The Johns Hopkins Manual of Gynecology and Obstetrics

 

Description:

Portable and easy to consult, The Johns Hopkins Manual of Gynecology and Obstetrics is a trusted on-the-spot reference for virtually any issue you’ll encounter in obstetrics, high-risk obstetrics, gynecology, reproductive endocrinology, infertility, and gynecologic oncology. The updated 6th Edition has been reorganized for quick reference, and contains thoroughly revised information culled from the collective expertise of residents and attending physicians at The Johns Hopkins University.

 

Table of Contents:

 

Part I: Obstetrics

1 Prepregnancy Counseling and Prenatal Care

PREPREGNANCY CARE AND COUNSELING

Health Optimization and Medical Assessment

Substance Use Assessment

Psychiatric Health

Review of Medications

Infectious Disease Screening

Immunizations

Social Assessment

Family History

Maternal Age

Nutritional Assessment

ROUTINE PRENATAL CARE

Pregnancy Dating

Nutrition, Weight Gain, and Exercise

Immunizations

Genetic Screening

Screening Tests

First Trimester Screening

Second Trimester Screening

Combined Screening

Cell-Free Fetal DNA Screening

Screening for Neural Tube Defects

Ultrasonographic Screening

Diagnostic Testing

2 Normal Labor and Delivery, Operative Delivery, and Malpresentations

STAGES AND PHASES OF LABOR

MECHANISM OF LABOR

MANAGEMENT OF NORMAL LABOR AND DELIVERY

Initial Assessment

History

Physical Exam

Standard Admission Procedures

Management of Labor

Induction of Labor

Oxytocin Administration

Labor Progress Assessment: Historical and Contemporary

Interventions for Abnormal Labor

FETAL HEART RATE EVALUATION

Overall Assessment

Management of Nonreassuring Fetal Heart Rate Patterns

Noninvasive Management

Invasive Management

ASSISTED SPONTANEOUS VAGINAL DELIVERY

OPERATIVE VAGINAL DELIVERY

Forceps Delivery

Vacuum Delivery

OBSTETRIC LACERATIONS

SHOULDER DYSTOCIA

Management

CESAREAN SECTION

VAGINAL BIRTH AFTER CESAREAN SECTION

MALPRESENTATIONS

Breech Presentation

External Cephalic Version

Abnormal Lie

3 Complications of Labor and Delivery

UTERINE DEHISCENCE OR RUPTURE

UMBILICAL CORD PROLAPSE

EMBOLIC DISEASE

Amniotic Fluid Embolism

Venous Thromboembolism

Postpartum Hemorrhage

Uterine Atony

Lacerations and Hematomas

Retained Products of Conception

Placenta Accreta Spectrum Disorders

Coagulopathy

UTERINE INVERSION

CHORIOAMNIONITIS

POSTPARTUM ENDOMYOMETRITIS

SEPTIC PELVIC THROMBOPHLEBITIS

4 Fetal Assessment

BACKGROUND

METHODS OF FETAL ASSESSMENT

Fetal Movement

Fetal Heart Rate Monitoring

Fetal Heart Monitoring With Ultrasonography

Fetal Blood Flow/Velocity and Dopplers

CONFOUNDING FACTORS IN FETAL ASSESSMENT

INDICATIONS FOR FETAL TESTING

5 Prenatal Complications

NAUSEA AND VOMITING OF PREGNANCY

CERVICAL INSUFFICIENCY

AMNIOTIC FLUID DISORDERS

Polyhydramnios

Oligohydramnios

FETAL GROWTH RESTRICTION

POSTTERM AND LATE-TERM PREGNANCY

INTRAUTERINE FETAL DEMISE

6 Preterm Labor and Preterm Prelabor Rupture of Membranes

PRETERM LABOR

Definitions

Incidence and Significance

Risk Factors

Steps to Minimize Risk of Preterm Labor and Delivery

Evaluation

Management

Route of Delivery Varies by Gestational Age

PRETERM PRELABOR RUPTURE OF MEMBRANES

Definitions

Incidence and Significance

Etiology

Evaluation

Management

7 Third-Trimester Bleeding

ABRUPTIO PLACENTAE

Epidemiology

Etiology

Complications

Diagnosis

History and physical examination

Laboratory tests

Management

Term Gestation, Hemodynamically Stable

Preterm and Term Gestations, Hemodynamic Instability

Preterm Gestation, Hemodynamically Stable

PLACENTA PREVIA

Epidemiology

Etiology

Complications

Diagnosis

History and Physical Exam

Laboratory Studies

Management

Term Gestation, Hemodynamically Stable

Preterm and Term Gestation, Hemodynamic Instability

Preterm Gestation, Hemodynamically Stable

LOW-LYING PLACENTA

VASA PREVIA

Epidemiology

Etiology

Complications

History

Diagnosis

Management

8 Perinatal Infections

VIRAL INFECTIONS

Human Immunodeficiency Virus

Cytomegalovirus

Varicella Zoster Virus

Parvovirus B19

Rubella (German Measles)

Influenza

Viral Hepatitis

Hepatitis A

Hepatitis B

Hepatitis C

Herpes Simplex Virus 1 and 2

BACTERIAL INFECTIONS

Group A Streptococcus (Bacteremia)

Group B Streptococcus

Listeria

Lyme disease

Syphilis

PROTOZOAN INFECTIONS

Toxoplasmosis

Malaria

EMERGING INFECTIONS

West Nile

Zika

9 Congenital Anomalies

EPIDEMIOLOGY

ETIOLOGY

SCREENING AND MANAGEMENT

CHROMOSOMAL ABNORMALITIES WITH ASSOCIATED CONGENITAL ANOMALIES

Trisomy 21 (Down Syndrome)

