Part 1: Obstetrics
Section 1: General Obstetrics
1.1: Reproductive System........................................................................................................................................................ 5
1.2: Embryology..................................................................................................................................................................... 11
1.3: Anatomical Changes During Pregnancy...................................................................................................................... 29
1.4: Physiological Changes During Pregnancy.................................................................................................................... 32
1.5: Antenatal Assessment..................................................................................................................................................... 36
1.6: Lifestyle Changes During Pregnancy............................................................................................................................ 49
1.7: Lactation.......................................................................................................................................................................... 50
Section 2: Labor and Delivery
2.1: Female Pelvis .................................................................................................................................................................. 58
2.2: Fetal Skull........................................................................................................................................................................ 65
2.3: Obstetric Examination................................................................................................................................................... 69
2.4: Normal Labor.................................................................................................................................................................. 78
2.5: Abnormal Labor ............................................................................................................................................................ 87
2.6: Normal Vaginal Delivery................................................................................................................................................ 89
2.7: Labor Analgesia.............................................................................................................................................................. 92
2.8: Breech Vaginal Delivery................................................................................................................................................. 94
2.9: Transverse Lie............................................................................................................................................................... 100
2.10: Abnormal Positions...................................................................................................................................................... 102
2.11: Fetal Monitoring Using Cardiotocography................................................................................................................ 110
2.12: Obstetric Maneuvers ................................................................................................................................................... 118
2.13: Cesarean Delivery......................................................................................................................................................... 122
2.14: Instrumental Delivery ................................................................................................................................................. 126
2.15: Obstetric Hysterectomy................................................................................................................................................ 135
2.16: Intrauterine Fetal Death.............................................................................................................................................. 137
Section 3: Early Pregnancy Complications
3.1: Ectopic Pregnancy........................................................................................................................................................ 141
3.2: Hydatidiform Mole....................................................................................................................................................... 150
3.3: Miscarriage.................................................................................................................................................................... 154
3.4: Cervical Incompetence................................................................................................................................................. 159
3.5: Medical Termination of Pregnancy Using Vacuum Aspiration................................................................................ 163
3.6: Medical Termination of Pregnancy............................................................................................................................. 168
Section 4: Complications of Pregnancy
4.1: Multifetal Gestation...................................................................................................................................................... 176
4.2: Antepartum Hemorrhage............................................................................................................................................ 190
4.3: Rh Negative Pregnancy................................................................................................................................................ 196
4.4: Intrauterine Growth Retardation............................................................................................................................... 199
4.5: Amniotic Fluid and its Abnormalities......................................................................................................................... 203
4.6: Preterm Baby................................................................................................................................................................ 208
4.7: Post-term Pregnancy.................................................................................................................................................... 214
Contents
Evidence Based Color Atlas of OBST ETRICS & GYNECOLO GY Diagnosis and Management
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Section 5: Medical Conditions During Pregnancy
5.1: Anemia in Pregnancy................................................................................................................................................... 226
5.2: Hypertensive Disorders of Pregnancy........................................................................................................................ 230
5.3: Gestational Diabetes..................................................................................................................................................... 233
5.4: Heart Disease During Pregnancy................................................................................................................................ 237
5.5: Thyroid Disorders During Pregnancy........................................................................................................................ 240
5.6: Asthma and Pregnancy................................................................................................................................................ 241
5.7: Tuberculosis in Pregnancy........................................................................................................................................... 242
Section 6: Postnatal Period
6.1: Lactation ....................................................................................................................................................................... 248
6.2: Abnormalities of Lactation.......................................................................................................................................... 248
6.3: Puerperium.................................................................................................................................................................... 250
6.4: Complications of Puerperium...................................................................................................................................... 252
6.5: Injuries to the Birth Canal........................................................................................................................................... 257
6.6: Episiotomy .................................................................................................................................................................... 260
6.7: Placenta and its Abnormalities.................................................................................................................................... 261
6.8: Umbilical Cord.............................................................................................................................................................. 265
6.9: Postpartum Hemorrhage............................................................................................................................................. 266
6.10: Uterine Rupture............................................................................................................................................................ 272
6.11: Uterine Inversion.......................................................................................................................................................... 273
6.12: Newborn Infant and its Care....................................................................................................................................... 274
Section 7: Imaging in Obstetrics
7.1: Instrumentation............................................................................................................................................................ 286
7.2: Technique....................................................................................................................................................................... 287
7.3: Normal Anatomy on Ultrasound................................................................................................................................. 289
