Die Ovarialtumoren gehoren heute mit zu den haufigsten Tumoren des weiblichen Genitale. Ihre morphologische Differentialdiagnostik und die sich darauf aufbauende gezielte Therapie ist aufgrund der Vielfalt dieser Tumoren ungleich viel komplizierter als in anderen Organen. Dement- sprechend liegt der Schwerpunkt dieses Buches auf dem Gebiet der Histo- pathologie. Spezialkenntnisse insbesondere tiber die selteneren Formen der Ovarialtumoren hangen von groBen Fallzahlen abo Hier ist der inter- nationale Erfahrungsaustausch von vorrangiger Bedeutung. Die derzeit weltweit anerkannte histogenetische Klassifikation der WHO erfahrt an- hand der Erfahrungen an drei deutschen Frauenkliniken kleine Erganzun- gen und Variationen. Einige Lander, Z. B. Israel verfUgen tiber groBe epi- demiologische Untersuchungen, deren Ergebnisse korrelierend aufgenom- men sind. Zur klinischen Diagnostik wurden in den letzten lahren mo- dernste Untersuchungsmt;thoden neu eingefUhrt; ihre Anwendung setzt jedoch individuell anzupassende kritische Indikationsstellungen voraus. AbschlieBend werden die sich sehr differenziert auf der histologischen Diagnostik aufbauenden modernen Moglichkeiten einer gezielten Thera- pie der Ovarialtumoren ausfUhrlich diskutiert. Hier steht die Chemothera- pie im Vordergrund. 1m Hinblick auf die Frage einer Hormonbehandlung kommt neuerdings auch dem Rezeptornachweis im Tumorgewebe Bedeu- tung zu. Diese Zusammenstellung spricht somit gleichermaBen Pathologen, Onkologen und Gynakologen an und will versuchen, gegenseitige Infor- mationslticken der Fachexperten auf dem Gesamtgebiet der Problematik der Ovarialtumoren in zumutbarer Klirze zu schlieJ3en. Daher nehmen ge- rade die selteneren und bisher weniger bekannten Tumoren in Bild und Text einen verhaltnismaBig breiten Raum ein auf Kosten der hinlanglich bekannten haufigeren Formen, bei denen Spezia1fragen der Differenti- diagnostik aufgrund neuester Erkenntnisse im Vordergrund stehen.

In der Gynakologie und Geburtshilfe nehmen naturliche wie auch synthetische Prostaglandine zunehmend einen breiteren Raum ein. Auf- grund der rasch voran schreitenden Entwicklung ist die Anwendung dieser Substanzen nicht nur im deutschen Sprachraum uneinheitlich. Die noch verhaltnismassig junge Forschung ist im letzten Jahr- zehnt im Aufbruch in alle medizinischen Fachrichtungen. Zeugnis dieser sturmischen Entwicklung sind etwa 100 Originalpublikationen pro Monat, die sich mit der pharmakologischen Wirkung auf physio- logische und pathophysiologische Prozesse, mit der Neusynthese von Prostaglandinderivaten und mit neuen Anwendungs- und Applikations- moglichkeiten befassen. 8 Jahre nach den von Hickl und Brunnberg (Upjohn) veranstalteten Hamburger Prostaglandin-Gesprachen(l6./17. 11.1973) halten wir es fur angezeigt und notwendig, eine kritische Bilanz der klinischen Bedeutung der Prostaglandine im Sinne einer Bestandsaufnahme fur unser Fachgebiet im deutschsprachigen Raum zu ziehen. Gleichzeitig wollen wir die verschiedenen Arbeitsgruppen in den wissenschaftlichen Dialog fUhren, um vielleicht die Basis fur die weitere Grundlagen- und klinisch-wissenschaftliche Forschung zu verbreitern. Die vorliegende Monographie will in dieser Richtung ei- ne Zusammenfassung des Homburger Prostaglandin-Symposiums (22./23.5.1981) und eine Orientierungshilfe sein. Sie entstand aus den Referaten und Vortragen, die sich auf 4 Hauptthemen bezie- hen: I. Theoretische Grundlagen in der klinischen Anwendung von Prostaglandinen, 11. Prostaglandine zur Geburtseinleitung, III. Anwendung von Prostaglandinen in der Gynakologie und IV. Prostaglandine zur Abortinduktion.