Trisomy 13 and 18

Turner Syndrome

Triploidy

COMMON SPECIFIC CONGENITAL ANOMALIES

10 Multifetal Gestation

DIAGNOSIS

ANTEPARTUM MANAGEMENT

MATERNAL COMPLICATIONS

FETAL COMPLICATIONS

DELIVERY

SPECIAL CONSIDERATIONS

11 Endocrine Disorders of Pregnancy

DIABETES MELLITUS

Pregestational Diabetes Mellitus

Diagnosis

Fetal Complications

Neonatal Complications

Maternal Complications

Management of Pregestational Diabetes in Pregnancy

Fetal Assessment for Pregestational Diabetes

Labor and Delivery in Diabetic Pregnancies

Postpartum Care for Diabetics

Gestational Diabetes

Screening and Diagnosis

Fetal and Neonatal Complications

Maternal Complications

Gestational Diabetes Mellitus Management

Fetal Assessment for Gestational Diabetes Mellitus

Labor and Delivery

Postpartum

THYROID DISORDERS

Thyroid Hormones in Pregnancy

Hyperthyroid Conditions

Hyperthyroid Management

Hypothyroid Conditions

Nodular Thyroid

PARATHYROID DISORDERS

Hyperparathyroidism

Hypoparathyroidism

PITUITARY DISORDERS

Prolactinoma

Acromegaly

Diabetes Insipidus

Other Pituitary Disorders

ADRENAL DISORDERS

Cushing Syndrome

Hyperaldosteronism

Pheochromocytoma

Adrenal Insufficiency

12 Hypertensive Disorders of Pregnancy

DEFINITIONS OF HYPERTENSIVE DISORDERS

CHRONIC HYPERTENSION

GESTATIONAL HYPERTENSION

PREECLAMPSIA

Management of Preeclampsia

Management of Preeclampsia Without Severe Features

Management of Preeclampsia With Severe Features

HELLP SYNDROME

ECLAMPSIA

13 Cardiopulmonary Disorders of Pregnancy

CARDIAC DISORDERS

Hemodynamic Changes During Pregnancy

Cardiac Disease in Pregnancy

Management of Patients With Known Cardiac Disease

Antibiotic Prophylaxis for Endocarditis

Congenital Heart Disease

Heart Transplant Recipients

Specific Cardiac Conditions

Cardiomyopathy

Valvular Disease

Arrhythmias

Ischemic Heart Disease

Cardiovascular Drugs in Pregnancy

RESPIRATORY DISORDERS

Pulmonary Changes During Pregnancy

Specific Respiratory Disorders

Asthma

Influenza

Cystic Fibrosis

Tuberculosis

Acute Respiratory Distress Syndrome

14 Genitourinary Assessment and Renal Disease in Pregnancy

KIDNEY AND URINARY TRACT DISORDERS

Renal Physiology in Pregnancy

Urinary Tract Disorders in Pregnancy

Urinary Tract Infection

Pyelonephritis

Nephrolithiasis

Polycystic Kidney Disease

Glomerular Disease

Acute Kidney Injury

Chronic Kidney Disease

15 Gastrointestinal Disease in Pregnancy

NONHEPATIC GASTROINTESTINAL DISORDERS

Nausea and Vomiting of Pregnancy

Acid Reflux

Peptic Ulcer Disease

Effects of Prior Bariatric Surgery on Pregnancy

Inflammatory Bowel Disease

Pancreatitis

Appendicitis

GALLBLADDER DISORDERS

LIVER DISORDERS

Hepatic Physiology in Pregnancy

Hepatic Disorders Unique to Pregnancy

Cholestasis of Pregnancy

Acute Fatty Liver of Pregnancy

Hepatic Disorders Not Directly Related to Pregnancy

Hepatitis

Cirrhosis

Budd-Chiari Syndrome

16 Autoimmune Disease in Pregnancy

PATHOPHYSIOLOGY

COMMON GENERAL MANAGEMENT CONCERNS

AUTOIMMUNE DISORDERS ENCOUNTERED IN PREGNANCY

Systemic Lupus Erythematosus

Preconception

Antenatal Period

Postpartum

Antiphospholipid Syndrome

Sjögren Syndrome

Addison Disease

Autoimmune Thyroid Disease

Type I Diabetes

Rheumatoid Arthritis

Scleroderma

Preconception

Antenatal

Postpartum

Dermatomyositis and Polymyositis

Mixed Connective Tissue Disease

Crohn Disease and Ulcerative Colitis

Myasthenia Gravis

Multiple Sclerosis

Immune Thrombocytopenic Purpura

Autoimmune Hemolytic Anemia

Autoimmune Neutropenia

Vasculitic Syndromes

Autoimmune Bullous Disease

Autoimmune Hepatitis

17 Neurologic Diseases in Pregnancy

HEADACHE

Imaging/Diagnosis

Common Obstetric Causes of Headache

Primary Headaches

Migraine

Tension Headaches

Cluster Headaches

Secondary Headaches

Cerebral Venous Thrombosis

Pseudotumor Cerebri (Idiopathic Intracranial Hypertension)

CARPAL TUNNEL SYNDROME

CHRONIC NEUROLOGIC DISEASES

Multiple Sclerosis

Preconception

Antepartum

Postpartum

Epilepsy

Preconception

Antepartum

Postpartum

Myasthenia Gravis

Preconception

Antepartum

Postpartum

Spinal Cord Injury

Bell Palsy in Pregnancy

POSTPARTUM COMPRESSION NERVE INJURIES

18 Psychiatric Disorders in the Pregnant and Postpartum Patient

MOOD DISORDERS AND PREGNANCY

Major Depressive Disorder

Postpartum Depressive Disorders

Bipolar Affective Disorders

Postpartum Mania and Psychosis

ANXIETY DISORDERS AND PREGNANCY

Pregnancy-Related Anxiety

Generalized Anxiety Disorder

Panic Disorder

POSTTRAUMATIC STRESS DISORDER AND PREGNANCY

OBSESSIVE-COMPULSIVE DISORDER AND PREGNANCY

PRIMARY PSYCHOTIC DISORDERS AND PREGNANCY/POSTPARTUM

PERIPARTUM TREATMENT OF PSYCHIATRIC ILLNESS

Pharmacotherapy

Strategies for Prepregnancy Planning and Unplanned Pregnancy

Nonpharmacologic Therapies

CARE OF THE DIFFICULT PREGNANT PATIENT

19 Substance Use Disorders in Pregnancy

DEFINITIONS AND GENERAL PRINCIPLES

EPIDEMIOLOGY, PATHOPHYSIOLOGY, AND MATERNAL/FETAL EFFECTS BY DRUG CATEGORY

Alcohol

Benzodiazepines

Club Drugs (Including MDMA [Ecstasy] and LSD [Acid])

