By Barry O'Reilly MD MRCOG FRANZCOG, Cecilia Bottomley MA MB BChir MRCOG, Janice Rymer MD FRCOG FRANZCOG ILTM
The ideal medical spouse; totally revised and up to date for this new edition.
- Focussed at the center curriculum
- Comprehensive assurance sign-posted by way of transparent, constant headings, from definition, aetiology, pathophysiology, historical past taking, common suggestion, scientific good points, investigations, administration, remedy, diagnosis and review to hazard elements and differential diagnoses.
- Includes self-assessment, emergency approaches and basic values.
The ideal medical better half; totally revised and up-to-date for this new edition.
- Focussed at the center curriculum
- Comprehensive insurance sign-posted through transparent, constant headings, from definition, aetiology, pathophysiology, historical past taking, normal recommendation, medical positive aspects, investigations, administration, therapy, analysis and evaluate to threat elements and differential diagnoses.
- Includes self-assessment, emergency techniques and basic values.
Read or Download Essentials of Obstetrics and Gynaecology, 2e PDF
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Additional info for Essentials of Obstetrics and Gynaecology, 2e
Pathophysiology Premenstrual syndrome and PMDD are poorly understood, but increased sensitivity to progesterone is thought to cause a fall in the concentration of neurotransmitters, including serotonin, hence the benefit of serotoninspecific reuptake inhibitors in treatment. Clinical features The symptoms of premenstrual syndrome always start after ovulation, worsen as menstruation approaches and resolve within the first few days of bleeding. Symptoms may be physical, emotional or behavioural. Polycystic ovarian syndrome 5 Physical symptoms include breast swelling and discomfort, abdominal bloating, oedema, weight gain, headaches or deterioration in asthma, migraine or epilepsy.
Fertility is only a possibility by ovum donation and in vitro fertilization (IVF). Anorexia- or exercise-related amenorrhoea Clear advice about lifestyle and diet is essential to restore periods. Most women recommence menstruating once exercise is reduced or the body mass index is above 19. If a woman continues to be amenorrhoeic, then some form of hormone replacement with COCP or HRT is needed to prevent osteoporosis. Prolactinoma Prolactinoma is generally managed by endocrinologists with bromocriptine or cabergoline.
Women should be encouraged to maintain their body mass index at between 20 and 30 to maximize the chance of conception. Most underweight women will ovulate once their body mass index exceeds 20, but those who do not may need further GnRH pulsatile stimulation. Polycystic ovarian syndrome Weight loss is the simplest treatment for anovulatory women with PCOS and they should all have clear advice about improved diet and exercise. Ovarian stimulation with clomifene results in a 40–60% conception rate after 6 months, though twins occur in 10% and triplets in 1%.