Vulvar disorders are prevalent but often overlooked conditions in the curricula of obstetrics and gynecology, dermatology, and primary care residency training programs. This has led many outpatient clinicians to feel unprepared to evaluate the patient with a vulvar complaint. Often patients with complex, chronic vulvar disorders have seen multiple providers in consultation before they are appropriately diagnosed and treated, leading to frustration amongst patients and providers alike as well as excessive health care costs. The goal of this issue is to present a practical review on vulvar disease for outpatient clinicians to improve patient care. The topics highlighted in this issue represent gaps in knowledge among residents, fellows, providers, and course and conference attendees. The issue begins with a general approach to the evaluation and management of vulvar disorders and then moves on to an article on vulvar pathology that will help clinicians obtain the most useful pathology reads from their biopsies. Also addressed are specific vulvar disorders or presenting findings that are common or challenging. A pelvic floor physical therapy colleague provides information on how this modality can help manage vulvar pain. The issue concludes with an article on hot topics in vulvar disease. In the last several years there has been a growing number of newly trained physicians committed to advancing patient care in the area of vulvar disease, and many of this issue's authors are part of this group. This issue should serve as a useful resource in the office of any provider who evaluates patients with vulvar complaints.

Get Through MRCOG Part 2: SBAs provides 3 exams' worth of questions mapped to the RCOG syllabus in the newly introduced SBA style. With detailed explanations and relevant references to guidelines, this is the definitive resource for those taking the MRCOG Part 2 examination.

The Guest Editors have collaborated on a state-of-the-art presentation of current clinical reviews on Quality in Neonatal Care. Top experts have prepared articles in the following areas: Standardizing Practices: How and why to standardize, using checklists, measuring variation; Health Informatics and Patient Safety; Using Statistical Process Control to Drive Improvement in Neonatal Care; Improving Value in Neonatal Intensive Care; Culture and Context in Quality of Care: Improving Teamwork and Resilience; Has Quality Improvement Improved Neonatal Outcomes; National Quality Measures in Perinatal Care; Perinatal and Obstetric Quality Initiatives; Family Involvement in Quality Improvement; Perinatal Quality Improvement: A Global Perspective; Delivery Room Care / Golden Hour; Respiratory Care and Bronchopulmonary Dysplasia; Reducing Incidence of Necrotizing Enterocolitis; Alarm Safety and Alarm Fatigue; and Patient Safety: Reducing Unplanned Extubations. Readers will come away with the clinical information they need improve quality in the NICU.

Dr. Nicholson's issue is devoted to providing health care to the underserved woman. Leading experts in the area have written reviews to address the leading thinking and management of patient outcomes in the following areas: Racial/ethnic Disparities in Health and Healthcare; Perinatal Quality Indicators and Achieving Birth Equity among Underserved Women; Reducing Disparities in Unintended Pregnancy; Family planning American style: Why it's so hard to control birth in the United States; Breaking the Cycle of Obesity in Women in Underserved Communities; Addressing Healthcare Disparities Among Sexual and Gender Minorities with Community Initiatives; Comparing Options for Patient-Centered Treatment for Uterine Fibroids: Addressing Patient-Centered Fibroid Management in Underserved Women of Childbearing Age; Aiding Underserved Women with Substance Use Disorders before and after Pregnancy; Tthe Role of Qualitative Research in Gynecologic and Reproductive Care; and Using the Electronic Health Record to Conduct Reserch in Population Health. Readers will come away with state-of-the-art information that they can immediately integrate into patient care.

Despite advances in medical technology and patient safety initiatives, maternal morbidity and mortality rates continue to increase. Maternal mortality trends in the US as reported from the CDC from 1989-2009 demonstrate increasing mortality trends from 7.2 deaths per 100,000 live births in 1987 to 17.8 deaths per 100,000 live births in 2009. To combat this problem, a thorough understanding of the critical medical and surgical issues that are often encountered in pregnancy is essential. Each article addresses a topic relevant to care of the critically ill gravida.

This is the first international study of maternal care and maternal mortality. Over the last two hundred years, different countries developed quite different systems of maternal care. Death in Childbirth is a meticulously researched analysis, firmly grounded in the available statistics, of the evolution of those systems between 1800 and 1950 in Britain, the USA, Australia and New Zealand, and on the continent of Europe. Irvine Loudon examines the effectiveness of various forms of maternal care by means of the measurement of maternal mortality - the number of women who died as a result of childbirth. His scholarly and comprehensive study sets out to answer a number of important questions. What was the relative risk of a home or hospital delivery, or a delivery by a midwife as opposed to a doctor? What was the safest country in which to have a baby, and what were the factors which accounted for enormous international differences? Why, against all expectations, did maternal mortality fail to decline significantly until the late 1930s? Death in Childbirth makes an invaluable contribution to medical and social history.

