Editor: ob rt Casanova Series Edi V ors: S She h S anley Zaslau Ob Wol ers Kl wer Heat C FlOV SHELF-LIFE OBSTETRICS AND GYNECOLOGY SHELF-LIFE OBSTETRICS AND GYNECOLOGY Editors Series Editors Elizabeth Buys, MD Veeral Sudhakar Sheth, MD, FACS Assistant Clinical Professor Director, Scientific Affairs Department of Obstetrics and Gynecology University Retina and Macula Associates University ofNorth Carolina School of Medicine Clinical Assistant Professor Mountain Area Health Education Center University of Illinois at Chicago Admitting Medical Staff Physician Chicago, Illinois Women's Services Stanley Zaslau, MD, MBA, FACS Mission Hospital Professor and Chief Asheville, North Carolina Urology Residency Program Director Kristina Tocce, MD, MPH Department of Surgery/Division of Urology Assistant Professor West Virginia University Medical Student Program Director Morgantown, West Virginia Assistant Director, Fellowship in Family Planning Department of Obstetrics and Gynecology Robert Casanova, MD, FACOG University of Colorado, Anschutz Medical Campus Assistant Dean of Clinical Sciences Curriculum Denver, Colorado Associate Professor Obstetrics and Michele A Manting, MD, MEd Gynecology Associate Professor and Director of Obstetrics and Gynecology Residency Interprofessional Education Program Director Department of Obstetrics and Gynecology Texas Tech University Health Sciences Paul L Foster School of Medicine Center Texas Tech University Health Sciences Center Lubbock, Texas Director of Simulation Department of Obstetrics and Gynecology University Medical Center El Paso, Texas ®Wolters Kluwer Health Philadelphia • Baltimore • New York • London Buenos Aires· Hong Kong· Sydney· Tokyo Acquisitions Editor: Tari Broderick Product Manager: Stacey Sebring Marketing Manager: Joy Fisher-Williams Production Project Manager: Alicia Jackson Designer: Stephen Druding Compositor: Integra Software Services Pvt Ltd Copyright© 2015 Lippincott Williams & Wilkins, a Wolters Kluwer business 351 West Camden Street Two Commerce Square Baltimore, MD 21201 2001 Market Street Philadelphia, PA 19103 Printed in China All rights reserved This book is protected by copyright No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews Materials appearing in this book prepared by individuals as part of their official duties as U.S government employees are not covered by the above-mentioned copyright To request permission, please contact Lippincott Williams & Wilkins at 2001 Market Street, Philadelphia, PA 19103, via email at permissions@lww.com, or via website at lww.com (products and services) Library of Congress Cataloging-in-Publication Data Shelf-life obstetrics and gynecology I co-editors Elizabeth Buys, Kristina Tocce, Michele Manting p ;cm Includes index ISBN 978-1-4511-9045-8 I Buys, Elizabeth (Elizabeth A.) , editor of compilation II Tocce, Kristina, editor of compilation III Manting, Michele, editor of compilation [DNLM: Genital Diseases, Female-Problems and Exercises Obstetrics-methods-Problems and Exercises Gynecology-methods­ Problems and Exercises Pregnancy Complications-Problems and Exercises WQ 18.2] RG111 618.10076 dc23 2013047865 DISCLAIMER Care has been taken to confirm the accuracy of the information present and to describe generally accepted practices However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication Application of this information in a particular situation remains the professional responsibility of the practitioner;the clinical treatments described and recom­ mended may not be considered absolute and universal recommendations The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with the current recommendations and practice at the time of publication However, in view of ongoing research, changes in government regula­ tions, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions This is particularly important when the recommended agent is a new or infrequently employed drug Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings It is the responsi­ bility of the health-care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice (800) 638-3030 or fax orders to (301) 223-2320 International customers should call (301) 223-2300 To purchase additional copies of this book, call our customer service department at Visit Lippincott Williams & Wilkins on the Internet: http:/ / www.lww.com Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6:00 pm, EST Contributors As h ley S Atkins, MSIV Richard Loftis, MD Texas Tech University Health Sciences Resident physician Center Department of Obstetrics & Gynecology Lubbock, Texas Mountain Area Health Education Center Asheville, North Carolina Samuel Barker, MSIV Texas Tech University Health Sciences Me l inda Ramage, F N P, RN Center Mountain Area Health Education Center Lubbock, Texas Asheville, North Carolina Jenn ifer B l