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This book is a concise guide to controversial topics in obstetrics and gynaecology.
Divided into two parts, the first section covers topics in obstetrics including pre-eclampsia, hypertension in pregnancy and recurrent miscarriage, and the second section discusses gynaecological issues such as pelvic organ prolapsed, PCOS and ovarian tumours.
Each chapter is presented with an overview of the topic, followed by in depth discussion on controversial issues regarding its management and follow up. Each debate ends with a conclusion, recommendations and extensive references.
Key points
Latika Sahu MD FICOG
Professor
Devender Kumar MD
Associate Professor
Usha Manaktala MD FIMSA FICOG
Director Professor
All at Department of Obstetrics and Gynaecology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
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Contents
Contents
Section 1
o
bstetri
C
s
1.
Controversies in Prenatal Screening for Aneuploidy
3
Sangeeta Gupta
Controversies
3
Risk Assessment: Twin Gestation
4
Noninvasive Prenatal Testing: Screening or Diagnosis?
5
2.
Prenatal Care: How Many Antenatal Visits are Required?
7
Reva Tripathi, Namita Jain
Objectives of a Prenatal Visit
7
Evolving Models of Prenatal Care
8
Recommendations by Various Organizations
11
3.
Management of Midtrimester Preterm Prelabor Rupture of the Membranes
14
Mumtaz Khan, Latika Sahu, Shelly Arora
Inpatient or Outpatient Management
15
Antenatal Surveillance: Maternal and Fetal
15
Role of Amniocentesis
16
Role of Prophylactic Antibiotic: Regimen and Duration
16
Role of Tocolysis
17
Role of Corticosteroids
17
Role of Amnioinfusion for Prevention of Pulmonary Hypoplasia
19
Role of Fibrin Glue
20
Timing of Delivery
20
Mode of Delivery
21
4.
Recurrent Miscarriage: The Role of Supplementation of Progesterone
24
Renu Tanwar, Neha Varun
Unexplained Recurrent Miscarriage
25
Role of Progesterone in Recurrent Miscarriage
25
Current Trials
28
xiv
Controversies in Obstetrics and Gynecology
5.
Monochorionic Twins: Is Elective Preterm Delivery Mandatory?
30
Latika Sahu, Krishna Agarwal, Rachna Sharma
Specific Complications of Monochorionic Twin Pregnancies
30
Optimal Timing and Mode of Delivery: Controversies
32
6.
Pre-eclampsia: Is there a Role of Prophylaxis?
38
Asmita Muthal Rathore, Rhythm Ahuja
Etiopathogenesis
38
Prophylaxis in Pre-eclampsia
38
Controversies in Prophylaxis for Pre-eclampsia
41
7.
Management of Gestational Diabetes Mellitus:
Insulin or OHA or Insulin with OHA
48
Ashok Kumar, Gunjan Bhatnagar, Madhur Kumar
Management—Controversies
48
Insulin Therapy
49
Drawbacks of Insulin Therapy: Need of Oral Hypoglycemic Agents
49
Other Oral Hypoglycemic Agents
54
8.
Mild Hypertension in Pregnancy: Management Options
57
Madhavi M Gupta
Preterm Birth
59
Neonatal Outcome
60
Economics
60
9.
Intrauterine Death of Fetus: Expectant Management versus
Immediate Induction of Labor
62
Deepti Goswami, Latika Sahu
Diagnosing IUFD and Disclosure to Parents
62
Identifying the Cause of IUFD: Maternal Assessment
62
Controversies
65
Looking for the Cause of IUD after Expulsion of the Fetus: Fetal and Placental Assessment
68
Postdelivery Care and Follow-up
69
Counseling for Subsequent Pregnancy
70
10.
Management of Adnexal Masses in Pregnancy
72
Chandan Dubey
Differential Diagnosis of Adnexal Masses
72
Controversies in Management
73
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