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OXFORD MEDICAL PUBLICATIONS

Oxford Handbook of

Obstetrics and

Gynaecology

Published and forthcoming Oxford Handbooks

Oxford Handbook for the Foundation Programme 3e Oxford Handbook of Acute Medicine 3e

Oxford Handbook of Anaesthesia 3e

Oxford Handbook of Applied Dental Sciences Oxford Handbook of Cardiology 2e

Oxford Handbook of Clinical and Laboratory Investigation 3e Oxford Handbook of Clinical Dentistry 5e

Oxford Handbook of Clinical Diagnosis 2e

Oxford Handbook of Clinical Examination and Practical Skills Oxford Handbook of Clinical Haematology 3e

Oxford Handbook of Clinical Immunology and Allergy 3e Oxford Handbook of Clinical Medicine—Mini Edition 8e Oxford Handbook of Clinical Medicine 8e

Oxford Handbook of Clinical Pathology Oxford Handbook of Clinical Pharmacy 2e Oxford Handbook of Clinical Rehabilitation 2e Oxford Handbook of Clinical Specialties 9e Oxford Handbook of Clinical Surgery 4e Oxford Handbook of Complementary Medicine Oxford Handbook of Critical Care 3e

Oxford Handbook of Dental Patient Care 2e Oxford Handbook of Dialysis 3e

Oxford Handbook of Emergency Medicine 4e Oxford Handbook of Endocrinology and Diabetes 2e

Oxford Handbook of ENT and Head and Neck Surgery Oxford Handbook of Epidemiology for Clinicians

Oxford Handbook of Expedition and Wilderness Medicine Oxford Handbook of Gastroenterology & Hepatology 2e Oxford Handbook of General Practice 3e

Oxford Handbook of Genetics

Oxford Handbook of Genitourinary Medicine, HIV and AIDS 2e Oxford Handbook of Geriatric Medicine

Oxford Handbook of Infectious Diseases and Microbiology Oxford Handbook of Key Clinical Evidence

Oxford Handbook of Medical Dermatology Oxford Handbook of Medical Imaging Oxford Handbook of Medical Sciences 2e Oxford Handbook of Medical Statistics

Oxford Handbook of Nephrology and Hypertension Oxford Handbook of Neurology

Oxford Handbook of Nutrition and Dietetics 2e Oxford Handbook of Obstetrics and Gynaecology 2e Oxford Handbook of Occupational Health 2e Oxford Handbook of Oncology 3e

Oxford Handbook of Ophthalmology 2e

Oxford Handbook of Oral and Maxillofacial Surgery Oxford Handbook of Paediatrics 2e

Oxford Handbook of Pain Management

Oxford Handbook of Palliative Care 2e

Oxford Handbook of Practical Drug Therapy 2e Oxford Handbook of Pre-Hospital Care Oxford Handbook of Psychiatry 3e

Oxford Handbook of Public Health Practice 2e

Oxford Handbook of Reproductive Medicine & Family Planning Oxford Handbook of Respiratory Medicine 2e

Oxford Handbook of Rheumatology 3e

Oxford Handbook of Sport and Exercise Medicine 2e Oxford Handbook of Tropical Medicine 3e

Oxford Handbook of Urology 3e

Oxford Handbook of

Obstetrics and

Gynaecology

Third Edition

Edited by

Sally Collins

Specialist Registrar in Obstetrics and Gynaecology,

The John Radcliffe Hospital,

Oxford, UK

Sabaratnam Arulkumaran

Professor of Obstetrics and Gynaecology,

St George’s Hospital Medical School,

University of London, UK

Kevin Hayes

Senior Lecturer/Honorary Consultant in Obstetrics

and Gynaecology, and Medical Education,

St George’s Hospital Medical School,

University of London, UK

Simon Jackson

Consultant Gynaecologist,

The John Radcliffe Hospital,

Oxford, UK

Lawrence Impey

Consultant in Obstetrics and Fetal Medicine,

The John Radcliffe Hospital,

Oxford, UK

1

3

Great Clarendon Street, Oxford, OX2 6DP,

United Kingdom

Oxford University Press is a department of the University of Oxford.

