Charles R. B. Beckmann - Obstetrics and Gynecology

Obstetrics and Gynecology

SEVENTH EDITION

Obstetrics and Gynecology

SEVENTH EDITION

American College of Obstetricians and Gynecologists

with

Charles R. B. Beckmann, MD, MHPE, FACOG

Former Professor of Obstetrics and Gynecology, Thomas Jefferson University College of Medicine, Philadelphia, Pennsylvania

Former Director, Offices of Ambulatory Care and of OB-GYN Academic Affairs, Department of Obstetrics and Gynecology, Albert Einstein Medical Center, Philadelphia, Pennsylvania

Frank W. Ling, MD, FACOG

Clinical Professor, Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine and Meharry Medical College, Nashville, Tennessee; Partner, Womens Health Specialists, PLLC, Germantown, Tennessee

William N. P. Herbert, MD, FACOG

Former William Norman Thornton Professor and Chair, Professor Emeritus, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia

Douglas W. Laube, MD, MEd, FACOG

Professor and former Chair, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

Past President (20062007), American College of Obstetricians and Gynecologists

Roger P. Smith, MD, FACOG

The Robert A. Munsick Professor of Clinical Obstetrics and Gynecology; Director, Medical Student Education; Director, Division of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana

Robert Casanova, MD, FACOG

Associate Professor of Obstetrics and Gynecology, Assistant Dean of Clinical Sciences Curriculum, Program Director Obstetrics and Gynecology, Clerkship Director Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Lubbock, Texas

Alice Chuang, MD, FACOG

Associate Professor, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina; Clerkship Director; Attending Physician

Alice R. Goepfert, MD, FACOG

Professor, Director of Education and Residency Program Director, Department of Obstetrics and Gynecology, The University of Alabama at Birmingham, Birmingham, Alabama

Nancy A. Hueppchen, MD, MSc, FACOG

Associate Professor and Director of Medical Student Education in the Department of Gynecology and Obstetrics, Assistant Dean for Clinical Curriculum, Johns Hopkins University School of Medicine, Baltimore, Maryland

Patrice M. Weiss, MD, FACOG

Chair and Professor, Department of Obstetrics and Gynecology, Carilion Clinic, Virginia Tech Carilion School of Medicine, Roanoke, Virginia

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Seventh Edition

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Library of Congress Cataloging-in-Publication Data

Charles R.B. Beckmann ... [et al.].

Obstetrics and gynecology7th ed.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-1-4511-4431-4 (alk. paper)

I. Beckmann, Charles R. B. II. American College of Obstetricians and Gynecologists. [DNLM: 1. Genital Diseases, Female. 2. Labor, Obstetric. 3. Pregnancy. WP 140] 618dc23

2012030604

DISCLAIMER

Care has been taken to confirm the accuracy of the information present and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular situation remains the professional responsibility of the practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations.

The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with the current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug.

Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice.

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In Memory of Martin L. Stone, M.D.

In each of the first six editions of this textbook, dating back 20 years now, Marty Stone has written the Foreword, and we have been honored to have him do so. His endorsement of our text has meant a great deal to us.

With this seventh edition of Obstetrics and Gynecology, the authors wanted to dedicate our text to our dear friend, colleague, and mentorMartin L. Stone, M.D. Unfortunately, during the final stages of preparing this edition, we learned that Marty, at age 92, had passed away. It is, therefore, fitting that this seventh edition be published in memory of Marty, whose contributions to womens health are numerous and long-lasting.

No one in our field of womens health has been more active, energetic, and engaged in improving education in obstetrics and gynecology than Marty Stone. A founding officer of the Association of Professors of Gynecology and Obstetrics (APGO) 50 years ago, he has held many leadership positions in health care education over his six-decade career, including, among others, serving as president of the American College of Obstetricians and Gynecologists, editor of ACOG Update, and two-term membership on the Residency Review Committee. From 1956 to 1978, Marty was Chair of Ob/Gyn at New York Medical College, after which he accepted the position of serving as the first ob/gyn chair at the then-new State University of New York (SUNY) School of Medicine at Stony Brook. Marty continues to serve there as professor and chair emeritus and consultant in education. Those who trained under Martys guidance hold him in great respect and admiration.