At the turn of the millennium, the world experienced a dramatic increase in funding for global health programs. Competing demands for these resources meant that policymakers needed access to valid, evidence-based information on the costs and consequences of a broad range of health interventions. By providing systematic and comparable information about purchasing health in LMICs, Disease Control Priorities in Developing Countries, Second Edition greatly informed and enriched these conversations and we hope -- improved resource allocations. Nearly ten years later, increased attention to chronic diseases and the importance of health systems in providing access to quality care is once again reshaping the global health landscape. Low- and middle-income countries are continuing to set priorities for funding and deploying specific interventions, but with a greater appreciation for the contribution of program and economic evaluation to informed decision-making. The need to make decisions across an increasingly complex set of policy and intervention choices, attuned to specific health system capabilities, makes a third iteration of Disease Control Priorities all the more critical. Similar to the first and second editions of Disease Control Priorities (DCP1 and DCP2), the aim of the third edition (DCP3) is to influence program design and resource allocation at global and country levels by providing an up-to-date comprehensive review of the effectiveness of priority health interventions. It presents systematic and comparable economic evaluations of selected interventions, delivery platforms, and policies based on newly developed economic methods. DCP3 further expands on the scope of intervention assessments found in DCP1 and DCP2 by presenting findings in nine individual volumes. It is clear that optimal global health programming requires a comprehensive evidence-base to help determine what works, what does not, how much it will cost. DCP3 will allow users to set global and national priorities for health in an informed manner."

It astounds the western world that such a highly industrialized nation as the Netherlands, with all the resources of modern medicine and technology, has a marked preference for home birth assisted by midwives. Van der Mark examines Dutch attitudes and practices surrounding birth from a sociohistorical point of view, explaining the importance of ideological consensus, the private nature of the Dutch family, the high regard for comfort and well being, and the professional development of midwives as trained and licensed practitioners. This volume will be welcomed by those convinced of the value of low-intervention home birth, but it will also be of interest to practitioners who must rely on technological procedures to manage the birth process. Since the Dutch hold one of the world records of pregnancy outcome statistics, readers will be interested in the Dutch midwifery model described here by various contributors.

Jane Dwinell has written an important book using real-life scenarios to illustrate her unique philosophy of childbirth, one that can only inspire women to take greater control over how and where they give birth. From her vantage point as a birth attendant, Dwinell recounts the moving birth experiences of twenty different women. Thus the reader learns that there are no right or wrong ways to give birth. In fact, the author shows how satisfying it can be for women to exercise their own strength, power and choice in the birth process instead of yielding to unnecessary technological and medical interventions. Birth, she says, is a process of wellness, not illness. Hence, most women don't need medication to help them deal with normal birth pains if they have the proper empowering support during labor.

When women give birth in a comfortable setting of their choice, the medical wrongs against them, committed in hospitals in the name of safety and technology, are prevented. In the face of opposition from an entrenched segment of the medical establishment, Dwinell dares the view that hospital care should not be routine but should be given only with good reason and the women's permission. For pregnant women and their partners, "Birth StorieS" makes a convincing argument that under normal circumstances wach women's intuitive knowledge and individual resources can help her to labor and deliver successfully in her own way. Nurses, midwives, doctors, and birth educators will find it useful to realize that there are many ways to give birth . . . that it is important for the family to be together and make their own choices . . . and that pregnant women can have safe births without excessive medical intervention. This book can also serve as a guide for professionals who want to develop this type of birthing model within their own institution.

The Guest Editors have created a comprehensive issue devoted to the most current and clinically relevant approach to hysterectomies and their alternatives. Top experts have written articles on the following topics: Alternatives to Hysterectomy: Management of Uterine Fibroids; Alternatives to Hysterectomy: Management of Menorrhagia; Hysterectomy for benign conditions of the uterus: Total Abdominal Hysterectomy; Hysterectomy for benign conditions of the uterus: Total Vaginal Hysterectomy; Hysterectomy for benign conditions of the uterus: Total Laparoscopic Hysterectomy/Laparoscopically Assisted Vaginal Hysterectomy; Hysterectomy for benign conditions of the uterus: Radical Hysterectomy Evidence basis for hysterectomy; Cesarean Hysterectomy; Management of ovaries at the time of benign Hysterectomy; Management of the peri- and postoperative patient undergoing hysterectomy; and Simulation and surgical competency: Current issues.

