Oxford Desk Reference: Obstetrics and Gynaecology

This irreplaceable reference compiles the most up-to-date and relevant material on obstetrics and gynaecology into one volume. Strongly evidence-based, it includes the latest knowledge and guidelines from a wide range of sources and contains the key recommendations that a practising obstetrician or gynaecologist needs to know; presenting them in a uniform and accessible way, allowing for quick diagnosis and optimal care. In line with the Royal College of Obstetrics and Gynaecology curriculum for specialty training, this book covers not just the clinical knowledge required but also information on the communication, technical and professional skills needed to practise in the specialty. With each chapter written by internationally renowned specialists and edited by five of the leading figures in obstetrics and gynaecology, this book will be a vital resource for all practising clinicians. Compiles all the relevant, evidence-based material on obstetrics and gynaecology, in an easily accessible, convenient format In line with the RCOG curriculum, with information on communication, technical and professional skills Features over 100 line drawings and photographs to aid identification and treatment Written by five of the leading figures in obstetrics and gynaecology including the president of the Royal College Sarabatnam Arulkumaran , Head of Obstetrics and Gynaecology, Division of Obstetrics and Gynaecology, St. George's University of London, London, UK, Lesley Regan , Clinical Professor, Department of Obstetrics and Gynaecology, St. Mary's Hospital and Imperial College, London, UK, David Farquharson , Consultant Gynaecologist, Department of Obstetrics and Gynaecology, Simpson Centre for Reproductive Health, Royal Infirmary, Edinburgh, UK, Ash Monga , Consultant Gynaecologist, Department of Obstetrics and Gynaecology, Southampton University Hospital, Southampton, UK, and Aris Papageorghiou , Consultant in Obstetrics and Maternal Fetal Medicine, Honorary Senior Lecturer, St George's University of London, London, UK Contributors: Dr Nihal Abdu Clinical Fellow in Maternal Medicine Epsom and St Helier Hospital, Surrey, UK Mr Nigel Acheson Consultant Gynaecological Oncologist Centre for Women's Health Royal Devon and Exeter NHS Foundation Trust, Exeter, UK Dr Rina Agrawal Consultant and Honorary Associate Professor in Obstetrics/Gynaecology and Specialist in Reproductive Medicine University College London and University Hospitals of Warwickshire London and Warwickshire, UK Dr Adil Akram Academic Clinical Fellow in Social and Community Psychiatry, St George's, University of London, London, UK Dr Sakina Ali Specialist Registrar in Neonatology St George's Hospital, London, UK Meredith J. Alston Department of Obstetrics and Gynecology Denver Health Medical Center University of Colorado School of Medicine, Denver, Colorado, USA Tiziana Arcangeli Temporary Clinical Fellow Fetal Medicine Unit, St. George's Hospital, London, UK Professor Sir Sabaratnam Arulkumaran Professor and Head of Obstetrics and Gynaecology St. George's University of London, London, UK Dr. Baris Ata Clinical and Research Fellow in Reproductive Endocrinology and Infertility McGill Reproductive Centre, Department of Obstetrics and Gynecology, McGill University, Royal Victoria Hospital, Montreal, Canada Dr Antonio Barbera Assistant Professor of Obstetrics and Gynaecology University of Colorado Medical Center, Denver, USA Ahmet A. Baschat Professor and Head, Section of Fetal Therapy University of Maryland School of Medicine Baltimore, Maryland, USA Dr. Amarnath Bhide Consultant in Obstetrics and Fetal Medicine, St. George's Hospital Honorary Senior Lecturer St. George's University of London, London, UK Professor Arijit Biswas Associate Professor National University of Singapore, Singapore Dr Cecilia Bottomley Consultant in Obstetrics and Gynaecology Chelsea and Westminster Hospital, London, UK Professor Peter Braude Head of Department of Women's Health King's College London, School of Medicine, Guy's, King's and St Thomas' Hospitals