Netter’s obstetrics and gynecology
Netters obstetrics and gynecology
PART I: ANATOMY AND EMBRYOLOGY
SECTION I
Embryology
1 Sexual Differentiation 3
2 Upper Genital Tract Development 4
3 Lower Genital Tract Development 5
4 Development of the Breast 7
SECTION II Anatomy
5 External Genitalia 11
6 Perineum 12
7 Vagina 13
8 Pelvic Viscera 15
9 Cervix, Uterus, and Adnexa 16
10 Ovaries 17
11 Breast 19
PART II: GYNECOLOGY AND WOMEN’S HEALTH
SECTION III General Health Considerations and Counseling
12 Puberty: Normal Sequence 25
13 Health Maintenance: Ages 12-18 Years 26
14 Health Maintenance: Ages 19-39 Years 28
15 Contraception: Counseling Principles 30
16 Health Maintenance: Ages 40-64 Years 32
17 Health Maintenance: Ages 65 Years and Older 35
SECTION IV Diseases, Disorders, and Common Problems
18 Abortion 41
19 Abuse: Physical and Sexual 44
20 Acne 46
21 Alzheimer Disease 48
22 Anemia 50
23 Anorectal Fistula 52
24 Anxiety 54
25 Asthma 56
26 Cholelithiasis 58
27 Chronic Pelvic Pain 60
28 Constipation 62
29 Crohn Disease 64
30 Depression (Unipolar) 66
31 Diverticular Disease 68
32 Domestic Violence 69
33 Dysmenorrhea:
Primary and Secondary 71
34 Dyspareunia:
Deep Thrust 73
35 Dysuria 75
36 Eating Disorders:
Anorexia Nervosa and Bulimia 77
37 Fibromyalgia 79
38 Gallbladder Disease 82
39 Gastritis 84
40 Gastroesophageal Reflux 85
41 Hair Loss 87
42 Headache:
Tension and Cluster 89
43 Headache:
Migraine 92
44 Hematuria 94
45 Hemorrhoids 96
46 Hyperthyroidism 97
47 Hypothyroidism 99
48 Infertility:
General Considerations ‘ 101
49 Irritable Bowel Syndrome 103
50 Low Back Pain 105
51 Melanoma 108
52 Myofascial Syndromes 110
53 Obesity 112
54 Osteoporosis 114
55 Pessary Therapy 117
56 Postcoital Bleeding 119
57 Premenstrual Syndrome 121
58 Pruritus Ani 123
59 Rape and Rape Trauma Syndrome 124
60 Sexual Dysfunction:
Libidinal and Orgasmic Dysfunction (Anorgasmia) 127
61 Sexually Transmitted Infections:
Chancroid 129
62 Sexually Transmitted Infections:
Chlamydia trachomatis 131
63 Sexually Transmitted Infections:
Condylomata Acuminata 133
64 Sexually Transmitted Infections:
Gonorrhea 135
65 Sexually Transmitted Infections:
Granuloma Inguinale (Donovanosis) 137
66 Sexually Transmitted Infections:
Herpes 139
67 Sexually Transmitted Infections:
Human Immunodeficiency Virus 141
68 Sexually Transmitted Infections:
Human Papillomavirus 144
69 Sexually Transmitted Infections:
Lymphogranuloma Venereum 147
70 Sexually Transmitted Infections:
Molluscum Contagiosum 149
71 Sexually Transmitted Infections:
Parasites 150
72 Sexually Transmitted Infections:
Syphilis 152
73 Sexually Transmitted Infections:
Trichomonas vaginalis 155
74 Thrombophlebitis 157
75 Toxic Shock Syndrome . 159
76 Ulcerative Colitis 162
77 Urinary Incontinence:
Bypass and Overflow 164
78 Urinary Incontinence:
Stress 166
79 Urinary Incontinence:
Urge 169
80 Urinary Tract Infection 171
81 Urodynamics Testing 174
82 Varicose Veins 176
SECTION V
Vulvar Disease
83 Acne Inversa (Hidradenitis Suppurativa) 181
84 Bartholin Gland
Abscess/lnfection 182
85 Bartholin Gland:
Cysts 184
86 Contact Vulvitis 186
87 Dyspareunia:
Insertional 187
88 Female Circumcision 188
89 Hymenal Stenosis 190
90 Hyperplastic Vulvar Dystrophy (Squamous Cell
Hyperplasia, Lichen Simplex Chronicus) 192
91 Imperforate Hymen 193
92 Labial Adhesions 194
