Errol Norwitz, Louis E. Phaneuf Professor of Obstetrics & Gynecology, Tufts University School of Medicine, Boston, USA.John Schorge, Clinical Director, Gillette Center for Women's Cancer, Massachusetts General Hospital, Boston, USA.

• ContentsList of contributors 7Preface 8Acknowledgments 8About the companion website 9Part 1 GynecologyGeneral1 History taking and physical examination 102 Anatomy of the female reproductive tract 123 The menstrual cycle 144 Abnormal vaginal bleeding 165 Ectopic pregnancy 186 Pelvic pain 207 Lower genital tract infections 228 Pelvic inflammatory disease (PID) 249 Benign disorders of the lower genital tract 2610 Benign disorders of the upper genital tract 2811 Endometriosis and adenomyosis 3012 Contraception 3213 Sterilization 3414 Breast disease 3615 Miscarriage 3816 Termination of pregnancy 4017 Gynecologic surgery 4218 Ethical and medicolegal issues 44Urogynecology19 Urinary incontinence 4620 Pelvic organ prolapse 48Reproductive endocrinology and infertility21 Puberty and precocious puberty 5022 Amenorrhea 5223 Polycystic ovarian syndrome (PCOS) 5424 Recurrent pregnancy loss 5625 The infertile couple 5826 Ovulation induction 6027 Assisted reproductive technology (ART) 6228 Menopause and hormone replacement therapy 64Gynecologic oncology29 Cervical dysplasia and HPV vaccine 6630 Cervical and vaginal cancer 6831 Vulvar cancer 7032 Uterine cancer 7233 Ovarian cancer 7434 Gestational trophoblastic disease (GTD) 76Part 2 Obstetrics General35 Embryology and early fetal development 7836 Fetal physiology 8037 Endocrinology of pregnancy and parturition 8238 Maternal adaptations to pregnancy 8439 Prenatal diagnosis 8640 Obstetric ultrasound 8841 Obstetrics in primary care 90Antepartum complications42 Infections in pregnancy: bacteria and protozoa 9243 Infections in pregnancy: viruses and spirochetes 9444 Hypertensive disorders of pregnancy 9645 Diabetes mellitus in pregnancy 9846 Cardiovascular disease in pregnancy 10047 Thyroid disease in pregnancy 10248 Other medical and surgical conditions in pregnancy 10449 Drugs and medications during pregnancy 10650 Disorders of amniotic fluid volume 10851 Disorders of fetal growth 11052 Antepartum fetal surveillance 11253 Hydrops fetalis 11454 Intrauterine fetal demise 11655 Multiple pregnancy 11856 Antepartum hemorrhage 12057 Premature labor 12258 Cervical in sufficiency and cervical cerclage 12459 Premature rupture of the membranes 126Intrapartum management60 Normal labor and delivery I 12861 Normal labor and delivery II 13062 Induction and augmentation of labor 13263 Abnormal labor and delivery 13464 Pain relief in labor 13665 Intrapartum fetal monitoring 13866 Surgical vaginal delivery 14067 Cesarean section delivery 142Postpartum complications68 Third stage of labor and postpartum hemorrhage 14469 The puerperium 14670 Circumcision 148Part 3 Self assessmentCase studies and questions 150Answers 152Further reading 162Index 163

Errol Norwitz, Louis E. Phaneuf Professor of Obstetrics & Gynecology, Tufts University School of Medicine, Boston, USA.John Schorge, Clinical Director, Gillette Center for Women's Cancer, Massachusetts General Hospital, Boston, USA.

