Index

Page numbers in italic refer to fi gures. Page numbers in bold refer to tables.

ABC approach, obstetric emergencies, 163 adolescence, see also puberty Alzheimer’s disease, HRT and, 451 abdomen acne vulgaris, 365–366 amenorrhoea circumference, fetus, 118 diabetes mellitus, 323 breastfeeding, 158 examination of neonate, 181 epilepsies, 284 ectopic pregnancy, 402 pain, children, 349 psychology, 268–269 menopause, 449 abdominal hysterectomy, 445–446 adrenal cortex, 327 amino acids, disorders of metabolism, abdominal wall, 25–26 androgens from, 264, 265 329–330 fetal anomalies, 73, 387 insuffi ciency, 327–328 aminophylline, 337 abnormal labour, 146–154 adrenal crisis, 327–328 amniocentesis, 75–76 abnormalities see congenital abnormalities; adrenal gland, 327–328 amniotic cavity, 40, 41 fetal anomalies adrenaline amniotic fl uid embolism, 169–170 abortion see termination of pregnancy croup, 334–335 amniotic fl uid index, 119 Abortion Act 1967, 429 neonatal resuscitation, 179 amniotic fl uid volume, 119 abruptio placentae, 112–113, 115–116 urticaria, 366 amniotomy abscess adrenarche, exaggerated premature, abruptio placentae, 113 breast, 159 266–267 induction of labour, 152 peritonsillar, 334 adrenocorticotrophin (ACTH), 21, 320 amoxicillin, 422 absence seizures, 283 Synacthen test, 327 rashes, 334 abuse (of child), 271–277 adult stem cells, 45 Amsel’s criteria, bacterial vaginosis, 421 accelerations, fetal heart rate, 119 aerobic vaginosis, 422 Amsler grid, 130–131, 131 accessory pathways, supraventricular tachy- afterload, 309 anaemia cardia, 316 afterpains, 156 children, 300–303 accidental haemorrhage, 112–113, 115–116 aganglionic segment, Hirschsprung’s dis- chronic renal failure, 361 acetazolamide, 133 ease, 387 Crohn’s disease, 346 achondroplasia, 10–11, 383 age fetus, 80, 92, 93, 200 aciclovir fertility and, 8, 410, 412, 413, 418 measles, 80 herpes simplex, 80 at menarche, 264 parvovirus, 200 varicella zoster, 81 pregnancy, 67 rhesus disease, 92 acid refl ux see gastroesophageal refl ux age-related macular degeneration, embry- multiple pregnancies, 42, 106 disease onic stem cells and, 45 parvovirus, 295 acidosis, neonates, 176 air bronchograms, 191 anaesthetic agents, subfertility, 413 acne vulgaris, 365–366 air enema, 388 anal canal neonates, 370 airway, neonate, 177–178 embryology, 53 acrocyanosis, 177 alanine transaminase, levels in pregnancy, fi s t u l a , 1 5 6 acrodermatitis enteropathica, 352 88 analgesia acrosome reaction, 33 alarm symptoms, chronic abdominal pain, endometriosis, 425–426 activated partial thromboplastin time, 349 headaches, 281 pregnancy, 88 albinism, 329 labour, 144, 145 active management of labour, 142 COPYRIGHTEDalbumin, levels in pregnancy, MATERIAL 88 postnatal, 156 active phase, fi rst stage of labour, 140 alcohol, subfertility, 413 puerperal sepsis, 160 acute arthritis-dermatitis syndrome, 422 alkaline phosphatase, 375 anaphase, 5 acute B-lymphoblastic leukaemia, 47 levels in pregnancy, 88 anaphase I, meiosis, 6 acute laryngotracheobronchitis see croup alleles, 4, 6, 251, 253 anaphase II, meiosis, 7 acute lymphoblastic leukaemia, allergic contact dermatitis, 365 anaphylactoid reaction, amniotic fl uid em- 305, 306 allergy, cow’s milk protein, 342, 344–345 bolism, 170 acute osteomyelitis, 380 allodynia, 377 Andersen disease, 330 acute renal failure, 359–361 alopecia areata, 371–372 androgenic anabolic steroids, subfertility, acute sickle cell crisis, 302 tinea capitis vs, 369 413 acyl-CoA dehydrogenase enzyme