Pelvic Organ Prolapse, or POP, is a little talked about female health issue that half of all childbearing women will experience late in life. There are more than 300,000 surgeries for POP annually. Due to various causes such as menopause, estrogen loss, genetics, childbirth or heavy lifting, a woman's pelvic organs can shift or drop. This can lead to POP symptoms, including some painful and embarrassing ones, as well as impacting a woman s sexuality. The condition has probably always existed, but has received little press or public acknowledgement so women could learn about the condition and treatment options. This book on POP fills an unfortunate void in women s health awareness. Sherrie Palm writes about her own personal experiences in Pelvic Organ Prolapse: The Silent Epidemic. She had never heard about the condition until she needed surgery for it. Palm explores the subject from all angles, providing the information women need to recognize the symptoms of POP and to become advocates for their own health. Pelvic Organ Prolapse: The Silent Epidemic named the winner for Women's Health in the USA Book News National BEST BOOKS 2009 Awards. http: //www.usabooknews.com/2009bestbooksawards.html More information about Sherrie Palm, and how she is creating awareness for this women's health issue can be found on her website: http: //sherriepalm.com/home About the Author: First-time author Sherrie Palm is a retired business owner. She lives in Wisconsin with her significant other; she has four children and seven grandchildren. Palm plans to conduct educational seminars on POP. She is also actively involved with the local Special Olympics and will donate a portion of the book s proceeds to the group.

Gynecologic malignancies, especially endometrial and ovarian cancers are among the most important and most severely affected by obesity. This volume of Energy Balance and Cancer, written by the world's leading experts in this field, is arranged to provide a transdisciplinary assessment of the pertinent issues, results of relevant research on mechanisms, and control, strategies for dealing with affected patients and improving outcomes and future research needs. The volume comprehensively covers the epidemiology linking obesity to endometrial and ovarian cancer as well as the public awareness of this critical problem. Subsequent chapters explain biologic aspects of linkages between energy balance and gynecologic malignancies. The volume further outlines strategies to disrupt the linkage between obesity and gynecologic malignancies and concludes with a series of chapters focused on management strategies for obese patients with gynecologic malignancies. This volume provides a valuable resource for all physicians, scientists and other transdisciplinary investigators and practitioners interested and involved in energy balance and cancer. It should be a particularly useful guide to optimize outcomes for all practitioners dealing with patients with gynecologic malignancies challenged by energy balance issues. Moreover, it should serve as a useful guide to students and investigators interested in conducting further research on defining and disrupting the important linkage between energy balance and gynecologic malignancies.

Obstetrician Gynecologists are frequently responsible for management of the primary care needs of their patients. A survey performed in 2005 found an estimated 37% of, non-pregnant patients, relies on gynecologists for routine primary care. The same study found that almost a quarter of gynecologists reported they needed additional primary care training across a broad set of medical topics (Acad Med. 2007; 82:602-607). The impetus for training in primary care skills is increasing. In response to language in the Affordable Care Act, the Institute of Medicine developed a report on clinical preventative services necessary for women (Clinical Preventative Services for Women: Closing the Gaps IOM. 2011; also Current Opinion in Obstetrics and Gynecology 2011, 23:471-480). The US Department of Health and Human services has adopted these IOM recommendations and, as a result, health plans are required to include these services. While initiatives such as the American Congress of Obstetricians and Gynecologists' Well-Woman Task Force and recent cross-specialty ACOG educational collaborations have begun to address supplemental educational needs, additional resources covering key primary care topics are necessary. This issue of Obstetrics and Gynecology Clinics is an ideal means for accomplishing this important goal.

There are more than 63,000 new cases of uterine and endometrial cancer each year in the United States, up from approximately 41,000 when the first edition of Uterine Cancer was published in 2009. A book focusing on these cancers was timely, with emergent sophistication in diagnosis increasingly impacting clinical decision-making. However, five years later, the need for an updated book on this topic is even stronger as oncologists recognize opportunities to impact the outcome on women that are increasingly diagnosed with these malignancies. Uterine Cancer: Screening, Diagnosis, and Treatment, Second Edition, part of the Current Clinical Oncology series, enhances the awareness on this somewhat neglected area of therapeutics, helping to integrate targeted therapies into the management of women with uterine cancer. Written by experts in the field in a highly practical and comprehensive manner, it is a must-have for all gynecological residents and fellows, as well as gynecological oncologists, medical oncologists, radiation oncologists, and family practice doctors who wish to provide their patients with the best possible care.

