Obstetrics_by_Ten_Teachers_19E_-_Kenny_Louise

316

Index

neural tube defects

patient-controlled analgesic device

case history, 80–1

(PCA), 204

screening, 57

Peel Report, 14

neurological disorders, 147–9

pelvic floor exercises, 269

Neville Barnes forceps, 232

pelvic inflammatory disease, 4

Newborn Life Support Course, 283–4

pelvic organs, abnormalities of, 87–8

NHS Litigation Authority (NHSLA),

pelvis

305, 306

anatomy, 186–8, 186–8, 189

nifedipine, 97, 124, 139, 250

android, 211

nipples, 268

examination, 10–11

nitrazine testing, 137

female, 190

nitrous oxide (NO), 204

pemphigoid gestationis (PG), 167

non-steroidal anti-inflammatory

penicillin, 151, 171, 179

drugs, 162

peptic ulcer disease, 158–9

nuchal lucency, 79–80, 83

peptides, 33

nuchal translucency, 114–15

perinatal death, 270, 270

perinatal mortality

obstetric palsy, 261

placental abruption, 129

odours, sensitivity to, 24–5

twins, 111–12

oedema, extremities, 11, 87

perineum

oestrogens, 31

anatomy, 188, 189

oligohydramnios, 9, 66, 94

infections, 259

omega-3 fatty acids, 35–6

repair, 226–7, 226

operative intervention, 224–40

trauma, 225–6

assisted delivery, 228

periods, regularity of, 4

case history, 239–40

periventricular leukomalacia (PVL), 299

instrument types, 230–4, 231, 232

persistent pulmonary hypertension

overview, 224

(PPHN), 297–8

prerequisites for instrumental

pethidine, 204

delivery, 229

phaeochromocytoma, 166

opiates, 93, 204

phenobarbitone, 148

opioids, 93

phenylketonuria, 291

Oracle Study, 139

phenytoin, 148

oral changes, 28

phosphatidylcholine, 41

Ortolani-Barlow tests, 290

physiological changes, 20–37

ovarian cysts, 88

blood, 22–4

ovarian hyperstimulation syndrome, 5

cardiovascular system, 26–8

oxygen consumption, 26

early pregnancy, 20–1

oxygenation, 25–6

endocrinology, 32–4

oxytocin, 32, 249, 258, 266

gastrointestinal changes, 29–30

in labour, 208, 209, 211, 212, 221

kidneys, 29–30

maternal brain, 24

palsy, 261, 296, 299

metabolism, 34–6

pancreas, 42

overview, 20

pancreatitis, 159

reproductive organ, 30–2

papilloedema, 11

respiratory tract, 25–6

parametritis, puerperal, 264

senses, 24–5

parasitaemia, 171

skin, 36

parathyroid disease, 165–6

summary, 37

parathyroid hormone (PTH), 165

urinary tract, 29–30

parathyroidectomy, 165

volume homeostasis, 21

parentcraft, 52

pituitary gland, 32–3

parity, 4

pituitary tumours, 166

paroxetine, 277

placenta, 33

partograms, 199, 200, 211, 211

abnormal placentation, 121

parvovirus, 174–5

disorders, 120–31

Patau’s syndrome, 39

localization, 65

317

definition, 247

high-risk asymptomatic women,

diagnosis, 248

140–2

key points, 249

key points, 142

management, 248–9, 249

new developments, 142

primary/secondary, 247

origin of, 132

risk factors, 248

prevalence, 132–4

secondary, 261

worries after, 133–4

potassium, 30

preterm delivery, twins, 111

reference values, 23

preterm labour (PTL)

