Contraception

Classification of Heart Diseases in Pregnancy: Incidence: 1% of all pregnancies 1-Rheumatic valve diseases (still the most common in the developing countries.) MS, MR, DM, AS, AR. 2-Congenital disorders (The most common in developed countries.) ASD, VSD, PDA, coarcitation of the aorta, Fallot's tetralogy, Eisenminger syndrome and Marfan syndrome. 3-Others: Arrhythmias, ischemic heart disease and cardiomyopathy.

New guidelines from the American College of Obstetricians and Gynecologists contain recommendations to help prevent, manage and treat blood clots in pregnant women. Blood clots are a leading cause of maternal morbidity, with pregnancy associated with a four-fold increase in the risk of thromboembolism. As such, ACOG released “Thromboembolism in Pregnancy” in the September 2011 issue of Obstetrics & Gynecology to guide clinicians in the prevention, management and treatment of blood clots during pregnancy.

Accurate diagnosis of uterine fibroids is essential in deciding if treatment is necessary, and planning appropriate treatment.n While a physical exam may suggest fibroids, other conditions such as ovarian cysts or adenomyosis may be mistaken for fibroids. For this reason, I routinely do an ultrasound examination at the time of the first visit when a woman has symptoms of abnormal bleeding or cramping, or if I feel an abnormality on examination.

The US Department of Health and Human Services announced on August 1, 2011, that women will receive preventive health services at no additional cost. This historic new guideline is an effort to improve use of preventive services and to reduce health care costs related to preventable diseases and conditions.

Hirsutism: • Not an increase in the number of hair follices but an alteration in their character. • An increase in the transformation of the vellus to terminal hair. • {Androgens will convert lanugo & vellus hair to terminal hair}.

Puberty Dr. Ashraf Fouda Damietta General Hospital Puberty It is a physiological phase lasting 2 to 5 years, during which the genital organs mature. Manifestations of puberty in the female include:

DEFINE Any deviation in normal frequency, duration or amount of menstration in women of reproductive age. NORMAL MENSES Frequency: 21-35 d Duration: 3-7 d Volume: 30-80 ml

• The name of this group of diseases was changed from "venereal diseases" to "sexually transmitted diseases" or "STDs" • Now many persons call them "sexually transmitted infections" or "STIs."

Serial BSU's • -hCG Levels Double Every 48 Hrs • < 66% Rise / 48 Hrs Consistent With Ectopic • Single Determination Not Helpful • Best If Done Within Same Laboratory • Never Rules Out Ectopic

1. Introduction • Pelvic inflammatory disease (PID) is a common cause of morbidity and accounts for 1 in 60 GP consultations by women under the age of 45

Definitions Primary amenorrheaFailure of menarche to occur when expected in relation to the onset of pubertal development. • No menarche by age 16 years with signs of pubertal development. • No onset of pubertal development by age 14 years. Secondary amenorrhea • Absence of menstruation for 3 or more months in a perviously mentruating women of reproductive age.

ORMELOXIFNE - A new Treatment Modality in DUB Dr. Surendra Nath Panda, M.S. Professor of Obstetrics and Gynaecology M.K.C.G. Medical CollegeBerhampur, Orissa, INDIA

CLINICAL PICTURE •Vaginal Bleeding I. Speculum Examination:The vagina is full with clots, portio exophytic or shows. Carcinoma crater surface bleeding stronger after touching.II. Palpation:Often large tumor that fills the small pelvis.

 Third Generation OC's: Safety and Indications for UseSlide 2 of 26Slide 3 of 26Slide 4 of 26Slide 5 of 26Slide 6 of 26Slide 7 of 26Slide 8 of 26Slide 9 of 26Slide 10 of 26Slide 11 of 26Slide 12 of 26Slide 13 of 26Slide 14 of 26Slide 15 of 26Slide 16 of 26Slide 17 of 26Slide 18 of 26Slide 19 of 26Slide 20 of 26Slide 21 of 26Slide 22 of 26Slide 23 of 26Slide 24 of 26Slide 25 of 26Slide 26 of 26

It has been suggested that hormonal risk factors act predominantly on estrogen receptor and progesterone receptor (ER/PR)-positive breast cancers. However, the data have been inconsistent, especially in younger women.

In a study published today in Europe's leading reproductive medicine journal Human Reproduction1, researchers from New York's Cornell University report the first IVF pregnancy to result from the use of tamoxifen as an ovarian stimulant.

Sore breasts can signal the onset of PMS -- that 'ouch' feeling tells some women they're premenstrual more reliably than a calendar. Cyclical breast soreness shouldn't cause concern, according to Women's Health America. However, breast pain doesn't have to be tolerated. Here's how to minimize discomfort, and how to recognize cautionary signs that should send you to your doctor.

Disclosure Declaration •Grant Support –National Institutes of Health, Ortho-McNeil Pharmaceutical, Inc, Pharmacia Corp., Berlex Laboratories, Proctor and Gamble •Honoraria and consultation fees –Ortho-McNeil Pharmaceutical, Inc., Berlex Laboratories, Pharmacia Corp., TAP Pharmaceuticals, Eli Lilly and Co. •Participation in company sponsored speakers’ bureau –Ortho-McNeil Pharmaceutical, Inc., Berlex Laboratories, Pharmacia Corp., Merck Pharmaceuticals.

Presented by Dr. Narayan M. Patel M.D., D.G.O. FICSEmeritus Professor Muni. Medical collegePostal address-Mahalaxmi Institute of Medical Teaching,3, Shantiniketan park, Naranpura,Nr. Sardar Patel Colony,AHMEDABAD- 380 014 (Gujarat) INDIA E mail:- nmpatel1932@wilnetonline.net