Clinical Strategies Gynecology and Obstetrics by P D Chan, Susan M. Johnson

By P D Chan, Susan M. Johnson

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Extra info for Clinical Strategies Gynecology and Obstetrics

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Adenomyosis, endometriosis, and fibroids increase in frequency as a woman ages, as do endometrial hyper­ plasia and endometrial polyps. Pelvic inflammatory disease and endocrine dysfunction may also occur. C. Laboratory tests 1. CBC and platelet count, Pap smear, and pregnancy test. 2. Screening for sexually transmitted diseases, thyroid­ stimulating hormone, and coagulation disorders (partial thromboplastin time, INR, bleeding time). 3. If a non-pregnant woman has a pelvic mass, ultrasonography or hysterosonography (with uterine saline infusion) is required.

D. Polycystic ovary syndrome is managed with mea­ sures to reduce hirsutism, resume menses, and fertility and prevent of endometrial hyperplasia, obe­ sity, and metabolic defects. E. Functional hypothalamic amenorrhea can usually be reversed by weight gain, reduction in the intensity of exercise, or resolution of illness or emotional stress. For women who want to continue to exercise, estrogen-progestin replacement therapy should be given to those not seeking fertility to prevent osteo­ porosis.

Vaginal or abdominal hysterectomy is the most absolute curative treatment. b. Dilatation and curettage can be used as a temporizing measure to stop bleeding. c. Endometrial ablation and resection by laser, electrodiathermy “rollerball,” or excisional resec­ tion are alternatives to hysterectomy. References: See page 166. Breast Cancer Screening and Diagno­ sis Breast cancer is the most common form of cancer in women. There are 200,000 new cases of breast cancer each year, resulting in 47,000 deaths per year.

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