lichen sclerosus
  - Other vulval dermatoses
  - Idiopathic vulval itch and pain
  - Cancer screening in gynaecology: overview
  - Ovarian and endometrial cancer screening
  - Cervical cancer:pathology and screening
  - Cervical cancer: cytology, colposcopy, and histology
  - Management of cervical intraepithelial neoplasia (CIN)
  - Management of cGIN and HPV
  - Gynaecological cancer: a multidisciplinary approach
  - Cervical cancer: aetiology and presentation
  - Cervical cancer: diagnosis
  - Cervical cancer: treatment
  - Ovarian cancer: aetiology
  - Ovarian cancer:presentation and investigation
  - Ovarian cancer: treatment
  - Ovarian cancer:chemotherapy and follow-up
  - Rare ovarian tumours: germ cell
  - Rare ovarian tumours: other
  - Borderline ovarian tumours
  - Endometrial hyperplasia
  - Endometrial cancer: aetiology and histology
  - Endometrial cancer: presentation and investigation
  - Endometrial cancer: treatment
  - Rare uterine malignancies
  - Vulval intraepithelial neoplasia (VIN)
  - Vulval intraepithelial neoplasia (VIN): management
  - Vulval cancer: aetiology and investigation
  - Vulval cancer: treatment
  - Vaginal cancer
  - Gestational trophoblastic disease (GTD): hydatidiform mole
  - Hydatidiform mole: management
  - Gestational trophoblastic disease: choriocarcinoma
  - Principles of chemotherapy
  - Side effects of chemotherapy: haematological and gastrointestinal
  - Side effects of chemotherapy: other
  - Chemotherapy for gynaecological cancer
  - Radiotherapy: principles
  - Radiotherapy: side effects
  - Radiotherapy: gynaecological cancers
  - Pain and its management
  - Symptoms of advanced gynaecological cancer
  - Principles of palliative care
- Chapter 23 Miscellaneous gynaecology
  - Imaging: pregnancy, postmenopausal bleeding, and menstrual disorders
  - Imaging: pain and subfertility
  - Imaging: masses and urogynaecology
  - Injuries in obstetric and gynaecological practice: overview
  - Ureteric injury
  - Bladder injury
  - Communication and record keeping
  - Medico-legal aspects of obstetrics and gynaecology: overview
  - Consent to treatment
  - Consent: other issues
  - Clinical risk management: identifying and analysing risks
  - Clinical risk management: risk reduction

2nd edition

It's finally here: the brand new edition of this bestselling handbook of obstetrics and gynaecology! The new author team, combining both UK trainees and highly experienced obstetricians and gynaecologists, have put together a wealth of practical advice on diagnosing and managing common problems and emergencies. Key evidence-based guidelines are supported by internet references, providing the most up-to-date clinical information as well as the perfect starting point for preparation for postgraduate exams.

About the Editors

Sally Collins Specialist Registrar in Obstetrics and Gynaecology, The John Radcliffe Hospital, Oxford, UK

Sabaratnam Arulkumeran Professor of Obstetrics and Gynaecology, St George's Hospital Medical School, University of London, UK

Kevin Hayes Senior Lecturer/Honorary Consultant in Obstetrics and Gynaecology, and Medical Education, St George's Hospital and Medical School, University of London, UK

Simon Jackson Consultant Gynaecologist, The John Radcliffe Hospital, Oxford, UK

Lawrence Impey, Consultant in Obstetrics and Fetal Medicine, The John Radcliffe Hospital, Oxford, UK

Disclaimer: Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work.

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