Endoscopy In Infertility Ecab

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Endoscopy in Infertility - ECAB

Author : Urvashi P Jha
Publisher : Elsevier Health Sciences
Page : 90 pages
File Size : 40,7 Mb
Release : 2009-12-15
Category : Medical
ISBN : 9788131232286

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Endoscopy in Infertility - ECAB by Urvashi P Jha Pdf

Historically, gynecologic endoscopy began in the 1930s with the development of diagnostic laparoscopy, but today gynecologic endoscopy has become an essential part of gynecologic surgery. In present practice, the benefits of hysteroscopy have become safely entrenched behind undeniable facts, to the hospitals as well as the patients. Hysteroscopy can be regarded as the gold standard for the evaluation of the uterine cavity in cases of abnormal uterine bleeding, infertility, recurrent pregnancy loss, and suspected intrauterine out-growth. It can be performed in the office setting (outpatient hysteroscopy) or as a day-case procedure, under general anesthesia (inpatient hysteroscopy). Outpatient hysteroscopy has been shown to be as accurate as inpatient hysteroscopy, and it has the advantage of reduced anesthetic risks, enhanced time–cost effectiveness, and patient preference. The factors behind the success of outpatient hysteroscopy are instrument quality, characteristics of the distension medium, the ability and experience of the operators, and recent technical advances, such as the introduction of small-diameter rigid and flexible hysteroscopes. The future looks to further simplification of instrumentation and hence, high safety and accuracy and expedited performance. "Hysteroscopy in Infertility" has addressed the relevant issues with dexterity by substantiating with relevant clinical experiences of authors, who are among the pioneers in this field.

Endoscopy in Infertility - Part II - A Perspective on Laparoscopy - ECAB

Author : Urvashi Prasad Jha
Publisher : Elsevier Health Sciences
Page : 235 pages
File Size : 53,9 Mb
Release : 2013-07-12
Category : Medical
ISBN : 9788131232293

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Endoscopy in Infertility - Part II - A Perspective on Laparoscopy - ECAB by Urvashi Prasad Jha Pdf

Historically, gynecologic endoscopy began in the 1930s with the development of diagnostic laparoscopy, but today gynecologic endoscopy, both laparoscopy and hysteroscopy, has become an essential part of gynecologic surgery. In present practice, the benefits of laparoscopy, hysteroscopy, and minimally invasive surgical procedures have become safely entrenched behind undeniable facts, to the patients as well as the hospitals. The endoscopic gynecologic surgery now involves the whole gamut of fetal surgery, embryoscopy, outpatient local anesthetic laparoscopy, total laparoscopic hysterectomy, and embolization of myomas. Another interesting fact to come to the fore is that, increasingly, the traditional treatments for infertility are being rendered obsolete by advanced reproductive technologies and gynecologic endoscopy. Endoscopy in Infertility has addressed the relevant issues with dexterity by substantiating with relevant clinical experiences of its authors, who are among the pioneers in this field.

Managing Infertility - ECAB

Author : Kamini Rao
Publisher : Elsevier Health Sciences
Page : 148 pages
File Size : 43,8 Mb
Release : 2012-06-15
Category : Medical
ISBN : 9788131232347

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Managing Infertility - ECAB by Kamini Rao Pdf

Assisted reproduction refers to a number of advanced techniques that aid fertilization in a couple diagnosed to have reduced fertility such as in women who have irreversible damage to their fallopian tubes or cervical mucous problems. These techniques can also benefit couples with unexplained infertility. Before 1978, infertility diagnosis and treatment revolved around surgical interventions such as fallopian tube(s) repair or inserting sperms into the uterus. Thus, the management was applicable and aimed at removing the mechanical blockage that prevented the fertilization of egg. Then ca.me Louise Brown and Dr. Patrick Steptoe, a couple who were destined to be associated forever in the infertility history books forever. This is because in 1978, Dr. Steptoe made it possible for Louise to conceive in a laboratory in England with IVF. From this turning point in the science of infertility, came techniques that addressed the biochemical and hormonal aspects of infertility thus marking the beginning of a whole new subspecialty called Reproductive Endocrinology. With Dr. Steptoe’s technique, called IVF (In Vitro Fertilization), couples who otherwise had no problems that could be surgically treated now had another option. With the inclusion of Information technology in all aspects of our life, the explosion of Assisted Reproduction Technologies (ART) has resulted in further sophistication of additional techniques, now responsible for the existence of over 20,000 human beings a year that would never have existed. ART deals with all aspects of the science of conception, be it investigating the couple, or determining their ovarian reserve to application of the most appropriate technique to aid conception in that couple.