Advances in research, knowledge and clinical practice in all branches of medicine have been rapid over the past decades and the speed is accelerating. Thus, as we enter the 1980s the pressure on specialists is to concentrate on ever-narrowing fields of their science. For the research worker this is desirable, but the practising clinician Our patient is a whole can have no clearly defined dividing lines. individual and every aspect of her makeup, physical and psychological, must always be taken fully into account. This is of vital importance in obstetrics and gynaecology. These two closely inter woven disciplines are branches of medical science in which emergency situations are not uncommon. Thus every practitioner, doctor, mid wife and nurse needs understanding of these subjects. Although tech nology advances rapidly, many basic principles remain the same. The chapters that follow deal with these, and modern trends in clinical management are discussed. For some decades the author has been in clinical charge of a matern ity hospital some 12 miles south of Central London. The hospital is a training school for obstetricians and midwives, and the local popula tion is adequately supplied with a general practitioner service. These circumstances are of some relevance because many views expressed are based on personal experience while others are based on countless books, articles, congresses and discussion with colleagues. To every source of information I express my thanks."

This expert guide will help readers learn about the role of hysteroscopy in the management of a range of common and less common gynaecological problems. In particular, the book covers the diagnosis and treatment of endometrial and uterine anatomical abnormalities that are associated with abnormal uterine bleeding and impairment of reproduction. Contemporary hysteroscopic techniques are described allowing the reader to understand how to perform both inpatient and outpatient procedures. Based on the annual RCOG/BSGE Diagnostic and Operative Hysteroscopy training course, this comprehensive guide covers fundamental topics such as equipment, energy modalities and operative set up. The book also explores innovative ambulatory surgery and hysteroscopic interventions in an operating theatre environment. Written by international experts in hysteroscopy and including sections on training in, and monitoring of clinical practice, this guide proves an ideal companion for health care professionals looking to provide best clinical practice and optimal patient experience.

Women most fully experience the consequences of human reproductive technologies. Men who convene to evaluate such technologies discuss "them": the women who must accept, avoid, or even resist these technologies; the women who consume technologies they did not devise; the women who are the objects of policies made by men. So often the input of women is neither sought nor listened to. The privileged insights and perspectives that women bring to the consideration of technologies in human reproduction are the subject of these volumes, which constitute the revised and edited record of a Workshop on "Ethical Issues in Human Reproduction Technology: Analysis by Women" (EIRTAW), held in June, 1979, at Hampshire College in Amherst, Massachusetts. Some 80 members of the workshop, 90 percent of them women (from 24 states), represented diverse occupations and personal histories, different races and classes, varied political commitments. They included doctors, nurses, and scientists, lay midwives, consumer advocates, historians, and sociologists, lawyers, policy analysts, and ethicists. Each session, however, made plain that ethics is an everyday concern for women in general, as well as an academic profession for some.

Women most fully experience the consequences of human reproductive technologies. Men who convene to evaluate such technologies discuss "them": the women who must accept, avoid, or even resist these technologies; the women who consume technologies they did not devise; the women who are the objects of policies made by men. So often the input of women is neither sought nor listened to. The privileged insights and perspectives that women bring to the consideration of technologies in human reproduction are the subject of these volumes, which constitute the revised and edited record of a Workshop on "Ethical Issues in Human Reproduction Technology: Analysis by Women" (EIRTAW), held in June, 1979, at Hampshire College in Amherst, Massachusetts. Some 80 members of the workshop, 90 percent of them women (from 24 states), represented diverse occupations and personal histories, different races and classes, varied political commitments. They included doctors, nurses, and scientists, lay midwives, consumer advocates, historians, and sociologists, lawyers, policy analysts, and ethicists. Each session, however, made plain that ethics is an everyday concern for women in general, as well as an academic profession for some.

