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INDEX 343
Pelvic inflammatory disease (Continued)
risk factors for, 46
treatment of
considerations for, 47
inpatient, 47
outpatient, 47
Pelvic inlet, 264
Pelvic midplane, 264
Pelvic organ prolapse, 79–83, 81b
definition of, 79
evaluation of, 80
grafts for, 81
hysterectomy in, 81
measurement of, 80, 80f
nonsurgical options for, 81
prevalence of, 80
risk factors for, 80, 80t
surgical procedures for, 81, 83t
symptoms associated with, 79
terminology for, 79t
treatment for, 81
Pelvic organs, innervation of, 69–70
Pelvic outlet, 264, 264f
Pelvic pain
acute, 69–73, 73b
chronic and, 70
most common causes of, 69
chronic, 73b
acute pain and, 70
causes of, 71t
common, 70
definition of, 70
differential diagnosis of, 70
endometriosis-related, 18
psychiatric considerations and, 73
treatment of, 72
Pelvimetry, 264
Pelvis
adhesions of, 71, 71f
assessment of, 264
fracture of, during pregnancy, 247
infection of, 69
as contraindication to hysterosalpingography, 104
renal, pregnancy-related changes in, 203
support structures from, 79
types of, 265f
Penetrating trauma, 245
abdominal, 245
Penicillin G, for group B Streptococcus, 236
Perfusion, uterine, 247
Perimenopausal women
abnormal uterine bleeding in, 15
anovulatory cycles in, 16
Perimenopause, definition of, 31
Perimortem cesarean delivery, 248
Perinatal morbidity, in intrauterine growth restriction
cause, 197
Perineal lacerations, care for, 323
Perioperative prophylactic tocolytics, 241
Peripartum cardiomyopathy (PPCM), 234
Perpetrator apology and remorse, in domestic abuse, 89
Persistent asthma, treatment of, 229
Pessaries, as pelvic organ prolapse treatment, 81, 82f
PGD. see Preimplantation genetic diagnosis (PGD)
PH. see Pulmonary hypertension (PH)
Phenobarbital, malformation rates associated to, 224,
225t
Phenylketonuria (PKU), 165
Phenytoin
interaction with folic acid, 224
malformation rates associated to, 224, 225t
Physical dependence, definition of, 249
Physical examination, in precocious puberty, 93
Pica, 167
PID. see Pelvic inflammatory disease (PID)
Piper forceps, 270, 270f
PKU. see Phenylketonuria (PKU)
Placenta
battledore, 153
function of, 152
in intrauterine growth restriction, 196
low-lying, 303
passage of drugs across, 286
pathophysiology of, 152–154, 154b
physical measurements of, 153
thyroid function in, 217
Placenta accreta, 153, 304
and placenta previa, association between, 305
as postpartum hemorrhage cause, 312–313
risk factors for, 305
Placenta increta, 153, 304
Placenta percreta, 153, 304
Placenta previa, 153, 303–308, 305b
bleeding caused by, 303
common risk factors for, 303
definition of, 303
diagnosis of, 304
fetal complications of, 304
incidence of, 303
management of, 304
manifestation of, 304
maternal complications of, 303
obstetric complications associated with, 303
and placenta accreta, association with, 305
recurrence of, 304
and smoking, 303
Placental abruption, 153, 303–308, 307b
chorionic, 305
definition of, 305
delivery of pregnancy complicated by, 307
diagnosis of, 306
fetal complications of, 306
incidence of, 305
laboratory studies for, 307
management of, 306–307
manifestation of, 305, 306f
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344 INDEX
Placental abruption (Continued)
maternal complications of, 306
nonsevere, 306
recurrence of, 307
risk factors for, 305
severe, 306
in trauma patients
monitoring, 247
sensitive predictor of, 247
Placental migration, 303
Plasma volume, in pregnant trauma patients, 246t
PMDD. see Premenstrual dysphoric disorder (PMDD)
PMS. see Premenstrual syndrome (PMS)