93 Lichen Planus 196
94 Lichen Sclerosus 197
95 Vulvar Cancer 199
96 Vulvar Hematoma 201
97 Vulvar Lesions 203
98 Vulvar Vestibulitis (Provoked Vulvodynia) 206
SECTION VI
Vaginal Disease
99 Cystocele/Urethrocele 211
100 Enterocele 212
101 Fistulae:
Gastrointestinal and Urinary Tract 214
102 Rectocele 216
103 Sarcoma Botryoides 218
104 Transverse Vaginal Septum 219
105 Vaginal Cysts 221
106 Vaginal Dryness 222
107 Vaginal Lacerations 223
108 Vaginal Prolapse 225
109 Vaginitis:
Atrophic 227
110 Vaginitis:
Bacterial (Nonspecific) and Bacterial Vaginosis 229
111 Vaginitis:
Monilial 231
112 Vaginitis:
Trichomonas 233
SECTION VII
Cervical Disease
113 Abnormal Pap Smear:
Atypical Squamous or Glandular Cells of Undetermined Origin 237
114 Abnormal Pap Smear:
Low-Grade Squamous Intraepithelial Lesions and High-Grade
Squamous Intraepithelial Lesions 239
115 Carcinoma in Situ (Cervix) 241
116 Cervical Cancer 243
117 Cervical Erosion 245
118 Cervical Eversion 246
119 Cervical Polyps 247
120 Cervical Stenosis 248
121 Cervicitis 250
122 Nabothian Cysts 252
SECTION VIII
Uterine Pathology
123 Adenomyosis 255
124 Asherman Syndrome (Uterine Synechia) 256
125 Dysfunctional (Abnormal) Uterine Bleeding 258
126 Endometrial Cancer 261
127 Endometrial Hyperplasia:
Simple and Complex 263
128 Endometrial Polyps 265
129 Endometritis 266
130 Hematometra 268
131 Intermenstrual Bleeding 269
132 Irregular Menstrual Periods 271
133 Menorrhagia 274
134 Postmenopausal Vaginal Bleeding 276
135 Sarcoma (Uterine) 278
136 Uterine Anomalies:
Bicornuate, Septate, and Unicornuate Uterus 280
137 Uterine Leiomyomata (Fibroids, Myoma) 282
138 Uterine Prolapse 284
SECTION IX
Adnexal Disease
139 Adenofibroma 289
140 Clear Cell Carcinoma 290
141 Dermoid Cyst 292
142 Dysgerminoma 293
143 Ectopic Pregnancy 295
144 Endometriosis 298
145 Epithelial Stromal Ovarian Tumors 301
146 Germ Cell Tumor 303
147 Granulosa Cell Tumors 304
148 Hydrosalpinx (Chronic Pelvic Inflammatory Disease) 307
149 Krukenberg Tumor 309
150 Mucinous Ovarian Cysts 310
151 Ovarian Cancer 312
152 Ovarian Cysts 315
153 Ovarian Fibroma 317
154 Ovarian Torsion 319
155 Pelvic Inflammatory Disease (PID) 321
156 Pseudomyxoma Peritonei 324
157 Serous Ovarian Cysts 325
158 Sertoli-Leydig Cell Tumor (Arrhenoblastoma) 327
159 Transitional Cell (Brenner) Tumor 329
SECTION X
Breast Diseases and Conditions
160 Accessory Nipples (Polythelia) 333
161 BRCA1 and BRCA2 Mutations 334
162 Breast Cancer 336
163 Breast Cyst 339
164 Breast Duct Ectasia 340
165 Breast Fat Necrosis 342
166 Breast Fibroadenoma 343
167 Breast Intraductal Papilloma 345
168 Fibrocystic Breast Change 347
169 Galactocele 349
170 Galactorrhea 351
171 Mammography 353
172 Mastitis (Lactational) 355
173 Mastodynia and Mastalgia (Breast Pain) 356
174 Mondor Disease 358
175 Nipple Discharge 360
176 Paget Disease of the Breast 362
SECTION XI
Reproductive, Genetic, and Endocrine Conditions
177 Abnormal Puberty 367
178 Amenorrhea:
Primary 369
179 Amenorrhea:
Secondary 371
180 Androgen Insensitivity Syndrome 372
181 Anovulation 374
182 Assisted Reproduction 376
183 Down Syndrome 379
184 Gonadal Dysgenesis 381
185 Hirsutism 384
186 Hyperprolactinemia 387
187 Infertility 390
188 Menopause 392
189 Polycystic Ovary Syndrome 395
190 Recurrent Pregnancy Loss 397
191 Sexual Ambiguity 399