ack, MSIII Univ e rsity of Colorado Anschutz Medical Texas Tech University Health Sciences Amy Richards, MSIV Campus Center Aurora, Colorado Lubbock, Texas Bennett Gard ner, MD Amanda M Roberts, MSIII Resident physician Texas Tech University Health Sciences Department of Obstetrics & Gynecology Center Mountain Area Health Education Center Lubbock, Texas Asheville, North Carolina Sara Scannel l , MSIII Rachel Harper, MSIII University of Colorado Anschutz Medical University of North Carolina School of Campus Medicine Aurora, Colorado Chapel Hill, North Carolina Meg han Sheehan, MSIII Sarah Jenkins, MSIII Texas Tech University Health Sciences University of Colorado Anschutz Medical Center Campus Lubbock, Texas Aurora, Colorado Susan Ulmer, MSII I Hol l i s Kon itzer, MS Ill University of Colorado Anschutz Medical University of North Carolina School of Campus Medicine Aurora, Colorado Chapel Hill, North Carolina Anna van der Horst, MSIII Jon Larrabee, MD University of North Carolina School of Resident physician Medicine Department of Obstetrics & Gynecology Chapel Hill, North Carolina Mountain Area Health Education Center Asheville, North Carolina v Introduction to the Shelf- Life Series The Shelf-Life series is an entirely new concept The books have been designed from the ground up with student input With academic faculty helping guide the production of these books, the Shelf-Life series is meant to help supplement the student's educational experience while on clinical rotation as well as prepare the student for the end-of-rotation shelf-exam We feel you will find these question books challenging but an irreplaceable part of the clinical rotation With high-quality, up-to-date content, and hundreds of images and tables, this resource will be something you will continue to refer to even after you have completed your rotation The series editors would like to thank Susan Rhyner for supporting this concept from its inception We would like to express our apprecia­ tion to Catherine Noonan, Laura Blyton, Amanda Ingold, Ashley Fischer, and Stacey Sebring, all of whom have been integral parts of the publishing team; their project management has been invaluable Veeral S Sheth, M D, FACS Stanley Zaslau, M D, M BA, FACS Robert Casanova, M D, FACOG vi Acknowledgments It has been a pleasure to work with the staff at Lippincott Williams &Wilkins on the first edition of Shelf Life Obstetrics and Gynecology, especially with Laura Blyton, Catherine Noonan, and Stacey Sebring Also, special thanks to Susan Rhyner who thought of me when developing this project I could not have done it without the help of my co-editors, Beth, Kris­ tina, and Michele My sincere thanks to you and to our student contribu­ tors who kept us focused I also want to thank the hundreds of medical students whom I have had the privilege to meet during my years as Clerkship Director You have taught me more than you will ever know and it has been an honor to play even a small role in your medical education Finally, I want to thank our families who allowed us to spend endless hours developing and tweaking questions Robert Casanova, M D, FACOG vii 1 Preventive Care Ethics 11 Genetics 19 Obstetrics 29 Obstetrics Screening and Surveillance 61 Obstetrics High Risk 85 Obstetrics Postpartum 133 Breast and Lactation 147 Gynecology 157 10 Contraception 201 11 Family Planning 217 12 Sexually Transmitted Infections 225 13 Neoplasia 243 viii 336 Figure Credits Philadelphia, PA: Lippincott Williams & Wilkins; 2003 Figure 9-5 From Zuber TJ, Mayeaux EF Atlas of Primary Care Procedures Philadel­ phia, PA: Lippincott Williams & Wilkins; 2003 Figure 9-6 From Zuber TJ, Mayeaux EF Atlas of Primary Care Procedures Philadelphia, PA: Lippincott Williams & Wilkins; 2003 Figure 9-7 From Baggish MS, Valle RF, Guedj H Hysteroscopy: Visual Perspectives of Uterine Anatomy, Physiology and Pathol­ ogy Philadelphia, PA: Lippincott Williams & Wilkins; 2007 Figure 0- From Baggish MS, Valle RF, Guedj H Hysteroscopy: Visual Perspectives of Uterine Anatomy, Physiology and Pathol­ ogy Philadelphia, PA: Lippincott Williams & Wilkins; 2007 Figure 10-2 Courtesy of Keith H Charlton, Robert D Maxwell (Chiro), Brisbane, Australia Figure 10-3 From Pillitteri A Maternal and Child Nursing 4th ed Philadelphia, PA: Lippincott, Williams & Wilkins; 2003 Figure 12- From Sweet RL, Gibbs RS Atlas of Infectious Diseases of the Female Genital Tract Philadelphia, PA: Lippincott Williams & Wilkins; 2005 Figure 12-2 From Beckmann CRB, Ling FW, Smith RP, et al Obstetrics and Gyne­ cology 5th ed Philadelphia, PA: Lippincott Williams & Wilkins; 2006 Figure 2-3 From Sweet RL, Gibbs RS Atlas of Infectious Diseases of the Female Genital Tract Philadelphia, PA: Lippincott Williams & Wilkins; 2005 Figure 2-4 From Willis MC Medical Terminology: A Programmed Learning Approach to the