• ContentsList of contributors 7Preface 8Acknowledgments 8About the companion website 9Part 1 GynecologyGeneral1 History taking and physical examination 102 Anatomy of the female reproductive tract 123 The menstrual cycle 144 Abnormal vaginal bleeding 165 Ectopic pregnancy 186 Pelvic pain 207 Lower genital tract infections 228 Pelvic inflammatory disease (PID) 249 Benign disorders of the lower genital tract 2610 Benign disorders of the upper genital tract 2811 Endometriosis and adenomyosis 3012 Contraception 3213 Sterilization 3414 Breast disease 3615 Miscarriage 3816 Termination of pregnancy 4017 Gynecologic surgery 4218 Ethical and medicolegal issues 44Urogynecology19 Urinary incontinence 4620 Pelvic organ prolapse 48Reproductive endocrinology and infertility21 Puberty and precocious puberty 5022 Amenorrhea 5223 Polycystic ovarian syndrome (PCOS) 5424 Recurrent pregnancy loss 5625 The infertile couple 5826 Ovulation induction 6027 Assisted reproductive technology (ART) 6228 Menopause and hormone replacement therapy 64Gynecologic oncology29 Cervical dysplasia and HPV vaccine 6630 Cervical and vaginal cancer 6831 Vulvar cancer 7032 Uterine cancer 7233 Ovarian cancer 7434 Gestational trophoblastic disease (GTD) 76Part 2 Obstetrics General35 Embryology and early fetal development 7836 Fetal physiology 8037 Endocrinology of pregnancy and parturition 8238 Maternal adaptations to pregnancy 8439 Prenatal diagnosis 8640 Obstetric ultrasound 8841 Obstetrics in primary care 90Antepartum complications42 Infections in pregnancy: bacteria and protozoa 9243 Infections in pregnancy: viruses and spirochetes 9444 Hypertensive disorders of pregnancy 9645 Diabetes mellitus in pregnancy 9846 Cardiovascular disease in pregnancy 10047 Thyroid disease in pregnancy 10248 Other medical and surgical conditions in pregnancy 10449 Drugs and medications during pregnancy 10650 Disorders of amniotic fluid volume 10851 Disorders of fetal growth 11052 Antepartum fetal surveillance 11253 Hydrops fetalis 11454 Intrauterine fetal demise 11655 Multiple pregnancy 11856 Antepartum hemorrhage 12057 Premature labor 12258 Cervical in sufficiency and cervical cerclage 12459 Premature rupture of the membranes 126Intrapartum management60 Normal labor and delivery I 12861 Normal labor and delivery II 13062 Induction and augmentation of labor 13263 Abnormal labor and delivery 13464 Pain relief in labor 13665 Intrapartum fetal monitoring 13866 Surgical vaginal delivery 14067 Cesarean section delivery 142Postpartum complications68 Third stage of labor and postpartum hemorrhage 14469 The puerperium 14670 Circumcision 148Part 3 Self assessmentCase studies and questions 150Answers 152Further reading 162Index 163

Errol Norwitz, Louis E. Phaneuf Professor of Obstetrics & Gynecology, Tufts University School of Medicine, Boston, USA.John Schorge, Clinical Director, Gillette Center for Women's Cancer, Massachusetts General Hospital, Boston, USA.

• ContentsList of contributors 7Preface 8Acknowledgments 8About the companion website 9Part 1 GynecologyGeneral1 History taking and physical examination 102 Anatomy of the female reproductive tract 123 The menstrual cycle 144 Abnormal vaginal bleeding 165 Ectopic pregnancy 186 Pelvic pain 207 Lower genital tract infections 228 Pelvic inflammatory disease (PID) 249 Benign disorders of the lower genital tract 2610 Benign disorders of the upper genital tract 2811 Endometriosis and adenomyosis 3012 Contraception 3213 Sterilization 3414 Breast disease 3615 Miscarriage 3816 Termination of pregnancy 4017 Gynecologic surgery 4218 Ethical and medicolegal issues 44Urogynecology19 Urinary incontinence 4620 Pelvic organ prolapse 48Reproductive endocrinology and infertility21 Puberty and precocious puberty 5022 Amenorrhea 5223 Polycystic ovarian syndrome (PCOS) 5424 Recurrent pregnancy loss 5625 The infertile couple 5826 Ovulation induction 6027 Assisted reproductive technology (ART) 6228 Menopause and hormone replacement therapy 64Gynecologic oncology29 Cervical dysplasia and HPV vaccine 6630 Cervical and vaginal cancer 6831 Vulvar cancer 7032 Uterine cancer 7233 Ovarian cancer 7434 Gestational trophoblastic disease (GTD) 76Part 2 Obstetrics General35 Embryology and early fetal development 7836 Fetal physiology 8037 Endocrinology of pregnancy and parturition 8238 Maternal adaptations to pregnancy 8439 Prenatal diagnosis 8640 Obstetric ultrasound 8841 Obstetrics in primary care 90Antepartum complications42 Infections in pregnancy: bacteria and protozoa 9243 Infections in pregnancy: viruses and spirochetes 9444 Hypertensive disorders of pregnancy 9645 Diabetes mellitus in pregnancy 9846 Cardiovascular disease in pregnancy 10047 Thyroid disease in pregnancy 10248 Other medical and surgical conditions in pregnancy 10449 Drugs and medications during pregnancy 10650 Disorders of amniotic fluid volume 10851 Disorders of fetal growth 11052 Antepartum fetal surveillance 11253 Hydrops fetalis 11454 Intrauterine fetal demise 11655 Multiple pregnancy 11856 Antepartum hemorrhage 12057 Premature labor 12258 Cervical in sufficiency and cervical cerclage 12459 Premature rupture of the membranes 126Intrapartum management60 Normal labor and delivery I 12861 Normal labor and delivery II 13062 Induction and augmentation of labor 13263 Abnormal labor and delivery 13464 Pain relief in labor 13665 Intrapartum fetal monitoring 13866 Surgical vaginal delivery 14067 Cesarean section delivery 142Postpartum complications68 Third stage of labor and postpartum hemorrhage 14469 The puerperium 14670 Circumcision 148Part 3 Self assessmentCase studies and questions 150Answers 152Further reading 162Index 163