St Thomas' Hospital, London, UK Joanna Cain Professor and Chair, Obstetrics and Gynaecology Department and Julie Neupert Stott Director, Center for Women's Health Oregon Health and Science University, Portland, Oregon, USA J. Chris Carey Director of Obstetrics and Gynecology and Director of Medical Education, Denver Health Professor and Affiliate Dean, University of Colorado School of Medicine Denver, Colorado, USA Dr Cissy Caroline Specialist Registrar in Obstetrics and Gynaecology St George's Hospital, London, UK Dr Julene Carvalho Consultant in Fetal and Paediatric Cardiology, St. George's Hospital, London, UK and Royal Brompton Hospital, London, UK Dr Charlotte Chaliha Consultant Obstetrician and Gynaecologist Department of Obstetrics and Gynaecology, Royal London and St Bartholomew's Hospitals, London, UK Mr. Edwin Chandraharan Consultant Obstetrician and Gynaecologist Lead Consultant Labour Ward and Lead for Clinical Governance St. George's Healthcare NHS Trust, London, UK Dr Mahesh A Choolani Associate Professor of Obstetrics and Gynaecology National University of Singapore, Singapore Professor Tony Kwok Hung Chung, Professor of Obstetrics and Gynaecology The Chinese University of Hong Kong, Shatin, Hong Kong Dr Britt Clausson Consultant Obstetrician and Gynaecologist and Honorary Senior Lecturer St George's University of London and Mayday Healthcare, Department of Obstetrics and Gynaecology, Mayday Healthcare, Croydon, London Dr Edward Coats Specialist Registrar Obstetrics and Gynaecology St Michael's University Hospital, Bristol, UK Mr Jason Cooper Clinical Director and Consultant Gynaecologist, University Hospital of North Staffordshire, Maternity Centre, Stoke on Trent, UK Sarah Creighton Consultant Gynaecologist Department of Women's Health University College Hospital, London, UK Professor Hilary O. D. Critchley Professor of Reproductive Medicine/Honorary Consultant in Obstetrics and Gynaecology University of Edinburgh, Edinburgh, UK Dr Mary Crofton Consultant Radiologist Imperial College Healthcare NHS Trust St Marys Campus, London, UK Naomi Crouch Specialist Registrar in Obstetrics and Gynaecology UCL Hospitals, London, UK Prof Howard Cuckle Adjunct Professor Department of Obstetrics and Gynecology Columbia University Medical Center, New York, USA Rohan D'Souza Clinical Fellow Fetal Medicine Unit, St. George's Hospital NHS Trust, London, UK Dr Melanie Davies Consultant Obstetrician and Gynaecologist University College London Hospitals, Reproductive Medicine Unit, London, UK Miss Mandish K. Dhanjal Consultant Obstetrician and Gynaecologist Honorary Senior Lecturer Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK Ms Claudine Domoney Chair of the Institute of Psychosexual Medicine, Consultant Obstetrician and Gynaecologist, Chelsea and Westminster Hospital, London, UK Dr Stergios K. Doumouchtsis Senior Specialist Registrar in Obstetrics and Gynaecology St George's Hospital, St George's University of London, London, UK Ms. Anita Dutta Senior Registrar in Obstetrics and Gynaecology Guy's and St. Thomas' NHS Foundation Trusts, London, UK Dr David I. M. Farquharson Consultant Gynaecologist Department of Obstetrics and Gynaecology Simpson Centre for Reproductive Health, Royal Infirmary, Edinburgh, UK Miss Azza Fattah Consultant Obstetrics and Gynaecology Pontefract General Infirmary, Pontefract, UK Dr Daniel Forton Consultant Hepatologist and Honorary Senior Lecturer St George's Hospital, London, UK Dr Markus Gess Clinical Research Fellow St George's University of London, UK Dr Madhusree Ghosh Specialist Registrar Obstetrics and Gynaecology St George's Hospital, London, UK Professor Ronald Gibbs Professor and Head of Obstetrics and Gynaecology University of Colarado, USA Dr David Gillott Lecturer Obstetricsand Gynaecology St Bartholomew's Hospital London University, London, UK Dr Catriona Hardie Specialist Registrar Department of Gynaecological Oncology, Glasgow Royal Infirmary, Glasgow, UK Dr. Phillip Hay Reader and Honorary Consultant Genitourinary and HIV Medicine St. George's, University of London, London, UK Mr Kevin