Principles and Practice of

Obstetrics and Gynecology

for Postgraduates

Federation of Obstetric and Gynaecological Societies of India

 Disclaimer
The statements and opinions contained in the chapters of the book on ‘‘Principles and Practice of Obstetrics
and Gynecology for Postgraduates’’ are solely those of the individual authors and contributors, and do not
necessarily reflect the opinions or recommendations of the FOGSI.
Because of rapid advances in the Medical Sciences, the editors recommended that independent verification of
diagnosis or drug doses should be undertaken and references should always be made to the approved
prescribing information for any product or procedure prior to its use.
Articles which have been published, become the property of FOGSI and should not be published or reproduced
in full or in part without the permission of the Editors. No part of this publication may be reproduced, stored
in a retrieval system or transmitted in any form or by any means, electronic mechanical, photographing,
recording, or otherwise without the prior written permission of the Editors of the book.
As far as possible we have tried to incorporate the Vancouver System of references. However, since we are in
transitional phase in some articles we could not incorporate the same.
Editors
 Principles and Practice of
Obstetrics and Gynecology
for Postgraduates
Third Edition

Editors
Pankaj Desai MD FICMCH FICOG
President FOGSI
Consultant Obgyn Specialist
Janani Maternity Hospital, Baroda, India
Narendra Malhotra MD FICOG
Consultant and Director
MNMH (P) Ltd., Agra
Apollo Pankaj Hospital (P) Ltd., Agra, India
President, Federation of Obstetric and Gynecological Societies of India 2008
Duru Shah MD FCPS FICS FICOG DGO DFP FICMCH
Program Director—Assisted Fertility Unit, Gynecworld
Medical Director—Gynecworld
Consultant Obstetrician and Gynecologist
Breach Candy Hospital, Jaslok Hospital and Research Center, Mumbai, India

A FOGSI Publication

JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD

New Delhi • Ahmedabad • Bengaluru • Chennai • Hyderabad • Kochi • Kolkata • Lucknow • Mumbai • Nagpur
Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
B-3 EMCA House, 23/23B Ansari Road, Daryaganj
New Delhi 110 002, India
Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021, +91-11-23245672
Rel: 32558559, Fax: +91-11-23276490, +91-11-23245683
e-mail: jaypee@jaypeebrothers.com
Visit our website: www.jaypeebrothers.com

Branches
• 2/B, Akruti Society, Jodhpur Gam Road Satellite
Ahmedabad 380 015, Phones: +91-079-26926233, Rel: +91-079-32988717
Fax: +91-079-26927094, e-mail: ahmedabad@jaypeebrother.com
• 202 Batavia Chambers, 8 Kumara Krupa Road, Kumara Park East
Bengaluru 560 001, Phones: +91-80-22285971, +91-80-22382956, Rel: +91-80-32714073
Fax: +91-80-22281761, e-mail: bangalore@jaypeebrothers.com
• 282 IIIrd Floor, Khaleel Shirazi Estate, Fountain Plaza, Pantheon Road
Chennai 600 008, Phones: +91-44-28193265, +91-44-28194897, Rel: +91-44-32972089
Fax: +91-44-28193231, e-mail: chennai@jaypeebrothers.com
• 4-2-1067/1-3, 1st Floor, Balaji Building, Ramkote Cross Road
Hyderabad 500 095, Phones: +91-40-66610020, +91-40-24758498, Rel:+91-40-32940929
Fax:+91-40-24758499, e-mail: hyderabad@jaypeebrother.com
• No. 41/3098, B & B1, Kuruvi Building, St. Vincent Road
Kochi 682 018, Kerala, Phones: 0484-4036109, +91-0484-2395739, +91-0484-2395740
e-mail: kochi@jaypeebrothers.com
• 1-A Indian Mirror Street, Wellington Square
Kolkata 700 013, Phones: +91-33-22451926, +91-33-22276404, +91-33-22276415
Rel: +91-33-32901926, Fax: +91-33-22456075, e-mail: kolkata@jaypeebrothers.com
• Lekhraj Market III, B-2, Sector-4, Faizabad Road, Indra Nagar
Lucknow 226016, Phones: +91-522-3040553, +91-522-3040554
e-mail:lucknow@jaypeebrothers.com
• 106 Amit Industrial Estate, 61 Dr SS Rao Road, Near MGM Hospital, Parel
Mumbai 400 012, Phones: +91-22-24124863, +91-22-24104532, Rel: +91-22-32926896
Fax: +91-22-24160828, e-mail: mumbai@jaypeebrothers.com
• “KAMALPUSHPA” 38, Reshimbag, Opp. Mohota Science College, Umred Road
Nagpur 440 009 (MS), Phones: Rel: 3245220, Fax: 0712-2704275
e-mail: nagpur@jaypeebrothers.com

Principles and Practice of Obstetrics and Gynecology for Postgraduates

© 2008, Federation of Obstetric and Gynaecological Societies of India (FOGSI)
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means:
electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the contributors, FOGSI, and the publisher.
This book has been published in good faith that the materials provided by contributors is original. Every effort is made to ensure accuracy of
material, but the publisher, printer and editors will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters
are to be settled under Delhi jurisdiction only.