Pneumonia, during pregnancy, 229
POI. see Primary ovarian insufficiency (POI)
Polycystic ovarian syndrome (PCOS), 66, 118–121, 120b
anovulation and, 108
as anovulation cause, 25
causes of, 119
diagnosis of
criteria for, 119
tests for, 120
findings in, 120
infertility related to, 106
long-term consequences of, 120
obesity and, 120
Polyembryoma, 143
Polyhydramnios, 171
congenital abnormalities associated with, 200
definition of, 200
obstetric complications caused by, 200
Polymenorrhea, 15
Positive pressure ventilation (PPV)
initiation of, 317
stopping of, 318
Postdural puncture, epidural analgesia-related, 290
Postmenopausal bleeding, differential diagnosis of, 135
Postmenopausal women
CA-125 levels in, 67
ovarian cancer in, 144
uterine bleeding in, 15
Postpartum care, 322–326, 325b
Postpartum depression, 324–325
treatment of, 325
Postpartum fever, 323
differential diagnosis of, 323
infection in, cause of, 323
Postpartum hemorrhage (PPH), 292
anesthesiologist in, 292
Postpartum period
activities restricted during, 322
common issues in, 322
hemorrhage during, 312–314
suppression of ovulation by, 323
Postpartum thyroiditis, 219, 324
prognosis for patients with, 219
Postvoid residual (PVR) determination, 75
Potter syndrome, 199
PPCM. see Peripartum cardiomyopathy (PPCM)
PPH. see Postpartum hemorrhage (PPH)
PPV. see Positive pressure ventilation (PPV)
Preconception counseling, 155–156, 156b
Preeclampsia
after delivery, 214
anesthetic risks associated with, 292
causes of, 212
common, 212
definition of, 211
delivery for, 213
effectiveness of aspirin risk of, 212
fetal risks associated with, 212
headaches and, 225
long-term effects, 212
maternal risks associated with, 212
monitored after delivery, 214
with pregestational diabetes, 212
prevention of, 212
risk factors for, 211–212
seizures as risk factor for, 224
with severe features, 211, 213
diagnosed before pregnancy, 213
subsequent pregnancies, 212
superimposed, 211
treatment of, 213
Pregestational diabetes, 206–210, 208b
complications associated with, 206
congenital anomalies in, 207
delivery indicated in pregnancies, 207
fetal assessment and, 207
incidence of, 206
neonatal consequences of, 207
thyroid function between, 206
type of testing of pregnant women with, 206
Pregnancy
with abnormal cytologic findings, considerations in,
124
abnormal uterine bleeding associated with, 15
as amenorrhea cause, 96
bleeding in, evaluating, 115–116
blood count during, 159
blood glucose levels monitored in, 209
cancer during, incidence of, 243
in carbohydrate metabolism, 150
cardiovascular disease in, 232–235, 235b
cardiovascular system during, 149
cerclage, 190
cervical insufficiency during, 189
coagulation parameters during, 151
complications of, preventing, by prenatal care, 162
contraindications to, 156
ectopic, 49–53, 51t, 53b, 69
common symptoms of, 50
definition of, 49
epidemiology of, 49
intrauterine pregnancy-associated, 49
laparoscopic view of, 69f
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INDEX 345
Pregnancy (Continued)
locations of implantation in, 50f
risk factors for, 49
surgical management of, 53
tubal surgery as risk for, 104
elective termination of, 189
exercise for, 162, 168b
false-positive and false-negative in, causes of, 149
headaches during, 225
hemoglobin electrophoresis during, 159
heterotopic, 49
HIV infection in, screening for, 160
as hypercoagulable state, 151
hypertension during, 211–215, 214b
definition of, 211
gestational hypertension, 211
imaging studies in, risk of, 243, 244t
infections during, 236–240, 239b
intimate partner violence during, 88
