Fetal Medicine (Royal College of Obstetricians and Gynaecologists Advanced Skills)

Based on the curriculum of the Royal College of Obstetricians and Gynaecologists' Advanced Training Skills Module in Fetal Medicine, this book provides a comprehensive knowledge base for all doctors practising in obstetrics and maternal-fetal medicine worldwide. It acts as a reference source for the many changing concepts in fetal medicine and is well-illustrated with images of normal and abnormal findings in pregnancy that will facilitate proper understanding of normal and pathological fetal development. Coverage includes embryology, fetal physiology; fetal anomalies; fetal diseases; prescribing and teratogenesis in pregnancy; termination of pregnancy; fetal growth and wellbeing; multiple pregnancy; the placenta and amniotic fluid; and diagnostic and therapeutic invasive procedures. Readers will benefit from the theoretical knowledge and vast clinical experience of the internationally renowned authorship. Overall this book will prepare you for dealing with congenital abnormalities detected during pregnancy, including the organization and supervision of screening programmes for structural and chromosomal anomalies. "This chapter has one chance to make a first impression on the reader. Similarly, the clinician has only one chance to make a first impression on the patient who has experienced domestic and/or sexual abuse, such that the patient has the confidence to disclose what has happened to her. . She or he may have taken months or years before feeling able to speak about what has happened, so it is essential that they experience a sympathetic, non-judgemental response from the clinician. Descriptions of the positive effects of an empathetic and non-judgemental responses have been given by two female doctors who themselves sought help following sexual violence and domestic abuse, respectively.1,2 This positive response also has the effect of validating the patient's experience of abuse. This chapter aims to describe the magnitude of the problem of domestic and sexual violence and abuse, and cover the important aspects of the initial contact between the clinician and the patient"--Provided by publisher Acute gynaecological problems are among the most common reasons for women of reproductive age to seek medical help. Emergency outpatient visits now outnumber elective clinical appointments in gynaecology. With a growing number of patients, increasingly complex diagnostic algorithms and a wide range of management options, the participation and training of senior doctors in this field is vital to ensure women receive the best possible treatment. This book provides a thorough overview of acute gynaecology and early pregnancy and has been designed to reflect the syllabus of the RCOG's Advanced Training Skills Module (ATSM) in 'Early pregnancy and emergency gynaecology'. It covers the diagnosis and management of routine clinical problems, such as miscarriage and tubal pregnancy, as well as less frequently seen presentations, such as uncommon forms of ectopic pregnancy and trophoblastic disease. The use of drugs in early pregnancy and management organisational aspects of care are also addressed. Ultrasound plays an integral part in the diagnosis and management of many gynaecological conditions; indeed, ultrasound forms part of the RCOG's mandatory training programme for doctors wishing to specialise in obstetrics and gynaecology. This book will be of use to both trainees and those already in clinical practice looking for a user-friendly reference guide. The use of ultrasound in gynaecology goes well beyond simple picture recognition: a skilful gynaecological sonographer will bring together scan findings and the clinical scenario to enhance patient care. This leads to targeted investigations and strategies for intervention. This book covers all aspects of the use of ultrasound in the fields of gynaecology and early pregnancy, with the contents including: postmenopausal bleeding; adnexal masses; pelvic pain; reproductive medicine; miscarriage; ectopic pregnancy; and ovarian cysts