By Joan Pitkin BSc MRCOG FRCS, Alison Peattie, Brian A. Magowan MB CHB FRCOG DIPFETMED
A hugely illustrated, brief, atlas-style textual content of obstetrics and gynaecology. info is split into brief issues that may be coated in a single or double-page spreads--with the utmost use of illustrations and minimum textual content.
* makes use of over 330 illustrations, line drawings, photographs, and boxes-134 in complete color-to exhibit the whole variety of illnesses and problems. * provides the entire key info obstetrics and gynecology in a brief, succinct, and easy-to-access structure. * Covers over 70 middle subject matters within the box, with each one subject offered in 1 or 2 double-page spreads.
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Extra resources for Obstetrics and gynaecology: an illustrated colour text
The fetal thyroid gland is active and secretes thyroid hormones from the 12th week. It is independent of maternal control, although maternal thyroid hormones do cross the placenta. Hypothyroidism This may present with fatigue, hair loss, dry skin, abnormal weight gain, poor appetite, cold intolerance, bradycardia and delayed tendon reflexes. If untreated, there is double the rate of spontaneous miscarriages and stillbirths compared to the normal population, as well as a risk of fetal neurological impairment.
There is a positive family history in up to 50% of cases. Transaminases are increased (less than threefold), and alkaline phosphatase levels are raised (above normal pregnancy values). Bilirubin is usually < 100mamol/l,and there may be pale stools and dark urine. Serum total bile acid concentration is increased early in the disease and may be the optimum marker. There are no serious long-term maternal risks but there is a risk of preterm labour, fetal distress and intrauterine fetal death. The fetus must be monitored closely and there is growing evidence that delivery at 37-38 weeks is appropriate.
V. + ventilation Postnatally, the mother may breast feed safely (drugs pass into the milk but are of little clinical significance). Advice should be given about safe and suitable settings for feeding, bathing, etc. Carbamazepine, phenytoin, primidone and phenobarbital induce liver enzymes, reducing the effectiveness of standard dose combined oral contraceptives, therefore a higher-dose oestrogen preparation is required 25 26 OBSTETRICS Acute hydronephrosis - loin pain - ureteric colic Chronic renal impairment - creatinine <125 mmol/l - good perinatal outcome - creatinine >125mirnol/l- often subfertility; fetal prognosis less good - dialysis - usually amenorrhoea; if pregnant, fetal prognosis very poor Those with asymptomatic bacteriuria should be treated as there is a 30-40% risk of developing symptomatic infection Fig.