Llewellyn-Jones Fundamentals of Obstetrics and Gynaecology, 9e

1292 Pages·2010·17.59 MB·English

by  Jeremy Oats MBBS DM FRCOG FRANZCOG

Llewellyn-Jones Fundamentals of
Obstetrics and Gynaecology

Ninth Edition
Jeremy Oats, MBBS DM FRCOG FRANZCOG
Chair Victorian, Consultative Council on Obstetric and Paediatric Mortality and Mobility

Professional Fellow, Department of Obstetrics and Gynaecology, University of Melbourne

Adjunct Professor, School of Public Health, La Trobe University, Melbourne, Australia

Suzanne Abraham, MSc PhD (Med) MAPS
Associate Professor, Department of Obstetrics and Gynaecology, Sydney Medical School, Royal North Shore Hospital,
University of Sydney

Director, Eating Disorder Unit, Northside Clinic, University of Sydney, Australia
Mosby
Front matter

Llewellyn-Jones Fundamentals of Obstetrics and Gynaecology
For Elsevier:
Commissioning Editor: Pauline Graham
Development Editor: Ailsa Laing
Project Manager: Kerrie-Anne McKinlay
Designer: Kirsteen Wright
Illustration Manager: Merlyn Harvey
Illustrators: Jennifer Rose, Amanda Williams, Debra Woodward and
AntBits
Llewellyn-Jones Fundamentals of Obstetrics and Gynaecology

9th Edition
Edited by
Jeremy Oats MBBS DM FRCOG FRANZCOG, Chair Victorian,
Consultative Council on Obstetric and Paediatric Mortality and Mobility;
Professional Fellow, Department of Obstetrics and Gynaecology, University of
Melbourne; Adjunct Professor, School of Public Health, La Trobe University,
Melbourne, Australia
Suzanne Abraham MSc PhD (Med) MAPS, Associate Professor,
Department of Obstetrics and Gynaecology, Sydney Medical School, Royal
North Shore Hospital, University of Sydney; Director, Eating Disorder Unit,
Northside Clinic, University of Sydney, Australia
Edinburgh London New York Oxford Philadelphia St Louis
Sydney Toronto 2010
Copyright

Mosby Elsevier
Ninth Edition © 2010, Elsevier Limited. All rights reserved.
Eighth Edition © Elsevier Limited 2005
Seventh Edition © Elsevier Limited 1999
Sixth Edition © Mosby Professional Ltd 1994
The right of Jeremy Oats and Suzanne Abraham to be identified as authors of
this work has been asserted by them in accordance with the Copyright, Designs
and Patents Act 1988,
No part of this publication may be reproduced or transmitted in any form or
by any means, electronic or mechanical, including photocopying, recording, or
any information storage and retrieval system, without permission in writing from
the publisher. Permissions may be sought directly from Elsevier’s Rights
Department: phone: [phone] (US) or ([phone] (UK); fax:
(+44) 1865 853333; e-mail: [email protected]. You may also
complete your request online via the Elsevier website at
http://www.elsevier.com/permissions.
ISBN 978 0 7234 3509 9
International Edition ISBN 978 0 7234 3508 2
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress
Notice

Knowledge and best practice in this field are constantly changing. As new
research and experience broaden our knowledge, changes in practice, treatment
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dosages and the best treatment for each individual patient, and to take all
approprate safety precautions. To the fullest extent of the law, neither the
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Preface to the ninth edition

Jeremy Oats, Suzanne Abraham
Publication of this ninth edition of Fundamentals of Obstetrics and
Gynaecology comes some 40 years later than the first edition, published by
Derek Llewellyn-Jones in 1969. In his introduction to the first edition, Derek
Llewellyn-Jones quoted from the World Health Organization Technical Report
Series 1952, no. 51:
The object of maternity care is to ensure that every expectant and nursing
mother maintains good health, learns the art of child care, has a normal
delivery, and bears healthy children.

In 2010 these objectives remain as salutary as they were in 1952.
Intervention rates continue to climb and many women are embarking on
pregnancy later in life and with more complex medical disorders; the need for
those caring for women and their children to apply the best available standards
of care is even more critical. In this ninth edition we have endeavoured to
continue the tradition established by Derek Llewellyn-Jones and added where
relevant a synthesis from the recommendations from high quality evidence-
based guidelines and practice reports.
As with previous editions we have not included a bibliography of
references as they are quickly rendered out-of-date. Our hope is that medical,
midwifery and nursing students reading this book will use it as the basis on
which to establish their ‘fundamental’ understanding of women’s health and then
pursue more detailed knowledge through the readily accessible electronic
databases and their own experience.
We remain indebted to our colleagues and our readers for their many
helpful suggestions and criticisms and corrections.
So, in the words of Derek Llewellyn-Jones, it is our hope ‘that
Fundamentals of Obstetrics and Gynaecology will continue to meet the needs of
today’s medical students and students of nursing and midwifery, and will
encourage self-learning skills while providing essential information in a readable
manner’.

Acknowledgements

We particularly wish to thank the following for their substantial contribution
to this ninth edition.
Dr Neil Roy for his meticulous revision of Chapters 26 and 27; Dr Helen
Savoia for updating the section on haematological disorders in Chapter 15; Dr
Amanda Sampson for her generous provision of all the ultrasound images;
Associate Professor Suzanne Garland for her detailed review of Chapters 17 and
33, and for permission to use her photographs reproduced in Figs 34.134.2 and
34.3; the Educational Resource Centre at the Royal Women’s Hospital,
Melbourne for allowing us to reproduce their illustrations on the management of
shoulder dystocia (Fig. 22.5); Dr Aldo Vacca for the photograph of the Vacuum
Extractor Omnicup (Fig. 24.16); Essure for the photograph of the Essure device
(Fig. 31.9); Organon for the photograph of the Implanon device (Fig. 31.5).
Also: Dr John Bell, John Gocking, Dr Jenny King, Gwen Moody, Dr Diane
Payton, Susan Hart and Down Syndrome Association for generously providing
pathology and clinical photographs.
Figures 26.3 and 41.2 are reproduced from Lissauer T, Clayden G. Illustrated
Textbook of Paediatrics, Second Edition, Mosby; 2001, with permission.