In celebration of its 20th anniversary, a thoroughly revised and expanded edition of the leading book on fertility and women's reproductive health. Since the publication of Taking Charge of your Fertility two decades ago, Toni Weschler has taught a whole new generation of women how to become pregnant, avoid pregnancy naturally and gain better control of their gynecological and sexual health by taking just a couple minutes a day using the proven Fertility Awareness Method. Now, this 20th Anniversary Edition has been thoroughly revised and fully updated with: the latest medical advances in assisted reproductive technologies (ART) more in-depth coverage of women's gynecological and sexual health new illustrations, photographs, and an expanded color insert new sample charts an expanded appendix Six new chapters including: Three Prevalent Conditions--Endometriosis, Ovarian Cysts and PCOS Natural Ways to Balance Your Hormones Preserving Your Future Fertility Miscarriages Idiopathic Infertility Causes of Unusual Bleeding Clear and comprehensive, yet warm and approachable, Taking Charge of Your Fertility is one of the most universally lauded health books on the market today. It is an essential reference for every woman of reproductive age.

Engage with practical and active solutions to day-to-day issues of reproductive medicine and the use of artificial reproductive techniques (ART), occurring in clinical and laboratory environments. Authored by leading experts in the field, this user-friendly guide is invaluable for any IVF practitioner and embryologist, facing everyday hands-on issues, through to high-pressure laboratory problems, efficiency ratings and ensuring cost-effective delivery of care. With the strict governance of regulatory bodies worldwide, the success of any fertility centre depends on successful problem solving, all day every day. Based on a wealth of experience, identify commonly occurring problems, and fresh perspectives of problem-solving, with 'must-have' protocols, patient information sheets and suggested equipment. This go-to companion tackles operational, organisational, clinical and laboratory issues to financial and clinical governance, with a focus on quick and effective solutions for the busy practitioner.

Extensive reviews have been published on the mor aspects, anatomy, ultrastructure, physiology, bio phology, anatomy, and physiology of the mam chemistry, endocrinology, pharmacology, and physiopathology of the mammalian ovary. The malian ovary. However, little attention has been given to the gaps between the physiological, endo contributors, who prepared their chapters metic ulously, are recognized experts in their respective crine and histochemical parameters of the ovary as disciplines and their writings reflect extensive per it relates to clinical aspects. There is a wealth of sonal experience and unpublished data of both publications concerning the biology of the ovary: basic and clinical sciences. Without the assistance of the purpose of this volume is to integrate this information with emphasis on modern concepts in good friends and permission to draw extensively microanatomy, physiology, methodology, clinical from investigations, this volume would not have complications, and therapeutic approaches. An been possible. attempt is made to place fundamental research in Thanks are due to G. F. Franchitto, F. Barberini, clear perspectives. P. Stoops. Lori Rust and J. Squiers for their editorial It is hoped that this volume will fulfil a long skills and for checking the references to the original standing need and serve as an important source for sources. Thanks are particularly due to 1. K. Smith investigators and clinicians concerned with the of Martinus Nijhoff Publishers BV for his excellent physiopathology of the ovaries for years to come. It cooperation during the production of the book."

During the past 3 years, little has been added to our funda mental knowledge of hormonal disorders in gynecology. Diagnostically, however, there has been an almost com plete departure from traditional chemical methods in favor of radioimmunoassay techniques. As a result, diagnostic capabilities which previously were restricted to large cen ters have now been extended to the office and small clinic. Accordingly, the chapters dealing with these techniques have been revised and updated. There is also new material on advances in the hormonal treatment of endometriosis and hyperprolactinemic states. Finally, the bibliography has been extensively revised to include a number of recently published books and survey articles of general interest. Paul J. Keller v Preface to the First German Edition Menstrual disorders and sterility are among the most com mon complaints noted by both the specialist and general practitioner. For many patients they are far more distress ful than is generally assumed. Recent years have brought our knowledge. While this has led to great advances in major improvements in the results of treatment, it has made it difficult for the nonspecialist to keep abreast of developments in the field of gynecologic endocrinology.