complex, alosiban, 151 androgens, 265 defi ciencies, 330–331 alpha-fetoprotein, 73 combined oral contraceptives, 435 add-back HRT, 426 alpha-methyldopa, pregnancy, 86 excess, 414 adenomyosis, 424 alpha thalassaemia, 302–303 puberty, 264 adherent placenta, 111–112 ALSO®, 163 android pelvis, 14 adhesions, tubal obstruction, 415 alveoli, lungs, 55–56 androstenedione, 264 456 / Index anembryonic pregnancy, 400 antibodies, see also antiphospholipid arterial blood gases, pulmonary embolism, anencephaly, 54 syndrome 168 screening, 73 coeliac disease, 344 arterial switch procedure, 315 aneuploidy, 252 maternal, 186–187 arteriolar spasm, retina, 130 obesity, 413 polyarticular arthritis, 378 arthritis screening, twin pregnancy, 105 systemic lupus erythematosus, 95 gonococcal infection, 422 Angelman syndrome, mutation, 254 viral infections, 99 juvenile idiopathic, 378–380, 383–384 angioedema, 366 antibody titres, rhesus disease, 93 paediatric, 378–380 angiotensin II, pregnancy, 62 anticipation (genetic), 254 parvovirus, 369 angiotensin converting enzyme inhibitors, anticoagulants, 167 septic, 381 pregnancy, 96 low molecular weight heparin (LMWH), arthritis mutilans, 379 angiotensin receptor blockers, pregnancy, 160, 167, 168 arthrogryposis, 383 96 pregnancy, Marfan syndrome, 96 artifi cial sphincter, 446 ankylosing spondylitis, 377 anticonvulsants see antiepileptic drugs; Asperger’s syndrome, 258–259 anomalies see congenital abnormalities; magnesium sulphate asphyxia, fetus fetal anomalies antidepressants cord entanglement, 105 anorexia nervosa, 268, 414 on ovulation, 415 diabetes mellitus, 91 anovulation, 414 postnatal, 157 aspiration pneumonitis, risk factors, 163 antenatal care, 64–70 antidiuretic hormone, 320 aspirin, 86, 102, 107 history-taking, 65–67, 99 defi ciency, 328 assisted vaginal delivery, 441–443, 447 intrauterine growth restriction syndrome of inappropriate secretion, 329 associations management, 120–121 antiemetics, 405 malformations, 251 surveillance, 118–120 antiepileptic drugs, 284 VACTERL, VATER, 386 antenatal screening, 71–81, 250 dystonia, 383 asthenozoospermia, 31 fetal anomalies, 72–76 pregnancy, 101 asthma, 333, 335–336, 337, 340, 393–394 infections, 76–77 antifungals, 420 astrocytomas, 306 postnatal review, 181 antihistamines, eczema, 364 retinal, 125–126 renal abnormalities, 356–357 antihypertensives, pregnancy, 86, 107 asylum-seekers, children, 272 antepartum haemorrhage, 110–111, 112– antinuclear antibodies (ANA), polyarticular asymmetric fetal growth restriction, 118 114, 115–116, 162 arthritis, 378 ataxia, 287 massive, 164–166, 171 antiphospholipid syndrome atomoxetine, 260 anterior abdominal wall, 25–26 miscarriage, 399, 402, 407 atonic seizures, 283 fetal anomalies, 73, 387 pregnancy, 96, 167 atony, uterus, 164, 171 anterior colporrhaphy, 446 antipsychotics, 100–101 atopic dermatitis, 364–365 anterior fontanelle, 382 on ovulation, 415 atopy, 335, 340 anterior horn cells, neuromuscular disor- antiretroviral treatment, children, 297 atresias, gastrointestinal tract, 73, 386 ders, 290 anus see anal canal atrial septal defect, 311–312 anthropoid pelvis, 14 anxiety, multiple pregnancy, 107 atrioventricular septal defect, 312 anti-cardiolipin antibody, 96 aorta atrophy anti-D immunoglobulin, 93, 111, coarctation, 313 skin, 293 187, 400 embryology, 55 villous, 344 postnatal, 156 transposition of the great arteries, 314 attention defi cit hyperactivity disorder, termination of pregnancy, 430 aortic arch, interruption, 313 259–261 antibiotics aortic fl