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Acute gynaecology and early...
Acute gynaecological problems are among the most common reasons for women of reproductive age to seek medical help. Emergency outpatient visits now outnumber elective clinical appointments in gynaecology. With a growing number of patients, increasingly complex diagnostic algorithms and a wide range of management options, the participation and training of senior doctors in this field is vital to ensure women receive the best possible treatment. This book provides a thorough overview of acute gynaecology and early pregnancy and has been designed to reflect the syllabus of the RCOG's Advanced Training Skills Module (ATSM) in 'Early pregnancy and emergency gynaecology'. It covers the diagnosis and management of routine clinical problems, such as miscarriage and tubal pregnancy, as well as less frequently seen presentations, such as uncommon forms of ectopic pregnancy and trophoblastic disease. The use of drugs in early pregnancy and management organisational aspects of care are also addressed
Monografía
monografia Rebiun34395075 https://catalogo.rebiun.org/rebiun/record/Rebiun34395075 m|||||o||d|||||||| cr|||||||||||| 131216s2011||||enk o ||1 0|eng|d 1-316-02277-3 1-316-02398-2 1-107-78612-6 1-283-26905-8 1-906985-49-9 9786613269058 UPVA 998450039403706 CBUC 991010754963506709 UkCbUP eng rda UkCbUP eng 618.2025 22 Acute gynaecology and early pregnancy edited by Davor Jurkovic and Roy Farquharson. electronic resource] Acute Gynaecology & Early Pregnancy London RCOG Press 2011 London London RCOG Press 1 online resource (xiv, 241 pages) digital, PDF file(s) 1 online resource (xiv, 241 pages) Text txt rdacontent computer c rdamedia online resource cr rdacarrier Advanced skills series Title from publisher's bibliographic system (viewed on 05 Oct 2015) Cover -- Title page -- Contents -- About then authors -- Acknowledgements -- Abbreviations -- Preface -- 1 Organisation and delivery of emergency care in early pregnancy and acute gynaecology -- Introduction -- Standards of practice -- Standards in early pregnancy care -- Standards in ectopic pregnancy -- Standards in recurrent miscarriage -- Staffing and training implications -- Opportunities for specialist training -- Audit and research issues -- Key points -- References -- 2 Epidemiology and aetiology of miscarriage and ectopic pregnancy -- Introduction -- Miscarriage -- Epidemiology -- Risk factors -- Maternal age -- Previous obstetric history -- Lifestyle and nutrition -- Aetiology -- First-trimester miscarriage -- chromosomal abnormalities -- parental structural chromosomal abnormalit y -- maternal medical conditions -- maternal uterine anomalies -- luteal phase defect -- Second-trimester miscarriage -- Ectopic pregnancy -- Epidemiology -- Risk factors -- Aetiology -- Conclusion -- References -- 3 Diagnosis of miscarriage -- Introduction -- Terminology -- Diagnosis of miscarriage on clinical examination -- Ultrasound findings -- Diagnosis of miscarriage -- Early embryonic demise -- Incomplete miscarriage -- Complete miscarriage -- Prediction of miscarriage -- Demographic characteristics -- Gestational sac -- Yolk sac -- Amniotic sac -- Crown-rump length -- Embryonic heart rate -- Role of biochemical markers -- Human chorionic gonadotrophin -- Progesterone -- Inhibin A -- Conclusion -- References -- 4 Conservative and surgical management of miscarriage -- Introduction -- Expectant management -- Success rates -- Complications -- Summary -- Medical management -- Treatment regimens -- Success rates -- Complications -- Summary -- Surgical management -- Surgical techniques -- Curettage under general anaesthesia Manual vacuum aspiration under local anaesthesia -- Success rates -- Complications -- Summary -- Conclusion -- References -- 5 Management of hyperemesis gravidarum -- Introduction -- Epidemiology -- Aetiology -- Endocrine factors -- Human chorionic gonadotrophin -- Thyroid hormones -- Mechanical factors -- Infective factors -- Psychological factors -- Diagnosis and investigations -- Complications -- Maternal complications -- Vitamin B6 and