Cocaine

Inhalants

Marijuana

Methamphetamines

Opioids

Tobacco

SCREENING AND ROUTINE CARE

MANAGEMENT AND REFERRAL

TREATMENT

LABOR AND DELIVERY PAIN MANAGEMENT

BREASTFEEDING AND POSTPARTUM ISSUES

20 Hematologic Disorders of Pregnancy

MATERNAL HEMATOLOGIC DISORDERS

Anemia

Hemoglobinopathies

Thrombocytopenia

Thromboembolic Disease

von Willebrand Disease

FETAL HEMATOLOGIC DISORDERS

Fetal Anemia and Alloimmunization

Fetal Thrombocytopenia

21 Neoplastic Diseases in Pregnancy

GENERAL TREATMENT CONCEPTS

Imaging

Surgery

Radiotherapy

Chemotherapy

SPECIFIC NEOPLASTIC CARCINOMAS

Cervical Carcinoma

Ovarian Carcinoma

Breast Carcinoma

Other Common Carcinoma in Reproductive-Aged Women

Melanoma

Hematologic

OUTCOMES AND FOLLOW-UP

Neonatal Outcomes

Breastfeeding

Future Pregnancy

22 Skin Conditions in Pregnancy

NORMAL AND COMMON CHANGES IN PREGNANCY

Connective Tissue

Vascular Changes Affecting Skin

Changes in Skin Pigmentation in Pregnancy

SKIN CONDITIONS UNIQUE TO PREGNANCY

SKIN CONDITIONS OUTSIDE OF PREGNANCY AND THE RESPONSE TO PREGNANCY

23 Surgical Disease and Trauma in Pregnancy

PERIOPERATIVE CONSIDERATIONS FOR NONOBSTETRIC SURGERY

Anatomic and Physiologic Changes in Pregnancy

Timing of Surgery

Diagnostic Imaging

Anesthesia and Intraoperative Hemodynamics

Surgical Technique

Fetal Monitoring

SURGICAL DISEASES IN PREGNANCY

Acute Appendicitis

Acute Cholecystitis

Bowel Obstruction

Ovarian Cysts and Torsion

Breast Mass During Pregnancy

Pregnancy After Bariatric Surgery

TRAUMA IN PREGNANCY

Specific Traumatic Injuries

Blunt Trauma

Penetrating Trauma

Thermal Injuries/Burns

Trauma Assessment in Pregnancy

CARDIOPULMONARY RESUSCITATION IN PREGNANCY

24 Postpartum Care and Breastfeeding

ROUTINE POSTPARTUM CARE

Normal Postpartum Physiology

The Perineum

Postpartum Immunizations and Injections

Discharge From the Hospital

The Postpartum Care Continuum: The “Fourth Trimester”

COMMON POSTPARTUM COMPLICATIONS

BREASTFEEDING

Recommendations

Contraindications to Breastfeeding

Breastfeeding and Maternal Medications

Breastfeeding and Contraception

Lactational Mastitis

Decreased Milk Supply

Weaning

25 Obstetric Anesthesia

PAIN PATHWAYS

OVERVIEW OF OBSTETRIC ANALGESIA/ANESTHESIA

TYPES OF OBSTETRIC ANALGESIA/ANESTHESIA

Local Injection (Field Block)

Peripheral Nerve Block (Pudendal, Paracervical)

Regional Anesthesia (Epidural, Spinal)

Systemic Analgesia

General Anesthesia

Anesthesia Consultation

Part II: General Gynecology

26 Primary and Preventive Care

ANNUAL WELL WOMAN VISIT

CANCER

Screening for Breast Cancer

Screening for Lung Cancer

Screening for Colorectal Cancer

Screening for Endometrial Cancer

Screening for Skin Cancer

Screening for Ovarian Cancer

Screening for Cervical Cancer

HEART AND VASCULAR CONDITIONS

Screening for Coronary Heart Disease

Screening for Dyslipidemia

Screening for Hypertension

METABOLIC, ENDOCRINE, AND NUTRITIONAL CONDITIONS

Screening for Diabetes

Screening for Thyroid Disorders

Screening for Osteoporosis

Screening for Obesity

Counseling on Nutrition

INFECTIOUS DISEASES

Screening for Human Immunodeficiency Virus

Screening for Chlamydia and Gonorrhea

SCREENING FOR OTHER MEDICAL CONDITIONS

Screening for Depression

Screening for Intimate Partner Violence

Screening and Counseling for Substance Abuse

Alcohol Abuse

Tobacco Use

COUNSELING

CARE FOR LESBIANS, BISEXUAL, AND TRANSGENDER WOMEN

IMMUNIZATIONS

OTHER PRIMARY CARE PROBLEMS

27 Infections of the Genital Tract

SCREENING

INFECTIONS OF THE LOWER FEMALE GENITAL TRACT

Vulvar Infections

Human Papillomavirus

Molluscum Contagiosum

Parasites

Pediculosis Pubis

Scabies

Genital Ulcers

Genital Herpes

Syphilis

Acute Genital Ulceration (Lipschütz Ulcers)

Other Ulcerative Lesions

Vaginitis

Bacterial Vaginosis

Trichomoniasis

Vulvovaginal Candidiasis

Cervicitis

Chlamydia

Gonorrhea

Mycoplasma genitalium

INFECTIONS OF THE UPPER GENITAL TRACT

Pelvic Inflammatory Disease

Tubo-ovarian Abscess

Endometritis (Nonpuerperal)

28 Contraception and Sterilization

TIERS OF EFFECTIVENESS

HIGHLY EFFECTIVE CONTRACEPTIVE METHODS

Sterilization (Permanent Contraception)