Threatened Miscarriage - ECAB

Author : Suneeta Mittal
Publisher : Elsevier Health Sciences
Page : 159 pages
File Size : 49,8 Mb
Release : 2013-07-12
Category : Medical
ISBN : 9788131232330

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Threatened Miscarriage - ECAB by Suneeta Mittal Pdf

Even though it seems simple the ability of the mother’s body to retain and nurture the fetus, which is of a non-identical genetic makeup, throughout the gestational period requires a delicate balance of hormonal orchestration to achieve the required immunological permissiveness. The obvious outcome of a failure to achieve this is rejection of the fetal "semi-allograft", which manifests as threatened miscarriage. The occurrence of threatened miscarriage or symptoms suggestive of it is fraught with anxiety both for the patient and the obstetrician, especially if the baby is eagerly awaited. In such a situation, a correct diagnosis and prompt evaluation is imperative to start immediate interventions and prevent the expulsion of the fetus. However it is equally important to rule out the other conditions that may mimic threatened miscarriage and avoid unnecessary interventions. This clinical update handbook attempts to address these and other issues associated with this potentially elusive condition. The first chapter serves to give a concise yet relevant overview about this topic. The various modes of presentation as well as the management protocol are elaborately covered in the second chapter. The chapter on Diagnostic Modalities explains how the risk factors and investigative findings can be used to predict and make an early diagnosis of the condition. It has also touched upon the other conditions that mimic threatened miscarriage and how those can be differentiated from it. The role of stress and how it affects the immunomodulation which is the basis of maternal tolerance of the fetus, is explored in detail in the fourth chapter. The last chapter highlights the complications associated with inappropriate treatment of the condition and explores the adverse effects and relative safety of the recommended treatment protocol. Most of the chapters also include several case reviews that illustrate the aspects covered and are enriched with the vast repertoire of personal experience of the eminent authors.

Polycystic Ovary Syndrome - ECAB

Author : Gita Ganguly Mukherjee
Publisher : Elsevier Health Sciences
Page : 159 pages
File Size : 41,8 Mb
Release : 2012-07-05
Category : Medical
ISBN : 9788131232224

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Polycystic Ovary Syndrome - ECAB by Gita Ganguly Mukherjee Pdf

PCOS is a complex endocrinopathy with wide-ranging variations and clinical manifestations. In the field of gynecology, the clinician is called upon to treat problems of menstrual irregularity, acne and hirsutism, infertility, obesity, and for education on long-term consequences. The mainstay of pharmacological treatment aims at ovarian suppression of androgen secretion. The most effective medical therapy for hirsutism in these cases thus appears to be antiandrogen drugs. The patients need to undergo the therapies for long periods and also understand the need of maintenance. Electrolysis and laser photothermolysis are considered the most effective cosmetic procedures. PCOS is a heterogeneous disorder and no single etiological factor fully accounts for the whole spectrum of the abnormalities in this condition. Only a few genes and mutations show considerable evidence of association with PCOS. Variable manifestation observed within PCOS patients may be due to the interaction with environmental factors with protective genomic variant and predisposing genes. The eminent authors of "Polycystic Ovary Syndrome" have enumerated the various options available described in detail their experiences regarding the various aspects of the condition.