intrauterine, 69
normal, 51t
kidneys and urinary tract during, 150
leiomyomas and, 22
migraines during, 225
molar, 146–147, 147f
nausea and vomiting in, 193–195, 194b
alternative therapies of, 194
causes of, 193
differential diagnosis of, 193
fetal complications of, 193
laboratory abnormalities, 193
severe maternal complications with, 193
treatment of, 194
neurologic issues in, 224–226, 226b
normal physiology of, 149–151, 151b
nutrition and, 164–168
oral ovulation agents and, 109
Pap smears in, 159
percentage of, 54
physiologic changes during
cardiovascular, 232
implication for plan of analgesia, 285
pulmonary, 227, 228f
in trauma patients, 246t
pulmonary disease in, 227–231, 230b
recurrent, loss of
definition of, 116
spontaneous abortion and, 113–117, 117b
reproductive tract during, 149
routine medication for, 162
seizure disorders during, 224
short cervix, options for, 192
skin changes in, 150
supine hypotension during, 150
surgery during, 241–244, 244b
surgical diseases in, 241–242
target glucose levels in, 209
terminate, methods to, 54
Pregnancy (Continued)
thyroid disease during, 216–219, 219b
thyroid function in, 150
trauma in, 245–248
facts of, 246
forms of, 245
frequency of, 245
initial evaluation of, 245
risk factors for, 245
tuberculosis in, screening for, 160–161
twin, placentation in, types of, 153
urinalysis during, 159
urine culture during, 159
viability of, PPROM in, 300
weight gain during, 159
work and, 162
Pregnancy test, results in, 149
Preimplantation diagnosis, 176
Preimplantation genetic diagnosis (PGD), 111
Preload, in mitral stenosis patients, 233
Premature birth, caused by trauma, 248
Premature ovarian failure, 100
Premature rupture of membranes (PROM), 299
evaluation of patient with, 300–301
incidence of, 299
polyhydramnios-related, 200
preterm, 295–302, 301b
complications of, 299
gonococci and, 160
incidence of, 299
intraamniotic infection in patients with, organisms
associated with, 299
management of, 301
recommendations for delivery in, 301
risk factors for, 299
significance of, before pregnancy viability, 300
tocolysis for, 301
symptoms of, 300
tests for, 301
Premenstrual dysphoric disorder (PMDD), 11
severe, treatment of, 11
Premenstrual syndrome (PMS), 11, 12b
causes of, 11
diagnosis of, 11
incidence of, 11
severe, treatment of, 11
symptoms of, 11
treatment of, 11
Prenatal care, 157
comprehensive, 157–163, 163b
laboratory tests for, 158, 158t, 160
in multiple gestation, 260–261
for obese patients, 255
Prenatal diagnosis, 175–177, 177b
offered in, 175
techniques in, 175
ultrasound findings in, 176
Preterm birth, risk of, 189
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346 INDEX
Preterm delivery, correlation with maternal weight gain,
164
Preterm gestations, labor and, 263
Preterm labor, polyhydramnios-related, 200
Primary dysmenorrhea, 12
Primary ovarian insufficiency (POI), 26, 100
Procidentia, 79
Progesterone
on gastrointestinal and biliary systems, 150
in luteal phase, 9
peak level of, 9
in pregnancy, as ectopic pregnancy indicator, 51
in puberty, 90
Progestins, 60
for endometrial cancer, 137
as endometriosis treatment, 19
for perimenopausal and menopausal women, 32
Prolonged active phase, of labor, 266
Prolonged descent, of labor, 266
Prolonged latent phase, of labor, 266
PROM. see Premature rupture of membranes (PROM)
Promethazine, as nausea and vomiting of pregnancy
treatment, 194
Propylthiouracil (PTU), 217
Prostaglandin F
2α
, 313t
Prostaglandin synthetase inhibitor, as preterm labor
treatment, 299
Prostaglandins, in menstruation, 9
Proteinuria, 211
during pregnancy, 211