192 Sheehan Syndrome 401
193 Turner Syndrome 403
194 Uterine Agenesis 405
195 Vaginal Agenesis 407
196 Virilization 408
PART III: OBSTETRICS
SECTION XII
Obstetrics: General Considerations
197 Preconceptional Care and Counseling 413
198 Routine Prenatal Care:
First Trimester 415
199 Routine Prenatal Care:
Second Trimester 416
200 Routine Prenatal Care:
Third Trimester 418
201 Antepartum Fetal Testing 420
202 Biophysical Profile 422
203 Contraction Stress Testing 424
204 Doppler Flow Studies 425
205 Nonstress Testing 427
206 Normal Labor 429
207 Fetal Heart Rate Testing:
Bradycardia 431
208 Fetal Heart Rate Testing:
Periodic Changes 433
209 Fetal Heart Rate Testing:
Reduced Variability 435
210 Fetal Heart Rate Testing:
Tachycardia 437
211 Obstetric Anesthesia/Analgesia 438
212 Normal Postpartum Changes 440
213 Breastfeeding (Lactation) 442
SECTION XIII
Obstetric Conditions and Concerns
214 Abnormalities of Placental Implantation 447
215 Active Management of Labor 449
216 Acute Fatty Liver of Pregnancy ‘ 450
217 Amniotic Fluid Embolism 452
218 Breech Birth 454
219 Caput Succedaneum 456
220 Cardiovascular Disease in Pregnancy 457
221 Cervical Insufficiency 460
222 Cholecystitis in Pregnancy 461
223 Chorioamnionitis 464
224 Diabetes Mellitus in Pregnancy 466
225 Fetal Alcohol Syndrome 468
226 Gestational Trophoblastic Disease 470
227 Gingivitis in Pregnancy 472
228 HELLP Syndrome 474
229 Hepatitis in Pregnancy 476
230 Hyperemesis Gravidarum 478
231 Intrauterine Growth Restriction 479
232 Multiple Gestation 482
233 Oligohydramnios 484
234 Placenta Previa 486
235 Placental Abruption 488
236 Polyhydramnios 489
237 Postpartum Breast Engorgement 491
238 Postpartum Depression 492
239 Preeclampsia and Eclampsia 494
240 Pruritic Urticarial Papules and Plaques of
Pregnancy (Puppp) 497
241 Puerperal Infection 499
242 Rh Incompatibility 501
243 Shoulder Dystocia 503
244 Third Trimester Bleeding 505
245 Trauma in Pregnancy 506
246 Uterine Atony and Postpartum Hemorrhage 508
247 Uterine Inversion 511
248 Uterine Rupture 513
PART IV: PROCEDURES
SECTION XIV
Procedures
249 Amniocentesis 517
250 Aspiration of Breast Cyst 518
251 Bartholin Gland Cyst/Abscess Drainage 520
252 Bartholin Gland Marsupialization 521
253 Breast Biopsy:
Core 523
254 Breast Biopsy:
Open 524
255 Cervical Cerclage 526
256 Cervical Conization (Cold Knife) 528
257 Cervical Polypectomy 529
258 Cesarean Delivery 531
259 Chorionic Villus Sampling 534
260 Circumcision (Male; Newborn and Infant) 536
261 Colposcopy 539
262 Cervical Cryocautery 541
263 Cystourethroscopy 542
264 Diaphragm Fitting 544
265 Dilation and Curettage 546
266 Endometrial Biopsy 548
267 Forceps-Aided Delivery 550
268 Hysteroscopy:
Diagnostic 552
269 Hysteroscopy:
Polyp and Leiomyoma Resection 554
270 Hysteroscopic Sterilization 556
271 Intrauterine Contraceptive Device Insertion 558
272 Intrauterine Contraceptive Device Removal 560
273 LEEP (Loop Electrosurgical Excision Procedure) and LLETZ (Large Loop Excision of
the Transformation Zone) Conizations 562
274 Pessary Fitting 564
275 Sonohysterography 566
276 Subdermal Contraceptive Capsule Insertion 568
277 Subdermal Contraceptive Capsule Removal 570
278 Transvaginal Ultrasonography 571
279 Trigger Point Injection 573
280 Urodynamic Testing: 282 Vacuum-Assisted Delivery 578
Complex 574