Language of Health Care Baltimore, MD: Lippincott Williams & Wilkins; 2002 Figure 2-5 From Sweet RL, Gibbs RS Atlas of Infectious Diseases of the Female Genital Tract Philadelphia, PA: Lippincott Williams & Wilkins; 2005 Figure 2-6 From Rubin E, Farber JL Pathology 3rd ed Philadelphia, PA: Lippincott Williams & Wilkins; 999 Figure 2-7 From Sweet RL, Gibbs RS Atlas of Infectious Diseases of the Female Genital Tract Philadelphia, PA: Lippincott Williams & Wilkins; 2005 Figure 2-8 From Sweet RL, Gibbs RS Atlas of Infectious Diseases of the Female Genital Tract Philadelphia, PA: Lippincott Williams & Wilkins; 2005 Figure 2-9 From Sweet RL, Gibbs RS Atlas of Infectious Diseases of the Female Genital Tract Philadelphia, PA: Lippincott Williams & Wilkins; 2005 Figure 2- From Sweet RL, Gibbs RS Atlas of Infectious Diseases of the Female Genital Tract Philadelphia, PA: Lippincott Williams & Wilkins; 2005 Figure 2- 1 From McConnell TH The Nature of Disease Pathology for the Health Professions Philadelphia, PA: Lippincott Williams & Wilkins; 2007 Figure 13-1 From Beckmann CRB, Ling FW, Smith RP, et al Obstetrics and Gyne­ cology 5th ed Philadelphia, PA: Lippincott Williams & Wilkins; 2006 Figure -2 Modified from Berek JS, Hacker NF Practical Gynecologic Oncol­ ogy 4th ed Philadelphia, PA: Lippincott Williams & Wilkins; 2005 Figure From Sweet RL, Gibbs RS Atlas of Infectious Diseases of the Female Genital Tract Philadelphia, PA: Lippincott Williams & Wilkins; 2005 Figure From Beckmann CRB, Ling FW, Smith RP, et al Obstetrics and Gynecol­ ogy 5th ed Philadelphia, PA: Lippincott Williams & Wilkins; 2006 Figure Credits Figure From Willis MC Medical Termi­ nology: A Programmed Learning Approach to the Language of Health Care Baltimore, MD: Lippincott Williams & Wilkins; 2002 Figure From Sweet RL, Gibbs RS Atlas of Infectious Diseases of the Female Genital Tract Philadelphia, PA: Lippincott Williams & Wilkins; 2005 Figure From Sweet RL, Gibbs RS Atlas of Infectious Diseases of the Female Genital Tract Philadelphia, PA: Lippincott Williams & Wilkins; 2005 337 5th ed Philadelphia, PA: Lippincott Williams & Wilkins; 2006 Figure From Eisenberg RL An Atlas of Differential Diagnosis 4th ed Philadelphia, PA: Lippincott Williams & Wilkins; 2003 Figure From McConnell TH The Nature of Disease Pathology for the Health Professions Philadelphia, PA: Lippincott Williams & Wilkins; 2007 Figure 10 From Beckmann CRB, Ling Figure From Beckmann CRB, Ling FW, FW, Laube DW, et al Obstetrics and Gyne­ cology 4th ed B altimore, MD: Lippincott Smith RP, et al Obstetrics and Gynecology Williams & Wilkins; 2002 Note: Page numbers followed by f indicate figures; those followed by t indicate tables Antenatal corticosteroids, 1 4- 1 A Abnormal uterine bleeding (AUB)-1, 58, 79- 80 endometrial hyperplasia and cancer, 181 Abortion, 45-46 -related deaths, 224 Abruption, 122 Abruptio placenta, - 22 Achondroplasia, Acyclovir, 06, 229 Adenomyosis, 8- 59, - 72, - 82 Advanced-stage ovarian cancer, 260 Albacore tuna ingestion, - 32 Alcohol counseling, 2-3 Alcohol use during pregnancy, 94-95 Alzheimer dementia, uterosacral ligaments, 79 Amenorrhea, 97, 223, 282, 286-289 Anterior placenta, transabdominal CVS, 1f, 2f Antibiotics, 73, 1 - 1 , 65 Antiepileptic drugs (AEDs), 97-98 Antipyretics, Apgar score, 33 , t, Appendicitis, 08 - 09 Argyll-Robertson pupil, 23 Arrest of labor, 29-30 See also Montevideo units (MVUs) Asherman syndrome, 90, 96 Asymptomatic bacteriuria (ASB), 73 identified and treated, 1 Atypical squamous cells of undetermined significance (ASCUS) , 245 Autoimmune disorder, Azithromycin, 99 lactational, 204 B MRI studies, Bacterial vaginosis (BV) , 225-226 serum prolactin, 92 American College of Obstetricians and Gynecologists (ACOG), 243 Amniocentesis, 78-79, 98-99, 22- 23 Amnioinfusion, 48 expectant management, 49 Amniotic a-fetoprotein (AFP) , 88 Amniotic fluid index (AFI) , 1 Ampicillin, 36- Androgen insensitivity syndrome (AIS), 283 Android, 30, 1f Anemia, red blood cell (RBC) destruction, 07 Anencephaly, 26- Anesthesia, 2 Aneuploidy, 2 , 23f trisomy pregnancies, 23 Anovulatory bleeding, - 92 wet mount, 226f Bacteriuria, 37 Basal body temperature method, 4, 4f, 5f Basic metabolic panel (BMP), 286 Benzodiazepine, 40 See also Hypothermia Beta-human chorionic gonadotropin ( � -hCG), , 8, 24 -242, 282 LLQ pain, quantitative level, , 59, 94- 95 and transvaginal U /S, 42 Betamethasone, 99- 00 Bilateral tubal ligations (BTLs), 202 benefits, 2 Biometry, 95-96 Biophysical profile (BPP), 76, 78 criteria for coding, 77t implications of score, 77t 339 340 I ndex Birth defects, 25- 126 Bishop score, 34 Ceftriaxone, 99, 233 Bladder pain syndrome, 65 Cellulitis, postoperative, 62- Blindness, 108 Cephalexin, 52-53 "Blueberry muffin" babies, MMR vaccination postpartum, 52 Cerebral edema, 95 BP, 2-3 Ceftriaxone + azithromycin, 