Female Sterilization

Male Sterilization

Long-Acting Reversible Contraception

Intrauterine Contraception

Implantable Contraception

SHORT-ACTING HORMONAL CONTRACEPTIVE METHODS

Progestin-only Methods

Injectable Contraception

Progestin-Only Pills

Combined Hormonal Contraceptives

Combined Oral Contraceptive Pills

Transdermal Patch

Intravaginal Ring

BARRIER METHODS

Condoms

Male (“Outside”) Condom

Female (“Inside”) Condom

Diaphragm

FERTILITY AWARENESS–BASED METHODS

EMERGENCY (POSTCOITAL) CONTRACEPTION

Levonorgestrel Emergency Contraceptive Pills

Ulipristal Acetate Emergency Contraceptive Pills

Copper Intrauterine Device

29 Abortion

PREGNANCY TERMINATION

Epidemiology and Safety

Evaluation and Counseling

SURGICAL ABORTION

Surgical Abortion in the First Trimester

Surgical Abortion in the Second Trimester

MEDICATION ABORTION

Medication Abortion in the First Trimester

Medication Abortion in the Second Trimester (Labor Induction)

Follow-up

COMPLICATIONS

Complications of Surgical Abortion

Complications of Medication Abortion

30 First and Second Trimester Pregnancy Loss and Ectopic Pregnancy

ASSESSMENT OF PREGNANCY LOCATION AND VIABILITY IN THE FIRST TRIMESTER

EARLY PREGNANCY LOSS IN THE FIRST TRIMESTER

SECOND-TRIMESTER PREGNANCY LOSS

ECTOPIC PREGNANCY

31 Abnormal Uterine Bleeding

MENSTRUAL DIMENSIONS

DIFFERENTIAL DIAGNOSIS OF ABNORMAL UTERINE BLEEDING

Premenarchal Bleeding

Reproductive-Aged Abnormal Bleeding

Postmenopausal Bleeding

EVALUATION OF ABNORMAL UTERINE BLEEDING

History

Physical Examination

Laboratory Testing

IMAGING TECHNIQUES AND TISSUE SAMPLING METHODS

Ultrasonography

Computed Tomography

Magnetic Resonance Imaging

Hysteroscopy

Endometrial Sampling

Dilation and Curettage

SPECIFIC CAUSES OF ABNORMAL UTERINE BLEEDING

Pregnancy-Associated Bleeding

Abnormal Uterine Bleeding in Nonpregnant Women

Structural Causes of Abnormal Uterine Bleeding

Polyp (AUB-P)

Adenomyosis (AUB-A)

Leiomyoma (AUB-L)

Malignancy and Hyperplasia (AUB-M)

Nonstructural Causes of Abnormal Uterine Bleeding

Coagulopathy (AUB-C)

Ovulatory Dysfunction (AUB-O)

Endometrial (AUB-E)

Iatrogenic (AUB-I)

Not Yet Classified (AUB-N)