B12 deficiency -- Wernicke's encephalopathy -- Hyponatraemia -- Mallory-Weiss tears -- Venous thromboembolism -- Termination of pregnancy -- Depression -- Fetal complications -- Management -- Dietary advice -- Intravenous fluid replacement -- Thiamine (vitamin B1 ) supplementation -- Antiemetic therapy -- Antihistamine antiemetics -- Phenothiazines -- Metoclopramide -- Specific 5 hydroxytryptamine (serotonin) antagonists -- Corticosteroids -- Alternative treatment options -- Total parenteral and enteral nutrition -- Termination of pregnancy -- Risk of recurrence -- Conclusion -- References -- 6 Diagnosis and treatment of recurrent miscarriage -- Introduction -- Maternal age -- Structural uterine abnormalities -- Antiphospholipid syndrome -- Unexplained recurrent pregnancy loss -- Conclusion -- References -- 7 Differential diagnosis and management of molar pregnancy -- Introduction -- Diagnosis -- Ultrasound and serum human chorionic gonadotrophin -- Complete hydatidiform moles -- Partial hydatidiform moles -- Pseudomoles -- Histological diagnosis -- Management -- Conclusion -- References -- 8 Drugs in early pregnancy -- Introduction -- Nutritional supplements -- Folic acid -- Vitamin A -- Drugs used for common early pregnancy ailments -- Antiemetics -- Thalidomide -- Antihistamines (H1 receptor antagonists -- Phenothiazines -- Serotonin inhibitors -- Vitamin B6 (pyridoxine -- Corticosteroids Antacids and proton pump inhibitors -- Laxatives and antidiarrhoeals -- Analgesics -- Paracetamol -- Aspirin -- Non-steroidal anti-inflammatory drugs -- Opioid analgesics -- Anti-migraine drugs -- Vaccines -- Antifungals -- Antibiotics -- Chlamydia -- Bacterial vaginosis and trichomonal vaginitis -- Gonorrhoea -- Pelvic inflammatory disease -- Urinary tract infections -- Tuberculosis -- Malaria -- Toxoplasmosis -- Syphilis -- HIV infection -- System-specific drugs used inearly pregnancy -- Anti-epileptics -- Valproate -- Phenobarbitone -- Phenytoin -- Carbamazepine -- Benzodiazepines -- Lamotrigine -- Other anti-epileptics and polypharmacy -- Antihypertensives -- Centrally acting antihypertensives -- Beta-blockers -- Calcium channel blockers -- Angiotensin-converting enzyme inhibitors -- Angiotensin 2 receptor antagonists -- Diuretics -- Anti-psychotics -- Antidepressants -- Selective serotonin reuptake inhibitors -- Lithium -- Neuroleptics -- Treatment of endocrine disorders -- Hypothyroidism -- Hyperthyroidism (thyrotoxicosis -- Diabetes and hypoglycaemic drugs -- oral hypoglycaemic agents -- insulin -- medications used for complications of diabetes -- Hyperprolactinaemia -- Cushing syndrome -- Anticoagulants -- Heparin -- Warfarin -- Treatment of rheumatic disorders -- NSAIDS -- Sulfasalazine -- Antimalarials -- Gold salts -- Penicillamine salts -- Corticosteroids -- Cytotoxic agents -- Ciclosporin -- Treatment of inflammatory bowel disease -- 5-aminosalicylic acid -- Sulfasalazine -- Corticosteroids -- Azathioprine and 6-mercaptopurine -- Infliximab -- Anti-asthmatics -- Treatment of liver diseases -- Drugs of abuse -- Opioids (heroin) -- Methadone -- Buprenorphine -- Benzodiazepines -- Amphetamines -- Cocaine -- Cannabis and d-lysergic acid diethylamide (LSD -- Management of patients with drug exposure -- References 9 Diagnosis of tubal ectopic pregnancy -- Introduction -- Presentation -- Risk factors -- Surgical diagnosis -- Ultrasound diagnosis -- Criteria for ultrasound diagnosis of tubal ectopic pregnancy -- Sensitivity of ultrasound for the diagnosisof ectopic pregnancy -- Prediction of ectopic pregnancy in women with a pregnancy of unknown location -- Serum hCG -- Serum progesterone -- Mathematical models -- Conclusions -- References -- 10 Conservative management of tubal ectopic pregnancy -- Introduction -- Systemic methotrexate -- Systemic methotrexate in a fixed multiple-dose regimencompared with laparoscopic salpingotomy -- Systemic methotrexate in a single-dose regimencompared with laparoscopic salpingotomy -- Single-dose compared with multiple-dose systemic methotrexate -- Systemic methotrexate in different doses -- Systemic methotrexate alone compared with