52 Cervical cancer, -2, 233-234 screening method, t Body mass index (BMI), 278 Cervical cerclage, 99- 00 B one densitometry, 4-5 B one mineral density, 207 Cervical intraepithelial neoplasia, 234 Cervical cytology, 244 B owel obstruction, 245 Cervical laceration, 220 Brachial plexus palsy, 1 Cervical ripening agents, 50 Braxton-Hicks contractions, 79-80 BRCA and BRCA genes testing, 24 Cervical squamous cell carcinoma male relative with breast cancer, 25 mutations, 26 U.S Preventative Services Task Force criteria for, 25 Breast and lactation, 14 - 56 Breast cancer cold-knife cone biopsy, 244 FIGO criteria, stages, 245 Cesarean delivery, 35-36 blood loss, 46 decelerations, 62f, 63f, 64f fetal monitoring, lf FHR tracings, -62 mammography, 47- 48 management plan, 50- induction, 1 open biopsy, 148- 49 operating room, 55 referral, general surgeon, 53 - 54 Breastfeeding, 40- cluster feeding phenomenon, 5 - 56 medical emergency, 22- 23 scar, 55-56 third-trimester bleeding, 108 vaginal bleeding, 1 0- 1 feeding pattern, - 52 Chancroid, 239 infection, baby's mouth, 54 medications and, 50 Chicken pox, 239 Breast Imaging Reporting and Data System (BI-RADS), 148 Brenner tumors, 291 Bulb dilation of cervix, 50 c Chlamydia sp., 277-278, 282, 288 infections, 225, 227, 233 Cholecystitis, 233 Cholera vaccination, 33 Chorioamnionitis, 59-60, 64 Choriocarcinoma, 250 Chorionic villus sampling (CVS), 24- 12 Cafe-au-lait spots, 20 See also Neurofibromatosis Calendar method, Candida albicans, 225 Carbamazepine, 208 Carboprost tromethamine, 40, 43 Chronic hypertension, biweekly NSTs, -82 Chronic pelvic pain (CPP) , 63 - 64, 236-237 Cigarette smoking and vulvar neoplasia, 248-249 Cardiac disease, 274 Cataracts, 95 Ciprofloxacin, 228 CA- 25, tumor markers, 254 Clomiphene, 279 testing, 26 -262 Cauliflower-like lesions, 237, 237f, 238 Colonoscopy, 4-5, 82 Cefazolin, 7- 38 Colposcopy, 249 Clindamycin, 67 Cocaine use during pregnancy, 94-95 Cefotetan, 235 and biopsies, 255, 257 Cefoxitin, 242 during pregnancy, 262-263 I ndex Combined oral contraceptive, Complete blood count (CBC), 286 Complete moles, 246, 246/ 341 Diarrhea, 22 Dicloxacillin, 54- 5 DiGeorge syndrome, 96 Congenital adrenal hyperplasia, 284 Dihydrofolate reductase, 220 Connexin-43, 30 Dilation and curettage (D&C), 39-40, 45, 128- 29, 74 Conscience, Consent process, - Constitutional delay, 289 Contraception, 6- 7, 20 - Copper intrauterine device (IUD ) , 7, mechanism, 202-203 post-procedure, 222 Cord prolapse, 02- incomplete abortion, 86 Dinoprostone, 50 See also Cervical ripening agents DNA analysis, fetal, 92-93 Donovan bodies, staining, 228, 228/ Dopamine, Down syndrome, Coronary artery disease, 284 Corpus luteum cyst, hemorrhagic, Doxycycline, , 8, 233 Cortisol levels test, 286 Drug use, consequences of, 14 DSPT See Deep septic pelvic thrombo- Costovertebral angle (CVA) tenderness, 94 Counseling, contraceptive, 7-8 Cravings, Cretinism, 94 Drug-eluting stent (DES), 278 phlebitis (DSPT) Ductal ectasia, 148 Duodenal atresia, 96 Culture and sensitivity, 8-9 Cyst, - 94 Dysmaturity syndrome, fetal, 35 Cystic fibrosis, 27-28, 280 Dyspareunia, 225 Cystic fibrosis transmembrane conduc­ Dysuria, 239 tance regulator ( CFTR) gene, 28 Cystic hygroma, 89, 90f E risk of aneuploidy, 90 Cystitis, 94 Cystocele, 265 D Dysmenorrhea, 222, 225 Ectopic pregnancies, 42 increased risk, 89- 90 transvaginal US, 0- Edinburgh Postnatal Depression Scale, - 42 Deafness, 08 Emergency contraception, 20 -202 Deep septic pelvic thrombophlebitis (DSPT), 05 Emergency hysterectomy, 86 Emergent laparoscop� 59 - 60 Dehydroepiandrosterone, 285 Endocrine disorders, 284, 285 Dehydroepiandrosterone sulfate (DHEAS), 278 Endometrial atrophy, 253 Depo-provera, , 205, 256-257 Depot medroxyprogesterone acetate Endometrial biopsy, 286 Endometrial hyperplasia endometrial biopsy, 79- 80, 97- 9 (DMPA) amenorrhea with, smoking, a s protective agent, 252-253 Endometrial implants, 280 and bone mineral density, Endometriosis, 59, 63 - 64 long-acting contraceptive effect, 22 Depression, Dermoid cyst, 94 Detrusor overactivity, Diabetes mellitus Endothelin- , 30 Enterocele, 265 Epithelial cells, 23 -232 Erythroblastosis fetalis, 07 Escherichia coli, 99-200 and total vaginal hysterectomy, 62 Esophageal atresia, 1 type 2, 284 Estimated gestational age (EGA) , 43 342 I ndex Estradiol, 24, 269 Estrogen-containing contraceptives, 206 Estrogen cream, 78 Fluoxetine, 94-95, Flu vaccine, Folic acid, 88 Estrogen receptors, 279 Follicle-stimulating hormone (FSH) , 278 Ethics, 1 - Footling breech presentation, 57-58, 58f Forceps-assisted vaginal delivery, 34 Etonogestrel contraceptive, 2 Euploid and aneuploidy gametes Fragile X disease, 280 chromosome translocation, 27 non-Mendelian inheritance patterns, 27 Expectant management, 20, 85 Exploration, surgical, Expulsion, 22 -222 G Galactorrhea, 