Perinatal Medicine - ECAB

Author : Shirish N Daftary
Publisher : Elsevier Health Sciences
Page : 182 pages
File Size : 53,6 Mb
Release : 2012-07-05
Category : Medical
ISBN : 9788131232231

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Perinatal Medicine - ECAB by Shirish N Daftary Pdf

Perinatal medicine encompasses various current topics in fetal diagnosis and management, besides preconception counseling. The concept of preconception counseling and healthcare evaluation optimizes a couple’s readiness for childbearing. This helps to minimize any foreseeable adverse factors through a careful diagnostic review and provision of appropriate intervention and therapy in advance. This has been dealt with in detail. The section on etiology and management aspects of Intrauterine Growth Retardation (IUGR) covers investigation and management of suspected or known fetal abnormalities, placental failure, and fetal growth retardation. Prenatal diagnostic procedures had limited access and safety so far, but this is a thing of the past today, especially after the advent of real-time ultrasonography. It brings an increasingly clearer visualization of the intrauterine space and has vastly broadened the scope for fetal diagnosis and treatment. The currently available ultrasound-guided procedures for fetal diagnosis and therapy are discussed at length in the chapter invasive ultrasound procedures. The discussed invasive ultrasound procedures include amniocentesis, cordocentesis, and chorionic villus sampling, done to detect neural tube defects, fetal lung maturity, and chromosomal abnormalities. The controversies surrounding the evaluation of fetal anomalies by ultrasound procedures are covered at length which we expect would be of special interest to the readers. Opinions abound as well as differ on the interpretation of the findings and counseling of couples, based on the same. This section focuses on the implications of missed fetal anomalies in this background and its impact on pregnancy outcome.

Obstetrics Counseling - ECAB

Author : Uday Thanawala,Hema Divakar
Publisher : Elsevier Health Sciences
Page : 127 pages
File Size : 48,9 Mb
Release : 2012-07-05
Category : Medical
ISBN : 9788131232248

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Obstetrics Counseling - ECAB by Uday Thanawala,Hema Divakar Pdf

Informed choice is the right of an individual. Gynecologists have immense responsibility and a unique opportunity to guide their patients through the various milestones/changes in their life by good counseling—menarche, sexuality, pregnancy, pelvic operations, and menopause. Adolescents should be taught about safe sex practices, premarital counseling, and contraception. Preconception counseling is also important in the identification of risk factors, disease states, and potential teratogens in the pregnancy. The availability of first-trimester prenatal diagnosis and the advent of presymptomatic diagnosis by DNA analysis have created increasing opportunities to avoid disorders characterized by early death, severe disease, or irreparable mental retardation, for example, periconceptional maternal folic acid supplementation has now been shown to provide high protective effect against neural tube defects. Similarly, certain maternal diseases, including diabetes, lupus, and myotonic muscular dystrophy, impose potential maternal, fetal, neonatal, and other complications. The preconception visits provide important opportunities for intervention, avoidance, or prevention in these cases. The patients’ ethnicity and medical and genetic family history are key elements in their evaluation, whereas patients with prolonged infertility of unknown cause or recurrent spontaneous abortion may have a 3–10% risk of a parental chromosome abnormality, which may also require chromosome analysis, as do their spouses.

Gynecologic Endocrinology - ECAB

Author : Suman Kher
Publisher : Elsevier Health Sciences
Page : 267 pages
File Size : 45,9 Mb
Release : 2012-06-15
Category : Medical
ISBN : 9788131232309

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Gynecologic Endocrinology - ECAB by Suman Kher Pdf

The diagnostic approach as well as the management of several endocrinological disorders underwent major modifications. Gynecological endocrinology made no exception, and light was finally thrown on a scarcely known area, so heavily influenced by ignorance and prejudices. Here some authoritative experts have addressed the several possibilities of hormonal interventions in the field of gynecology. The most recent research development has led to the better understanding of the physiopathological rationale, underlying appropriate treatments and even evaluation of the new routes of hormone administration. Current medical therapy of different conditions has been thoroughly reviewed, including precocious puberty, hyperandrogenism, premature ovarian failure, polycystic ovarian syndrome, and menopause. Keeping in mind the requirements of the society, the practitioners need to update themselves on the current approach and wide variety of treatment options now available. India has a distinct need for the comprehensive programs that fit into the Indian context of the situation. It has to be a continuous process, which approaches the problem on the basis of the experience of the specialists in India who are among the stalwarts in this field. In its quest to better approach the topic, Elsevier has pooled its existing resources with those of the internationally acclaimed Obstetricians and Gynecologists of India who have chosen to apply their rich clinical knowledge and expertise to serve the Indian patients.