It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries

© Oxford University Press, 2013

The moral rights of the authors have been asserted

First edition published 2005

Second edition published 2008

Third edition published 2013

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press,

or as expressly permitted by law, or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction

outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above

You must not circulate this book in any other binding or cover and you must impose the same condition on any acquirer

British Library Cataloguing in Publication Data

Data available

ISBN 978–0–19–969840–0

Printed in China by

C&C Offset Printing Co. Ltd.

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breast-feeding.

v

Contents

 

Preface

vi

 

 

 

Acknowledgements vii

 

 

Abbreviations

ix

 

 

Contributors

xxiii

 

1

Normal pregnancy

 

1

2

Pregnancy complications

 

49

3

Fetal medicine

 

 

 

107

4

Infectious diseases in pregnancy

 

155

5

Medical disorders in pregnancy

 

185

6

Labour and delivery

 

263

7

Obstetric anaesthesia

 

327

8

Neonatal resuscitation

 

339

9

Postnatal care

 

 

 

349

10

Obstetric emergencies

 

373

11

Perinatal and maternal mortality

 

403

12

Benign and malignant tumours in pregnancy

 

419

13

Substance abuse and psychiatric disorders

 

429

14

Gynaecological anatomy and development

 

457

15

Normal menstruation and its disorders

 

501

16

Early pregnancy problems

 

525

17

Genital tract infections and pelvic pain

 

549

18

Subfertility and reproductive medicine

 

569

19

Sexual assault

 

 

 

613

20

Contraception

 

621

21

Menopause

 

 

 

635

22

Urogynaecology

 

653

23

Benign and malignant gynaecological conditions

 

685

24

Miscellaneous gynaecology

 

771

 

Index

799

 

 

vi

Preface

Welcome to the third edition of this Oxford Handbook. In obstetrics and gynaecology, as in all fields of medicine, the available evidence, technology and guidelines can move forward at a rapid pace and often prove difficult to keep up with. As the majority of junior doctors are well aware, the gaps in our knowledge often become apparent at the most inopportune moments; this book seeks to fill those gaps rapidly and effectively. It uses the well-known Oxford Handbook format to facilitate easy navigation around concise, clinically relevant, evidence-based information. It can be quickly dipped into for specific answers between seeing patients in clinic or on delivery suite, as well as providing a solid, general grounding for those just beginning in the specialty. It also has sufficient depth and detail to provide a good starting point in the preparation for postgraduate exams. To ensure the most up-to-date information is always available, emphasis has been placed on providing relevant web addresses, especially for guidelines and useful organizations. Text boxes have also been employed to help highlight some of the more important pieces of information.

Although this handbook is most likely to be used by trainees within the specialty, we envisage it will be useful for all those involved in women’s health, including GPs, midwives, and medical students. We hope you find it a helpful resource and that it proves to be a valuable companion and guide in your everyday practice of obstetrics and gynaecology.

vii

Acknowledgements

We would like to thank all our second edition authors, especially the trainees at the John Radcliffe and St George’s hospitals. Additionally, we are very grateful to those who have gone the extra mile to ensure that our third edition chapters are up to date, especially Charlotte Bennett, Lucy MacKillop, and Jo Morrison who reviewed the highly specialized areas of neonatology, maternal medicine, and oncology to ensure that they contained the best available evidence. We would also like to thank the doctors of all grades who anonymously reviewed some of the text, providing valuable feedback and further fine-tuning the finished manuscript. To conform to the Oxford Handbook style and to avoid overlap and repetition, some contributions have been considerably edited and we thank all our authors for their understanding. We are most grateful to Prof. Basky Thilaganathan for providing many of the ultrasound images and Ms Penny Trotter for the colposcopy pictures. Last, but definitely not least, we would like to thank our partners and families who continue to remain so patient and supportive throughout this project, especially Berni O’Connor ‘for doing all the real work on the home front’ and David Reynard ‘for putting up with all this’.

Sally Collins, Sabaratnam Arulkumaran, Kevin Hayes, Simon Jackson, and Lawrence Impey London and Oxford, October 2012

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