Potter’s syndrome, 43

clinical features, 135–6

pre-eclampsia, 121–5, 166

differential diagnosis, 136

aetiology, 122–3

examination, 136

case history, 130

fetal assessment, 140

clinical presentation, 123

investigations, 136

definition, 121–2

multiple pregnancies, 115–16

differentiation from systemic lupus

spontaneous, 132, 132

erythematosus (SLE), 161

symptomatic women, 138–40

emergencies, 249–51

vaginal examination, 136

epidemiology, 122

preterm pre-labour rupture of the

history taking, 4, 11

membranes (PPROM), 132,

incidence, 122

132, 262

investigations for, 124

clinical features, 137

management, 124, 125

differential diagnosis, 137

overview, 120

examination, 137

pathophysiology, 122–3

history, 137

prevention, 125

investigations, 137–8

risk factors, 122, 156

risk factors, 135

screening, 57–8, 58, 125

symptomatic women, 138–40

superimposed, risk factors, 156

primary biliary cirrhosis (PBC), 160

symptoms and signs, 250

primary dysfunctional labour, 212

treatment, 124

procoagulant factors, 22

prednisolone, 158, 159

professional bodies, involvement in

pregnancy

maternity care, 15–16

confirmation of, 52

progesterone, 141

dating, 53

prolactin, 31, 32–3, 266

expected date of delivery (EDD), 53

propylthiouracil (PTU), 165

see also multiple pregnancies;

