Internal Medicine

Download NMS Obstetrics and Gynecology (National Medical Series for by Samantha M. Pfeifer PDF

By Samantha M. Pfeifer

NMS Obstetrics and Gynecology delivers clinically appropriate content material in quick-review define layout for college students engaged within the obstetrics and gynecology rotation. situations, questions, and a finished examination mix to supply extra help, no matter if the scholar is getting ready for the SHELF examination or USMLE Step 2. Differential prognosis and diagnostic checking out info is well obvious for speedy overview prior to seeing a sufferer or proposing on rounds. The text's easy-to-navigate, two-color layout positive aspects broad margins for note-taking. 

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A. Nonlactating mothers may begin using a contraceptive soon after delivery if they wish to avoid becoming pregnant. Combination of oral contrceptives, depo-medroxyprogesterone acetate, or subdermal etonogestrel implant may be offered before discharge. b. Lactating mothers may begin using progestin-only oral contraceptives as soon as their milk supply is established. Progesterone-only contraceptives such as oral contraceptive pills, depo-medroxyprogesterone acetate, etonogestrel subdermal implant, do not appear to have adverse effects on lactation.

2. Ultrasonographic recognition of the fetus a. After 5 weeks of amenorrhea, an early chorionic (gestational) sac is visible as a small, fluidfilled structure surrounded by an echogenic rim of tissue on transvaginal ultrasound. The embryo is apparent within the gestational sac after 6 weeks of amenorrhea. b. Fetal heart activity is seen by real-time ultrasonography after 6 weeks of gestation. The normal heart rate may be as low as 90 beats/min at 6 weeks and increases during the first trimester.

However, if her cycle is 35 days, then she probably ovulates on cycle Day 21. This would change her EDC. 4. Accurate dating of pregnancy is essential as clinical decisions are based upon the specific gestational age. B Naegele’s rule The EDC is determined by subtracting 3 months and adding 7 days to the first day of the last menstrual period (LMP). For example, if the LMP is July 15, then the EDC is April 22. This assumes a 28-day menstrual cycle with ovulation occurring on Day 14. C Ultrasound may be used to confirm or identify an EDC when the LMP is uncertain.

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