By Jeremy Oats, Suzanne Abraham
1. Gynaecological and obstetric background and examination
2. Ovulation and the menstrual cycle
3. perception and placental development
4. Embryo and fetus
5. Physiological and anatomical adjustments in pregnancy
6. Antenatal care
7. body structure and anatomical adjustments in childbirth
8. path and administration of childbirth
9. The puerperium
10. Minor problems of pregnancy
12. Extrauterine pregnancy/ectopic gestation
13. Antepartum haemorrhage
14. Hypertensive illnesses in pregnancy
15. Cardiovascular, respiration, haematological, neurological and gastrointestinal problems in pregnancy
16. Endocrine problems in being pregnant
17. Infections in the course of pregnancy
18. ailments of the placenta and membranes
19. adaptations within the length of pregnancy
20. The at-risk fetus
21. irregular fetal shows
22. irregular labour (dystocia) and lengthy labour
23. issues within the puerperium
24. Obstetric operations
25. The epidemiology of obstetrics
26. the baby child
27. The low-birthweight baby
28. problems of menstruation
29. mental and actual problems of the menstrual cycle
30. Human sexuality
31. notion regulate
33. Infections of the genital tract
34. Atrophic and dystrophic conditions
35. Endometriosis and adenomyosis
36. Benign tumours, cysts and malformations of the genital tract
37. Premalignant and malignant stipulations of the feminine genital tract
38. Uterovaginal displacements, harm and prolapse
39. The urinary tract and its dating to gynaecology
40. The breast
41. Gynaecological difficulties in formative years and adolescence
42. The menopause
43. Anatomy of the feminine genital tract
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Additional info for Llewellyn-Jones Fundamentals of Obstetrics and Gynaecology (9th Edition)
11 The fall in blood pressure from the aorta through the umbilical circulation and liver to the inferior vena cava (IVC) in the mature fetal lamb. The increasing blood flow as pregnancy advances compensates for ageing changes that occur in the placenta, and for the development of placental infarcts. FUNCTION OF THE PLACENTA The placenta acts for the fetus as: • An organ of respiration • An organ of nutrient transfer and excretion • An organ of hormone synthesis. It also acts as an immunological barrier protecting the fetus (formed from paternal as well as maternal genes) from rejection by the mother’s immune system.
Gastric secretion is reduced and food remains longer in the stomach. The intestinal musculature is relaxed, with lower motility, which permits a greater absorption of nutrients but may lead to constipation. RENAL SYSTEM CHANGES The smooth muscle of the renal pelvis and ureters relaxes, causing their dilatation. This increases the capacity of the renal pelvis and ureters from 12 mL to 75 mL and Human chorionic gonadotrophin can reduce the immune response of pregnant women. In addition, serum levels of IgG, IgA and IgM decrease from the 10th week of pregnancy, reaching their lowest level at the 30th week and remaining at this level to term.
From the 20th week growth almost ceases and the uterus expands by distension, the stretching of the muscle fibres being due to the mechanical effect of the growing fetus. With distension the wall of the uterus becomes thinner and the shape cylindrical (Fig. 2). The uterine blood vessels also undergo hypertrophy and become increasingly coiled in the first half of pregnancy, but no further growth occurs after this, and the additional length required to match the continuing uterine distension is obtained by uncoiling the vessels.