婦産科學（英文原版改編版留學生與雙語教學用） [Obstetrics and Gynecology] pdf epub mobi txt 电子书 下载 2025

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[印度] 薩達娜·古普塔（Sadhana Gupta） 著

出版社： 清华大学出版社

ISBN：9787302463092

版次：1

商品编码：12154654

包装：平装

外文名称：Obstetrics and Gynecology

开本：16开

出版时间：2017-03-01

用纸：胶版纸

页数：721

字数：1664000

正文语种：中文，英文

編輯推薦

　　正版原版，原汁原味，留學生與雙語教學用。

內容簡介

　　本書係統地介紹瞭婦産科學的基本知識，包括婦産科的解剖、生理、孕産期保健、産科常見並發癥和閤並癥及各種婦科疾病的診斷與治療等。內容簡明易懂，圖文並茂，適閤作為臨床醫學專業本科生中英文雙語教學、留學生英文教學、碩士研究生和博士研究生教學的婦産科學教材。本書也可以作為其他醫學相關專業學生和青年醫生學習婦産科學的參考教材。

作者簡介

　　薛鳳霞，天津醫科大學總醫院婦産科行政主任，教授，博導。中華醫學會婦産科分會常委，中華婦産科雜誌編委，從事國際學院、7年製教學多年。國傢十一五教材《婦産科學》編委，全國高等醫藥院校教材《婦産科學》五年製、七年製編委。主持國傢自然基金等科研項目10餘項。獲得天津市科技進步奬等多項奬項。

內頁插圖

目錄

Section One Basic Sciences in Obstetrics and Gynecology
1　Anatomy… ……………………………………………………………………………………………………… 3
2　Reproductive Physiology………………………………………………………………………………………… 33
3　Conception, Fertilization and Implantation… …………………………………………………………………… 51
4　Fetal Growth, Placenta and Umbilical Cord……………………………………………………………………… 62
5　Embryology… …………………………………………………………………………………………………… 78
Section Two Gynecology
6 Gynecological History and Clinical Examination………………………………………………………………… 91
7 Pediatric and Adolescent Gynecology… ………………………………………………………………………… 96
8 Gynecological Infection and STD………………………………………………………………………………… 105
9 Amenorrhea… …………………………………………………………………………………………………… 139
10 Abnormal Uterine Bleeding… ………………………………………………………………………………… 148
11 Infertility………………………………………………………………………………………………………… 158
12 Polycystic Ovarian Syndrome (PCOS)… ……………………………………………………………………… 174
13 Hirsutism………………………………………………………………………………………………………… 180
14 Menopause……………………………………………………………………………………………………… 184
15 Benign Lesions of the Vulva and Vagina………………………………………………………………………… 192
16 Benign Disorders of the Uterine Cervix………………………………………………………………………… 202
17 Benign Disorders of Uterine Corpus (Fibroids, Adenomyosis and Endometrial Polyp) ………………………… 206
18 Benign Adnexal Masses… ……………………………………………………………………………………… 222
19 Premalignant and Malignant Disorders of the Vulva and Vagina… …………………………………………… 234
20 Premalignant and Malignant Disorders of the Uterine Cervix… ……………………………………………… 244
21 Premalignant and Malignant Disorders of the Uterine Corpus… ……………………………………………… 267
22 Premalignant and Malignant Disorders of Ovaries and Fallopian Tubes………………………………………… 278
23 Gestational Trophoblastic Diseases……………………………………………………………………………… 291
24 Endometriosis…………………………………………………………………………………………………… 299
25 Pelvic Organ Prolapse (POP)…………………………………………………………………………………… 309
26 Urinary Incontinence…………………………………………………………………………………………… 321
27 Genital Ambiguity and Intersexuality…………………………………………………………………………… 333
28 Contraception…………………………………………………………………………………………………… 341
Section Three Obstetrics
29 Preconceptional Counseling, Physiological Changes in Pregnancy and Antenatal Care………………………… 365