Hayes Consultant / Senior Lecturer in Obstetrics and Gynaecology Department of Obstetrics and Gynaecology St George's Hospital, London, UK Gretchen Heinrichs Assistant Professor Obstetrics and Gynaecology Denver Health and University of Colorado Denver, School of Medicine, Denver, Colorado, USA Professor Jenny Higham Director of Education Faculty of Medicine, Imperial College London, London, UK Professor Pak Chung Ho Chair Professor of Obstetrics and Gynaecology Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, China Prof G. Justus Hofmeyr Consultant/Associate Professor Department of Obstetrics and Gynaecology, East London Hospital Complex and Walter Sisulu University, East London, South Africa Dr Tessa Homfray Consultant Geneticist Division of Clinical Developmental Sciences, St. George's Healthcare NHS Trust, London, UK Mr Etienne Horner Consultant Obstetrics and Gynaecology St Mary's Hospital, Imperial College Healthcare NHS Trust, London UK Miss Polly Hughes Consultant Obstetrician and Gynaecologist St George's NHS Trust, St George's Hospital, London, UK Jennifer Hyer, Obstetrics and Gynecology, Attending Physician, Denver Health Medical Center Senior Instructor, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Denver, Colorado, USA Christos Ioannou Clinical Research Fellow Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford, UK Associate Professor A. Ilancheran Senior Consultant Division of Gynaecologic Oncology Department of Obstetrics and Gynaecology National University Hospital, Singapore Dr Smita Jain Consultant Obstetrician and Gynaecologist University Hospital of Northern British Columbia, Prince George, British Columbia, Canada Dr Haider Jan Specialist Registrar in Obstetrics and Gynaecology St George's Hospital, London, UK Swati Jha Subspecialist in Urogynaecology, Consultant Obstetrician and Gynaecologist, Sheffield Teaching Hospitals NHSFT Sheffield Miss Antoinette Johnson Consultant Obstetrician and Gynaecologist Epsom and St Helier Hospital, Surrey, UK Mr Davor Jurkovic Consultant Gynaecologist Department of Obstetrics and Gynaecology University College Hospital, London, UK Miss Vijaysri Kakumani Consultant Obstetrician and Gynaecologist Epsom and St. Helier University Hospital NHS Trust, UK Dr Nigel Leonard Kennea Consultant Neonatologist St George's Hospital, London, UK Dr Rahat Khan Clinical Fellow in Maternal Medicine Epsom and St Helier Hospital, Surrey, UK Stephen Kennedy Clinical Reader and Head of Department Nuffield Department of Obstetrics and Gynaecology, University of Oxford, John Radcliffe Hospital, Oxford, UK Dr Andrew Kent Consultant Psychiatrist and Senior Lecturer St George's, University of London, London, UK Professor Chris Kettle Midwife and Professor of Women's Health, University Hospital of North Staffordshire (NHS Trust), Stoke-on-Trent, UK Mark Kilby Professor of Fetal Medicine, School of Clinical and Experimental Medicine, The College of Medical and Dental Sciences, University of Birmingham and Department of Fetal Medicine, Birmingham Women's Foundation Trust, Edgbaston, Birmingham, UK Dr Emma Kirk Specialist Registrar Obstetrics and Gynaecology The Whittington Hospital, London, UK Mona B. Krull Department of Obstetrics and Gynecology Denver Health Medical Center Assistant Professor, University of Colorado School of Medicine Denver, Colorado, USA Dr Ali Kubba Consultant Community Gynaecologist, Guy's and St Thomas' Hospital NHS Trust, Honorary Senior Lecturer, Department of Obstetrics and Gynaecology, Kings College, London, UK Dr Terence Lao Associate Professor of Obstetrics and Gynaecology Chinese University of Hong Kong, Hong Kong Professor William Ledger Professor of Obstetrics and Gynaecology University of Sheffield, Sheffield, UK Christoph Lees Consultant in Obstetrics and Fetal-Maternal Medicine and Lead, Fetal Medicine Rosie Maternity Hospital, Addenbrookes Hospital , Cambridge, UK Dr Karin Leslie Clinical Lecturer St George's, University of London, London, UK Miss Jilly Lloyd, Specialist Registrar Obstetrics and Gynaecology University Hospital Lewisham, London, UK Associate