First Edition : 1996

Second Edition : 2003
Third Edition : 2008
ISBN 978-81-8448-215-7

Typeset at JPBMP typesetting unit

Printed at Ajanta Offset
 To
our teachers
for teaching us the art and science of obstetrics and gynaecology and
for their major contribution in making us what we are today

our patients
for their unstained faith in us, which has helped us to develop
our vast clinical experience and self confidence

our students
who continue to stimulate us to be researchers, teachers as well as students

our families
for their support and for tolerating our repeated stints at various works and
for sharing their personal family time and of course
for supporting us and for always encouraging us

FOGSI
for giving us an opportunity to express ourself and to serve science and humanity

Editors of Third Edition

Pankaj Desai
Narendra Malhotra
Duru Shah
 Preface to the Third Edition

As a part of “Gyan Abhiyaan” (Knowledge Campaign) we at the team of FOGSI Cares 2007 undertook many and
varied knowledge campaigns. This book is one part of that campaign. Our aim in getting this latest edition of the
book was principally to generate a top-class first reference-book in the subject for PG students and practitioners. The
subjects selected and the contributors have therefore been carefully selected as per their expertise and standing in
the subject.
We have always felt that the doctor who does not read has no advantage over someone who can not read. They
say knowledge, money and water should flow—lest they stink. We sure on referring this book the readers will be
able to refresh their knowledge keep it flowing.
This book is the culmination of thoughts and work done by our own FOGSI members who know the pulse of the
Indian women. Their clinical experience on the various health issues related to our women is immense and invaluable.
We thank them immensely for their contribution without which the book would have no meaning. We are confident
that our postgraduate students would benefit tremendously from this updated version of the Textbook of Obstetrics
and Gynecology by FOGSI.

Pankaj Desai Narendra Malhotra Duru Shah

 Preface to the First Edition

The field of Obstetrics, Gynecology and Family Welfare is a dynamic one. The truisms of yesterday are the questions
of today and hopefully, the truths of tomorrow.
In this age of rapidly growing information and technology, there have been many noteworthy advances in the
recent years which have had a major impact on the practice of Obstetrics and Gynecology Changing social and
cultural environment has brought with it different needs and expectations of the society from our specialty.
New technologies for diagnosis, treatment and prevention of disorders of the fetus have burgeoned in modern
obstetrics, which has grown from the concept of merely assisting childbirth into a highly specialized field. The fetus
as a patient has now become a reality for the obstetricians. Principles and Practice of Obstetrics and Gynecology is the
product of our attempt to advance these objectives.
This book has been written keeping in view the latest concept in the understanding of various obstetrics and
gynecological conditions as well as their management, without omitting the basic principles and their applied
pathophysiology. The text covers extensively topics relevant to the Indian context, like malaria, jaundice and other
infections in pregnancy, which are rampant in the developing countries. Management of obstructed labor and the
art instrumental delivery is still pertinent in our setup. These are dealt with by the masters of these old and dying
skills.
The reader is also appraised of the state-of-the-art technology in modern obstetrics and gynecology involving
transvaginal ultrasonography, color Doppler, fetal surveillance and intrauterine interventions. The concept of auditing
maternal morbidity and mortality has also been introduced to lay a firm foundation of clinical research and promote
a logical approach in stead of blindly following the traditional and irrational practices.
The authors have done a meticulous survery of the current literature and have amalgamated it with their rich
experience to make the text a pleasurable reading. It has been our endeavor to see that the content of this book is both
current and comprehensive; and this volume serves as a basic textbook for the postgraduates and as a handy reference
for the practitioners.
In order to be a teacher, one must always be a student. Compiling and editing this book has been a personal
learning experience.