prostaglandins, 139, 221

twin pregnancies

proteinuria, 7

prelabour rupture of membranes

maternal, 72

(PROM), 220

testing for, 124

premature infants, 45

Proteus, 89

case history, 45–6

prurigo of pregnancy, 167

prematurity, main problems of, 299

pruritic folliculitis, 167

prenatal diagnosis, 75–84

pruritus, 36

classification, 75–6

Pseudomonas, 89

definition, 75

psychiatric disorders, 272–80

invasive, 76–9

antenatal, 278

key points, 83

case histories, 274–5, 276, 277

new developments, 84

key points, 280

non-invasive, 75, 76

management of pre-existing, 274–7

overview, 75

maternal mortality, 272–3

pre-test counselling, 76–7

new-onset, 277–80

reasons for, 75

normal emotional and psychological

preterm births

changes, 273

aetiology, 134

overview, 272

classification, 134

post-natal, 278

definition, 132

psychiatric problems, antenatal, 60

318

Index

Rhesus disease

Short Report, 14

aetiology, 104–5

shoulder dystocia, 254–6, 255

key points, 108

risk factors, 255

management in sensitized woman,

sickle-cell anaemia, 144–5

107–8

sickle-cell disease, neonatal, 291

prevalence, 105

sickle-cell disease (SCD), 144–5

sensitizing events, 105

in antenatal care, 56

severity assessment, 71

sight, 25

Rhesus iso-immunization, 104–5

Simpson forceps, 232, 232

prevention, 105–6

skin

Rhesus sensitization, 106

disease, 167

rheumatoid arthritis (RA), 162

fetal, 43–4, 45

ribavirin, 183

maternal, 36

risk, identification, 6

premature infants, 46

risk management, clinical (CRM),

skin tags, 288

223

small for gestational age (SGA),

ritodrine, 138–9

case history, 73

rotation, in labour, 193, 194

smoking, 3

Royal College of Obstetricians and

antenatal care, 52

Gynaecologists (RCOG), 15–16,

antenatal complications, 93, 94

293

fetal growth restriction, 126, 128

rubella, 169–70

social history, history taking, 2–3, 12

in antenatal care, 56

sodium, 21, 30

reference values, 23

Sabin-Feldman dye test, 172

sodium valproate, 148

sacral pits, 288–9

special educational needs (SEN), 298

salmetrerol, 150

speculum examination, 10

sarcoidosis, 150–1

spina bifida, 303

schizophrenia, 275–6

screening, 57

scleroderma, 162

spinal anaesthesia, 207

screening

spiramycin, 172

antenatal, 57–8

Staphylococcus aureus, 268

chlamydia, 57

steroids, 148, 162

diabetes, 57

maternal, 138

Down’s syndrome, 57, 79

systemic lupus erythematosus, 162

fetal abnormalities, 57, 114–15

Stillbirth and Neonatal Death Society

neonatal, 289–92, 294–5

(SANDS), 270

pre-eclampsia, 57–8, 58, 125

stockings, elastic, 91

prenatal diagnosis, 75–84

streptococci, 89

see also ultrasound

streptococcus, Group B (GBS), 141

sebaceous glands, 36

Streptococcus agalactiae, 178

secondary postpartum haemorrhage

Streptococcus viridans, 268

(PPH), 261

stretch marks, 36

seizures, causes, 148

striae gravidarum, 36

selective serotonin reuptake inhibitors

Sturge-Weber syndrome, 288

(SSRIs), 277, 278, 279

substance abuse, 93–4, 273

self-examination, 7

suckling, 31, 32

senses, 24–5

suicides, 272–3

severe acute respiratory syndrome

sulphasalazine, 162

(SARS), 151

sulphonamides, 262

sex steroid hormones, 33

surfactant, 41, 47

sexing fetus, 84

sutures, 142, 142

shingles, 174

symphysiotomy, 261–2

shock

symphysis pubis diastasis, 261–2

endotoxic, 265

symphysis pubis dysfunction, 85

septic, 265

symphysis-fundal height (SFH), 8, 8, 9

septicaemic, 265

Syntometrine, 249

319

triglycerides, reference values, 23

biophysical profiles (BPPs), 69–70, 69

triplets, 109, 118–19

case history, 73–4

trisomies, 113, 114

cervical, 141

Edward’s syndrome, 39

clinical applications, 62–6

Patau’s syndrome, 39

compression ultrasound, 91

see also Down’s syndrome

diagnostic, 61–2

twin pregnancies

early pregnancy scan, 72

amniocentesis, 114

fetal well-being, 66–73

case history, 119

guiding invasive procedures, 72

chromosomal defects, 113

multiple pregnancies, 115

complications, 111–13, 112

as new intervention, 13

death of one fetus, 112

overview, 61

delivery requirements, 118

pregnancy dating by, 2, 53

incidence, 109

in prenatal diagnosis, 76

intrapartum management, 116–18

preterm pre-labour rupture of the

maternal physiology, 111

membranes, 137

physiology, 111

probes, 61, 62

postpartum haemorrhage, 118

puerperium, 261

prevalence, 109

scanning, 2, 49

ultrasound identification of, 64–5,

scanning schedule in clinical

65

practice, 66

see also multiple pregnancies

third trimester, 73

twin-to-twin transfusion syndrome

transvaginal, 61–2

(TTTS), 65, 71, 95, 113–14, 115

20 week scan, 72–3

twins

see also Doppler ultrasound

conjoined (Siamese), 111

umbilical artery, Doppler investigation,

delivery, 116–18

70–2, 70–1

dichorionic, 110, 112–13, 114, 115

umbilical cord accidents, emergencies,

dizygotic, 110, 110, 113

253–4

fetal abnormalities, 113

under-nutrition, maternal, 126

fetal growth restriction, 112

urate, 29, 30

fraternal, 110

urea, 29

identical, 110

reference values, 23

monoamniotic, 110, 114

ureaplasm, 141

monochorionic, 110, 112–14, 115

uric acid, reference values, 23

monozygotic, 110, 110–11, 110, 113

urinalysis, in antenatal care, 56

non-identical, 110

urinary examination, 7

perinatal mortality, 111–12

urinary tract, 29–30

preterm, 118

fetal, 43

see also multiple pregnancies; twin

infections (UTIs), 88–9

pregnancies

uterine anomalies, congenital, 88

Twins and Multiple Birth Association

uterine atony, 248

(TAMBA), 116

uterine inversion, 252, 252

uterine rupture, 251–2

ulcerative colitis, 159

risk factors, 251

ultrasound, 12

uterus, 30–1, 31, 33

aims, 72–3

abnormal cavity, 135

assessment of fetal well-being, 66,

dysfunctional activity, 208–9

66–72

involution, 258–9