28 , 287 Gap junction a- protein See Connexin-43 Garda�l, 3, 6, 256-257 Gardnerella, 225 F Family planning, 7-224 Gastroesophageal sphincter tone, 39 Gastrointestinal disorders, 65 Fascial dehiscence, Female sexual response, 267 GC/Chlamydia screening, 2-4, 239 ROME III criteria, 166 "Feminine itching;' 249-250 Gentamicin and clindamycin, 7- Fetal alcohol syndrome, - 24 Genetics, -28 Fetal chromosomal abnormalities, 87 Fetal dysmaturity syndrome, Germ cell malignancy risk, 283 Gestational diabetes, 80, Fetal heart tones (FHTs), 39, 74-75 variability, 75-76 Fetal macrosomia, 80- Fetal meconium aspiration, 34-35 Fetal sutures, 37 Fetus chest X-ray, electronic monitoring, status, 4-75 exposure from radiologic procedures, 128t growing, vascular interruption, 93 maternal, scheduled NSTs, Gestational diabetes mellitus (GDM), 95 Gestational trophoblastic disease (GTD ) , 254-255 Glomerular filtration rate, 39 Glucose-6-phosphate dehydrogenase (G6PD) deficiency hemolytic anemia, X-linked recessive disorder, 9-20 mortality, 38 - 39 Gonadal cancer, 283 Gonadal dysgenesis, 290 skin-to-skin with mother, 38, 144- 45 Gonadotropin-releasing hormone (GnRH) "Fever blisters;' FHTs See Fetal heart tones (FHTs) antagonist, Gonococcus (GC) test, 52 Fibroids See also Pregnancy(ies) Gonorrhea, 227 culture and sensitivity, 8-9 development, 86-87 MRI study, submucous and intramural, 86 Fine needle aspiration (FNA) , 148- 49 First-trimester abortion, First-trimester bleeding, genetic error, 255 First-trimester screening, 69 Fitz-Hugh and Curtis syndrome, 96, 227 Fluconazole, 239-240 Flu-like symptoms, 228-229 and breastfeeding, 149 Gonorrhea and chlamydia cultures, -2 G5P0222, Grade enterocele, 77 Gram-negative rods, antibiotic for, - 54 Granuloma inguinale, 228 Granulosa-theca cell tumor, 259 "Ground glass" lesions, 82- See also Laparoscopy Group B strep, 66-67 rectovaginal culture for, 67-68 Growth ultrasound, 80 I ndex Guillain- Barre syndrome (GBS), 46 Hysterectomy, 76- 77, 90, 2-2 , 273 Bishop score, 47, 47t expectant management, 47 Hysterosalpingogram, 279 group B strep, 66-67 I Gynecology, 15 7-200 Gynecoid pelvis, 30, 1/ 343 Imiquimod, 248 Immediate endocervical curettage, 245 Immunoglobulin A content, 52 H Impaired renal function, 1 - 1 Hashimoto thyroiditis, 28 Healthcare providers, 1 - Heavy menstrual bleeding (HMB), 57, 8/ PALM-COEIN classification system, HELLP syndrome, 04 Hematocolpos, 287 Hemophilia, , 280 See also X-Linked inheritance Hemorrhage, 70- , 220 Heparin trial, Hepatitis A, vaccination, 33 Hepatosplenomegaly, Herpes simplex virus (HSV), 2 , 234 High-grade squamous intraepithelial lesion (HGSIL) , 245 High-risk HPV typing, 256, 264 Hirsutism, 278-279, 29 Holoprosencephaly, 26- Hormone replacement, 270 Human chorionic gonadotropin (hCG) quantitative level, 246 Human papillomavirus (HPV), 233-234 testing ACO G recommendations, 243 Pap smears, 243 Huntington disease elective fertilization techniques, 26 neurodegenerative changes, 26 symptoms, 26 Hydralazine therapy, -82 Impending eclampsia, 04 Incompetent cervix, 07 Induced labor, 33-34 Infertility, 277-278 assessment, 7, -72 Informed consent, 13 Inguinal lymphadenopathy, 232 Inhibin A, , 69-70 Initial fetal heart tracing remained category , 40 digital examination, tocolysis, Intermenstrual bleeding (IMB), 58 International Federation of Gynecology and Obstetrics (FIGO) criteria, 245 Interstitial cystitis, Intraductal papilloma, Intrauterine contraception, 22 -222 Intrauterine device (IUD), copper, 202-203 fertilization and, 209 mechanism, 202-203 and PID, 207-208 postpartum insertion, 203 removal, Intrauterine growth retardation (IUGR), 87 Intrauterine pregnancy, 7-2 Intrauterine pressure catheter (IUPC), 29 Intrauterine system (IUS) levonorgestrel- containing, 209-2 X-ray o f abdomen/pelvis, 1f, 2 Hydrochlorothiazide, 67- 68, Hydronephrosis, 245 Intravenous ( IV) magnesium, 03 - 04 Hyperemesis, 1 6- 1 Intubation, Hypogonadotropic hypogonadism, 289 Hyponatremia, 74, 75/ Ipratropium, 68- 69 Hypothermia, 40 IUGR See Intrauterine growth retardation Hypothyroidism, 274, 276, 28 congenital, 94 in pregnancy, 96-97 Iron deficiency, (IUGR) IUPC See Intrauterine pressure catheter (IUPC) 344 I ndex K M Kallmann syndrome, 96 Macrosomia, 95 Karyotype analysis, 289 Magnesium sulfate, 43-44, 1 5, 36, Kegel exercises See Pelvic floor strength­ ening exercises Krukenberg tumor, 260- Magnesium therapy, 1 - 1 Maintenance allergy, 09 Mammogram, 4-5, 8, 49 Mastitis, 54- 55 Maternal-infant bonding and breastfeed­ L Labetalol, 44, 1 Labor and delivery (L&D) admission and expectant management on, 66 recorded tracing, 82f, 83 Labor, artificial induction, 50 Lactational amenorrhea, Lactogenesis, 147 Lamellar body count, 32 Laparoscopy, 60 direct visualization, 82- 83 Last menstrual period (LMP), 85, 234-235 and US in first trimester, 58 