281 Urodynamic Testing: Index 581
Simple 576
SECTION I
Embryology
1 Sexual Differentiation 3
2 Upper Genital Tract Development 4
3 Lower Genital Tract Development 5
4 Development of the Breast 7
SECTION II Anatomy
5 External Genitalia 11
6 Perineum 12
7 Vagina 13
8 Pelvic Viscera 15
9 Cervix, Uterus, and Adnexa 16
10 Ovaries 17
11 Breast 19
PART II: GYNECOLOGY AND WOMEN’S HEALTH
SECTION III General Health Considerations and Counseling
12 Puberty: Normal Sequence 25
13 Health Maintenance: Ages 12-18 Years 26
14 Health Maintenance: Ages 19-39 Years 28
15 Contraception: Counseling Principles 30
16 Health Maintenance: Ages 40-64 Years 32
17 Health Maintenance: Ages 65 Years and Older 35
SECTION IV Diseases, Disorders, and Common Problems
18 Abortion 41
19 Abuse: Physical and Sexual 44
20 Acne 46
21 Alzheimer Disease 48
22 Anemia 50
23 Anorectal Fistula 52
24 Anxiety 54
25 Asthma 56
26 Cholelithiasis 58
27 Chronic Pelvic Pain 60
28 Constipation 62
29 Crohn Disease 64
30 Depression (Unipolar) 66
31 Diverticular Disease 68
32 Domestic Violence 69
33 Dysmenorrhea:
Primary and Secondary 71
34 Dyspareunia:
Deep Thrust 73
35 Dysuria 75
36 Eating Disorders:
Anorexia Nervosa and Bulimia 77
37 Fibromyalgia 79
38 Gallbladder Disease 82
39 Gastritis 84
40 Gastroesophageal Reflux 85
41 Hair Loss 87
42 Headache:
Tension and Cluster 89
43 Headache:
Migraine 92
44 Hematuria 94
45 Hemorrhoids 96
46 Hyperthyroidism 97
47 Hypothyroidism 99
48 Infertility:
General Considerations ‘ 101
49 Irritable Bowel Syndrome 103
50 Low Back Pain 105
51 Melanoma 108
52 Myofascial Syndromes 110
53 Obesity 112
54 Osteoporosis 114
55 Pessary Therapy 117
56 Postcoital Bleeding 119
57 Premenstrual Syndrome 121
58 Pruritus Ani 123
59 Rape and Rape Trauma Syndrome 124
60 Sexual Dysfunction:
Libidinal and Orgasmic Dysfunction (Anorgasmia) 127
61 Sexually Transmitted Infections:
Chancroid 129
62 Sexually Transmitted Infections:
Chlamydia trachomatis 131
63 Sexually Transmitted Infections:
Condylomata Acuminata 133
64 Sexually Transmitted Infections:
Gonorrhea 135
65 Sexually Transmitted Infections:
Granuloma Inguinale (Donovanosis) 137
66 Sexually Transmitted Infections:
Herpes 139
67 Sexually Transmitted Infections:
Human Immunodeficiency Virus 141
68 Sexually Transmitted Infections:
Human Papillomavirus 144
69 Sexually Transmitted Infections:
Lymphogranuloma Venereum 147
70 Sexually Transmitted Infections:
Molluscum Contagiosum 149
71 Sexually Transmitted Infections:
Parasites 150
72 Sexually Transmitted Infections:
Syphilis 152
73 Sexually Transmitted Infections:
Trichomonas vaginalis 155
74 Thrombophlebitis 157
75 Toxic Shock Syndrome . 159
76 Ulcerative Colitis 162
77 Urinary Incontinence:
Bypass and Overflow 164
78 Urinary Incontinence:
Stress 166
79 Urinary Incontinence:
Urge 169
80 Urinary Tract Infection 171
81 Urodynamics Testing 174
82 Varicose Veins 176
SECTION V
Vulvar Disease
83 Acne Inversa (Hidradenitis Suppurativa) 181
84 Bartholin Gland
Abscess/lnfection 182
85 Bartholin Gland:
Cysts 184
86 Contact Vulvitis 186
87 Dyspareunia:
Insertional 187
88 Female Circumcision 188
89 Hymenal Stenosis 190
90 Hyperplastic Vulvar Dystrophy (Squamous Cell
Hyperplasia, Lichen Simplex Chronicus) 192
91 Imperforate Hymen 193
92 Labial Adhesions 194
93 Lichen Planus 196
94 Lichen Sclerosus 197