Dr. Iglesia has created an issue devoted to pelvic floor disorders that has a strong focus on the evidence behind current treatments and diagnostic methods. The authors are top experts in their areas and have contributed reviews on the most important topics in pelvic floor disorders, including Stress Urinary Incontinence; Urge Urinary Incontinence; Pelvic Organ Prolapse Native Tissue repairs; Pelvic Organ Prolapse Vaginal and Laparoscopic Mesh; Fecal Incontinence; PFDR Pelvic Floor Disorders Registry; Ultrasound Imaging of the Pelvic Floor; and Childbirth/Pelvic Floor Epidemiology to name a few.

In recent years a lot of emphasis has been placed on obtaining consent for surgical and medical procedures to avoid litigation. This has become an integral part of clinical risk management and clinical governance. Problems relating to consent are the reason for a great proportion of medico-legal claims. Adequate, informed consent and better record keeping will avoid a lot of complaints and litigation. This book aims to help to understand the types of consent , how to obtain consent, and its medico-legal implications when things go wrong. It is designed to help in obtaining consent for common procedures undertaken in obstetrics and gynaecology. It is intended not only for doctors, but also for midwives, nursing staff, medical students and allied health professionals. And it is also particularly relevant for overseas doctors who are new and generally less familiar with the risk management, clinical governance and litigation system in the UK. Another use of this book is to provide an invaluable on the spot reference for various operations and their complications, ways and means of minimising risk, and dealing with difficult situations. The speciality of obstetrics and gynaecology is sued more frequently than any other. This book should help all those who are involved in the ob/gyn department to minimise the risk and danger of incurring such action.

Presenting the most current and relevant information on the diagnosis and management of primary ovarian insufficiency, also known as premature ovarian failure (POI/POF), this book presents two equally important voices. The first is the scientific, evidence-based voice discussing the latest information on POI/POF in a concise and logical fashion: etiologies, symptoms, genetics, mechanisms, associated conditions, as well as psychological and lifestyle considerations. The second voice presents the first-person stories of affected women, who are often faced with a diagnosis of irreversible infertility at a very young age and who somehow learn to live with great uncertainty about their ability to create a family - a core identity issue for many women. It is thus not simply a clinical, case-based presentation, but a more collaborative effort between clinicians who are well-versed in the field and women who have POI/POF. Primary Ovarian Insufficiency: A Clinical Guide to Early Menopause will therefore be an excellent practical yet personal reference for OB/GYNs, reproductive medicine specialists, and any clinician, nurse or health care worker treating women living with POI/POF.

Given that millions of women have entered menopause each year since the dawn of time, it's bizarre that it still feels like uncharted territory for the women who are going through it. Dr. Heather Hirsch is committed to changing that. Unlock Your Menopause Type helps women cut through the informational noise and learn how to manage their symptoms most effectively by identifying their personal Menopause Type(s). This is not a one-size fits all solution. Unlock Your Menopause Type features a helpful quiz to identify women's individual Menopause Type(s) such as: -Premature -Sudden -Full-Throttle -Mind-Altering -Seemingly Never-ending -Silent Each type gets a full prescription for exercises, diet and strategies to regain mental focus and make menopause a routine part of maturity rather than a rollercoaster ride of unexpected symptoms and discomfort. The book also includes: -The last word on whether to replace declining hormones -What to do if you're a combination of types -How to get on top of (as it were) changes in your sex life -Crowd-sourced tips and tricks from Dr Hirsch's friend group and patients Dr Hirsch addresses the physical and emotional challenges of menopause and provides solutions from her years of practice. With knowledge, priorities and a plan, you can feel great through midlife and beyond.

The discipline of obstetrics and gynaecology, which dates back many centuries, is unique in that care is extended to every stage in a woman's life. More recently there have been significant scientific advancements and technological inventions that have transformed the health and care of women. Essential Gynaecology aims to deliver core knowledge aligned with clinical application for the treatment of relevant gynaecological conditions. Essential Gynaecology is written by various specialists from South African obstetrics and gynaecology departments. Each chapter is written with dedication and has been carefully selected to fulfil curriculum requirements. Topics covered include gynaecological history and examination, contraception, abnormal uterine bleeding, gynaecological infections, benign and malignant gynaecological conditions, infertility, female urinary incontinence and pelvic organ prolapse, menopause, sexual violence against females and termination of pregnancy. In addition to covering basic content, the text also includes colour photos and multiple choice questions for self-assessment. Essential Gynaecology offers fundamental information for the MBChB programme in gynaecology and responds to a need for a defined focus area. It is recommended for medical students, medical officers, associate clinicians, interns, medical practitioners and OB-GYN registrars.