ow murmur, 317 attitude (fetus), defi ned, 140 acne vulgaris, 366 aortic root, Marfan syndrome, 96 audit, antenatal screening, 74 bacterial tonsillitis, 334 aortic stenosis, 313 aura, migraine, 279, 280 impetigo, 367 aortic valve, tetralogy of Fallot, 314 auscultation mastitis, 159 Apgar scores, 177 labour, 142 nephrotic syndrome, 359 aplastic crisis, parvovirus, 295 paediatric examination, 210 osteomyelitis, 380 apnoea pregnancy, 68 pelvic infl ammatory disease, perinatal hypoxia, 176–177 autism spectrum disorder, 256, 258–259, 422–423 of prematurity, 191 262 pneumonia, 338 apparent placental migration, 111 autoimmune diseases puerperal sepsis, 160 appendicitis, 388 connective tissue disorders, 95–96 sepsis, 201 Apt test, 114 hypothyroidism, 325 for surgery, 311 array comparative genomic hybridisation, premature ovarian failure, 449 syphilis, 199 254 autosomal dominant inheritance, 253 termination of pregnancy, 432 arrest of labour, 149–150 autosomal dominant polycystic kidney dis- urinary tract infections, 354–355 arrhythmias, 316 ease, 357 Index / 457 autosomal recessive inheritance, 254 birth trauma, 182–183 bottle feeding, 185, 186 autosomal recessive polycystic kidney dis- diabetes mellitus, 91 bow legs, 375 ease, 357 birthweight, 187, 214–215 brachial plexus injury, 168, 182 avascular necrosis, femoral head, 376 bisacromial diameter, 141 bradycardia, uterine inversion, 170 axillary murmurs, 210 Bishop score, 152 brain, see also central nervous system azathioprine, 96 bisphosphonates, 452 adolescence, 269 azithromycin bites, 273, 274 HRT on, 450, 451 sexually transmitted diseases, 421, 422 bladder, 16 paediatrics, 278–287 termination of pregnancy, 432 bladder care, postnatal, 156 tumours, 306, see also space-occupying azoospermia, obstructive, 417 Blakemore, Sarah-Jayne, TED talk, 269 lesions Blalock–Taussig shunt, 314 brain-sparing eff ect, 118 B-lymphoblastic leukaemia, acute, 47 blastocoele, 39 branch pulmonary artery stenosis, 317 B-Lynch suture, 166 blastocyst, 39, 40, 52 Brandt–Andrews method, 142 baby blues, 157 blastomeres, 39 Braxton Hicks contractions, 60 back pain, 97, 377–378 bleeding, see also haemorrhage breast milk, 158 bacteria, urine cultures, 354 combined oral contraceptives, 435 ejection, 158–159 bacterial meningitis, 295–296 early pregnancy, 399–401, 407 preterm infant, 192 bacterial tonsillitis, 334 ectopic pregnancy, 402–403 stasis, 159 bacterial tracheitis, 335 gastrointestinal tract, 349–350 breastfeeding, 157–159, 185, 188 bacterial vaginosis, 420–421 HRT, 450 anticoagulants, 167 bacteriuria, 77 at implantation, 40–41 antidepressants, 157 balanced translocation, 253 Nexplanon®, 437 antipsychotics, 101 balanitis xerotica et obliterans, 389 bleeding disorders, 303–305 benzodiazepines, 100 banding, pulmonary artery, 310 blindness cow’s milk protein allergy, 345 barium enema, intussusception, 388 hypertension, 358 hypertension, 87 Barlow test, 181, 182 pre-eclampsia, 130 lamotrigine, 101 barrier methods, contraception, 434–435 vitamin A defi ciency, 352 lithium, 100, 157 baseline fetal heart rate, 119 blisters, staphylococcal scalded skin syn- breasts, see also isolated premature Bazett’s formula, 316 drome, 367 thelarche beclometasone, 340 blood fl ow Million Women study, 451 beginning of life, ethics, 46 pregnancy, 61 breath-holding attacks, 282 Beighton score, hypermobility, 376 pulmonary, patent ductus arteriosus, 318 breech presentation, 148 Bell’s staging, necrotising enterocolitis, 193 blood group testing, rhesus disease, 