Professor Jeffrey J.H. Low Head, Division of Gynaecologic Oncology Senior Consultant, Department of Obstetrics and Gynaecology National University Hospital, Singapore Professor Mary Ann Lumsden Prof of Gynaecology and Medical Education and Head of Division of Developmental Medicine University of Glasgow, UK Dr Jane MacDougall, Consultant in Reproductive Medicine Addenbrooke's Hospital, Cambridge, UK Dr Gemma Malin Clinical Research Fellow Department of Obstetrics and Gynaecology, University of Birmingham, Birmingham Women's Hospital, Birmingham, UK Dr Sahar Mansour Consultant Geneticist SW Thames Regional Genetics Service St George's, University of London, London, UK Mr Isaac Manyonda Consultant Obstetrician and Gynaecologist and Clinical Reader in Obstetrics and Gynaecology St George's University of London, London, UK Dr Lizbeth K. McCarthy Assistant Professor of Obstetrics and Gynaecology University of Colarado, USA Professor Neil McClure Professor of Obstetrics and Gynaecology Queen's University Belfast, Belfast, UK Dr Louise Melson Consultant Obstetrician and Gynaecologist Poole Hospital, Poole, Dorset, UK Lina Michala Lead in Paediatric and Adolescent Gynaecology Alexandras Hospital, Athens, Greece Pedro Miranda-Seijo Clinical Instructor University of Colorado School of Medicine, Denver Health Hospital, Denver, Colorado, USA Miss Shruti Mohan SpR Obstetrics and Gynaecology Imperial College Healthcare NHS Trust St Mary's Hospital, London, UK Mr Ash Monga Consultant Gynaecologist Department of Obstetrics and Gynaecology, Southampton University Hospital, Southampton, UK Dr Judy Myles Senior Lecturer/Consultant Psychiatrist Division of Mental Health, St George's University of London, London, UK Dr. Vivek Nama Clinical Research Fellow Department of Obstetrics and Gynaecology St. George's University of London, London, UK Professor Kypros H. Nicolaides Director Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK Dr Rachel L. O'Donnell Specialist Trainee Obstetrics and Gynaecology Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, Edinburgh, UK Dr Tim J. von Oertzen Consultant Neurologist/Epileptologist Epilepsy Group, Atkinson Morley Neuroscience Centre, St. George's Hospital, London, UK Mr Kamal Ojha Consultant Gynaecologist St Georges Hospital, Colposcopy Office, London , UK Mrs Caroline Overton Consultant Obstetrician and Gynaecologist Subspecialist in Reproductive Medicine and Laparoscopic Surgery St Michael's University Hospital, Bristol, UK Nick Panay Consultant Gynaecologist, Subspecialist in Reproductive Medicine and Surgery Imperial College Healthcare NHS Trust and Chelsea and Westminster Hospital NHS Foundation Trust, London, UK and Honorary Senior Clinical Lecturer, Imperial College London, UK Miss Louise M. Page SpR Obstetrics and Gynaecology Imperial College Healthcare NHS Trust St Mary's Hospital, London, UK Dr Aris T. Papageorghiou Consultant in Obstetrics and Maternal Fetal Medicine Honorary Senior Lecturer St George's, University of London, London, UK Dr Leonie Penna Consultant Obstetrician, King's College Hospital, London, UK Dr Nicola Persico Clinical Research Fellow Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK Mr Christian Phillips Consultant in Obstetrics and Gynaecology Basingstoke and North Hampshire Hospital, Basingstoke, UK Dr Gianluigi Pilu Department of Obstetrics and Gynecology University of Bologna and Policlinico S. Orsola-Malpighi, Bologna, Italy Ms Sheila Radhakrishnan Consultant in Community Gynaecology Royal Free Hospital London, UK Dr Kalaivani Ramalingam Registrar - Obstetrics and Gynaecology Princess Anne Hospital, Southampton, UK Professor Lesley Regan Clinical Professor Department of Obstetrics and Gynaecology, St. Mary's Hospital and Imperial College, London, UK Professor Wendy Reid Royal Free Hospital, Hampton, London, UK Shauna L. Reinblatt Clinical and Research Fellow McGill Reproductive Centre, Department of Obstetrics and Gynecology, McGill University Health Center, Montreal, Canada Shaun Rogers Senior Embryologist The London Bridge Fertility, Gynaecology and Genetics