Kamal Buckshee
Vasant B Patwardhan
Rustom P Soonawala (1996)
 List of Contributors

AK Debdas Anu Vij BN Chakraborty

Jamshedpur Mumbai Kolkata
Chapter 64 Chapter 99 Chapter 90
Abha Majumdhar Anupam Gupta Barun Sarkar
New Delhi Agra Agra
Chapter 80 Chapter 47 Chapter 12
Aditi Singhi Anupama Rao Basab Mukherjee
Mumbai Bangalore Kolkata
Chapter 117 Chapter 20 Chapter 122
Alka Kriplani Arti Matah Beena
Banaras Chapter 126
New Delhi
Chapter 7 Behram S Anklesaria
Chapter 118
Arun Tewari Ahmedabad
Alka Saraswat
Agra Chapter 121
Agra
Chapter 60 Bijit Choudhary
Chapters 16, 54 Asha Oumachigui
Alok Vashishtha Chapter 52
Pondicherry Biju P
Haridwar Chapter 25
Chapter 17 Cochin
Asha R Rao Chapter 115
Alokendu Chatterjee Coimbatore Bimal Moday
Kolkata Chapter 79 Mumbai
Chapters 2, 52 Ashish Kale Chapter 100
Ameet Patki Aurangabad C B Nagori
Mumbai Chapter 125
Ahmedabad
Chapter 93 Ashok Khurana
Chapter 74
Ameya C Purandare New Delhi
Chandravati
Mumbai Chapter 29
Lucknow
Chapter 58 Ashwini Bhalerao Gandhi
Chapter 34
Amitava Mukhopadhyay Mumbai
CN Purandare
Kolkata Chapters 82, 83, 100
Mumbai
Chapter 66 Ashwini Kale
Chapter 70
Amol P Pawar Chapter 128
D Pushpalatha
Mumbai Atul Munshi
Hyderabad
Chapter 125 Ahmedabad
Chapter 51
Anand N Bhalerao Chapters 35, 109
B I Patel Deepika Deka
Pune New Delhi
Ahmedabad
Chapter 65 Chapters 6,30,120
Chapter 96
Anita Sabharwal DK Dutta
B K Mitra
New Delhi Kolkata
Durgapur
Chapter 39 Chapter 67 Chapter 46
Anjali Taneja B L Nayak Dujal Munshi
New Delhi Sameas Giri Ahmedabad
Chapter 50 Chapter 107 Chapter 35
Anjoo Agarwal B Shakuntala Baliga Duru Shah
Lucknow Bangalore Mumbai
Chapter 71 Chapter 48 Chapters 26, 114
 X Principles and Practice of Obstetrics and Gynecology for Postgraduates

E Sarulatha Jyotsna Gandhi MP Patil

Chapter 83 Mumbai Chapter 38
Gautam Bhattacharjee Chapter 27 Madhulika Kabra
Chapter 110 K Jayakrishnan New Delhi
Gautam N Allahabadia Kerala Chapter 6
Mumbai Chapter 105 Madhuri A Patel
Chapter 88 K M Nadkarni Mumbai
Gayatri P Nagpure Vapi Chapter 40
Chapter 44 Chapter 60 Mahendra N Parikh
Giovanni Miniello Kaizad R Damania Chapter 131
Agra Mumbai Mandakini Megh
Chapter 111 Chapter 13 Chapter 132
Girija Wagh Kamal Buckshee Mandakini Parihar
Chapters 56,63,133 Noida Mumbai
Gita Ganguly Mukherjee Chapters 11,12 Chapters 18,49
Kolkata Kamini A Rao Maninder Ahuja
Chapter 122 Bangalore Faridabad
Gourisankar Kamilya Chapters 85,86 Chapters 4,5
Kolkata Kanan Yelikar Manish Banker
Chapter 62 Aurangabad Ahmedabad
Harshad Parasnis Chapters 125, 128
Chapters 84,89
Pune Manjari Matah
Kavita N Singh
Chapter 108 Banaras
Jabalpur
Hema Divakar Chapter 9
Chapter 7
Bangalore Manju Mataliya
KC Gurnani
Chapter 20 Mumbai
Shahganj, Agra
Himangi Warke Chapter 54
Chapter 42
Mumbai Manju Puri
KK Das
Chapter 69 New Delhi
Chapter 67
Hiralal Konar Chapter 50
Konkon Mitra
Kolkata Manu Sobti
Durgapur
Chapters 14,44,81 Mumbai
Chapter 67
Hrishikesh Pai Chapter 72
Krishnendu Gupta
Chapter 94 Markendey Katju
Chapter 52 New Delhi
Jaideep Malhotra
Krutika Khopkar
Agra Chapter 125A
Mumbai Maya Hazra
Chapters 61,91,92,95,96,97,120
Chapter 22 Vadodara
Jaya Prakash Shah
Kuldeep Singh Chapter 3
Chapter 96
Jayant G Mehta New Delhi Maya Lulla
Chennai Chapter 97 Mumbai
Chapter 87 Kumud M Ingle Chapter 101
Jaydeep Tank Mumbai Maya Sood
Mumbai Chapter 69 New Delhi
Chapter 59 Kurush P Paghdiwalla Chapter 39
Joshep Kurian Mumbai Meenakshi Bharath
Chennai Chapter 73 Navi Mumbai
Chapter 61 Latha Chaturvedula Chapter 18
Joydev Mukherji Chapter 25 Meera Desai
Kolkata M Banumathy Baroda
Chapters 2, 62 Chapter 103 Chapter 43
 List of Contributors XI