MANAGEMENT OF ABNORMAL UTERINE BLEEDING

Medical Therapy

Surgical Treatment

32 Chronic Pelvic Pain

TYPES OF PELVIC PAIN

EVALUATION OF CHRONIC PELVIC PAIN

Imaging and Laboratory Testing

Laparoscopy and Consults

DIFFERENTIAL DIAGNOSIS OF PELVIC PAIN

MANAGEMENT OF CHRONIC PELVIC PAIN

Medical Therapy

Surgical Treatment

Other Treatment Options

33 Uterine Leiomyomas and Benign Adnexal Masses

ADNEXAL MASSES

Evaluation and Diagnosis

Paratubal/Paraovarian Cysts

Ovarian Masses

Functional Ovarian Cysts

Endometriomas

Ovarian Teratomas

Infectious Etiologies

The Unstable Patient

The Pediatric and Adolescent Population

Pregnancy

UTERINE MASSES

Leiomyoma

Etiology and Pathophysiology

Classification and Types of Fibroids

Clinical Manifestations and Diagnosis

Treatment for Leiomyomas

Observation

Medical Therapy

Surgical Therapy

Myomectomy

Hysterectomy

Uterine Artery Embolization

Magnetic Resonance Imaging–Guided Focused Ultrasound Surgery

Radiofrequency Ablation

Congenital Anomalies

34 Breast Diseases

ANATOMY

BREAST EXAM

COMMON BREAST DISORDERS AND COMPLAINTS

Mastalgia

Nipple Discharge

Breast Infections

Breast Mass

BREAST CANCER

Risk Factors

Screening and Diagnosis

Mammography

Abnormal Mammogram

Alternate Screening Modalities

Premalignant Breast Lesions

Malignant Breast Lesions

Staging and Prognostic Factors

Treatment

Surgical or Local Treatment

Systemic Therapy

Metastatic or Advanced Disease

Prevention

Pregnancy and Breast Cancer

35 Benign Vulvar Disorders

ANATOMY OF THE VULVA

INFECTIOUS DISEASES OF THE VULVA

Sexually Transmitted Infections

Bacterial Skin Infections of the Vulva

DERMATOSES AND INFLAMMATORY CONDITIONS

Behçet Syndrome

Fox-Fordyce Disease

Hidradenitis Suppurativa

Atrophic Vulvovaginitis

Contact Dermatitis

Psoriasis

Lichen Simplex Chronicus

Lichen Planus

Lichen Sclerosus

VULVAR PAIN SYNDROMES

Vulvodynia

Vulvar Vestibulitis Syndrome

Levator Ani Syndrome

Vulvar Neuropathy

BENIGN VULVAR LESIONS

Urethral Caruncle

Acrochordon

Seborrheic Keratoses

Lipoma

BENIGN VULVAR CYSTS

Bartholin Gland Cyst

Epidermal Inclusion Cysts

Mucus Cysts

Gartner Duct Cysts

Skene Duct Cysts

36 Female Sexual Function and Dysfunction

EPIDEMIOLOGY

PHYSIOLOGY OF SEXUAL FUNCTION

THEORIES OF SEXUAL FUNCTION

DIAGNOSIS OF SEXUAL DISORDERS

Screening

Physical Exam

SEXUAL DYSFUNCTION DISORDERS

Desire

Arousal

Treatments for Both Desire and Arousal Disorders in Women

Orgasmic

Pain

Genitopelvic Pain/Penetration Disorder

Vaginismus and Vulvodynia

Assessment and Exam for Vaginismus and Vulvodynia

Treatment for Vaginismus and Vulvodynia

SEXUAL FUNCTION AND SPECIAL POPULATIONS

37 Intimate Partner and Sexual Violence

INTIMATE PARTNER VIOLENCE

Definitions

Background and Statistics

Routine Intimate Partner Violence Screening

Suspecting Intimate Partner Violence

Assessment of Risk

Interventions

Special Populations

Pregnancy

Elder Abuse

Child Abuse

Abuse of Disabled Women

Women With Undocumented Immigrant Status

Sex Workers

SEXUAL VIOLENCE

Definitions

Background

Evaluation and Management

Resources

Patient History

Physical Examination

Diagnostic Testing

Treatment

Psychosocial Sequelae

Special Populations

Children

Adolescents

Human Trafficking

Female Genital Mutilation

38 Pediatric Gynecology

GYNECOLOGIC EVALUATION OF A PREPUBERTAL CHILD

General Pediatric Physical Exam

Pediatric Pelvic Exam: Positioning

Pediatric Pelvic Exam: Assessment

Pediatric Exam: Documentation

GYNECOLOGIC EVALUATION OF AN ADOLESCENT

Special Considerations in Care of the Adolescent

Adolescent Gynecologic Exam

COMMON PEDIATRIC GYNECOLOGY COMPLAINTS

Vulvovaginitis

History: Key Points

Physical Examination

Etiologies of Vulvovaginitis

Prepubertal Vaginal Bleeding

Vulvovaginitis

Urethral Prolapse

Genital Tumors

Endometrial Shedding

Trauma and Sexual Abuse

Traumatic Injuries

Sexual Abuse

Labial Adhesions

Adnexal Masses/Ovarian Torsion

Surgical Considerations for Laparoscopy in Children

DISORDERS OF PUBERTY

Delayed Puberty

Hypergonadotropic Hypogonadism (High Follicle-Stimulating Hormone)

Hypogonadotropic Hypogonadism (Low Follicle-Stimulating Hormone)

Eugonadism (Normal Follicle-Stimulating Hormone)

Key Points in Evaluation and Management of Delayed Puberty

Precocious Puberty

Gonadotropin-Dependent Disorders—Central Precocious Puberty

Gonadotropin-Independent Disorders—Pseudoprecocious Puberty

Key Points in Evaluation and Management of Precocious Puberty

Premature Thelarche

AMBIGUOUS GENITALIA

Male Feminization

Female Virilization

CONGENITAL ANOMALIES OF THE FEMALE REPRODUCTIVE TRACT

Part III: Reproductive Endocrinology and Infertility

39 The Menstrual Cycle

MENSTRUAL CYCLE OVERVIEW

PHASES OF THE MENSTRUAL CYCLE

The Early Follicular Phase

The Midfollicular Phase

The Late-Follicular Phase

The Luteal Phase

40 Infertility and Assisted Reproductive Technologies

INFERTILITY

Definitions

Incidence

DIFFERENTIAL DIAGNOSIS

Ovarian Factor

Uterine Factor

Tubal Factor

Cervical Factor

Male Factor

Recurrent Implantation Failure

EVALUATION

Indications for Evaluation

History and Physical Examination

Evaluation for Ovarian Factor

Evaluation for Structural Factor

Evaluation for Male Factor

TREATMENT FOR INFERTILITY

Treatment of Ovulatory Disorders

Treatment of Endometriosis

Treatment of Uterine Factor

Treatment of Tubal Factor

Treatment of Recurrent Implantation Failure

Treatment of Male Factors

TREATMENTS BEYOND OVULATION INDUCTION WITH TIMED INTERCOURSE

Intrauterine Insemination

Assisted Reproductive Technologies

Preimplantation Genetic Testing

CONTROLLED OVARIAN HYPERSTIMULATION AND PROTOCOLS FOR IN VITRO FERTILIZATION

OOCYTE RETRIEVAL, CULTURE, FERTILIZATION, AND TRANSFER

THIRD-PARTY REPRODUCTION

COMPLICATIONS OF ASSISTED REPRODUCTIVE TECHNOLOGIES

Ovarian Hyperstimulation Syndrome

Multiple Pregnancy

Heterotopic Pregnancy

Fetal/Neonatal Effects

Effects of Intracytoplasmic Sperm Injection

FERTILITY PRESERVATION

Embryo Cryopreservation

Oocyte Cryopreservation

Ovarian Tissue Cryopreservation

Gonadotropin-Releasing Hormone Agonists Treatment Prior to Chemotherapy

Ovarian Transposition

41 Recurrent Pregnancy Loss

EPIDEMIOLOGY AND DEFINITION

ETIOLOGIES

Genetic

Uterine Pathology

Endocrine/Metabolic Dysfunction

Antiphospholipid Syndrome

Hereditary Thrombophilias

Immune Dysfunction

Male Factors

Infection and Environmental Exposures

Psychological Factors

EVALUATION

TREATMENT PRINCIPLES

42 Menstrual Disorders: Endometriosis, Dysmenorrhea, and Premenstrual Dysphoric Disorder

ENDOMETRIOSIS

Theories of the Pathogenesis of Endometriosis

Patient Characteristics

Clinical Presentation

Abnormal Clinical Findings Associated With Endometriosis

Diagnosis of Endometriosis

Treatment

Surgical Treatment

Endometriosis and Infertility

Endometriosis and Ovarian Malignancy

DYSMENORRHEA

Pertinent Findings in History and Physical Exam

Treatment of Dysmenorrhea

PREMENSTRUAL DISORDER: PREMENSTRUAL DYSPHORIA AND PREMENSTRUAL DYSPHORIC DISORDER

Evaluation and Diagnosis

Treatment

43 Evaluation of Amenorrhea

DEFINITION

EVALUATION OF AMENORRHEA

When to Evaluate for Amenorrhea

Pertinent History for Amenorrhea

Physical Examination for Amenorrhea

Laboratory Evaluation of Amenorrhea

Imaging Evaluation of Amenorrhea

Further Evaluation and Other Considerations

Progesterone Withdrawal for Evaluation of Amenorrhea

Differential Diagnosis for Primary Amenorrhea

Differential Diagnosis for Secondary Amenorrhea

ETIOLOGIES OF AMENORRHEA—SYSTEMATIC EVALUATION

Genital Outflow Tract and Uterine Abnormalities Resulting in Amenorrhea

Ovarian Abnormalities Resulting in Amenorrhea (Hypergonadotropic Hypogonadism)

