By Joan Pitkin Alison Peattie Brian A. Magowan
A hugely illustrated, brief, atlas-style textual content of obstetrics and gynaecology. info is split into brief themes that may be coated in a single or double-page spreads--with the utmost use of illustrations and minimum text.Uses over 330 illustrations, line drawings, images, and boxes-134 in complete color-to exhibit the total diversity of ailments and disorders.Presents the entire key info obstetrics and gynecology in a quick, succinct, and easy-to-access format.Covers over 70 center issues within the box, with each one subject awarded in 1 or 2 double-page spreads.
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Additional info for Obstetrics and Gynecology: An Illustrated Colour Text
The incidence of all malformations is increased, Diabetes in pregnancy I especially congenital heart disease and neural tube defects. Multiple abnormalities are common. Caudal regression syndrome (absence of vertebrae anywhere below T10) is rare but peculiar to diabetics. The most common form is sacral agenesis [Fig. 1). Tight diabetic control is therefore very important at the time of organogenesis to reduce the incidence of congenital malformations. As organogenesis occurs during the first 7-9 weeks of fetal life, and patients rarely book for antenatal care before 10-12 weeks, pre-conceptual counselling is the only way to gain diabetic control in time.
There is a hereditary element and an association with obesity. NIDDM is less common in the childbearing years. Insulin-dependent diabetes (IDDM) occurs most often in young adults and is due to cellular and humoral autoimmunity to pancreatic beta cells. In pregnancy, diabetic control needs to be as careful for NIDDM as IDDM to avoid adverse perinatal outcome. White's classification (Table 1) is often used to grade the severity of the disease. In general, the more severe the disease the greater the perinatal mortality and incidence of congenital malformations.
The perinatal mortality rate has been dramatically reduced and now approaches 9/100 000. 5 g/dl in the third. The apparent fall in level throughout pregnancy is due to the relatively greater rise in maternal plasma volume compared to the rise in red cell mass. This physiological dilution of the maternal blood ensures normal circulation with less cardiac work than might be expected allowing for the increased amount of clotting factors and fibrinogen. Anaemia may affect 10% of pregnancies in developed countries and is considerably commoner in developing countries, where it is a major source of maternal morbidity and a contributor to mortality.