LEEP See Loop electrosurgical excision procedure (LEEP) Left lower quadrant (LLQ) pain, 59 - 60 Leiomyomas, 1 9, 84 Leopold maneuvers, 58, 59f ing, 3 - 34 Maternal serum a-fetoprotein (MSAFP), 87-88 Mayer-Rokitansky- Kuster-Hauser syndrome, 290 Meconium aspiration, fetal, 34-35 Menarche, McRobert and suprapubic pressure, 1 Meconium aspiration syndrome, 48-49 Medical abortion, 9-220 Medroxyprogesterone, 269-2 70 inj ections, 238-239 Meigs syndrome, 96 Menopause, 265-283 "Menorrhagia;' 57, 222 Mesonephric duct, 287 Methotrexate, 56, 50, 9-220, 279 intramuscular, 75 - 76 Methylergonovine, 43 Levonorgestrel, Metronidazole, 232 Levonorgestrel-containing IUS, 209-2 0, Midcycle ovulatory pain, 206-207 22 , 282 pregnancy test, Mid-urethral sling, 167 Mifepristone and misoprostol, 9-220 Levothyroxine, 96-97, Minilaparotomy, 2-2 Limb-reduction, 93-94 Misoprostol, 143 defects, - 26 Lipid profile, 4-5 intravaginal, 50 Mittelschmerz, 206-207 Lipid screen, MMR vaccination postpartum, 52, 60 Lisinopril, - 68 Moderate bleeding, Lithium therapy, 1 See also Pregnancy(ies) Long-acting reversible contraception, 203 Loop electrosurgical excision procedure (LEEP), 99, 258, 263 Lorazepam, 40, 140- See also Hypo­ thermia Low-grade squamous intraepithelial lesion (LGSIL), 256-257 Lynch I, II syndrome, 25 Moderate-intensity exercise regimen, 54 Molar pregnancy, 247-248, 254-255 Monogamous sexual relationship, 273 -274 Montevideo units (MVUs), 29 MSAFP See Maternal serum a-fetoprotein (MSAFP) Mullerian agenesis, 289 Mullerian duct, 287 Mullerian-inhibiting hormone (MIH) , 290 I ndex Multiparity, 63 345 Ovary(ies) MVUs See Montevideo units (MVUs) cancer risk, 5-6 Myomectomy, 1 cysts, 96- Myometrial invasion, 252 red, white, or blue lesions on, Oxybutynin, Oxytocin, 65, 143- 144 N Naegele rule, 47-48 Neisseria sp., 38, 225, 242 p Neonatal varicella, 06 Painless punched-out ulcer, 230f Neoplasia, 243 -264 PALM-COEIN classification system, Neural tube defects (NTDs) , 50- PAPP-A See Pregnancy-associated plasma Neurofibromatosis, 20 Nifedipine, 1 protein A (PAPP-A) Pap smear, 1, 3-4, 235, 243 -244, Nitrofurantoin pending culture, Parabasal cells, 266 N o acute distress (NAD) , - Paramesonephric duct, 287 Neonatal resuscitation, 3 Paroxetine, 03 Nonreassuring fetal H R , 36 Patient autonomy, - Nonsteroidal anti-inflammatory drugs Pelvic congestion syndrome (PCS), 66 (NSAIDs), 84 Nonstress test (NST) , 75-76 biweekly, 80-82 fetal movement, 78 Normal spontaneous vaginal delivery (NSVD) , 34- NTDs See Neural tube defects (NTDs) Pelvic floor strengthening exercises, 77- 78 Pelvic inflammatory disease (PID), 58 - 59, 225, 229-230, 273, 277-278 with TOA, 24 hospitalization, 242 with IV antibiotics, 242 Nuchal translucency (NT) , 69, 88 Pelvic pain, 8, 253 Nulliparity, 5-6, 222 Penicillin G, 67, 232 NuvaRing, 257, 25 8f Percutaneous umbilical blood sampling Perinatal survival, 89 Obesity, Pitocin, 50 (PUBS), 92-93 Obstetrics, 29-60 Placenta accreta, - 86, 00 high risk, 85 - 32 Placenta previa, - 22 postpartum, 3 - 46 Plasma volume, 38 screening and surveillance, - Platypelloid pelvis, 30, lf Oligohydramnios, Pneumococcal vaccine, 4-5 liguria, Polycystic ovarian syndrome (PCOS), 1 1- 12 Open biopsy, 148- 149 Oral contraceptive pills ( O CPs), 20 , 225-226, 230, 274-275 bleeding patterns, 203 bone mineral density, 207 - 92 Polyhydramnios, 1 Postabortal syndrome, 8-2 Post menopause, vaginal bleeding, 268-269 combination of, 205-206 Postpartum fever, 40 dosage, 204 Postpartum hemorrhage (PPH), 34- trials, 273 Post-procedure, antibiotic prophylaxis, Osteoporosis, 283 222-223 Ovarian carcinoma, 284 Postterm pregnancy, 34-35 Ovarian function, 288 Potter syndrome, 346 I ndex PPH See Postpartum hemorrhage (PPH) Prune belly syndrome, PPROM See Preterm premature rupture of PUBS See Percutaneous umbilical blood sampling (PUBS) membranes (PPROM) Prader-Willi syndrome, 35, 96 Pudendal nerve, 275 during labor, 64 Preconception counseling, 72 Preeclampsia and spontaneous abortion, 121 Pulmonary embolism (PE), 240 Purified protein derivative (PPD) test, 27- 28 FHTs, 1/ Pregnancy-associated plasma protein A (PAPP-A), 68-69 Pregnancy(ies) , 6-7, 277 Pyelonephritis, 1 7, 3 follow-up, 1 Pyuria, 37 cervical incompetence during, 99 desired medical abortion, 7-2 drug use consequences, - epileptic medication and, 97-98 fetal status, close electronic monitoring of, 74-75, 75f hospitalization, 02 physiologic edema, 56-57 preterm labor, 73-74 prolonged labor and induction, 145 pyelonephritis with, 73-74 recommended treatment, termination, 1 - procedural changes, 223-224 tobacco use during, 68 transvaginal US in ER, ultrasound for growth, 79-80 US of gallbladder, 09- 1 vaginal bleeding, 1 Premarital sex, 273 Premature rupture of membrane (PROM), 35-36 Premenstrual syndrome (PMS), 86- Preterm delivery, - 74, 04 Preterm premature rupture