Proximal tubal disease, treatment of, 104
Psychological dependence, definition of, 249
PTU. see Propylthiouracil (PTU)
Pubarche, 95b
Puberty, 90–95, 95b
age of onset of, 91
definition of, 90
delayed, 92
causes of, 94, 94t
diagnostic workup for, 94
factors that determine, 90–91
hormonal changes during, 90
physical signs of, 90
precocious, 92
gonadotropin releasing hormone in, 92
Pubic hair, development of, 90, 91t
Pudendal nerve block, 289
Puerperium, 322
Pulmonary disease, in pregnancy, 227–231, 230b
Pulmonary hypertension (PH), 232–233
Purpura, idiopathic thrombocytopenic, 220t,
222–223
Pyelonephritis
hospital admission, 203
as pelvic pain cause, 72
pregnant women at increased risk for, 203
Pyridoxine, as nausea and vomiting of pregnancy
treatment, 194
Q
Q-tip test, 75
QuantiFERON-TB Gold test, for tuberculosis, 229–230
R
Radiation therapy
for cervical cancer, 133
for vulvar cancer, 127
Radical hysterectomy, complications associated with, 133
Radiograph, bone age, in precocious puberty, 93
Radioiodine therapy, contraindication during pregnancy,
219
Radiologic imaging, in pregnant patients, 245
Raloxifene, as osteoporosis treatment, 34t
RBC antigen groups, clinically significant, 201
RBC mass, in pregnant trauma patients, 246t
Rectocele, 79t
Recurrent pregnancy loss (RPL)
definition of, 116
empiric treatments for, 117
identifiable cause for, 116
initial workup for, 116
spontaneous abortion and, 113–117, 117b
Regional anesthesia, 289, 291
neonatal outcomes with, 292
Regurgitant valve lesions, 234
Regurgitation, during pregnancy, 234
Relaxin, 153
Remifentanil, 287
Remorse, from perpetrator, in domestic abuse, 89
Renal disease, in pregnancy, 203–205, 204b
chronic, 204
Renal transplant
medication for, 204
risks in pregnancy for women, 204
Reproductive age, leiomyomas in, 21
Reproductive organs, causes of chronic pain, 70–71
Reproductive system, menstrual cycle and, 7
Reproductive tract, changes in, during pregnancy, 149
Residual volume, during pregnancy, 227, 228f
Respiratory system
changes in, during pregnancy, 150
pregnancy-related changes in, 287t
Resuscitation
ABCDs of, 317
newborn, 315–321, 321b
continuation of, with no heart rate, 319
discontinuation of, 319
epinephrine for, 318
percentage of newborns requiring, 316
preterm infants, at risk for resuscitation, 316
risk factors associated with need for, 316, 316b
venous access for, primary site of, 318
of obstetric patient, 293
Retinopathy, diabetic, 206
Reversed end-diastolic velocity, 180
Rh alloimmunization, 201
Rh immune globulin (RhoGAM), 159, 246–247
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INDEX 347
Rheumatic heart disease, as mitral stenosis, 233
Rheumatoid arthritis, 220t, 222
RhoGAM. see Rh immune globulin (RhoGAM)
Rho(D) immunoglobulin, 201
in Rh-negative women, for spontaneous abortions, 116
Right upper quadrant pain, associated with preeclampsia,
211
Ritgen maneuver, 267, 269f
Roe v. Wade decision, 56
ROMA score, 68
RPL. see Recurrent pregnancy loss (RPL)
Rubella antibody titer, 160
Rubella infection, congenital, 238
Rubella syndrome, congenital, 160
Rubella vaccine, 160
S
Safety plan, for intimate partner violence, 89
Salpingitis, as ectopic pregnancy cause, 49
Salpingo-oophorectomy, as endometriosis treatment, 19
Salpingostomy
distal, 104
as ectopic pregnancy treatment, 53
Sarcoidosis, 230
Sarcoma
of endometrial cancer, 136
vulvar cancer and, 126
Seat belts, pregnant women and, 248
Second trimester screening, for congenital malformation
diagnosis, 184
Second trimester serum markers, 259
Second trimester surgical termination
in abortion, 56