7.4: Early Pregnancy Scanning........................................................................................................................................... 291
7.5: Normal Third Trimester Pregnancy Scan ................................................................................................................. 294
7.6: Three-Dimensional Imaging........................................................................................................................................ 301
7.7: Doppler Ultrasound...................................................................................................................................................... 308
7.8: Congenital Abnormalities............................................................................................................................................ 315
7.9: Case Studies in Obstetrics............................................................................................................................................ 320
Part 2: Gynecology
Section 8: General Gynecology
8.1: Gynecological Anatomy................................................................................................................................................ 328
8.2: Gynecological Examination......................................................................................................................................... 335
8.3: Menstrual Cycle............................................................................................................................................................ 346
8.4: Principles of Surgery.................................................................................................................................................... 349
8.5: Adolescent and Pediatric Gynecology......................................................................................................................... 356
8.6: Tuberculosis................................................................................................................................................................... 360
Section 9: Menstrual Disorders
9.1: Abnormal Menstrual Bleeding.................................................................................................................................... 365
9.2: Dysfunctional Uterine Bleeding................................................................................................................................... 371
9.3: Dysmenorrhea .............................................................................................................................................................. 371
Contents
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9.4: Premenstrual Syndrome............................................................................................................................................... 373
9.5: Postmenopausal Bleeding............................................................................................................................................. 374
9.6: Treatment of Menstrual Disorders.............................................................................................................................. 375
9.7: Menopause .................................................................................................................................................................... 378
9.8: Müllerian Abnormalities.............................................................................................................................................. 384
9.9: Amenorrhea................................................................................................................................................................... 387
Section 10: Benign Tumors of Genital Tract
10.1: Fibroids.......................................................................................................................................................................... 397
10.2: Benign Ovarian Lesions............................................................................................................................................... 408
10.3: Cervical Lesions............................................................................................................................................................ 413
10.4: Vulvar Lesions............................................................................................................................................................... 415
10.5: Benign Breast Disease................................................................................................................................................... 418
Section 11: Malignancies of Genital Tract
11.1: Endometrial Cancer..................................................................................................................................................... 427
11.2: Leiomyosarcoma........................................................................................................................................................... 432
11.3: Ovarian Cancer............................................................................................................................................................. 433
11.4: Cervical Intraepithelial Neoplasia............................................................................................................................... 437
11.5: Invasive Cancer of the Cervix..................................................................................................................................... 446
11.6: Vulvar Cancer............................................................................................................................................................... 450
11.7: Cancer of the Fallopian Tubes..................................................................................................................................... 453
11.8: Breast Cancer................................................................................................................................................................ 453
Section 12: Uterus
12.1: Uterine Prolapse............................................................................................................................................................ 464
12.2: Uterine Retroversion.................................................................................................................................................... 477
12.3: Adenomyosis.................................................................................................................................................................. 478
12.4: Uterine Malformations................................................................................................................................................. 479
12.5: Hysterectomy................................................................................................................................................................. 486
12.6: Genitourinary Fistulae................................................................................................................................................. 501
12.7: Urinary Incontinence.................................................................................................................................................... 504
12.8: Hysteroscopy................................................................................................................................................................. 506
12.9: Laparoscopy.................................................................................................................................................................. 509
12.10: Robotic Surgery............................................................................................................................................................ 513
Section 13: Abnormalities in Conception
13.1: Causes of Infertility...................................................................................................................................................... 521
13.2: Diagnosis of Infertility.................................................................................................................................................. 522
13.3: Assisted Reproductive Techniques For Treatment of Infertility.............................................................................. 526
13.4: Surgery For Treatment of Infertility........................................................................................................................... 531
13.5: Polycystic Ovarian Disease.......................................................................................................................................... 534
13.6: Hirsutism....................................................................................................................................................................... 538
13.7: Endometriosis................................................................................................................................................................ 541
Section 14: Infections of the Genital Tract
14.1: Vaginal Discharge......................................................................................................................................................... 549
14.2: Sexually Transmitted Diseases..................................................................................................................................... 553
14.3: Pelvic Inflammatory Diseases...................................................................................................................................... 557
Evidence

15.1: Contraception................................................................................................................................................................ 565
15.2: Temporary Methods of Contraception....................................................................................................................... 566
15.3: Method of Copper-T Insertion.................................................................................................................................... 576
15.4: Insertion of Mirena....................................................................................................................................................... 578
15.5: Permanent Methods of Female Contraception.......................................................................................................... 580