of membranes (PPROM), 64 Preventive care, - Progesterone, 220 Q Quiescence, 30 R Rabies vaccination, 33 Radioiodine ablation, 96-97 Rapid plasma reagin (RPR) , 235-236 Rapid uterine involution, 52 Rash, 230 Rectocele, 265 Repeat suction curettage, Reproductive issues, 277-29 Retroplacental clot, 1 Reversible contraception with patients, Rhesus type, 7-2 Rh-positive blood type, 44-45 Right upper quadrant (RUQ), 233 Risperidone for schizoaffective disorder, 97- ROME I I I criteria, 66 Rotterdam criteria for PCOS, Rubella syndrome, congenital, 94 triad of deformities, 08 Rupture of membrane (ROM), s cream, 99- 00 Seatbelt use, 2-3 effect, 46 Second-trimester screening test, 70- Progestin-only contraceptives ("mini-pills"), Seizure activity, maternal, 44 205-207 See also Oral contraceptive Septic abortion, pills (OCPs) Sertoli-Leydig tumor, 262, Prolactin, 55- 56, Serum screening, 70-7 Prolactinoma, Severe preeclampsia, 43-44, 1 Prostaglandin analog, Sex-chromosome abnormalities, 22 Prostin E2, 143 Sexual abuse, 274 Prozac See Fluoxetine Sexual activity, 1 I ndex Sexual dysfunction lipid profile, - lack of satisfaction, 273-274 mammogram, - relationship issues, 275-276 pap smear, , - sexual history, STD, -4 Sexuality, -276 Sexually transmitted disease (STD), 232-233 testing for, -4, 2t Sexually transmitted infections (STis), 8, 225-242, 278 thyroid, Testosterone, 278, 289-290 Thromboembolic disease, 206 Thyroid screening, Thyroid-stimulating hormone (TSH ) , prevention, 244 Sexual orientation 347 96-97 Thyrotropin- releasing hormone (TRH ) , 28 patient's medical problems, 275-276 and premarital sex, 272-273 Tidal volume, 37-38 sexual thoughts and attitudes, 272 Tobacco and alcohol counseling, - Sexual or physical abuse, 66- 67 Tobacco use during pregnancy, , 26 Sexual response cycle, 274 Tocolysis, Sickle cell anemia, 129- 30, 280 Tonsillectomy, 277-278 Small pox vaccination, 33 Total lung capacity, 37-38 Smoking cessation, Transvaginal 1JS, 42, 56, 1 7, 20- , 130- Spina bifida, 50-5 Spironolactone, 7- 8 color Doppler, 1 - 1 Spontaneous vaginal delivery (SVD ) , Transverse vaginal septum, 287 Staphylococcus sp., 73-74, 42, 53 Treponema pallidum, 232, 239 Stein-Leventhal syndrome, 284 Stepwise sequential screening, 90- serum culture for, 85 Trial of labor after Cesarean section "Strawberry cervix;' 238 Struma ovarii, 268 (TOLAC), 55-56 Trichomonads, 238 Subdermal contraceptive, 208-209, 22 Trichomonas vaginalis, 225, 232 Succenturiate lobe, 1 Trichomoniasis, 225, 232 Sulfamethoxazole, 228 Trimethoprim, 228 Syphilis, 230 Trimethoprim/ sulfamethoxazole, 169- 70, congenital, 94-95 88, 228 Triploidy, 246-247 Trisomies , 18, and 13, 23-24, 24f, 44, 30 T Tachycardia, 229-230 Tay-Sachs disease, 72, 280 amniocentesis, 22 chorionic villus sampling, 22 paternal serum screening for, -22 Tennessee Orthopaedic Alliance (TOA) , 24 -242 risk, 69 Tubal factor, 277-278 Tubo-ovarian abscess (TOA) , 235 Turner syndrome, 22, 283, 288 Typhoid vaccination, 3 u Teratomas, 259 1Jlcer, 227-228 Testicular feminization, 283 1Jlipristal acetate, Testing and/or examinations 1Jltrasound, 78-79, 24- 25, 48 bone densitometry, 4-5 biometry to verify diagnosis, - 96 BP, 2-3 for fetal growth restriction, 09 GC/chlamydia, 2-4 gonorrhea and chlamydia cultures, - for gallbladder, 1 for growth, 80 348 I ndex pelvic, 0-2 1 schedule growth, 80 vaginal, 269 Umbilical artery, 32 Umbilical cord compression, 65 Unintended pregnancy, 267-268 Urethritis, 233 Urethrocele, 265 Urinalysis, 53-54, 67- 68 Urinary tract infection (UTI) , antibiotic treatment, 89 cephalexin use, frequent sexual intercourse, pregnancy and, 53 S saprophyticus, as agent, 73-74, 42 urinalysis, Urine culture, 88 Escherichia coli count in, 99-200 cytology, 169 dipstick, 56-57 output, - 62 overflow incontinence, 78- 79 pregnancy test, Urogenital sinus, 287 v Vaccinations, 32-33 Vacuum -assisted delivery, 74- 75 Vaginal agenesis, 290 Vaginal birth after Cesarean section (VBAC), 55-56 Vaginal bleeding, 90- , Vaginal burning, 228, 229f Vaginal delivery, 42- 143 Vaginal neoplasm, 25 Vaginal ring contraceptive, 204-205 Vaginal vault prolapse, 265 Valproic acid, Vasa previa, 85-86 color Doppler via transvaginal US, 1 STAT cesarean section, 1 Venereal disease research laboratory (VDRL) , 235 Venogram, 166 Veracity, 16 Vitamin B 12, 3 Vulva and vestibule innervation, 275 Vulvar intraepithelial neoplasia (VIN), 248 biopsy of lesion, 25 follow-up surveillance, 249 U S Preventive Services Task Force (USPSTF ) , 235 Uterine atony, -32, 144 w Uterine compression sutures, 34- Wolffian duct, 287 Uterine contractility, 42-43 Wolffian system, 283 Uterine evacuation, - Women with menopause, -272 Uterine rupture, 66, See also Cesarean Word catheter, 72, 73f, 74f delivery Uteroplacental insufficiency, 82-83 Uterus bimanual uterine massage, 145- 46 induction of labor, 145 manual massage, 34- X X-Linked inheritance, , 1f X-Linked recessive disorders, 88-89 muscular contraction, 145 y pelvic ultrasound, 0, 1f Yellow fever vaccination, 3 [...]