Overcoming Drug Resistance in Gynecologic Cancers provides up-to-date information related to important gynecologic cancers and focuses on mechanisms of drug resistance, genetics, signaling, immunology, health disparities, nanotechnology, economic considerations and financial impacts. The book covers not only drug resistance but also important means to reverse resistance both in the laboratory and clinic. The book discusses topics such as lifestyle, nutrition and risk of gynecologic cancers, the financial impact of drug resistance, chemosensitizing agents and targeted therapies in cervical, endometrial and ovarian cancer, immunotherapy to overcome drug resistance, and genetic polymorphisms in gynecologic cancers. Additionally, it discusses ethnic and racial health disparity perspectives and future developments in chemosensitizing activities to reverse drug resistance in gynecologic cancers. It is a valuable resource for cancer researchers, oncologists, clinicians and other biomedical field members who are interested in new approaches to improve chemotherapy outcome in patients with gynecologic cancers.

A 35-year-old woman arrives on the labour ward complaining of abdominal pain and vaginal bleeding at 36 weeks 2 days' gestation. The pain started 2 hours earlier while she was in a cafe and is not relieved by lying still or walking around. The bleeding is bright red. You are the medic on duty... 100 Cases in Obstetrics and Gynaecology presents 100 obstetric- or gynaecology-related scenarios commonly seen by medical students and junior doctors in the emergency department, outpatient clinic, or on the ward. A succinct summary of the patient's history, examination, and initial investigations-including photographs where relevant-is followed by questions on the diagnosis and management of each case. The answer includes a detailed discussion on each topic, with further illustration where appropriate, providing an essential revision aid as well as a practical guide for students and junior doctors. Making speedy and appropriate clinical decisions, and choosing the best course of action to take as a result, is one of the most important and challenging parts of training to become a doctor. These true-to-life cases will teach students and junior doctors to recognize important obstetric and gynaecological conditions, and to develop their diagnostic and management skills.

Fully updated to reflect changes to the curriculum and question format since publication of the original edition, this book is essential reading for all Part 1 MRCOG candidates. A chapter has been added to mirror the new curriculum domain of data interpretation. Edited by experienced RCOG examiners and written by contributors to the RCOG's revision course, this comprehensive textbook provides extensive coverage of all curriculum areas covered by the Part 1 examination (the basic sciences which are vital to the clinical practice of obstetrics and gynaecology). Fully illustrated in colour throughout to aid understanding, this is the one textbook that every Part 1 candidate should own. The content is complementary to RCOG's eLearning programme StratOG (https://stratog.rcog.org.uk) which offers a range of products to support training and professional development in obstetrics and gynaecology, including banks of Single Best Answer (SBA) questions that offer candidates invaluable practice at tackling this demanding examination.

In July 1978 a group met in Aberdeen to discuss the whole range of new proteins recently isolated from the human placenta. With the exception of Yuri Tatarinov all the main pioneers in the field were present, and this book arose from the discussions which took place. Each author was asked to bring a written man uscript corresponding to but not necessarily identical with their verbal presentation. Nobody was given a specified remit, for the reason that the subject is so new that it would be impossible to design the meeting or the book in advance. Each speaker was left free to put on display whatever he thought was interesting or important about the newly isolated proteins. Inevitably this has led to much overlap, since everybody tends to follow the same path at first. Nevertheless, we shall probably never achieve so much agreement again. Only Vernon Stevens was set a fixed title out side the immediate field of new placental proteins. This arose from the very exciting possibility that the new proteins could be used to induce an autoimmune state to products of conception and thus serve as the basis for a new method of contraception. There are few findings at present which bear specifically on this proposal, but the experience of Vernon Stevens with hCG could serve as a model of the problems that might be encountered with SP and PAPP-A."