Hypothalamic Dysfunction Resulting in Amenorrhea (Hypogonadotropic Hypogonadism)

Pituitary Disorders Resulting in Amenorrhea

Normogonadotropic Amenorrhea

44 Polycystic Ovary Syndrome and Hyperandrogenism

DEFINITION AND ANDROGEN PHYSIOLOGY

SIGNS AND SYMPTOMS OF HYPERANDROGENISM

Normal Hair Growth and Physiology

Hirsutism

Hypertrichosis

Hair Loss

Virilization and Clitoromegaly

Skin Changes

Voice Changes

ANDROGENS IN THE FEMALE

Testosterone

Androstenedione

Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate

Dihydrotestosterone

Sex Hormone–Binding Globulins

CAUSES OF HYPERANDROGENISM

DIAGNOSIS OF HYPERANDROGENISM

History and Physical Examination

Laboratory Evaluation

POLYCYSTIC OVARY SYNDROME

Diagnosis of Polycystic Ovary Syndrome

Pathophysiology of Polycystic Ovary Syndrome

Consequences of PCOS

Treatment for Hyperandrogenism/Polycystic Ovary Syndrome

Fertility Treatment for Polycystic Ovary Syndrome

NONCLASSICAL (LATE-ONSET) CONGENITAL ADRENAL HYPERPLASIA

Epidemiology

Signs and Symptoms

Diagnosis

Treatment

ANDROGEN-PRODUCING OVARIAN OR ADRENAL TUMORS

CUSHING SYNDROME

Signs and Symptoms

Diagnosis

Treatment

IDIOPATHIC AND DRUG-INDUCED HIRSUTISM

45 Definitions and Epidemiology of Menopause

PHYSIOLOGY OF MENOPAUSE

Natural Menopause

Primary Ovarian Insufficiency

Medical Menopause

Surgical Menopause

SYMPTOMS

Menstrual Cycle Disturbances

Vasomotor Menopause Symptoms

Genitourinary Syndrome of Menopause

Cognitive Changes

Depression and Anxiety

SPECIAL CONCERNS FOR MENOPAUSAL WOMEN

Bone Health

Cardiovascular Health

HORMONAL REPLACEMENT THERAPY STUDY SUMMARIES

Nurses’ Health Study Observational Study

Women’s Health Initiative Prospective Randomized Controlled Trial

Heart and Estrogen/Progestin Replacement Study Prospective Randomized Controlled Trial

Kronos Early Estrogen Prevention Study

Postmenopausal Estrogen/Progestin Interventions Trial Prospective Randomized Controlled Trial