... ease is multifactorial and is not possible to assess the risk to the fetus (D) Advise the patient that her son 's disorder is X-linked recessive and her daughter has a 25% chance of being unaffected and a 25% chance of being a carrier (E) Advise the patient that her son 's disease is autosomal recessive and the risk to the female fetus is 25% The answer is D : Advise the patient that her son 's d isorder... G2P2 last menstrual period 3 weeks ago who presents for contraceptive counseling She got divorced about a year and a half ago and has had three male sexual partners since then Since her husband had a vasectomy, she has tried to use condoms as much as possible but wants to review her options She considers herself to be in good health with no medical problems and no previous surger­ ies She denies smoking... gonorrhea, and chlamydia cultures Pregnancy test Mammogram The answer is C: Pap smear, gonorrhea and chlamyd ia cu ltures This patient is sexually active with multiple partners and does not always use con­ doms, so she needs to be screened for sexual transmitted diseases (STDs) Her last pap smear was 3 years ago, so even though she has never had an abnormal one she should receive one today One would consider... is the most appropriate next step in determining the risk of fetal Tay-Sachs disease? (A) (B) (C) (D) Maternal first-trimester serum screening Amniocentesis in the second trimester Chorionic villus sampling in the first trimester Paternal serum screening for Tay-Sachs 22 S h e l f- Life O b stet r i c s and G y n e c o l o g y The answer is D : Paternal seru m screening for Tay-Sachs Cystic fibro­ sis,... course is culture and sensitivity If this is negative, you may repeat the urinalysis and consider referral for cystoscopy CHAPTER A 1 3-year-old girl presents to a Title X clinic requesting birth control While taking her history, it is discovered that she is sexually active with a partner who is 23 years of age She states that they are in a monogamous relationship and that this is consensual She is... (A) She finds abortion procedures unpleasant to perform (B) She fears of criticism from family and/ or society (C) She wishes to utilize her professional authority and advocate her personal positions on abortion (D) She feels performing abortions would risk her personal wholeness or identity The answer is D : She feels perform ing abortions would risk her per­ sonal wholeness or identity Conscience has... also develop this disease What is your next step? (A) Advise the patient that her son likely has an autosomal dominant disease, and there is a significant chance that her daughter will also have hemolytic anemia (B) Advise the patient that her son 's disease is not a genetic disorder and there is almost no risk to her female fetus (C) Advise the patient that the causes and inheritance of her son 's dis­... fibroids at age 3 8 who presents for annual examination She has a history of hypertension and diabetes but has not been tak­ ing her meds She has had her tonsils and appendix removed in the past Her family history is remarkable for hypertension and diabetes in both parents Her father and brother both had heart attacks in their 4 0s She has been married for 28 years and feels that she is in a stable... became sexually active at 1 7 and has had five lifetime male partners She has no medical problems and has never had any surgery She leads a relatively sedentary lifestyle now due to her college schedule although she used to engage in moderate aerobic exercise She drinks moderately on weekends, but denies tobacco or drug use On examination, she is in no acute distress (NAD) Her vital signs are stable and. .. carriers X-linked recessive diseases are transmitted from carrier women to affected men While collecting a thorough family and personal history, a 24-year-old, G l PO, at 1 0 weeks is discovered to be of Ashkenazi Jewish descent Her blood is sent for cystic fibrosis, familial dysautonomia, Tay-Sachs, Can­ avan, Gaucher, and Niemann-Pick disease screening She is found to be a carrier for Tay-Sachs disease ... Robert Casanova, M D, FACOG vii 1 Preventive Care Ethics 11 Genetics 19 Obstetrics 29 Obstetrics Screening and Surveillance 61 Obstetrics High Risk 85 Obstetrics Postpartum 133 Breast and Lactation... Obstetrics and Michele A Manting, MD, MEd Gynecology Associate Professor and Director of Obstetrics and Gynecology Residency Interprofessional Education Program Director Department of Obstetrics and. ..SHELF-LIFE OBSTETRICS AND GYNECOLOGY SHELF-LIFE OBSTETRICS AND GYNECOLOGY Editors Series Editors Elizabeth Buys, MD Veeral Sudhakar Sheth, MD, FACS Assistant Clinical