fetal demise in, 56
Secondary dysmenorrhea, 12
Seizure disorders, during pregnancy, 224
Seizures
in preconception counseling, 155
preeclampsia-related, 292
Selective estrogen receptor modulators (SERMs), 32, 34t
Selective fetoscopic laser coagulation, for twin-twin
transfusion syndrome treatment, 259
Selective reduction, for twin-twin transfusion syndrome,
260
Selective serotonin reuptake inhibitors, as amenorrhea
cause, 100
Semen analysis, 104, 104b
prior to in vitro fertilization, 110
Sepsis, neonatal, GBS infection and, 161
Septic pelvic thrombophlebitis, 323
Serial amnioreduction, for twin-twin transfusion
syndrome treatment, 259
SERMs. see Selective estrogen receptor modulators (SERMs)
Serologic testing, for syphilis, 160
Sertoli-Leydig cell tumors, of malignant SCSTs, 144
Sex cord stromal tumors (SCSTs), malignant, 144–145
Sex hormone-binding globulin (SHBG), of androgen
action, 118
Sexual arousal disorder, 29
Sexual dysfunction
definition of, 28
DSM-V definition of, 28–29
etiology of, 29
evaluation of, 29
female, 28–30, 30b
devices for treatment of, 30
types of disorders in, 28
potential barriers to treatment of, 29
prevalence of, 28
Sexual interest disorder, 29
Sexual response cycle, phases of, 28
Sexuality, aspects of, 28
Sexually transmitted diseases
screening for, during preconception counseling, 155
tests for, benefit of, 160
Sexually transmitted infections (STIs), in lower genital
tract, 42
SGA. see Small for gestational age (SGA)
Shirodkar cerclage, 190
Shock, hypovolemic
suspected, 319
management of, 319
in uterine blood flow, 247
Sickle cell trait, 159
Simpson forceps, 270, 270f
Single-gene defects, 187
Single-gene disorders, 186
Sinus tumors, endodermal, 143
Skin, changes of, in pregnancy, 150
Small for gestational age (SGA), 196
Smoking
as cause of cervical cancer, 131
as ectopic pregnancy risk factor, 49
effect on fertility, 102
and placenta previa, 303
during pregnancy, cessation of, 252–253
in in vitro fertilization success, 111
Sodium balance, during pregnancy, 203
Somatic complaints, from intimate partner violence,
88
Sonohysteroscopy, prior to in vitro fertilization, 110
Sperm
assessment of, 103
in in vitro fertilization, 111
Spermicides, 58
Spina bifida, 177
Spinal analgesia, 288, 289f, 293
Spinal anesthesia, as peripheral vasodilation cause, 232
Spinal headaches, 290
definition of, 290
treatment of, 290
Spironolactone
for hirsutism, 119, 119t
for premenstrual syndrome, 12
Splenic artery aneurysm rupture, 242
Splenic rupture, 242
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348 INDEX
Squamous cell carcinoma
of cervical cancer, 131
of vulvar cancer, 126
Stab wounds
abdominal, 245
management of, 247
Standard “drink,” 248
Status asthmaticus, 229
Status epilepticus, 225
Sterilization
permanent, 62–63
for premenstrual syndrome, 12
Streptococcus, group B, screening of, 236
during pregnancy, 161
Streptococcus pneumoniae, as pneumonia cause, 229
Stress, as anovulation cause, 25
Stress urinary incontinence, 74
nonsurgical treatments for, 75, 76f
surgical options for, 76, 77f
versus UUI, 75
Strict intrapartum glycemic control, 210
Stromal tumors, 145
Subclinical hypothyroidism, 218
Substance abuse, signs of, 253. see also Drug abuse
Succenturiate placenta, 153
Sumatriptan, for migraines, 225
Superfecundation, 257, 258f
Superimposed preeclampsia (SIPE), definition of, 211
Supine hypotension, during pregnancy, 150
Supplementation, for multiple gestation, 260
Surfactants, deficiency of, 316
Surgery, during pregnancy, 241–244, 244b
Surgical abortion, 54
complications of, 56
Surgical diseases, in pregnancy, 241–242