95 Vulvar Cancer 199
96 Vulvar Hematoma 201
97 Vulvar Lesions 203
98 Vulvar Vestibulitis (Provoked Vulvodynia) 206
SECTION VI
Vaginal Disease
99 Cystocele/Urethrocele 211
100 Enterocele 212
101 Fistulae:
Gastrointestinal and Urinary Tract 214
102 Rectocele 216
103 Sarcoma Botryoides 218
104 Transverse Vaginal Septum 219
105 Vaginal Cysts 221
106 Vaginal Dryness 222
107 Vaginal Lacerations 223
108 Vaginal Prolapse 225
109 Vaginitis:
Atrophic 227
110 Vaginitis:
Bacterial (Nonspecific) and Bacterial Vaginosis 229
111 Vaginitis:
Monilial 231
112 Vaginitis:
Trichomonas 233
SECTION VII
Cervical Disease
113 Abnormal Pap Smear:
Atypical Squamous or Glandular Cells of Undetermined Origin 237
114 Abnormal Pap Smear:
Low-Grade Squamous Intraepithelial Lesions and High-Grade
Squamous Intraepithelial Lesions 239
115 Carcinoma in Situ (Cervix) 241
116 Cervical Cancer 243
117 Cervical Erosion 245
118 Cervical Eversion 246
119 Cervical Polyps 247
120 Cervical Stenosis 248
121 Cervicitis 250
122 Nabothian Cysts 252
SECTION VIII
Uterine Pathology
123 Adenomyosis 255
124 Asherman Syndrome (Uterine Synechia) 256
125 Dysfunctional (Abnormal) Uterine Bleeding 258
126 Endometrial Cancer 261
127 Endometrial Hyperplasia:
Simple and Complex 263
128 Endometrial Polyps 265
129 Endometritis 266
130 Hematometra 268
131 Intermenstrual Bleeding 269
132 Irregular Menstrual Periods 271
133 Menorrhagia 274
134 Postmenopausal Vaginal Bleeding 276
135 Sarcoma (Uterine) 278
136 Uterine Anomalies:
Bicornuate, Septate, and Unicornuate Uterus 280
137 Uterine Leiomyomata (Fibroids, Myoma) 282
138 Uterine Prolapse 284
SECTION IX
Adnexal Disease
139 Adenofibroma 289
140 Clear Cell Carcinoma 290
141 Dermoid Cyst 292
142 Dysgerminoma 293
143 Ectopic Pregnancy 295
144 Endometriosis 298
145 Epithelial Stromal Ovarian Tumors 301
146 Germ Cell Tumor 303
147 Granulosa Cell Tumors 304
148 Hydrosalpinx (Chronic Pelvic Inflammatory Disease) 307
149 Krukenberg Tumor 309
150 Mucinous Ovarian Cysts 310
151 Ovarian Cancer 312
152 Ovarian Cysts 315
153 Ovarian Fibroma 317
154 Ovarian Torsion 319
155 Pelvic Inflammatory Disease (PID) 321
156 Pseudomyxoma Peritonei 324
157 Serous Ovarian Cysts 325
158 Sertoli-Leydig Cell Tumor (Arrhenoblastoma) 327
159 Transitional Cell (Brenner) Tumor 329
SECTION X
Breast Diseases and Conditions
160 Accessory Nipples (Polythelia) 333
161 BRCA1 and BRCA2 Mutations 334
162 Breast Cancer 336
163 Breast Cyst 339
164 Breast Duct Ectasia 340
165 Breast Fat Necrosis 342
166 Breast Fibroadenoma 343
167 Breast Intraductal Papilloma 345
168 Fibrocystic Breast Change 347
169 Galactocele 349
170 Galactorrhea 351
171 Mammography 353
172 Mastitis (Lactational) 355
173 Mastodynia and Mastalgia (Breast Pain) 356
174 Mondor Disease 358
175 Nipple Discharge 360
176 Paget Disease of the Breast 362
SECTION XI
Reproductive, Genetic, and Endocrine Conditions
177 Abnormal Puberty 367
178 Amenorrhea:
Primary 369
179 Amenorrhea:
Secondary 371
180 Androgen Insensitivity Syndrome 372
181 Anovulation 374
182 Assisted Reproduction 376
183 Down Syndrome 379
184 Gonadal Dysgenesis 381
185 Hirsutism 384
186 Hyperprolactinemia 387
187 Infertility 390
188 Menopause 392
189 Polycystic Ovary Syndrome 395
190 Recurrent Pregnancy Loss 397
191 Sexual Ambiguity 399
192 Sheehan Syndrome 401
193 Turner Syndrome 403