Mehroo Hansotia Nutan Jain Pratap Kumar

Mumbai Muzaffarnagar Manipal
Chapter 38 Chapter 112 Chapter 55
Milind R Shah Pankaj Desai Pratima Anajaria
Sholapur Baroda Chapter 36
Chapter 57 Chapter 21 Pravin M Patel
Monesh Shah Parikshit D Tank Ahmedabad
Chapter 91 Mumbai Chapters 84, 89
Murad E Lala Chapters 13,23 Preeti Matah
Partha Guharoy Agra
Mumbai
Chapter 88 Chapter 7
Chapter 100
Partha Mukherjee Priti Kumar
Murari S Nanavati
Kolkata, WB Lucknow
Mumbai Chapter 34
Chapter 31 Chapters 2,7
Purnima Chatterjee
Nandita Maitra Parul J Kotdawala
Kolkata
Baroda Chapters 75,127
Chapter 66
PG Paul
Chapter 3 Purvi Patel
Nandita Palshetkar Kochi Baroda
Mumbai Chapter 115 Chapter 21
Chapter 116 Picklu Choudhury Rahul Wani
Narendra Malhotra Chapter 44 Chapter 129
Agra PK Sekharan Rajendra Singh Pardeshi
Calicut Aurangabad
Chapters 61,92,95,96,97
Chapter 106 Chapter 125
Nayana A Dastur
PK Shah Rajyashri Sharma
Mumbai
Mumbai Aligarh
Chapter 58 Chapter 95 Chapter 33
Neera Agarwal Prachi Bhikaji Shitut Reena
New Delhi Mumbai Chapter 126
Chapter 37 Chapter 119 Richa Singh Chauhan
Neeraj Gupta Pradeep Kumar Garg Agra
New Delhi New Delhi Chapters 104,105
Chapter 6 Chapter 118 Rishma Pai
Neharikaa Pradnya Parulkar Mumbai
Chapter 120 Mumbai Chapter 116
Neharika Malhotra Chapter 78 Ritu P Khiwal
Agra Prakash Bhatt Chapter 39
Chapter 61 Surat R N Goel
Nikhil Jani Chapter 49 Agra
Prakash K Mehta Chapter 125B
Mumbai
Banglore Rohit V Bhatt
Chapter 113
Chapters 1,8 Chapter 130
Nikhil Purandare
Prakash Trivedi Roopa J Pai
Mumbai Mumbai Coimbatore
Chapter 70 Chapter 117 Chapter 79
Nivedita Chattopadhyay Prakash V Pawar Ruchira Menka Jha
Kolkata Mumbai New Delhi
Chapter 2 Chapter 125 Chapter 76
Nozer Sheriar Pranay Shah Sadhana Desai
Mumbai Mumbai Mumbai
Chapter 53 Chapter 102 Chapters 49,88
XII Principles and Practice of Obstetrics and Gynecology for Postgraduates