92–93 forceps for delivery, 442 benign epilepsy with centrotemporal spikes, blood loss, delivery, 142 preterm delivery, 151 283 blood pressure second twin, 171 benign intracranial hypertension, 133 children, 361 Bristol stool chart, 348 benign paroxysmal vertigo, 282 maternal collapse, 163 British Th oracic Society, guidelines on benign prostatic hypertrophy, 29 pregnancy, 61, 83–88, 107 asthma, 336 benzodiazepines, 100 abruptio placentae, 112, 115 brittle bone disease, 383 beta-blockers, hyperthyroidism, 325 measurement, 85 broad ligament, 18 beta-HCG, 398 blood supply bromocriptine, 415 beta thalassaemia, 303 gastrointestinal tract, 53 bronchiolitis, 337–338 β 2-agonists, 337 ovaries, 19 respiratory syncytial virus, prevention, betamethasone vagina, 17 194 pre-eclampsia, 87 blood transfusions, 164–165, 171, see also bronchodilators, 337 preterm labour, 151 exchange transfusions bronchopulmonary dysplasia, 192 bilaminar disc, 40 Bochdalek hernia, 387 brow presentation, 148 bilateral renal agenesis, 356 body mass index, 320 Browne’s classifi cation, placenta praevia, bilirubin, 186 subfertility, 413 110 levels in pregnancy, 88 body surface area, children, 392 Brudzinski sign, 296 neonates, 186 bone, 375, see also osteogenesis imperfecta bruising diabetes mellitus, 91 HRT, 451 children, 272–273 bimanual compression, uterus, 166 alternatives, 452 neonates, 182 biopsy infections, 380–381 buccal route, drugs, 392 glomerulonephritis, 358 injection contraception and, 436 bulbourethral glands, 29 Hirschsprung’s disease, 349 tumours, 380 bullae, see also epidermolysis bullosa nephrotic syndrome, 360 bone marrow skin, 293, 364 biparietal diameter, neonate, 382 acute lymphoblastic leukaemia, 305 bupivacaine, 144 Bird-modifi cation ventouse cups, 442 drugs via, 392 burns, 273–274 458 / Index cabergoline, 415 paediatric examination, 210 termination of pregnancy, 431 caesarean section, 443–444 postnatal, 156 complications, 431 adherent placenta, 112 carnitine, transport defect, 330–331 Trichomonas vaginalis, 422 diabetes mellitus, 91 carpal tunnel syndrome, pregnancy, 97 CFTR protein, 339 eclampsia, 87 carriers, recessively-inherited chancre, 77 incisions, 60, 443–444 disorders, 254 Charcot–Marie–Tooth disease, 253 multiple pregnancy, 106, 170 Case Conferences, child abuse, 276 CHARGE syndrome, 251 perimortem, 163 cataract, 123, 124, 181 chest placenta praevia, 111 catecholamines, ventricular septal defect, infections see pneumonia postoperative care, 156 309 paediatric examination, 211 pre-eclampsia, 87, 101 catheters (urinary), 107 chest compressions, neonatal resuscitation, thromboembolism, 106 cavernous haemangiomas, 371 178–179 vasa praevia, 113–114 cavernous sinus, Sheehan syndrome, 132 chest X-rays caff eine, 191 ceftriaxone, 422 aortic stenosis, 313 calcium cell cycle, 5–6 bronchopulmonary dysplasia, 192 homeostasis, 325–326 cells, 4–10 coarctation of the aorta, 313 supplementing, 326, 327 proliferation, 9 pneumonia, 338, 339 cancer, see also retinoblastoma cellulitis, 367 pulmonary embolism, 168 bone, 380 CEMACH report 2006–2008 pulmonary plethora, 310 cervix, antepartum haemorrhage, 114 psychiatric disorders, 157 pulmonary stenosis, 313 children, 305–306 puerperal sepsis, 159, 160 respiratory distress syndrome, 191 embryonic stem cells and, 45 pulmonary embolism, 160 tetralogy of Fallot, 314 gestational trophoblastic neoplasia, Centers for Disease Control and Preven- transposition of the great arteries, 315 405–406 tion, on pelvic infl ammatory dis- chickenpox, 