Centre, London, UK Dr Shanthi Sairam Associate Specialist in Fetal Medicine and Fetal Cardiology Fetal Medicine Unit St Georges Hospital, London, UK Mr Rehan Salim Consultant Gynaecologist Reproductive Medicine Unit, University College London Hospitals, London, UK Ippokratis Sarris Specialist Registrar in Obstetrics and Gynaecology, London Deanery, London, UK Dr Frank Schroeder Consultant Anaesthetist St George's Hospital, London, UK Einat Shalom-Paz Clinical and Research Fellow McGill Reproductive Center, McGill University Health Center, Royal Victoria Hospital, Montreal, Canada Mr. Hassan Shehata Consultant Obstetrician and Obstetric Physician Epsom and St. Helier University Hospital NHS Trust, UK Dr Nadeem Siddiqui Consultant Gynaecological Oncologist Department of Gynaecological Oncology, Glasgow Royal infirmary, Glasgow, UK Norma J. Stiglich Associate Director of Obstetrics and Gynecology Denver Health Medical Center and Assistant Professor University of Colorado School of Medicine, Denver, Colorado, USA Dr Jo Sykes Macmillan Consultant in Palliative Medicine Depratment of Palliative Medicine Torbay Hospital, Torqusy Devon Dr. Seang Lin Tan James Edmund Dodds Professor and Chairman Department of Obstetrics and Gynecology, McGill University and Obstetrician and Gynecologist-in-Chief McGill University Health Centre and Medical Director, McGill Reproductive Centre Department of Obstetrics and Gynecology McGill University, Royal Victoria Hospital, Montreal, Quebec, Canada Dr Alison Taylor Consultant Gynaecologist and Subspecialist in Reproductive Medicine Lister Fertility Clinic Lister Hospital, London, UK Miss Ranee Thakar Consultant Urogynaecologist Mayday University Hospital, Croydon, UK Professor Basky Thilaganathan Director, Fetal Medicine Unit Department of Obstetrics and Gynaecology, St Georges Hospital, London, UK L. Chesney Thompson Associate Professor Vice Chair Deptartment of Obstetrics and Gynecology Chief of General Obstetrics and Gynecology University of Colorado School of Medicine, Aurora, Colorado, USA Dr Sifa Turan Perinatal Instructor Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, USA Mr. Dhiraj Uchil Consultant Obstetrician and Gynaecologist, University Hospital Lewisham, London, UK Austin Ugwumadu Consultant Obstetrician and Gynaecologist / Senior Lecturer Department of Obstetrics and Gynaecology, St George's Hospital, London, UK Mr Sameer Umranikar Consultant Obstetrician and Gynaecologist Princess Anne Hospital, Southampton, UK Dr Catalina Valencia Clinical Research Fellow Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK Dr W.Hamish B.Wallace Consultant Paediatric Oncologist, Royal Hospital for Sick Children, Edinburgh, UK Miss Lisa Webber Consultant Gynecologist Specialist in Reproductive Medicine, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK Dr Andrew Weeks Senior Lecturer in Obstetrics University of Liverpool, Liverpool Women's Hospital, Liverpool, UK Professor Catherine Williamson Professor of Obstetric Medicine Chelsea and Queen Charlotte's Hospital, London, UK Davinia White Consultant in Reproductive Medicine St Mary's Hospital, London, UK Kathryn Witzeman, Assistant Professor, University of Colorado Department of Obstetrics and Gynaecology Denver Health Medical Center, Denver, Colorado, USA Dr. Ernest Hung Yu Ng Associated Professor The University of Hong Kong, Department of Obstetrics and Gynaecology, Queen Mary Hospital, Pokfulam, Hong Kong CONTENTS Introduction 1.1: Examination of the obstetric patient 1.2: Examination of the gynaecological patient 1.3: Communication, confidentiality, breaking bad news and obtaining consent 1.4: Legal framework for care in Obstetrics and Gynaecology Obstetrics 2.1: Normal pregnancy 2.2: Complications of early pregnancy 2.3: Care of the fetus 2.4: Maternal medicine and infections 2.5: Obstetric conditions 2.6: Care in labour 2.7: Common obstetric techniques, procedures and surgery Gynaecology 3.1: Reproduction 3.2: Benign and urogynaecology 3.3: Benign, premalignant and malignant tumours in gynaecology 3.4: Common gynaecological procedures and surgery