Safala Shroff Snehamay Chaudhuri Tarun Kr Ghosh

Mumbai Kolkata Kolkata
Chapters 26,114 Chapter 81 Chapter 66
Sakshi Tomar Sonal Karia Tejas Dave
Chapters 95,96 Ahmedabad Chapter 89
Saloni Nanavati Chapter 70 Tejshree Singh
Mumbai (Mampal) Sonal Panchal New Delhi
Chapter 31 Ahmedabad
Chapter 80
Sanjay B Rao Chapters 28,98
Thankam R Verma
Chapter 124 Sonali Tank
Mumbai Chennai
Sanjay Gupte
Chapter 41 Chapter 87
Pune
Soundra Raghavan Trupti Nadkarni
Chapters 63, 123
Chapter 126 Mumbai
Sanjay Munshi
Ahmedabad Sreelakshmi Chapter 24
Chapter 109 Chapter 55 Uday Thanawala
Sarita Bhalerao Subhash M Nargolkar Navi Mumbai
Mumbai Pune Chapter 22
Chapter 24 Chapter 65 Uma Vaidyanathan
Sarita S Mehendale Subrat Lall Seal New Delhi
Pune Kolkata Chapter 120
Chapter 15 Chapter 62 Urvashi Prasad Jha
Satyen Kasabwala Suchitra Pandit New Delhi
Cochin Mumbai Chapter 76
Chapter 115 Chapters 119, 124 Usha B Saraiya
Sudip Chakraborty
Saunitra Inamdar Mumbai
Kolkata
Chapter 44 Chapters 40,101,111
Chapter 68
Seema Jain Usha R Krishna
Sujal Munshi
Mumbai Mumbai
Chapter 89
Chapter 26 Chapter 78
Sukanta Misra
Shaheen Vandana Chadda
Chapter 45
Aligarh New Delhi
Sukhpreet Patel
Chapter 33
Mumbai Chapter 19
Shalini Rajaram Chapter 114 Vandana G Shetty
New Delhi Sulochana Gunasheela Mumbai
Chapter 37 Bangalore Chapter 82
Shashikant Umbardand Chapter 77 Vandana Walvekar
Mumbai Sumita Mehta Mumbai
Chapter 119 New Delhi
Shirish N Daftary Chapter 36
Chapter 37 Vijay C Pawar
Mumbai Sunil Bansal
Chapter 32 Mumbai
Agra
Shirish Patwardhan Chapters 93,119,124
Chapters 10,12
Pune Vijay Mangoli
Sushma Gupta
Chapters 56,133 Chapter 88
Chapter 47
Shirish S Sheth Swasti Vimla P Pawar
Mumbai New Delhi Mumbai
Chapter 73 Chapter 76 Chapter 125
Shyam Desai Sylvia D’Costa Vinita Das
Mumbai Mumbai Lucknow
Chapter 113 Chapter 117 Chapter 71
SK Giri Tanya B Rohtagi Vivek M Joshi
Cuttack New Delhi Pune
Chapter 107 Chapters 11,12 Chapter 65
 Contents

SECTION 1: PREPREGNANCY CARE 17. HIV Infection in Pregnancy .............................. 152

1. Preconception Care ................................................. 3 Alok Vashishtha
Prakash K Mehta 18. Recurrent Spontaneous Abortions: Current
2. From Safe Motherhood to Reproductive Choices in Treatment ......................................... 164
Child Health ............................................................. 8 Mandakini Parihar, Meenakshi Bharath
Alokendu Chatterjee, Joydeb Mukherjee, SECTION 3: FETUS AS A PATIENT
Partha Mukherjee, Nivedita Chattopadhyay
19. Prenatal Diagnosis and
3. Principles of Antenatal, Intranatal and Postnatal
Therapeutic Procedures ..................................... 175
Care at First and Second Referral Centers ....... 14
Vandana Chadda
Maya Hazra, Nandita Maitra
20. Fetal Infections .................................................... 181
4. Changing Trends in Maternal Nutrition
Hema Divakar, Anupama Rao
and Interventions .................................................. 19
21. Recent Trends in the Management of
Maninder Ahuja
Recurrent Pregnancy Wastage .......................... 191
5. Maternal Exercises, Yoga and
Pankaj Desai, Purvi Patel
Dance Therapy ....................................................... 39
22. Intrauterine Growth Restriction Diagnosis and
Maninder Ahuja
Management ........................................................ 203
6. Genetic Counseling for Obstetricians .............. 54
Uday Thanawala, Krutika Khopkar
Deepika Deka, Neerja Gupta, Madhulika Kabra
23. Controversies in the Management of
SECTION 2: MEDICAL DISORDERS IN Twin Pregnancies ................................................ 212
PREGNANCY Parikshit D Tank
7. Anemia in Pregnancy ........................................... 69 24. Preterm Premature Rupture of Membranes .. 216
Manjari Matah, Partha Mukherjee, Arti Matah, Sarita Bhalerao, Trupti Nadkarni
Preeti Matah 25. Current Trends in the Management of Preterm
8. Hematological Problems in Pregnancy ............. 88 Labor ...................................................................... 221
Prakash K Mehta Asha Oumachigui, Latha Chaturvedula
9. Hemoglobinopathies in Pregnancy ................... 94 26. New Approach to Management of Rhesus
Kavita N Singh Allo-immunization ............................................. 230
10. Hypertension in Pregnancy ............................... 100 Duru Shah, Safala Shroff, Seema Jain
Sunil Bansal 27. Fetal Surveillance–Newer Developments ...... 242
Jyotsna Gandhi
11. Cardiac Disease in Pregnancy .......................... 108
28. Fetal Echocardiography ...................................... 249
Tanya B Rohatgi, Kamal Buckshee
Sonal Panchal
12. Diabetes in Pregnancy: Current Concepts ..... 115
29. The Genetic Sonogram ...................................... 269
Tanya B Rohatgi, Kamal Buckshee, Sunil Bansal,
Ashok Khurana
Barun Sarkar
30. Fetal Therapy–Medical and Surgical .............. 275
13. Liver Disease in Pregnancy ............................... 124
Deepika Deka
Kaizad R Damania, Parikshit D Tank
14. Malaria in Pregnancy ......................................... 128 SECTION 4: INTRAPARTUM MANAGEMENT
Hiralal Konar 31. Place of Induction of Labor in Modern
15. Thrombophilia in Pregnancy ............................ 135 Obstetrics .............................................................. 295
SS Mehendale Murari S Nanavati, Saloni Nanavati
16. Pregnancy and Renal Disease ........................... 143 32. Modern Management of Labor ........................ 299
Alka Saraswat Shirish N Daftary
XIV Principles and Practice of Obstetrics and Gynecology for Postgraduates