XIV
Contents
30 Normal Labor…………………………………………………………………………………………………… 393
31 First Trimester Vaginal Bleeding………………………………………………………………………………… 415
32 Recurrent Pregnancy Loss and Bad Obstetrical History………………………………………………………… 436
33 Late Pregnancy Complications… ……………………………………………………………………………… 442
34 Third Trimester Bleeding… …………………………………………………………………………………… 464
35 Disproportionate Fetal Growth… ……………………………………………………………………………… 478
36 Multiple Pregnancy……………………………………………………………………………………………… 485
37 Disorders of Amniotic Fluid… ………………………………………………………………………………… 494
38 Special Cases in Obstetrics… …………………………………………………………………………………… 499
39 Hypertensive Disorders in Pregnancy…………………………………………………………………………… 502
40 Diabetes Mellitus and Pregnancy………………………………………………………………………………… 514
41 Hematological Disorders in Pregnancy… ……………………………………………………………………… 521
42 Cardiac Disease in Pregnancy…………………………………………………………………………………… 532
43 Thyroid Dysfunction with Pregnancy…………………………………………………………………………… 539
44 Jaundice, Hepatitis and Gastrointestinal Disorders in Pregnancy………………………………………………… 544
45 Renal Disorders in Pregnancy…………………………………………………………………………………… 551
46 Nervous System Disorders in Pregnancy………………………………………………………………………… 556
47 Asthma in Pregnancy… ………………………………………………………………………………………… 561
48 Local Abnormalities……………………………………………………………………………………………… 565
49 Infection During Pregnancy… ………………………………………………………………………………… 573
50 Malpresentation and Malposition……………………………………………………………………………… 581
51 Dystocia and Cephalopelvic Disproportion……………………………………………………………………… 600
52 Postpartum Hemorrhage………………………………………………………………………………………… 609
53 Puerperium……………………………………………………………………………………………………… 621
54 Essential of Normal Newborn Assessment and Care… ………………………………………………………… 628
55 Special Topics in Obstetrics……………………………………………………………………………………… 636
56 Critical Care Obstetric…………………………………………………………………………………………… 657
Section Four Appendices
Appendix 1 Investigations in Gynecology… ……………………………………………………………………… 667
Appendix 2 Operative Obstetrics…………………………………………………………………………………… 677
Appendix 3 Fetal Medicine………………………………………………………………………………………… 699
Appendix 4 Drug Use in Pregnancy………………………………………………………………………………… 701
Appendix 5 Psychological Aspects in Obstetrics and Gynecology… ……………………………………………… 703
Section Five Annexures
Annexure 1 Medical Eligibility Criteria for Initiation and Continuation of Intrauterine Devices (IUDs)… ……… 711
Annexure 2 Medical Eligibility Criteria for Initiation and Continuation of Combined OCs/Combined Injects/
Transdermal Patches and Vaginal Rings… …………………………………………………………… 714
Annexure 3 Medical Eligibility Criteria for Emergency Contraceptive Pills (ECPs)… …………………………… 717
Annexure 4 Normal Values in Pregnancy… ……………………………………………………………………… 718
Annexure 5 Indications and Risks of Common Vaccines During Pregnancy……………………………………… 720