Women’s Health Initiative Memory Study

Part IV: Female Pelvic Medicine and Reconstructive Surgery

46 Urinary Incontinence and Lower Urinary Tract Symptoms

IMPACT ON HEALTH

ETIOLOGY AND RISK FACTORS

TYPES OF URINARY INCONTINENCE AND LOWER URINARY TRACT SYMPTOMS

PATIENT EVALUATION

History

Physical Exam

Diagnostic Tests

TREATMENT

Conservative Treatment of Lower Urinary Tract Symptoms/Urinary Incontinence

Nonsurgical Treatment of Stress Urinary Incontinence

Surgical Treatment of Stress Urinary Incontinence

Conservative Treatment of Overactive Bladder

Medical Management of Overactive Bladder

Surgical Management of Overactive Bladder

Treatment of Mixed Urinary Incontinence

URINARY RETENTION

Etiology

Treatment for Urinary Retention

47 Pelvic Organ Prolapse

EPIDEMIOLOGY

RISK FACTORS

PELVIC ORGAN PROLAPSE SIGNS AND SYMPTOMS

RECOMMENDED EVALUATION FOR PATIENT WITH SUSPECTED PROLAPSE

TREATMENT OF PELVIC ORGAN PROLAPSE

Surgical Procedures for Pelvic Organ Prolapse

Reconstructive Surgery

Obliterative Procedures

Augmented Surgery

Use of Mesh in Vaginal Prolapse Surgery

48 Anal Incontinence

ETIOLOGY

PATIENT EVALUATION

TREATMENT

Conservative Treatments

Procedural Treatments

Surgical Treatments

Part V: Gynecologic Oncology

49 Cervical Intraepithelial Neoplasia

EPIDEMIOLOGY OF CERVICAL NEOPLASIA

PRIMARY PREVENTION

Vaccination

Other Primary Prevention

SCREENING GUIDELINES

Special Populations

SCREENING METHODS

Pap Smear Cytology

Human Papillomavirus Testing

DIAGNOSTIC CATEGORIES: CYTOLOGY

Atypical Squamous Cells

Atypical Glandular Cells

Low-Grade Squamous Intraepithelial Lesions

High-Grade Squamous Intraepithelial Lesions

MANAGEMENT STRATEGIES: CYTOLOGIC ABNORMALITIES

Atypical Squamous Cells of Undetermined Significance

Special Populations

Atypical Squamous Cells Cannot Exclude High-Grade

Atypical Glandular Cells

Special Populations

Low-Grade Squamous Intraepithelial Lesion

Special Populations

High-Grade Squamous Intraepithelial Lesion

Special Populations

MANAGEMENT STRATEGIES: hrHPV POSITIVE ON PRIMARY SCREENING

DIAGNOSTIC CATEGORIES VIA COLPOSCOPY: HISTOLOGY

Cervical Intraepithelial Neoplasia 1

Cervical Intraepithelial Neoplasia 2/3

Adenocarcinoma In Situ

MANAGEMENT STRATEGIES: HISTOLOGIC ABNORMALITIES

Treatment Modalities

Ablative Methods

Excisional Methods

Management of Cervical Intraepithelial Neoplasia 1

Special Populations

Management of Cervical Intraepithelial Neoplasia 2/3

Special Populations

Management of Adenocarcinoma In Situ

Special Populations

50 Cervical Cancer

EPIDEMIOLOGY OF CERVICAL CANCER

SCREENING, PRESENTATION, AND DIAGNOSIS

Clinical Presentation

Diagnosis of Cervical Cancer

DISEASE PROGRESSION, STAGING, AND PROGNOSIS

Routes of Cervical Cancer Spread

Staging of Cervical Cancer

Prognostic Factors for Cervical Cancer

Histologic Subtype

Histologic Grade

Other Prognostic Factors

MANAGEMENT OF CERVICAL CANCER

Surgical Management

Fertility-Preserving Surgical Options

Primary Chemoradiation Therapy

Chemotherapy

Immunotherapy

Combined Modalities

Management by Stage of Disease

Treatment-Related Complications

Posttreatment Surveillance and Recurrence

Special Management Issues

Cervical Cancer in Pregnancy

Cervical Cancer in Human Immunodeficiency Virus–Infected Women

Cervical Hemorrhage

Obstructive Uropathy

Venous Thromboembolism

CERVICAL CANCER AND GLOBAL HEALTH

51 Cancer of the Uterine Corpus

EPIDEMIOLOGY OF UTERINE CANCER

RISK FACTORS FOR UTERINE CANCER

SCREENING

PRESENTATION, EVALUATION, AND DIAGNOSIS

Clinical Presentation

Evaluation

STAGING AND PROGNOSIS

Pretreatment Evaluation

Staging of Uterine Cancer

Surgical Staging Procedures

Cytoreduction

Histopathologic Factors for Uterine Cancer

PROGNOSTIC FACTORS

MANAGEMENT OF UTERINE CANCER

Management of High-Risk Uterine Cancer

Radiation Therapy

Cytoreductive Surgery

Chemotherapy and Immunotherapy

Special Considerations

Clear Cell and Uterine Serous Carcinoma

Carcinosarcoma

Fertility Preservation

Incomplete Surgical Staging

Medical Contraindications to Surgery

POSTTREATMENT SURVEILLANCE

UTERINE SARCOMA

Leiomyosarcoma

Endometrial Stromal Sarcoma

Prognosis for Uterine Sarcoma

52 Ovarian Cancer

EPIDEMIOLOGY OF OVARIAN CANCER

EPITHELIAL OVARIAN TUMORS

Risk Factors

Screening and Prevention

Presentation and Diagnosis

Staging and Prognosis

Prognostic Factors

Management of Epithelial Ovarian Cancer

Tumors of Low Malignant Potential

Early Invasive Disease (Stage I or II)

Advanced Invasive Disease

Posttreatment Surveillance

Complications of Advanced Ovarian Cancer

Survival

Peritoneal Carcinoma

GERM CELL OVARIAN TUMORS

Epidemiology

Pathology

Diagnosis

Germ Cell Tumor Types

Management of Germ Cell Tumors

SEX CORD–STROMAL OVARIAN TUMORS

Granulosa Cell Tumor

Sertoli-Leydig Cell Tumor

SPECIAL CONSIDERATIONS IN OVARIAN CANCER

53 Hereditary Cancer Syndromes

IDENTIFICATION OF HIGH-RISK WOMEN AND REFERRAL STRATEGIES

SPECIFIC HEREDITARY GYNECOLOGIC CANCER SYNDROMES

Hereditary Breast and Ovarian Cancer

BRCA1 and BRCA2

Other Ovarian Cancer–Associated Gene Mutations

Lynch Syndrome

Cowden Syndrome

Peutz-Jeghers Syndrome

Li-Fraumeni Syndrome

Newly Defined Nonsyndrome Mutations

TARGETED THERAPY FOR MUTATION CARRIERS

54 Premalignant and Malignant Disease of the Vulva and Vagina

PREMALIGNANT NEOPLASTIC DISEASES OF THE VULVA AND VAGINA

Vulvar Intraepithelial Neoplasia

Vaginal Intraepithelial Neoplasia

Treatment of Vulvar Intraepithelial Neoplasia and Vaginal Intraepithelial Neoplasia

MALIGNANT NEOPLASTIC DISEASES OF THE VULVA

Vulvar Squamous Cell Carcinoma

Verrucous Carcinoma

Basal Cell Carcinoma

Melanoma

Paget Disease of the Vulva

Bartholin Gland Carcinoma

Vulvar Sarcoma

MALIGNANT NEOPLASTIC DISEASES OF THE VAGINA

Squamous Cell Vaginal Cancer

Adenocarcinoma of the Vagina

Melanoma

Sarcoma

Embryonal Rhabdomyosarcoma (Sarcoma Botryoides)

55 Gestational Trophoblastic Disease

TYPES OF TROPHOBLASTIC CELLS

CLASSIFICATION OF GESTATIONAL TROPHOBLASTIC DISEASE: ETIOLOGY, PATHOLOGY, AND CLINICAL PRESENTATION

Nonneoplastic Trophoblastic Lesions: Exaggerated Placental Sites and Placental Site Nodules

Exaggerated Placental Sites

Placental Site Nodules

Molar Pregnancy: Complete and Incomplete Mole

Complete Mole

Incomplete Mole

Gestational Trophoblastic Neoplasia: Invasive Mole, Choriocarcinoma, and Placenta Site and Epithelioid Trophoblastic Tumor