Sympathetic nervous system, during pregnancy, 285
Syphilis, 37, 42–43
infection
congenital, 238
maternal, 238
serologic testing for, 160
stage of, 43
Systemic lupus erythematosus, 220t, 221
neonatal, 221
Systemic vascular resistance, regurgitation and, 234
T
TACE, for alcohol abuse screening, 250
Tachycardia, 273
idiopathic right ventricular outflow tract, 234
Tamoxifen, as osteoporosis treatment, 34t
Tamponade techniques, for postpartum hemorrhage, 312
Tanner staging, 90, 91f, 91t
Tay-Sachs disease, 186
TB. see Tuberculosis (TB)
Tension building, in domestic abuse, 89
Teratomas, 143
benign cystic, 67
Terbutaline, as tocolytic agent, 298
TESE. see Testicular sperm extraction (TESE)
Testicular sperm extraction (TESE), 111
Testosterone, production of, 118
Thecomas, of malignant SCSTs, 144
Thelarche, 90
Therapeutic rest”, for prolonged latent phase, 266
Third trimester, potential causes of bleeding in, 305
Thrombocytopenia
fetal, 223
preeclampsia-related, 292
Thromboembolic disease, during pregnancy
diagnosis of, 229
treatment of, 229
Thrombophlebitis, septic pelvic, 323
Thyroid, function between pregestational diabetes,
206
Thyroid cancer, 219
Thyroid disease
ovulation induction and, 108
during pregnancy, 216–219, 219b
screened for, 216
Thyroid dysfunction, causing anovulation, 26
Thyroid function
changes of, in pregnancy, 150
during pregnancy, 216
testing, during pregnancy, 216t
Thyroid function tests
for amenorrhea, 96
in precocious puberty, 93
Thyroid gland in pregnancy, 216
Thyroid nodule, 219
during pregnancy, 217
Thyroid storm, 218
Thyroiditis, postpartum, 219, 324
Thyrotoxicosis, of pregnancy, differential diagnosis
of, 217
Tidal volume, pregnancy-related increase in, 227
Time, best, for surgical procedures, 241
Tobacco, obstetric complications of, 252
Tocolytic drugs, anesthetic implications of, 292
Tocolytic therapy
agents of, 298–299
contraindications to, 299
for PPROM, 301
for preterm labor treatment, 298
Tocolytics, perioperative prophylactic, 241
TOLAC. see Trial of labor after cesarean section (TOLAC)
Total lung capacity, during pregnancy, 227, 228f
Total parenteral nutrition, as nausea and vomiting of
pregnancy treatment, 194
Toxoplasmosis, 167
during pregnancy, 238–239
Transabdominal cerclage, 190
Transvaginal ultrasound (TVUS), 50–51
Trauma, in pregnancy, 245–248
facts of, 246
forms of, 245
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INDEX 349
Trauma, in pregnancy (Continued)
frequency of, 245
initial evaluation of, 245
risk factors for, 245
Treponema pallidum, in maternal syphilis infection, 238
Trial of labor after cesarean section (TOLAC)
contraindications to, 281
and induction of labor, 282
risks of, 281
successful, 281
and twin pregnancies, 282
and VBAC, 280
Trichomoniasis, 41t, 42
Trisomies, autosomal, in spontaneous abortion, 113
Trisomy 13, as autosomal chromosomal disorders, 184t
Trisomy 16, 113
Trisomy 18, 175
as autosomal chromosomal disorders, 184t
Trisomy 21, 176
as autosomal chromosomal disorders, 184t
Trophoblastic cells, differentiation of, 152
TTTS. see Twin-twin transfusion syndrome (TTTS)
Tubal disease, treatment of, 104
Tubal factor, infertility and, 103
Tubal ligation, 62
Tubal occlusion, 62–63
Tubal patency, in infertility assessment, 103
Tuberculosis (TB)
in pregnancy, 229–230
screening of, in pregnant women, 160–161
treatment of, 230
Tucker-McLane forceps, 270, 270f
Tumors, ovarian, as precocious puberty cause, 93
Turner syndrome, 117b, 185t
TVUS. see Transvaginal ultrasound (TVUS)
Twin gestations, chorionicity in, 153
Twin pregnancy, placentation in, types of, 153