33. Intrapartum Fetal Monitoring Controversies .. 308 52. Steroidal Contraception and
Rajyashri Sharma, Shaheen Nonsteroidal Contraception .............................. 457
34. Management of Obstructed Labor at a Krishnendu Gupta, Bijit Chowdhury,
Referral Center .................................................... 318 Alokendu Chatterjee
Chandrawati, Priti Kumar 53. Abortion Practices in India ............................... 468
35. Instrumental Vaginal Delivery ........................ 328 Nozer Sheriar
Atul Munshi, Dujal Munshi 54. Complications and Sequelae of MTP ............. 473
36. Modern Management of Breech Alka Saraswat, Manju Mataliya
Presentation .......................................................... 340 55. Permanent Methods of Sterilization ............... 481
Vandana Walvekar, Pratima Anjaria Pratap Kumar, Sreelakshmi
37. Changing Trends in Cesarean Section ............ 346 56. Social Work in Modern Medicine ................... 487
Neera Agarwal, Sumita Mehta, Shalini Rajaram Girija Wagh, Shirish Patwardhan
38. Active Management of Third Stage of Labor 351 57. Intrauterine Contraceptive Device .................. 490
MP Patil Milind R Shah
58. Emergency Contraception ................................. 502
SECTION 5: POSTPARTUM CONDITIONS
Nayna A Dastur, Ameya C Purandare
39. Management of Postpartum Hemorrhage ...... 357 59. MTP Act—Interpretation and Implications ... 509
Maya Sood, Ritu P Khiwal, Anita Sabharwal Jaydeep Tank
40. Puerperal Sepsis .................................................. 365 60. Vasectomy and Male Partner Involvement
Madhuri A Patel, Usha B Saraiya in Family Planning and Welfare ...................... 513
41. Breastfeeding Promotion ................................... 373 KM Nadkarni, Arun Tewari
Sonali Tank
42. Postpartum Psychiatric Disorders ................... 378 SECTION 8: GENERAL GYNECOLOGY
KC Gurnani 61. Approach to Abnormal Uterine Bleeding ...... 519
43. Postpartum Exercises .......................................... 384 Jaideep Malhotra, Narendra Malhotra, Joshep Kurian,
Meera Desai Neharika Malhotra
44. Postpartum Collapse .......................................... 391 62. Fibroids—Epidemiology, Etiopathophysiology
Hiralal Konar, Saunitra Inamdar, Picklu Choudhury, and Diagnosis ...................................................... 528
Gayatri P Nagpure Joydev Mukherji, Gourisankar Kamilya, Subrata Lall
Seal
SECTION 6: EMERGENCIES IN PREGNANCIES
63. Current Management of Fibroid ...................... 534
45. Antepartum Hemorrhage .................................. 403 Girija Wagh, Sanjay Gupte
Sukanta Misra 64. Prolapse: Pathological Anatomy and its
46. Tumors during Pregnancy—Management ..... 420 Bearing to the Selection of its Treatment ....... 546
DK Dutta AK Debdas
47. Surgical Emergencies during Pregnancy ........ 423 65. Current Trends in the Management of
Anupam Gupta, Sushma Gupta Prolapse ................................................................. 555
48. Critical Care in Obstetrics: An Overview ...... 431 Subhash M Nargolkar, Anand N Bhalerao,
B Shakuntala Baliga Vivek M Joshi
49. Emergency Obstetric Care for Reducing Maternal 66. Pelvic Inflammatory Disease ............................ 563
Mortality ............................................................... 441
Purnima Chatterjee, Tarun Kr Ghosh,
Sadhana Desai, Prakash Bhatt, Mandakini Parihar
Amitava Mukhopadhyay
SECTION 7: FAMILY WELFARE AND 67. Ectopic Pregnancy—Current Concepts ........... 568
CONTRACEPTION KK Das, BK Mitra, Konkon Mitra
50. History and Development of 68. Endometriosis ...................................................... 577
Contraception ....................................................... 449 Sudip Chakravarti
Manju Puri, Anjali Taneja 69. Urinary Tract Infection in Women .................. 587
51. Natural Methods of Family Planning— Kumud M Ingle, Himangi Warke
Barrier Contraception ......................................... 454 70. Stress Urinary Incontinence .............................. 596
D Pushpalatha CN Purandare, Sonal Karia, Nikhil Purandare
 Contents XV