精彩書摘

　　Conception, Fertilization
　　3
　　and Implantation
　　A baby is God’s opinion that the world should go on.
　　introdUction
　　Life begins when an oocyte is fertilized by sperm. The union of egg and sperm at fertilization is one of the most important process in biology.
　　Gametogenesis is the process involved in the maturation of two highly specialized cells (spermatozoon in male and ovum in the female) before they unite to form zygote.
　　oogenesis
　　The process involved in development of mature ovum is called oogenesis. The primitive germ cells take their origin from the yolk sac at about the end
　　of 3rd week of intrauterine life and their migration
　　to the developing gonadal ridge is completed round about the end of 4th week. In female gonads the germ cells undergo a number of rapid mitotic divisions and differentiate into Oogonia. The numbers of oogonia are maximum at 20th week, which number about 7 million. While the majority of oogonia continue to
　　divide, some enter into the prophase of first meiotic
　　division and are called primary oocytes. Primary oocyte is surrounded by flat cells and is called primordial follicle which are present in the cortex of the ovary. After birth there is no more mitotic division and all oogonia are replaced by the primary oocytes
　　which have finished the prophase of the first meiotic
　　division and remain in the resting phase (dictyotene stage) between prophase and metaphase. Total
　　number of primary oocyte at birth is approximately
　　2 million.
　　Maturation of oocyte is reduction of the number of chromosomes to half. Before the onset of first meiotic division, the primary oocyte doubles its DNA by replication, so they have double amount of normal protein content. There are 22 pairs of autosomes which determine the body characteristics and one
　　pair of sex chromosomes named XX. The first stage of
　　maturation occurs with full maturation of the ovarian follicle just prior to ovulation. Final maturation occurs only after fertilization.
　　The primary oocyte undergoes first meiotic division giving rise to secondary oocyte and one polar body. The secondary oocyte contains haploid number of chromosomes (23X) and nearly all the cytoplasm. Small polar body contains half of chromosomes (23X) but only scanty cytoplasm. Ovulation occurs just after the formation of secondary oocytes (Fig. 3.1B).
　　The secondary oocyte completes the second meiotic division only after fertilization by the sperm in the fallopian tube. It results again in formation of 2 daughter cells. The larger one is called mature ovum containing (23X) and the smaller one is called second polar body containing same number of chromosomes. The first polar body may also undergo the second meiotic division. In the absence of fertilization, the secondary oocyte does not complete the second meiotic division and degenerates as such.
　　Structure of Mature Ovum
　　A fully mature ovum is the largest cell in the body
　　measuring 130 μm in diameter. It consists of cytoplasm
　　and a nucleus with eccentric nucleolus and contains
　　23X chromosomes. During fertilization, the nucleus
　　is converted into a female pronucleus. The ovum is surrounded by a cell membrane called vitelline membrane. There is an outer transparent mucoprotein
　　Section –1 . Basic Sciences in Obstetrics and Gynecology
　　envelope called Zona pellucida. In between vitelline membrane and Zona pellucida there is a narrow space called, perivitelline space which accommodates the polar bodies. After escape from primordial follicle, oocyte retains a covering of granulosa cells known as corona radiata, which is derived from cumulus oophorous (refer Figs 2.4A and B).
　　Spermatogenesis
　　Spermatogenesis is the production of mature sperm. It occurs in the seminiferous tubules of the testis. The primordial germ cells divide to produce spermatogonia, the precursor of mature sperm. At onset of puberty the spermatogonia located at the basal lamina of the seminiferous tubercle begin to divide mitotically to produce primary spermatocytes.
　　Primary spermatocytes remain in stage of prophase of the first meiotic division for long time (16 days). Each spermatocytes contains 22 pair of autosomes and one pair of sex chromosomes named XY.With completion of first meiotic division, two secondary spermatocytes are formed having equal share of cytoplasm and haploid number of chromosomes either 23X or 23Y. Immediately after there is a second meiotic division with formation of 4 spermatids, each containing
　　haploid numbers of chromosomes, two with 23X and two with 23Y (Fig. 3.1A). Spermiogenesis is the differentiation of round spermatids to motile spermatozoa. In this process a series of morphological changes occur which produce motile sperms and takes about 61 days. The most visible change is the reduction in size and formation of tail, which allows the sperm cell to swim. The chromosomes in the sperm cells are almost crystallized by a special set of sperm specific proteins called protamines. In fact this protamine induced condensation of the sperm chromosome is so extensive that the size of sperm nucleus is about one thirtieth of the size of the mature human egg. This compact structure of the sperm is important for its motility.
　　The production of spermatozoa in the testis requires the presence of germ cells and their transformation and maturation is under the control of hypothalamic and pituitary hormones and testicular androgens.
　　The Mature Sperm
　　Spermatozoa are produced at the onset of puberty in boys. Thereafter, the seminiferous tubules of the testis will go on producing sperms daily until 60 years of age and beyond. Following spermatogenesis, the spermatozoa pass through seminiferous tubule to rete testis, on to the vasa differentia, the head of the epididymis and hence, 12 days later to the tail of epididymis. The transport of mature sperm is facilitated via muscular activity within the epididymis
　　and vas. The seminal fluid is made up from secretion
　　of bulbourethral gland, seminal vesicle, the prostrate and epidymal fluid. During this time the sperm acquire motility and undergo the final biochemical changes that give them ability to fertilize the ovum.
　　The sperm has complex structure. It contains haploid number of chromosomes (22 + X or Y). It is few microns long. It has head which consist principally of the condensed nucleus and acrosomal cap. Acrosome is rich in enzyme. Tail gives the motility and propulsion while the mid piece acts as energy source. At the time of intercourse, million of sperms are deposited in vagina (Fig. 3.2). Seminal fluid containing sperm coagulates immediately following ejaculation. Under normal circumstances it liquefies within 20 minutes. The basic pH of the seminal fluid protects the spermatozoa from acidity of vagina. They travel in all directions, some through the cervix, where in midcycle the molecules of cervical mucus untangle their barbed fence like morphology to assume straight lines.
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