194 Uterine Agenesis 405
195 Vaginal Agenesis 407
196 Virilization 408
PART III: OBSTETRICS
SECTION XII
Obstetrics: General Considerations
197 Preconceptional Care and Counseling 413
198 Routine Prenatal Care:
First Trimester 415
199 Routine Prenatal Care:
Second Trimester 416
200 Routine Prenatal Care:
Third Trimester 418
201 Antepartum Fetal Testing 420
202 Biophysical Profile 422
203 Contraction Stress Testing 424
204 Doppler Flow Studies 425
205 Nonstress Testing 427
206 Normal Labor 429
207 Fetal Heart Rate Testing:
Bradycardia 431
208 Fetal Heart Rate Testing:
Periodic Changes 433
209 Fetal Heart Rate Testing:
Reduced Variability 435
210 Fetal Heart Rate Testing:
Tachycardia 437
211 Obstetric Anesthesia/Analgesia 438
212 Normal Postpartum Changes 440
213 Breastfeeding (Lactation) 442
SECTION XIII
Obstetric Conditions and Concerns
214 Abnormalities of Placental Implantation 447
215 Active Management of Labor 449
216 Acute Fatty Liver of Pregnancy ‘ 450
217 Amniotic Fluid Embolism 452
218 Breech Birth 454
219 Caput Succedaneum 456
220 Cardiovascular Disease in Pregnancy 457
221 Cervical Insufficiency 460
222 Cholecystitis in Pregnancy 461
223 Chorioamnionitis 464
224 Diabetes Mellitus in Pregnancy 466
225 Fetal Alcohol Syndrome 468
226 Gestational Trophoblastic Disease 470
227 Gingivitis in Pregnancy 472
228 HELLP Syndrome 474
229 Hepatitis in Pregnancy 476
230 Hyperemesis Gravidarum 478
231 Intrauterine Growth Restriction 479
232 Multiple Gestation 482
233 Oligohydramnios 484
234 Placenta Previa 486
235 Placental Abruption 488
236 Polyhydramnios 489
237 Postpartum Breast Engorgement 491
238 Postpartum Depression 492
239 Preeclampsia and Eclampsia 494
240 Pruritic Urticarial Papules and Plaques of
Pregnancy (Puppp) 497
241 Puerperal Infection 499
242 Rh Incompatibility 501
243 Shoulder Dystocia 503
244 Third Trimester Bleeding 505
245 Trauma in Pregnancy 506
246 Uterine Atony and Postpartum Hemorrhage 508
247 Uterine Inversion 511
248 Uterine Rupture 513
PART IV: PROCEDURES
SECTION XIV
Procedures
249 Amniocentesis 517
250 Aspiration of Breast Cyst 518
251 Bartholin Gland Cyst/Abscess Drainage 520
252 Bartholin Gland Marsupialization 521
253 Breast Biopsy:
Core 523
254 Breast Biopsy:
Open 524
255 Cervical Cerclage 526
256 Cervical Conization (Cold Knife) 528
257 Cervical Polypectomy 529
258 Cesarean Delivery 531
259 Chorionic Villus Sampling 534
260 Circumcision (Male; Newborn and Infant) 536
261 Colposcopy 539
262 Cervical Cryocautery 541
263 Cystourethroscopy 542
264 Diaphragm Fitting 544
265 Dilation and Curettage 546
266 Endometrial Biopsy 548
267 Forceps-Aided Delivery 550
268 Hysteroscopy:
Diagnostic 552
269 Hysteroscopy:
Polyp and Leiomyoma Resection 554
270 Hysteroscopic Sterilization 556
271 Intrauterine Contraceptive Device Insertion 558
272 Intrauterine Contraceptive Device Removal 560
273 LEEP (Loop Electrosurgical Excision Procedure) and LLETZ (Large Loop Excision of
the Transformation Zone) Conizations 562
274 Pessary Fitting 564
275 Sonohysterography 566
276 Subdermal Contraceptive Capsule Insertion 568
277 Subdermal Contraceptive Capsule Removal 570
278 Transvaginal Ultrasonography 571
279 Trigger Point Injection 573
280 Urodynamic Testing: 282 Vacuum-Assisted Delivery 578
Complex 574
281 Urodynamic Testing: Index 581
Simple 576