71. Genital Fistula ..................................................... 606 90. Reconstructive Surgery in Infertility .............. 765
Vinita Das, Anjoo Agarwal BN Chakravarty
72. Genitourinary Fistula Repair ............................ 612 91. Overview of ART ................................................ 779
Manu Sobti Monesh Shah, Jaideep Malhotra
73. Decision Making for the Choice of 92. Cloning—Current Research .............................. 795
Hysterectomy ....................................................... 620 Narendra Malhotra, Jaideep Malhotra
Shirish S Sheth, Kurush P Paghdiwalla 93. Stem Cell Research ............................................. 812
Ameet Patki, Vijay Pawar
SECTION 9: ENDOCRINOLOGY
94. Lasers in Human Reproduction ....................... 821
74. Female Endocrinology and its Clinical Hrishikesh Pai
Relevance .............................................................. 635
CB Nagori SECTION 11: IMAGING IN OBSTETRICS AND
75. Disorders of Menstruation in GYNECOLOGY
Adolescent Age .................................................... 646 95. Ultrasonography in Gynecology ...................... 833
Parul J Kotdawala PK Shah, Narendra Malhotra, Sakshi Tomar,
76. Hormone Therapy (HT): Current Concepts ... 655 Jaideep Malhotra
Urvashi Prasad Jha, Ruchira Menka Jha, Swasti 96. Obstetric Ultrasound .......................................... 858
77. Management of Hyperprolactinemia .............. 670 Narendra Malhotra, Sakshi Tomar, Jaya Prakash Shah,
Sulochana Gunasheela BI Patel, Jaideep Malhotra
78. Polycystic Ovary Syndrome and Hirsutism ... 676 97. Color Doppler in Decision Making for
Usha R Krishna, Pradnya Parulkar Delivery ................................................................. 877
79. Luteal Phase Inadequacy ................................... 687 Narendra Malhotra, Kuldeep Singh, Jaideep Malhotra
Asha R Rao, Roopa J Pai 98. 3D and 4D US in Obstetrics and
80. Hyperandrogenism ............................................. 694 Gynecology ........................................................... 885
Abha Majumdar, Tejshree Singh Sonal Panchal
81. Thyroid and Adrenal Disorders in 99. CT-MRI in Obstetrics and Gynecology .......... 903
Gynecology ........................................................... 702 Anu Vij
Snehamay Chaudhuri, Hiralal Konar
SECTION 12: ONCOLOGY
82. Clinical Approach to Primary Amenorrhea ... 709
Ashwini Bhalerao Gandhi, Vandana G Shetty 100. Surgical Management of Vulvar Tumors ....... 917
83. Precocious Puberty— Ashwini Bhalerao Gandhi, Murad E Lala, Bimal Mody
Clinical Dilemmas in Practice .......................... 716 101. Cervical Intraepithelial Neoplasia: Diagnosis and
Ashwini Bhalerao Gandhi, E Sarulatha Management ........................................................ 923
Maya Lulla, Usha B Saraiya
SECTION 10: INFERTILITY 102. Downstaging of Cervical Cancer ..................... 931
84. Basic Management of Infertility ..................... 723 Pranay Shah
Manish Banker, Pravin M Patel 103. Surgical Treatment of Cervical Cancer ........... 939
85. Induction of Ovulation ...................................... 731 M Banumathy
Kamini A Rao 104. Ovarian Tumors—Epidemiology and
86. Premature Ovarian Failure ................................ 737 Classification ....................................................... 944
Kamini A Rao Richa Singh Chauhan
87. Male Factor in Infertility ................................... 743 105. Ovarian Carcinoma—Clinical Features/
Jayant G Mehta, Thankam R Varma Diagnosis/Principles of Treatment .................. 947
88. Intrauterine Insemination— K Jayakrishnan, Richa Singh Chauhan
Current Perspective ............................................ 750 106. Gestational Trophoblastic Disease .................. 954
Sadhana Desai, Partha Guharoy, Mehroo Hansotia, PK Sekharan
Gautam N Allahbadia, Vijay Mangoli 107. Endometrial Carcinoma ..................................... 971
89. Tubal Factors in Infertility ................................ 758 SK Giri, BL Nayak
Pravin M Patel, Manish Banker, Tejas Dave, 108. Germ Cell Tumors .............................................. 981
Sujal Munshi Harshad Parasnis
XVI Principles and Practice of Obstetrics and Gynecology for Postgraduates

