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Postpartum mastitis occurs sporadically in nursing mothers shortly after they return home, or it may occur in epidemic form in the hospital. Staphylococcus aureus is usually the causative agent. Inflammation is generally unilateral, and women…

Preterm (premature) labor is labor that begins before the 37th week of pregnancy; it is responsible for 85% of neonatal illnesses and deaths. The onset of labor is a result of a…

Introduction

Breast feeding should be encouraged by education throughout pregnancy and the puerperium. Mothers should be told the benefits of breast feeding - it is emotionally satisfying, promotes mother-infant bonding, is economical, and gives significant…

The antibody anti-Rho(D) is responsible for most severe instances of hemolytic disease of the newborn (erythroblastosis fetalis). About 15% of whites and much lower proportions of blacks and…

Introduction

Elective major surgery should be avoided during pregnancy. Normal uncomplicated pregnancy does not alter operative risk except as it may interfere with the diagnosis of abdominal disorders and increase the technical…

Five to 10 percent of women have vaginal bleeding in late pregnancy. The clinician must distinguish between placental causes (placenta previa, placental abruption, vasa previa) and nonplacental causes (infection, disorders of the lower genital tract,…

Introduction

Essentials of Diagnosis

Hydatidiform Mole

• Amenorrhea.
• Irregular uterine bleeding.
• Serum hCG ß-subunit < 40,000 mU/mL.
• Passage of grape-like clusters of enlarged edematous villi…

Introduction

Essentials of Diagnosis

• Amenorrhea or irregular bleeding and spotting.
• Pelvic pain, usually adnexal.
• Adnexal mass by clinical examination or ultrasound.
• Failure of serum level of hCG to double…

Introduction

Recurrent abortion has been defined as the loss of three or more previable (< 500 g) pregnancies in succession. Recurrent abortion occurs in about 0.4-0.8% of all pregnancies. Abnormalities related to recurrent…

Introduction

Essentials of Diagnosis

• Intrauterine pregnancy at less than 20 weeks.
• Low or falling levels of hCG.
• Bleeding, midline cramping pain.
• Open cervical os.
• Complete or partial expulsion…

Introduction

Essentials of Diagnosis

• Morning or evening nausea and vomiting.
• Persistent vomiting severe enough to result in
• weight loss, dehydration,…

During an otherwise normal low-risk pregnancy, travel can be planned most safely between the 18th and 32nd weeks. Commercial flying in pressurized cabins does not pose a threat to the fetus. An…

Introduction

The first prenatal visit should occur as early as possible after the diagnosis of pregnancy and should include the following: history, physical examination, laboratory tests, advice to patients, and tests and…

Nutrition in pregnancy significantly affects maternal health and infant size and well-being. Pregnant women should have nutrition counseling early in prenatal care and access to supplementary food programs if necessary. Counseling should stress abstention…

Introduction

It is advantageous to diagnose pregnancy as promptly as possible when a sexually active woman misses a menstrual period or has symptoms suggestive of pregnancy. In the event of a…

Introduction

Introduction

Essentials of Diagnosis

 
• Vaginal irritation, pruritus, pain, or unusual discharge.

Introduction

 
• Women neither secretly want to be raped nor do they expect, encourage, or enjoy rape.  
• Rape is always a terrifying experience in which most victims fear for their lives.  
• The rapist…

Introduction

Essentials of Diagnosis

 
• Cessation of menses due to aging or to bilateral oophorectomy.  
• Elevation of FSH and LH levels.  
• Hot flushes and night sweats (in 80% of women).  …

Introduction

Voluntary control of childbearing benefits women, men, and the children born to them. Contraception should be available to all women and men of reproductive ages. Education about contraception and access to contraceptive pills or devices…

Introduction

A couple is said to be infertile if pregnancy does not result after 1 year of normal sexual activity without contraceptives. About 25% of couples experience infertility at some point in their reproductive lives; the…

Introduction

Questions related to sexual functioning should be asked as part of the reproductive history. Two helpful questions are, “Are you sexually active?” and “Are you having any sexual difficulties at this time?”

Introduction

Essentials of Diagnosis

 
• Chronic anovulation.  
• Infertility.  
• Elevated plasma testosterone.  
• Insulin resistance.  
• Evidence of hyperandrogenism including hirsutism, acne, and alopecia.

Introduction

Essentials of Diagnosis

 
• Vague gastrointestinal discomfort.  
• Pelvic pressure and pain.  
• Many cases of early-stage cancer are asymptomatic.  
• Pelvic examination, CA 125, and ultrasound are mainstays of diagnosis.