By Jeremy J N Oats MBBS DM FRCOG FRANZCOG, Suzanne Abraham MSc PhD(Med) MAPS

Comprehensive insurance of the medical necessities of either obstetrics and gynaecology in a single reasonable quantity. a brand new workforce of authors provides the most recent advances within the administration of being pregnant and the therapy of gynaecological problems in a well-written, easy-to-read variety. Shorter chapters, up to date terminology, clearer scans, and extra line drawings are only the various clean, new alterations that carry this well known reference updated and make it appropriate to brand new practice

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Additional resources for Llewellyn-Jones Fundamentals of Obstetrics and Gynaecology, 9e

Example text

2G, H). IMPLANTATION Implantation occurs 8–10 days after ovulation in most healthy pregnancies. The morula is rapidly propelled along the Fallopian tube to enter the uterine cavity. During its passage, fluid passes through canaliculae in the zona pellucida to create a central fluid-filled cavity in the morula, forming a blastocyst (see Fig. 2I). On reaching the uterine cavity the zona pellucida becomes distended and thin. It soon disappears, leaving the surface cells of the blastocyst in contact with the endometrial stroma.

The supraclavicular regions and axillae are next palpated. The latter can only be palpated satisfactorily if the pectoral muscles are relaxed. This relaxation can be obtained if the physician supports the patient’s arms while palpating the axillae. Palpation is then performed with the patient lying supine, her shoulders elevated on a small pillow. Palpation should be gentle and orderly, using the flat of the fingers of one hand. Each portion of the breast should be palpated systematically, beginning at the upper, inner quadrant, followed by palpation of each portion sequentially until the upper, outer quadrant is finally examined.

Operative procedures in obstetrics and gynaecological surgery When a consultant or a trainee undertakes an operative procedure, the record of that procedure should be recorded in some detail in the operation notes, preferably by the operating surgeon, signed and dated. When the woman is visited after childbirth or after an operative procedure she should be given time and the opportunity to ask questions, and the answers should be given simply and clearly. All observations should be recorded and signed.

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