294–295, see also varicella HRT on, 451 ease, 423 zoster testes, 27 centiles, 216, 350 incubation period, 293 vaginal discharge, 423 central cyanosis, 313 chignon, 443 candidiasis, 370 central nervous system, 278–291, see also child abuse, 271–277 irritant contact dermatitis vs, 365 brain child disability teams, 258 vulvovaginal, 420 fetal anomalies, 73 Child in Need, 276 capacitation, spermatozoa, 33 paediatric examination, 211, 244 child protection, 272 capillary refi ll time, 210 central precocious puberty, 267 childbirth see delivery caps (contraceptive), 434–435 central retinal vein occlusion, 131 childhood absence epilepsy, 283 caput succedaneum, 182 central serous retinopathy, 130–131 childhood phase, growth, 215 defi ned, 140 centrioles, 5, 6 Children’s Act 2008, 272 carb counting, 322 centromeres, 5 chin support, neonatal resuscitation, 178 carbamazepine, 101 cephalohaematoma, 182, 183 Chlamydia trachomatis, 421–422 carbimazole, 325 cerclage, cervix, 402 eye, 202 carbohydrates, disorders of metabolism, cerebral haemorrhage, 193 gonococcal infection vs, 422 330 cerebral oedema, pre-eclampsia, 130 pelvic infl ammatory disease, 415 carbon dioxide, pregnancy, 61 cerebral palsy, 245, 285–287 chloasma, 130 carboprost, 166 cerebrospinal fl uid chloride channel, cystic fi brosis, 339 cardiac arrest, uterine inversion, 170 hydrocephalus, 290 chocolate cyst, 424 cardiac catheterisation, 310 intraventricular haemorrhage, 193 cholestasis, obstetric, 99 transposition of the great arteries, 315 meningitis, 296 chordee, 389 cardiac output, pregnancy, 163 cervix, 18 choriocarcinoma, 406 cardiac surgery, children, 310 abnormal labour, 147–148 chorion, 41 cardiomyopathy, peripartum, 160 causes of antepartum chorionic villous sampling, 76 cardiopulmonary resuscitation, 163 haemorrhage, 114 chorionicity, 104–105 neonates, 175–180 Chlamydia trachomatis, 421 chorioretinal scar, 202 cardiotocography, 101, 108, 119–120 excitation, 403 chromosomes, 4, see also karyotyping; sex abruptio placentae, 112, 116 incompetence, 402 chromosomes labour, 142 labour, 140, 142 disorders, 252–253 prolonged pregnancy, 115 dilatation rates, 149 hypergonadotrophic hypogonadism, reduced fetal movements, 114 preterm, 152 414–415 cardiovascular system mucus, 420 miscarriage, 399, 402 embryology, 54–55 natural family planning, 434 screening, 74, 250 fetal anomalies, 73 pregnancy, 60 chronic abdominal pain, 349 HRT on, 451 ripening, 152 chronic granulomatous disease, 297 Index / 459 chronic nephritis, defi ned,84 comorbidities after molar pregnancy, 406 chronic non-specifi c diarrhoea of child- attention defi cit hyperactivity disorder, pregnancy, 66 hood, 348 260 contractions (labour), 142 chronic osteomyelitis, 381 autism spectrum disorder, 259 abnormalities, 149 chronic renal failure, 361 developmental coordination disorder, 261 hypertonic, 152 circumcision, 389 learning disability, 257 measurement, 148 citalopram, 100 obesity, 320–321 contractions (Braxton Hicks), 60 clamping, umbilical cord, 142 complete miscarriage, 400 controlled traction, umbilical cord, 142 classical incision, caesarean section, 444 complex regional pain syndrome, 377 convulsions see seizures clavicle, fractures, 182–183 computed tomography copper, disorders of metabolism, 331 cleavage, 39, 398 epilepsies, 284 copper coils, contraceptive, 437, 438 clinical genetics, 250–251 pulmonary angiography, 168 cord entanglement, 105, 106 clitoris, 19–20 concealed haemorrhage, abruptio placentae, cord prolapse, 169 virilisation, 