It has been our privilege to edit this volume which is complementary to the first book on Carbohydrate Metabolism in Pregnancy and the Newborn and which is based on work presented at the 2nd Aberdeen Colloquium bearing the same title held in April, 1978. The growth of knowledge of this subject in the 5-year period since the 1st Aber- deen Colloquium in 1973 is truly remarkable and fully justifies this second exposition of current ideas in this field at the present time. For example, the 1973 meeting failed to cover such recent to- pics as H. L. A. typing, glycosylated haemoglobin, control of glycae- mia in labour with the use of the artificial pancreas, fetal brea- thing and pregnancy specific B-glycoprotein and this volume provi- des such an opportunity. The scope of this book is broader and in- cludes data on placenta and fetal congenital anomaly related to ma- ternal diabetes and many aspects of birthweight while there is also a section on maternal weight and nutrition in pregnancy. In a wider prospective one of the stimuli for such work has been the impetus given by the regular meetings starting in 1969 of the Diabetic Preg- nancy Study Group of the European Association for the Study of Dia- betes. This has allowed much more effective integration of research on diabetic pregnancy. The work of the members of the Diabetic Preg- nency Study Group is widely represented in this publication.

In Memoriam xiii Preface xvii Chapter 1 Development, Mechanisms of Action and Evaluation of IUD Performance 2 Chapter 2 IUD Insertion 28 Chapter 3 Uterine Perforation 54 Chapter 4 Pelvic Inflammatory Disease 92 Chapter 5 Bleeding 138 Chapter 6 Cervical and Uterine Pathology 158 Chapter 7 Intrauterine Pregnancy 172 Chapter 8 Ectopic Pregnancy 194 Chapter 9 Return to Fertility after IUD Discontinuation 222 Chapter 10 IUD Complications in Perspective 232 Appendices 243 Index 253 Foreword Ever since Hippocrates observed that foreign bodies placed in the uterus would help to prevent pregnan cy, periodic interest in this information and its use has resulted in attempts to control unwanted fertil ity. Prior to the 1900s, this interest was somewhat episodic. Because of anxiety about infection, early attempts flourished only briefly and then were no more. In the twentieth century, however, as a result of renewed interest in intrauterine contraception, particularly in the developing countries, a number of individuals throughout the world began experiment ing with a variety of new intrauterine devices. Since then, a great number of these devices have been studied; a few have survived careful scrutiny, and IUDs now represent the second most commonly used form of medical contraception. It is estimated that approximately 15 million devices are in use at the present time, 3 to 4 million of them in the United States."

Uterine fibroids are very common in women of reproductive age and are mostly benign. However, they are often a cause of abnormal bleeding and, in severe cases, can cause infertility. This comprehensive guide reviews the clinical management of uterine fibroids, with a particular focus on practical surgical techniques. Engage with topics such as the anatomy of the pelvis, key theatre equipment and surgical treatments including hysteroscopic and laparoscopic techniques. Features also include debates around morcellation, and less invasive treatments such as uterine artery embolisation are also covered. An online video library of surgical procedures reinforces the practical techniques taught in the book and detailed colour images supplement the book's thorough coverage of fibroid management. This makes Modern Management of Uterine Fibroids an essential resource for practicing gynaecologists and IVF specialists, as well as students.

This book is a practical guide for medical practitioners as they navigate through breastfeeding problems that occur in day-to-day practice. If mothers have a breastfeeding complication they are often directed to their GP. In complex situations, medical staff will be making decisions around what treatment plan to follow and whether a mother can keep breastfeeding. In recent years there has been growing evidence that medical professionals often advise mothers to stop breastfeeding while undergoing treatment, when in reality this was not a necessary step. In a time when breastfeeding rates are decreasing, it is important that medical professionals give accurate advice and support a mother's choice to breastfeed if the situation allows it. A Guide to Supporting Breastfeeding for the Medical Profession includes contributions from a wide range of medical professionals and each chapter is written with the practitioner in mind. Contributors include GPs, paediatricians, neonatologists, lactation specialists and midwives. Doctors have a vital role to play in supporting and facilitating breastfeeding, and without the appropriate knowledge they can often inadvertently sabotage it. This book will be of interest to GPs and paediatricians as well as nurse prescribers, midwives and health visitors.