Medical Disorders in Pregnancy - ECAB

Author : Hema Divakar
Publisher : Elsevier Health Sciences
Page : 194 pages
File Size : 48,9 Mb
Release : 2009-11-15
Category : Medical
ISBN : 9788131232279

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Medical Disorders in Pregnancy - ECAB by Hema Divakar Pdf

The management of medical disorders in pregnancy has undergone significant changes in the recent years. The pattern of disease has changed with improvements in socio-economic conditions. For example, the incidence of antenatal anemia has decreased progressively in the past few decades, and pulmonary tuberculosis (which used to be prevalent) is now seen only rarely. Chronic rheumatic heart disease has also become less common. On the other hand, gestational diabetes has become more common. This may be due partly to the setting up of screening services for gestational diabetes in many hospitals. The four most common medical disorders complicating pregnancy are anemia, diabetes mellitus, cardiac disease, and thyroid disorders. In addition, because of the improvements in the medical, obstetric, and anesthetic management of pregnancy, many women with medical disorders can go through a pregnancy without major problems. There has also been a progressive decrease in the perinatal mortality associated with some medical disorders, such as diabetes. It is important for all healthcare professionals involved in the management of pregnant women with medical disorders to be conversant with the latest developments in order to provide the best care to these women. The chapters in this issue are certainly helpful in this respect. The eminent authors for the various chapters have discussed the various options available describing in detail their experiences regarding the various aspects of the condition.

Endometriosis - ECAB

Author : Sadhana Desai
Publisher : Elsevier Health Sciences
Page : 126 pages
File Size : 50,7 Mb
Release : 2012-06-15
Category : Medical
ISBN : 9788131232323

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Endometriosis - ECAB by Sadhana Desai Pdf

Endometriosis is a condition that often leads to a variety of symptoms that range from pain complaints to infertility. Endometriosis is also found in women who are asymptomatic. The diagnosis of endometriosis can be made clinically with reliability similar to that of one made surgically. Medical treatment options are effective, as are surgical treatment options. Complications associated with surgery, however, push the balance in favor of medical therapy whenever possible. Based on the body of evidence available at present, women with endometriosis-related complaints should be treated with a first-line medical therapy. If that fails, a second-line medical therapy is warranted under most conditions. Laparoscopic surgery should be reserved for patients in whom second-line medical therapy has failed or is contraindicated by desire to conceive immediately or as soon as possible.

Thyroid Dysfunction and Pregnancy - ECAB

Author : Sujata Misra
Publisher : Elsevier Health Sciences
Page : 160 pages
File Size : 40,5 Mb
Release : 2012-07-26
Category : Medical
ISBN : 9788131232354

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Thyroid Dysfunction and Pregnancy - ECAB by Sujata Misra Pdf

It is an established fact that thyroid hormones play an important role in the metabolism of the body. Pregnancy is a state of significant hormonal as well as metabolic changes, and thyroid hormones have a significant impact on maternal metabolism and fetal development during pregnancy. The fetus relies on maternal thyroid hormone for the development of the CNS, especially in the early stages of gestation, and uncorrected maternal hypothyroidism in this period can leave the child with permanent life-long neurological deficits. From the maternal point of view, a thyroid dysfunction encountered during pregnancy may continue even after delivery as postpartum thyroiditis. Hence, any thyroid dysfunction, be it hypo- or hyperthyroidism, can have serious deleterious consequences if not detected promptly and managed properly. The established guidelines and newer trends for the treatment of thyroid dysfunction are discussed in this update. Thyroid hypofunction has also been known to affect the fertility of women in reproductive age group. With the increasing incidence of infertility and advent of methods to treat them, the early detection and adequate treatment of thyroid hypofunction becomes an unavoidable part of assisted reproductive techniques, in the present day scenario. Even subclinical thyroid disorders can affect the reproductive capacity of non-pregnant women and impact the fetomaternal wellbeing in those who conceive. However, not all cases of subclinical hypothyroidism warrant pharmacological treatment. The guidelines for treatment of subclinical hypothyroidism in the pregnant and non-pregnant states are discussed in detail in this clinical update. An important aspect of reproductive health is family planning, and one of the commonly used means to achieve it is hormonal contraceptives. The interaction of thyroid hormones with hormonal contraceptives and the means of testing thyroid dysfunction in an individual taking hormonal contraceptives have been elucidated in this update.