327, 332 112, 113, 115 Cori disease, 330 cloaca, 53 condoms, 434 cornea, pregnancy, 130 clomifene, 42, 414 condylomata lata, 199 coronary vascular disease, HRT on, 451 clonic seizures, 283 congenital abnormalities, 72–76, 249–255 corpora cavernosa, 29 cloning, 46 abdominal wall, 387 corpus albicans, 36 closed comedones, 365 minor, 182 corpus luteum, 22, 35, 36 clotrimazole, 420 termination of pregnancy, 429–430 corrected QT interval, 316 clozapine, 101 twin pregnancy, 105 cortical bone, 375 breastfeeding and, 157 uterus, 66, 402, 416–417 cortical cerebral oedema, pre-eclampsia, club foot, 382 congenital adrenal hyperplasia, 181, 130 clubbing, 210 327–328, 331–332 corticosteroids see steroids coagulation system, 303 congenital complete heart block, 316 corticotrophin-releasing hormone, 320 inherited disorders, 304–305 congenital cystic adenomatoid malforma- cortisol, Cushing’s syndrome, 328 pregnancy, 61 tion, 73 cough, croup, 334 coagulopathy, abruptio placentae, congenital diaphragmatic hernia, 71, 73, courses 112–113 81, 387 Newborn Life Support, 176 coarctation of the aorta, 313 congenital hypothyroidism, 324–325 training for emergencies, 163 coast of Maine appearance, 327 congenital infection, 197–199 Couvelaire uterus, 113 Coats disease, 124–125 congenital muscular dystrophy, 289 Cowper’s glands, 29 cobalamin see vitamin B12 congenital myopathies, 289 cow’s milk, 186 Cobb angle, 377, 378 congenital nephrotic syndrome, 359 iron defi ciency, 300 cocaine, subfertility, 413 congenital varicella syndrome, 200 protein allergy, 342, 344–345 coccygeus muscle, 16 conjoined twins, 42, 105 cradle cap, 370 coeliac disease, 344 conjugated equine oestrogen, Women’s cranial diabetes insipidus, 328 coelom, extra-embryonic, 41 Health Initiative, 450–451 cranial nerves coils, contraceptive, 437–438 conjugation, bilirubin, 186 paediatric examination, 211 COL3A1 gene, 97 conjunctivitis, 202 Sheehan syndrome, 132 cold, common, 334 connective tissue disorders, pregnancy, 95–97 cranial sutures, 216, 382 cold sores, 294 conotruncal septum, 55 craniosynostosis, 382 colectomy, infl ammatory bowel disease, conscientious objection, termination of craniotabes, 326 346 pregnancy, 429 crawling, gross motor development, 220 collagens, Ehlers–Danlos syndrome, 97 consent, operative vaginal delivery, 441 creams collapse, maternal, 163, 164 consonance, puberty, 264 eczema, 364 coloboma, 126, 251 constipation oestrogens, 452 colorectal cancer, HRT on, 451 children, 348–349 creatine kinase, 288, 289 colostrum, 159 pregnancy, 98 creatinine colporrhaphy, 446 constitutional delay of growth and puberty, levels in pregnancy, 88 colposuspension, 446 267–268 pregnancy, 91 combined oral contraceptives, 435–436, contact dermatitis, 365 cremasteric fascia, 26 438 continuous combined HRT, 450, 452 cri du chat syndrome, 252–253 for endometriosis, 425–426 continuous positive airway pressure, pre- Crohn’s disease, 345, 346, 352 after molar pregnancy, 406 term infant, 190 fi s t u l a , 4 2 3 combined test, trisomy 21, 74 contraceptives, 433–439, see also combined croup, 334–335, see also bacterial comedones, 365 oral contraceptives; intrauterine tracheitis common cold, 334 contraceptive devices cruising, gross motor development, 221 communicating hydrocephalus, 291 HRT and, 452 cryptorchidism, 30, 181, 389–390 460 / Index crystalline lens obesity, 67 diaphragms (contraceptive), 434–435 ectopia, 329 operative, 441–443, 447 diaphyses, 375 pregnancy, 130 pelvic shape, 14 diarrhoea, 345–348 cultures preterm, 