Twin-twin transfusion syndrome (TTTS), 259, 259t
Twins
aneuploidy in, 257
monozygotic, 257, 258f
occurrence of, 257
presentation of, combinations in, 261
Type 2 diabetes, 209
U
Ulipristal acetate pill, 62
Ultrasound
for abnormal uterine bleeding, 16
for breast mass evaluation, 86
for chorionicity, 257
Doppler, during pregnancy, 171
in establishing the estimated due date, 169
examination, 170
accuracy in, 171
chorionicity in multiple gestations, 171, 173f
imaging, for fetal cardiac activity, 149
M-mode, 171
Ultrasound (Continued)
for multiple gestation, 260–261
obstetric, 169–174, 171b
Doppler, 171
first trimester, 169
for nuchal translucency, 170
for placenta previa diagnosis, 304
second trimester, 169–170
ovulation and, 103
pelvic, in precocious puberty, 93
in placental thickness, 153
prenatal, 162
probe, 169
risk of, 243
techniques in prenatal diagnosis, 175
technology, 169
transvaginal pelvic, 142
for trauma evaluation, 245
Ultrasound-guided transverse abdominal plane (TAP)
block, 293
Umbilical artery
Doppler velocimetry of, 197
single, 153
Umbilical artery Doppler velocimetry, 178
Umbilical artery velocimetry interpreted, 180,
181f
Umbilical cord blood, acid-base analysis of,
320
Uniparental disomy (UPD), 187
Unstable lie, 310
Unstable repeat expansion, 187
UPD. see Uniparental disomy (UPD)
Ureteral obstruction, as pelvic pain cause, 72
Ureters, pregnancy-related changes in, 203
Urethra, lesions near, precautions in, 128
Urethral sphincter, impaired function of, 74
Urgency urinary incontinence, 74
nonsurgical treatments for, 75–76
versus SUI, 75
surgical options for, 77, 77t–78t
Uric acid, pregnancy increase, 203
Urinalysis
during pregnancy, 159
for urinary incontinence evaluation, 75
Urinary incontinence, 74–78, 78b
associated with chronic urinary retention, 74
continuous, 74
definition of, 74
differential diagnosis of, 77t–78t
laboratory tests for, 75
physical examination findings associated with,
74–75
stress, 74
treatment of, 77t–78t
types of, 74
urgency, 74
Urinary retention, chronic, urinary incontinence
associated with, 74
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350 INDEX
Urinary system, during pregnancy, 203
physiologic changes, 203
Urinary tract
changes in, during pregnancy, 150
pregnancy-related changes in, 203
Urinary tract infection (UTI), as pelvic pain cause, 72
Urine, cocaine metabolites in, 251
Urine culture, during pregnancy, 159
Urine ovulation predictor kits (OPKs), 103
Urodynamics, multichannel, 75
Urolithiasis, during pregnancy, 203
initial evaluation in, 203
Use, defined, in alcohol and drug abuse, 249
Uterine anatomy, in infertility assessment, 103
Uterine artery embolization (UAE), as leiomyoma
treatment, 23
Uterine atony, in multiple gestation, 261
Uterine bleeding, abnormal, 15–17, 17b
anovulation and, 25
categorization of, 15–16, 15t
evaluating, 135
history and physical examination of, 16
laboratory tests for, 16
leiomyoma-related, 21–22
treatment of, 17
Uterine cancer, 135–138, 138b
Uterine cavity, assessment of, prior to in vitro fertilization,
110
Uterine contractions, 264–265
Uterine monitoring, role of, in intrapartum fetal
surveillance, 278
Uterine neoplasm, as pelvic pain cause, 71
Uterine prolapse, 79t
Uterine rupture, 281
risk factors for, 281, 281t
signs and symptoms of, 281
Uterine septum, management of, 106
Uterine size, in pregnant trauma patients, 246t
Uteroplacental insufficiency , in intrauterine growth
restriction, 197
Uterotonics, for uterine atony, 312, 313t
Uterus
atony of, 292
as postpartum hemorrhage cause, 312, 312b
uterotonics for, 312, 313t
bicornuate, management of, 106