Although there are far more opportunities for LGBTQ people to become parents than there were before the 1990s, attention to the reproductive challenges LGBTQ families face has not kept pace. Reproductive Losses considers LGBTQ people's experiences with miscarriage, stillbirth, failed adoptions, infertility, and sterility. Drawing on Craven's training as a feminist anthropologist and her experiences as a queer parent who has experienced loss, Reproductive Losses includes detailed stories drawn from over fifty interviews with LGBTQ people (including those who carried pregnancies, non-gestational and adoptive parents, and families from a broad range of racial/ethnic, socio-economic, and religious backgrounds) to consider how they experience loss, grief, and mourning. The book includes productive suggestions and personal narratives of resiliency, commemorative strategies, and communal support, while also acknowledging the adversity many LGBTQ people face as they attempt to form families and the heteronormativity of support resources for those who have experienced reproductive loss. This is essential reading for scholars and professionals interested in LGBTQ health and family, and for individuals in LGBTQ communities who have experienced loss and those who support them. See additional material on the companion website: www.lgbtqreproductiveloss.org/

Der vorliegende Supplementband enthalt Beitrage zum Thema "Aktuelle Probleme der padiatrischen Endokrinologie". Dabei handelt es sich urn erwei- terte Fassungen von Vortragen, die auf dem 1. Symposium des Ludwig-Boltz- mann-Institutes fur padiatrische Endokrinologie im September 1976 in Wien gehalten wurden. Die Reihenfolge der Veroffentlichung entspricht der Vor- tragsfolge auf dem Symposium. Der Bogen der abgehandelten Themen ist weit gespannt und spiegelt da- mit den groiSen Bereich wider, den die padiatrische Endokrinologie - ein relativ junges Spezialgebiet der Kinderheilkunde - he ute bereits umfaiSt. Durch die sturmischen Fortschritte der Biochemie und der Labormethoden wurden und werden einerseits standig neue Erkenntnisse gewonnen, anderer- seits aber auch standig neue Problemstellungen eroffnet. Durch die Beteiligung international bekarinter Experten am Vortragsprogramm, und damit am Inhalt des Supplements, wurde das Gesamtkonzept hinsichtlich seiner Qualitat wie auch seiner Aktualitat entscheidend bereichert. W. SWOBODA H. ZIMPRICH Inhaltsverzeichnis SAENGER, Po, LEVINE, L. So, WIEDEMANN, Eo, SCHWARTZ, Eo, KORTH-SCHUTZ, So, PAREIRA, Jo, HEINIG, Bo, NEW, Mol.

Epigenetics is the study of how certain genes are activated without modification at the DNA sequence level, resulting in genetically similar individuals having different clinical outcomes. As contemporary medicine increasingly aims to personalize the medical approach to a patient's genetic profile, the factors that can affect which genes are expressed also increase in importance and relevance to the clinician. This text from experts will give the clinician in Reproductive Medicine a reliable grounding in current thinking and research on this fast-moving topic, with many clinical implications.

This volume focuses on endometriosis from its pathogenesis and the importance of the early diagnosis to treatment, throughout all aspects of femininity that this disease affects, impacting health and quality of life. It also covers treatment strategies for the pain and for the disease management according to the age and needs of the patient, from adolescence to menopause, passing through the fertile age and the consequences that this disease can have on fertility and pregnancy. This book is a useful, clear and up-to-date tool for gynecologists, gynecological surgeons, reproductive medicine and general practitioners and is an important source of information to face this more and more frequent and devastating disease.