systemic methotrexatein combination with mifepristone -- Expectant management -- Expectant management compared with local and systemic prostaglandins -- Expectant management compared with systemic methotrexate -- Recommendations for clinical practice -- Conclusion -- References -- 11 Surgical management of tubal ectopic pregnancy -- Introduction -- Indications for surgical treatment of tubal ectopic pregnancy -- Surgical approach -- Laparoscopic compared with open surgery -- Linear salpingostomy compared with salpingectomy -- Linear salpingostomy -- Salpingectomy -- Linear salpingostomy versus salpingectomy -- Complications of surgery -- Persistent trophoblast -- Bleeding -- Conclusion -- References -- 12 Diagnosis and management of non-tubal ectopic pregnancy -- Introduction -- Interstitial pregnancy -- Diagnosis of interstitial pregnancy -- Clinical features -- Ultrasonography -- Other investigations -- Differential diagnosis -- Management of interstitial pregnancy -- Surgical treatment laparotomy -- laparoscopy -- Conservative management -- medical treatment -- expectant management -- uterine artery embolisation -- Fertility after interstitial pregnancy -- Cervical and caesarean-scar pregnancies -- Diagnosis of cervical and caesarean-scar pregnancies -- Clinical features -- Ultrasonography -- Differential diagnosis -- Management of cervical and caesarean-scarpregnancies -- Surgical management -- Medical management -- Fertility after cervical and caesarean-scar pregnancies -- Ovarian pregnancy -- Diagnosis of ovarian pregnancy -- Management of ovarian pregnancy -- Cornual pregnancy -- Diagnosis of cornual pregnancy -- Clinical features -- Ultrasonography -- Other investigations -- Differential diagnosis of cornual pregnancy -- Management of cornual pregnancy -- Surgical management -- Expectant management -- Fertility after cornual pregnancy -- Abdominal pregnancy -- Diagnosis of abdominal pregnancy -- Management of abdominal pregnancy -- Conclusion -- References -- 13 Diagnosis and management of acute pelvic pain -- Introduction -- History and clinical examination -- Laboratory tests -- Ultrasound -- Computed tomography and magnetic resonance imaging -- Further investigations and treatment -- Conclusion -- References -- 14 Management of vaginal bleeding in the acute clinical setting -- Introduction -- Acute presentation of vaginal bleeding -- Causes of acute heavy vaginal bleedingand principles of management -- Dysfunctional uterine bleedingThe haemodynamic state of the -- Prolapsed uterine fibroid -- Uterine inversion -- Uterine arteriovenous malformations -- Haematological disorders -- Acute bleeding and use of hormonalcontraception -- Postmenopausal bleeding -- Abnormal bleeding in women on hormone replacement therapy -- Genital tract trauma -- Foreign bodies -- Sexual assault -- Conclusion -- References 15 Current concepts in screening and outpatient management of pelvic inflammatory disease Acute gynaecological problems are among the most common reasons for women of reproductive age to seek medical help. Emergency outpatient visits now outnumber elective clinical appointments in gynaecology. With a growing number of patients, increasingly complex diagnostic algorithms and a wide range of management options, the participation and training of senior doctors in this field is vital to ensure women receive the best possible treatment. This book provides a thorough overview of acute gynaecology and early pregnancy and has been designed to reflect the syllabus of the RCOG's Advanced Training Skills Module (ATSM) in 'Early pregnancy and emergency gynaecology'. It covers the diagnosis and management of routine clinical problems, such as miscarriage and tubal pregnancy, as well as less frequently seen presentations, such as uncommon forms of ectopic pregnancy and trophoblastic disease. The use of drugs in early pregnancy and management organisational aspects of care are also addressed English Obstetrical emergencies Jurkovic, D. Davor) 1958-) editor Royal College of Obstetricians and Gynaecologists (Great Britain) Staff Content Provider 1-906985-32-4 Advanced skills series