Preface to the Fourth Edition v
Preface to the First Edition vi
Historical Landmarks and Evolution
of the Art and Science of Obstetrics vii
SECTION I BASICS OF REPRODUCTION 1
1 Reproductive Anatomy 1
2 Fundamentals of Reproduction 15
3 The Fetus 28
4 Birth Defects, Genetics, Teratology and
Counselling 34
5 Maternal Physiologic Changes in Pregnancy 37
6 Endocrinology of Pregnancy 44
SECTION II NORMAL PREGNANCY 49
7 Diagnosis of Pregnancy 49
8 The Fetus In Utero and Fetopelvic
Relationship 54
9 Prenatal (Antenatal) Care 59
10 Fetus at Risk: Identifi cation and Assessment 80
SECTION III MEDICAL, SURGICAL AND
GYNAECOLOGICAL DISORDERS IN
PREGNANCY 85
11 Hypertensive Disorders in Pregnancy 85
12 Epilepsy in Pregnancy/Seizure Disorders 100
13 Anaemia in Pregnancy 104
14 Heart Diseases in Pregnancy 116
15 Diabetes in Pregnancy 126
16 Thyroid Disorders in Pregnancy 138
17 Urinary Infections and Pyelonephritis in
Pregnancy 142
18 Malaria in Pregnancy 146
19 Dengue Fever Complicating Pregnancy 151
20 Hepatic Disorders in Pregnancy 153
21 Bronchial Asthma in Pregnancy 159
22 Tuberculosis Complicating Pregnancy 162
23 Rh Isoimmunization 166
24 HIV Infection Complicating Pregnancy 175
25 Perinatal Infectious Diseases (TORCH) 180
26 Surgical Disorders in Pregnancy 187
27 Gynaecological Disorders in Pregnancy 192
SECTION IV OBSTETRIC DISORDERS
IN PREGNANCY 197
28 Early Pregnancy Loss 197
29 Ectopic Pregnancy 206
30 Fetal Growth Restriction 213
31 Multifetal Pregnancy 220
32 Antepartum Haemorrhage 228
33 Placenta Praevia 230
34 Accidental Haemorrhage (Placental
Abruption) 236
35 Amniotic Fluid Abnormalities 241
36 Post-term Pregnancy 245
37 Intrauterine Fetal Death 247
38 Gestational Trophoblastic Disease 250
SECTION V NORMAL LABOUR 257
39 Onset of Labour 257
40 Uterine Activity in Labour 262
41 Effects of Labour on Mother and Fetus 267
42 Clinical Course of Labour 269
43 Mechanism of Labour 273
44 Documentation of Labour (Partogram) 278
45 Management of Labour 283
SECTION VI ABNORMAL LABOUR 291
46 Abnormal Fetal Positions
and Presentations 291
47 Prolonged Labour 319
48 Abnormal Uterine Action 325
49 Contracted Pelvis and Cephalopelvic
Disproportion 330
50 Obstructed Labour 336
51 Rupture of the Uterus 340
52 Other Maternal Soft-Tissue Traumas 344
53 Postpartum Haemorrhage 347
54 Preterm Labour 355
55 Prelabour Rupture of Membranes 362
56 Induction of Labour 364
57 Fetal Surveillance in Labour 372
58 Fetal Distress (Non-Reassuring Fetal Status) 378
59 Obstetric Shock 381
60 Amniotic Fluid Embolism (Pulmonary Embolism)
in Obstetrics 388
61 Coagulation Disorders and
Thrombocytopenia 391
SECTION VII PUERPERIUM 395
62 Normal Puerperium 395
63 Disorders of the Puerperium 403
SECTION VIII DRUGS IN OBSTETRICS 427
64 Obstetric Analgesia and Anaesthesia 427
65 Drugs in Pregnancy and Lactation 434
SECTION IX INVESTIGATIONS
IN OBSTETRIC PRACTICE AND ASSESSMENT
OF FETAL WELL BEING 451
66 Ultrasonography in Fetal Health
Assessment 451
67 Antenatal Detection of Abnormal Fetal
Development 463
68 Antenatal Testing for Fetal
Well-being: Cardiotocography 468
SECTION X OBSTETRIC INTERVENTIONS
AND SURGERIES 475
69 Surgical Procedures in Early Pregnancy 475
70 Versions 482
71 Episiotomy 486
72 Obstetric Forceps 489
73 Vacuum Extraction (Ventouse) 493
74 Caesarean Delivery 497
75 Surgical Management of Obstetric
Haemorrhage 502
76 Decompression Procedures 507
SECTION XI SAFE MOTHERHOOD 511
77 The Safe Motherhood Initiative 511
78 Maternal Mortality 516
79 Perinatal Mortality 521
SECTION XII THE NEWBORN INFANT 525
80 Care and Examination of the Newborn 525
81 Adaptation and Resuscitation of the
Newborn 531
82 Problems of the Newborn 534
83 Infections in the Newborn 541
84 Congenital Fetal Malformations 546
85 Neurological Presentations in the
Newborn 558
86 The Small Newborn (Low Birthweight) 561
SECTION XIII CONTRACEPTION
AND TERMINATION OF PREGNANCY 563
87 Contraception 563
88 Induced Abortions and Medical Termination
of Pregnancy 580
SECTION XIV CONTEMPORARY OBSTETRIC
PRACTICE 583
89 Immunology and Pregnancy 583
90 Trauma in Pregnancy 588
91 Sexually Transmitted
Diseases in Pregnancy 592
92 Substance Abuse in Pregnancy 595
93 Medicolegal Issues and Risk
Management 598
94 Special Cases in Obstetric
Practice 602
95 Evolution of Obstetric Practice 606
SECTION XV CLINICAL ASPECTS
IN OBSTETRICS AND GYNAECOLOGY 613
96 Obstetric History Taking 613
97 Obstetric Examination 615
98 Labour Care – A Ready Reckoner 620
99 Obstetric Management – Decision Making 630
100 Management in Postcaesarean Pregnancy 632
101 Specimens in Obstetrics 638
102 Obstetric Instruments 643
Index 657