Invasive Mole

Choriocarcinoma

Placental Site and Epithelioid Trophoblastic Tumor

DIAGNOSIS AND MANAGEMENT

Nonneoplastic Trophoblastic Lesions

Molar Pregnancy

Risk Factors

Imaging and Lab Evaluation

Pathologic Diagnosis

Management

Considerations for Future Pregnancies

Persistent Gestational Trophoblastic Disease/Gestational Trophoblastic Neoplasia

Risk Factors

Imaging and Lab Evaluation

Diagnostic Criteria

Staging and Management of Gestational Trophoblastic Neoplasia

Management of Nonmetastatic Disease and Low-Risk Metastatic Disease

Management of High-Risk or Metastatic Disease

Considerations for Future Pregnancies

Management of Intermediate Trophoblastic Tumors: Placental Site Trophoblastic Tumor and Epithelioid Trophoblastic Tumor

56 Chemotherapy, Antineoplastic Therapy, and Radiation Therapy

CELL CYCLE

CHEMOTHERAPY, TARGETED THERAPY, AND HORMONAL AGENTS

Chemotherapy

Targeted Therapy

Hormonal Therapy

COMMON SIDE EFFECTS OF CHEMOTHERAPY, TARGETED THERAPY, AND HORMONAL AGENTS

RADIATION THERAPY

Clinical Radiation Sources

Common Side Effects of Radiation Therapy

PRIMARY TREATMENT MODALITIES ACCORDING TO CANCER SITE

Epithelial Ovarian Cancer

Nonepithelial Ovarian Cancers

Cervical Cancer

Vulvar Cancer

Vaginal Cancer

Uterine Cancers

Endometrioid Endometrial Carcinoma

Uterine Leiomyosarcomas

Uterine Carcinosarcomas

Gestational Trophoblastic Tumors

57 Palliative and End-of-Life Care

DEFINITIONS

Palliative Care

Hospice Care

SYMPTOM MANAGEMENT

Pain

Dyspnea

Anorexia/Cachexia

Nausea/Vomiting

Ascites

Malignant Bowel Obstruction

Constipation

Sleep/Wake Disturbances

Fatigue

Delirium

Mood Disorders

COMMUNICATION

ADVANCE CARE PLANNING

END-OF-LIFE CARE ISSUES

CAREGIVER SUPPORT

Part VI: Surgery in Obstetrics and Gynecology

58 Anatomy of the Female Pelvis

ABDOMINAL WALL

Layers of the Anterior Abdominal Wall

Vasculature of the Abdominal Wall

PELVIC VISCERA

Vagina

Uterus

Ligaments of the Uterus

Adnexae

Ureter

SURGICAL SPACES OF THE PELVIS

VASCULATURE OF THE ABDOMEN AND PELVIS

VULVA AND PERINEUM

External Anatomy

Superficial Compartment of the Vulva

Pelvic Floor

Posterior Triangle

NERVES OF THE PELVIS AND PERINEUM

Pelvic Diaphragm

Perineum

LYMPHATIC DRAINAGE OF THE PELVIS

59 Surgical Approaches in Gynecologic Surgery

MINIMALLY INVASIVE SURGERY IN GYNECOLOGY

Benefits of Minimally Invasive Surgery

Laparoscopy

Robot-Assisted Laparoscopic Surgery

Laparoendoscopic Single Site/Single-Site Incision Laparoscopic Surgery

Minimally Invasive Hysterectomy

Transvaginal Hysterectomy

Laparoscopically Assisted Vaginal Hysterectomy

Laparoscopic Hysterectomy (Including Robotic Assisted)

Minimally Invasive Myomectomy

Laparoscopic Entry Techniques

Laparoscopic Entry Sites

Port Placement

Removal of Large Specimens

Port Closure and Trocar Site Complications

Uterine Manipulation During Minimally Invasive Surgery Procedures

Minimally Invasive Surgery in the Obese Patient

LAPAROTOMY IN OPERATIVE GYNECOLOGY

Abdominal Wall Incisions

Closure Techniques

60 Perioperative Care and Complications of Gynecologic Surgery

PREOPERATIVE CARE

Informed Consent

Medical Evaluation and Optimization

Preoperative Evaluation

Preoperative Management

Hemorrhage Prevention Optimization

INTRAOPERATIVE COMPLICATIONS

Hemorrhage

Ureteral Injury

Bladder Injury

Bowel Injury

Nerve Injury

Complications Specific to Laparoscopy

Complications Specific to Hysteroscopy

POSTOPERATIVE COMPLICATIONS

Postoperative Fever

Postoperative Infection

Wound Infection

Incisional or Vaginal Cuff Cellulitis

Necrotizing Fasciitis

Venous Thromboembolism

Imaging

Therapy

Ileus and Bowel Obstruction

Diarrhea

Genitourinary Fistulae

ENHANCED RECOVERY AFTER SURGERY

Preadmission/Preoperatively

Intraoperatively

Postoperatively

Outcomes

61 Critical Care

CARDIOVASCULAR CRITICAL CARE

Heart Failure

Acute Coronary Syndrome

Cardiac Arrhythmias

Hypotension and Shock

RESPIRATORY CRITICAL CARE

Acute Respiratory Distress Syndrome

Oxygen Therapy

FLUIDS AND ELECTROLYTES

Hyponatremia

Hypernatremia

Hypokalemia

Hyperkalemia

Hypocalcemia

Hypercalcemia

Acid-Base Disorders

RENAL FAILURE

HEMATOLOGIC CRITICAL CARE

Anemia

Thrombocytopenia

Disseminated Intravascular Coagulation

INFECTIOUS DISEASES

Sepsis

SPECIAL OBSTETRIC CONSIDERATIONS IN CRITICAL CARE

62 Quality, Safety, and Value in Women’s Health

BACKGROUND

QUALITY ASSURANCE

CONTINUOUS IMPROVEMENT

CLINICAL INNOVATION

Index

 

An aparitie	25 Jun. 2020
Autor	Betty Chou
Dimensiuni	15.27 x 2.29 x 22.86 cm
Editura	LWW
Format	Paperback
ISBN	9781975140205
Limba	Engleza
Nr pag	856