compression of the inferior vena cava (IVC) by, 150
congenital anomalies of, as infertility cause, 105,
105f
Couvelaire, 307
dextrorotation of, 149
ectopic pregnancy and, 49
inversion of, 313
involution of, 322
leiomyomatous, 21–24, 22f, 23b
malformations of, management of, 106
perforation, surgical abortion and, 56
UTI. see Urinary tract infection (UTI)
V
Vagina
abnormalities of, developmental, 39
benign lesions of, 36–39, 39b
cystic lesions of, 38, 39f
examination of, 267
pelvic support of, 79
solid tumors of, benign, 38
Vaginal birth after cesarean (VBAC) delivery, 279–283,
282b
benefits of, 280–281
and TOLAC, 280
Vaginal bleeding
abortion in, differentiating, 114
in first trimester, of pregnancy, 113
Vaginal breech delivery, 310
complications of, 311
Vaginal cancer, 126–130, 129b
incidence of, 128
manifestation of, 128
pattern of spread in, 128
risk factors for, 128
staging of, 128, 129t
survival rates for, 129
treatment of, 129
Vaginal fluid, in lower genital tract infections, 40
Vaginal intraepithelial neoplasia (VAIN), 124
Vaginal pain, causes of, 71
Vaginal progesterone, 192
Vaginal vault prolapse, 79
Vaginitis, 40, 41t
atrophic, 42
Vaginosis, bacterial, 41t, 42
VAIN. see Vaginal intraepithelial neoplasia (VAIN)
Valproic acid, 224
malformation rates associated to, 224, 225t
Valvuloplasty, percutaneous, 234
Vancomycin, for group B Streptococcus, 236
Varenicline, 253
Variability, 273
change in, cause of, 273
Varicella infection, in pregnancy, 239
VAS. see Vibroacoustic stimulation (VAS)
Vas deferens, congenital bilateral absence of, 184
Vasa previa, 304
Vasectomy, 63
Vasodilation, peripheral, anesthesia-related, 232
Velamentous cord insertion, 153
Velocimetry, Doppler, 180, 197, 202
Venous thromboembolism (VTE), 229
recommendations for, 241
Ventricular septal defect, most common, 233
Vertex
breech twins, delivery of, 261
transverse twins, delivery of, 261
vertex twins, delivery of, 261
Vibroacoustic stimulation (VAS), 180
Victims, of intimate partner violence, 89
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INDEX 351
VIN. see Vulvar intraepithelial neoplasia (VIN)
Violence, intimate partner, 88–89, 89b
Viral infections, as intrauterine growth restriction cause,
196
Viral load, in HIV infection, 160
Virilization, 118
Visits, number of, for multiple gestation, 261
Vital capacity, during pregnancy, 227, 228f
Vitamin B
6
, as nausea and vomiting of pregnancy
treatment, 194
Vitamin D, as osteoporosis treatment, 34t
Vitamin supplementation, during pregnancy, 165
VTE. see Venous thromboembolism (VTE)
Vulva
benign lesions of, 36–39, 39b
cause of, 36
pigmented, 38
components of, 36, 36f
cystic lesions of, 38, 39f
dermatoses of, 38
dysplasia of, 126
Paget disease of, extramammary, 39
solid tumors of, benign, 38
Vulvar cancer, 126–130, 129b
diagnosis of, 126
histologic types of, 126
incidence of, 126
pattern of spread in, 126
risk factors of, 126
Vulvar cancer (Continued)
staging of, 127, 127t
survival rates for, 128
symptoms of, 126
treatment of, 127
vulvar dysplasia and, difference of, 126
Vulvar intraepithelial neoplasia (VIN), 124
Vulvovaginal candidiasis, 40
W
Warfarin, 229
Weight
in anovulation, 108
birth, for multiple gestation, 261
in pregnancy, recommended, 255
Weight gain
maternal, effect on birth weight, 196
for multiple gestation, 260
during pregnancy, 159, 164
during prenatal care, 157
Weight loss, anovulation-related, 25
White classification of diabetes in pregnancy, 206, 206t
X
X-linked disorders, 186–187
Y
Yolk sac, 152
Yuzpe method, 62
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