ECAB Progesterone: The Multifaceted Molecule - E-Book

Author : Sanjay Gupte,Girija Wagh
Publisher : Elsevier Health Sciences
Page : 184 pages
File Size : 52,6 Mb
Release : 2014-12-11
Category : Medical
ISBN : 9788131239537

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ECAB Progesterone: The Multifaceted Molecule - E-Book by Sanjay Gupte,Girija Wagh Pdf

ECAB Progesterone: The Multifaceted Molecule - E-Book

ECAB Luteal Phase Insufficiency - E-Book

Author : Madhuri Patil,Sheela V Mane
Publisher : Elsevier Health Sciences
Page : 120 pages
File Size : 52,7 Mb
Release : 2014-12-11
Category : Medical
ISBN : 9788131239612

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ECAB Luteal Phase Insufficiency - E-Book by Madhuri Patil,Sheela V Mane Pdf

ECAB Luteal Phase Insufficiency - E-Book

High-Risk Labor and Delivery - ECAB

Author : Shirish N Daftary
Publisher : Elsevier Health Sciences
Page : 272 pages
File Size : 43,8 Mb
Release : 2012-06-19
Category : Medical
ISBN : 9788131232316

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High-Risk Labor and Delivery - ECAB by Shirish N Daftary Pdf

The high-risk pregnant patient can present to the labor and delivery setup with significant complications that can result in morbidity and mortality. The goal of the obstetricians is always to have a safe outcome for both the mother and the baby, irrespective of the severity of the illness. Therefore, a thorough understanding of the underlying problems and expert management by the obstetrician are extremely important. Further, these parturient can be critically ill, requiring intensive care management. So, good communication among the various teams and the latest information on the management of such patients are critical in order to provide the highest possible level of care. The information in this text will hopefully give the reader the best and most up-to-date knowledge with regard to management of problems and challenges in dealing with a high-risk parturient. This book brings together an outstanding group of authors from the discipline of Obstetrics and Gynaecology in an attempt to present a comprehensive and current summary of high-risk labor and delivery and will be useful to both the practitioner in academic medicine and in private practice.

Critical Issues in Obstetrics - ECAB

Author : Prakash Trivedi
Publisher : Elsevier Health Sciences
Page : 150 pages
File Size : 48,7 Mb
Release : 2009-09-15
Category : Medical
ISBN : 9788131232262

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Critical Issues in Obstetrics - ECAB by Prakash Trivedi Pdf

Globally, pregnancy and childbirth are periods of high morbidity and mortality for women. The key to reducing the risks associated with pregnancy and childbirth is early recognition and provision of high quality care. The aims of critical care issues’ management are broad, the need to address the defects in conceiving followed by early recognition, prevention, and management of preterm births and threatened miscarriages along with studying the essential factors responsible for the same. Infertility has been ranked as one of the greatest sources of stress in a person’s life, comparable to a somatic disease such as cancer and ranked second to that involving the death of a family member or divorce. The role of stress and immunomodulation as a causative factor for infertility has been studied in greater details in recent times due to the changing lifestyles and a relevant discussion has been provided by the author with specific considerations in the Indian clinical settings. Endometriosis is the disease of the millennium, a sticky, perplexing and unconquerable pathology, which has remained an enigma. With increased awareness about endometriosis, improved methods of diagnosis like transvaginal sonography, liberal use of laparoscopy and more frequent evaluation of CA 125, the incidence of endometriosis is rising and thus, a clear understanding of the condition with application of the various advances in the recognition and also the new management protocols being followed, are the need of the day for the practitioners across the country. The polycystic ovary syndrome (PCOS), which features amenorrhea, hirsutism, and obesity, which was initially considered a reproductive and cosmetic concern of young women of reproductive age group, has more recently been recognized to have metabolic and cardiovascular associations that make it of major consequence for women of all age groups worldwide. Keeping in mind the requirements of the society, the practitioners need to update themselves on the current approach and the wide variety of choices now available. This book encompasses the rich experience of the specialists in India who are among the stalwarts in this field.