By Paul D. Chan MD, Susan M. Johnson MD

Gynecology and Obstetrics summarizes analysis and administration of universal issues that happen in ladies. this article studies licensed therapy directions for either inpatients and outpatients. 149 pages.

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Sample text

2. Breast development should be assessed by Tan­ ner staging. 3. The genital examination should evaluate clitoral size, pubertal hair development, intactness of the hymen, depth of the vagina, and presence of a cervix, uterus, and ovaries. If the vagina can not be penetrated with a finger, rectal examination may allow evaluation of the internal organs. Pel­ vic ultrasound is also useful to determine the presence or absence of müllerian structures. 4. The skin should be examined for hirsutism, acne, striae, increased pigmentation, and vitiligo.

A pregnancy test should be per­ formed at the 2-week return visit if conception is suspected. Emergency Contraception 1. 5 to 25 mg Trimethobenzamide (Tigan), 250 mg 2. Administer the first dose of oral contraceptive pill within 72 hours of intercourse, and administer the second dose 12 hours after the first dose.

Treatment of primary amenorrhea is directed at correcting the underlying pathology; helping the woman to achieve fertility, if desired; and prevention of complications of the disease. B. Congenital anatomic lesions or Y chromosome material usually requires surgery. Surgical correc­ tion of a vaginal outlet obstruction is necessary be­ fore menarche, or as soon as the diagnosis is made after menarche. Creation of a neovagina for patients with müllerian failure is usually delayed until the women is emotionally mature.

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