Clinical Keys for This Chapter ▪ Acute pelvic pain of sudden onset can be caused by both gynecologic and nongynecologic disorders. Adnexal accidents such as rupture or torsion of ovarian cysts, pelvic infections, tubal rupture of ectopic pregnancies, and aborting…
Clinical Keys for This Chapter ▪ The adnexa are composed of the ovaries and fallopian tubes, along with the blood vessels, ligaments, and connective tissues located along both sides of the uterus. Benign ovarian masses may be classified as functional,…
Clinical Keys for This Chapter ▪ Uterine fibroids (also called leiomyomas) are benign smooth muscle tumors, and about 80% are asymptomatic. They are very common, with an estimated prevalence of 70% by the sixth decade of life. Uterine tumors presenting…
Clinical Keys for This Chapter ▪ Benign vulvovaginal problems are among the ten leading disorders encountered by primary care clinicians in the United States. Women with these disorders commonly present with irritation and pruritus (itching), but many conditions are asymptomatic…
Clinical Keys for This Chapter ▪ Diabetes and thyroid disorders are among the most common and consequential medical conditions that occur during pregnancy, labor, and the postpartum period. Diabetes may precede pregnancy or may occur because of pregnancy, with a…
Clincal Keys for This Chapter ▪ The hormonal and nonhormonal changes that occur during pregnancy and parturition are regulated through a physiological mechanism referred to as the fetoplacental unit. A series of hormones and transmitters are produced by each of…
Clinical Keys for this Chapter ▪ The female reproductive cycle (menstrual cycle) may be viewed as four separate physiologic cycles (hypothalamic, pituitary, ovarian, and endometrial) but is actually a highly complex and integrated event. This 28 (±7) day cycle allows…
Clinical Keys for This Chapter ▪ The upper vagina, cervix, uterus, and fallopian tubes are formed from the paramesonephric (müllerian) ducts. The absence of the Y chromosome leads to the development of the müllerian (female) system with virtual total regression…
Clinical Keys for this Chapter ▪ The clinical approach to obstetric and gynecologic patients requires sensitivity and an understanding that medical issues related to birth and reproductive care require a trusting relationship between a woman and her obstetrician and gynecologist…
Clinical Keys for this Chapter ▪ Clinical practice in obstetrics and gynecology, based upon the principles of safe, ethical and value-based care, is facilitated by viewing wellness and sickness in the context of a life-course perspective. Effective clinical care of…