109. Radiation Therapy in Gynecological 121. Breast and the Gynecologist ......................... 1143
Cancer .................................................................... 989 Behram S Anklesaria
Atul Munshi, Sanjay Munshi 122. Medicolegal Aspects of Obstetric Practice 1150
110. Role of Chemotherapy in Gynecologic Gita Ganguly Mukherjee, Basab Mukherjee
Malignancies ...................................................... 1001 123. Medicolegal Deficiencies in
Gautam Bhattacharjee Gynecological Practice ................................... 1156
111. HPV Infection and its Role in Cervical Sanjay Gupte
Cancer .................................................................. 1006 124. Audit in Obstetrics and Gynecology .......... 1159
Usha B Saraiya, Giovanni Miniello Suchitra N Pandit, Vijay Pawar, Sanjay B Rao
125. The Obstetrician and Gynecologist and the
SECTION 13: ENDOSCOPY
Indian Laws ..................................................... 1166
112. Diagnostic Endoscopy in Gynecology Prakash V Pawar, Kanan Yelikar, Rajendrasingh
(Laparoscopy and Hysteroscopy) ................... 1015 Pardeshi, Amol P Pawar, Ashish Kale, Vimla P Pawar
Nutan Jain 125A. Medical Negligence ....................................... 1179
113. Endoscopy in Infertility ................................... 1030 Markandey Katju
Shyam Desai, Nikhil Jani 125B. Legal Forms and Registrations for
114. Laparoscopic Electrocauterization Medical Practice in India ............................ 1194
of Ovarian Surface (LEOS) .............................. 1035 RN Goel
Duru Shah, Safala Shroff, Sukhpreet Patel 126. Immunotherapy in Obstetrics and
115. Widening Horizons of Operative Gynecology ...................................................... 1227
Laparoscopy ....................................................... 1048 Soundara Raghavan, Beena, Reena
PG Paul, Satyen Kasabwala, P Biju 127. Fluid Management in Labor ......................... 1233
116. Hysteroscopy in Infertility .............................. 1060 Parul Kotdawala
Nandita Palshetkar, Rishma Pai 128. Female Feticide in India ................................ 1238
117. Laparoscopic Hysterectomy— Kanan Yelikar, Ashwini Kale
Current Concepts .............................................. 1070 129. Blood and Blood Component Transfusion 1240
Prakash Trivedi, Aditi Singhi, Sylvia D’Costa Rahul Wani
118. Complications of Endoscopic Surgery 130. How to Answer Questions in Theory and
in Gynecology .................................................... 1098 Viva in Postgraduate Examination? ............ 1244
Pradeep Kumar Garg, Alka Kriplani Rohit V Bhatt
SECTION 14: MISCELLANEOUS 131. How to Write a Paper for Publication ? ...... 1247
Mahendra N Parikh
119. Menopause: A Phase in Woman’s Life ......... 1111
132. How to become a Good Doctor:
Suchitra Pandit, Shashikant Umbardand,
Ethics in Obstetrics and Gynecology .......... 1252
Vijay C Pawar, Prachi Bhikaji Shitut
Mandakini Megh
120. Applications of Genetics in Modern
133. FOGSI as a Brand for Woman’s Health ..... 1255
Obstetrics and Gynecology ............................. 1122
Girija Wagh, Shirish Patwardhan
Deepika Deka, Uma Vaidyanathan, Jaideep Malhotra,
Neharikaa Index .................................................................. 1259