151 ectopic pregnancy, 403 blood, osteomyelitis, 380 twin pregnancy, 106, 108 dichorionic twins, 104 urine, 354 previous history, 65 early delivery, 106 Cushing’s syndrome, 328 trauma, 164, 168, see also birth trauma selective termination of pregnancy, 105 cuts, neonates, 182 dementias, HRT and, 451 diet, see also nutrition cyanosis, 313–314 denominator, fetal position, 140 chronic renal failure, 361 coarctation of the aorta, 313 Depo-Provera, 436 coeliac disease, 344 neonates, 179 depression Crohn’s disease, 346 cyanotic heart lesions, 313–315 multiple pregnancy, 106 diabetes mellitus, 322 cyclical HRT, 450 postnatal, 106, 157, 161 glomerulonephritis, 358 cycling, gross motor development, 227 pregnancy, 100 diff erentiation, 10 cyclizine, 405 dermatitis, 364–365 DiGeorge syndrome, 313 cystic fi brosis, 339 dermatology see skin 1,25-dihydroxyvitamin D3, 325 glomerular fi ltration rate, 393 dermatomes, 56 dilatation of cervix, labour, 140 mutations, 251 dermatomyositis, 289 dimercaptosuccinic acid scan, urinary tract cystic hygromas, 72 Dermovate®, 364 infections, 355 cystic renal disease, 357 desaturations, oxygen, 191 dinoprostone, 152 cystothionine synthase defi ciency, 329 desmopressin, for von Willebrand’s disease, diploidy, 4, 6, 34 cystourethrocele, 17, 446 305 diplopia, idiopathic intracranial hyperten- cysts desogestrel, 436 sion, 133 ovaries, pregnancy, 65 developing countries, termination of preg- dipstick tests, urinary tract infections, 354 skin, 293, 364 nancy, 430 disability, defi ned,245 cytokinesis, 6, 7 development, 216–240 discharge from hospital, preterm infant, 194 cytomegalovirus (CMV), 78, 80, 197–198 assessment, 242–244 discriminatory zone, HCG, 398 cytotoxic drugs, pregnancy and, 96 central nervous system, disorders, 256–262 dislocatable DDH, 381 cytotrophoblast, 40, 41 delay, 241–248, 257 dislocated DDH, 381 lungs, 55 dislocations, hip, 180, 182 D-dimer, 167 placenta, 398 disorder, defi ned, 245 dangerous placenta praevia, 111 developmental coordination disorder, 261 disordered development, 242 dartos fascia, 26 developmental dysplasia of hip, 180, 381 disproportion, feto-pelvic, 147, 149, 150 dating scans, 67 dexamethasone disseminated intravascular coagulopathy, prolonged pregnancy, 115 fetal growth restriction, 121 113, 131, 164 twin pregnancy, 105 pre-eclampsia, 87 distribution of drugs, 392 daydreaming, 282 preterm labour, 151 divers, patent foramen ovale, 311 DDAVP, for von Willebrand’s disease, 305 dextrose diving refl ex, 176 decelerations, fetal heart rate, 119–120 neonatal resuscitation, 179 dizygotic twins, 41, 42, 104, 105 decidua basalis, 398 Wernicke’s encephalopathy, 405 fetal anomalies, 105 decidual cast, 403 diabetes insipidus, 328 DMPK gene, 289 decidualisation, 39–40, 398 diabetes mellitus DMSA scan, urinary tract infections, 355 decompression sickness, patent foramen children, 321–323 DNA, polymerase chain reaction, 255 ovale, 311 ketoacidosis, 321, 322–323 DNA screening, fetus, 74 deep vein thrombosis, 166–167, 168 fl uid replacement, 393 documentation, child abuse, 276 dehydration maternal, 187 dominant inheritance fl uid defi cit, 393 multiple pregnancy, 106 autosomal, 253 gastroenteritis, 347 pregnancy, 89–92, 93, see also gestational X-linked, 254 dehydroepiandrosterone sulphate, 60, 264 diabetes donation, oocytes, 415 delayed development, 241–248, 257 retinopathy, 131, 132 dopamine, 320 delayed puberty, 267–268 prevention of complications, 323 dopamine antagonists, 100–101 deletions (mutations), 251, 252–253 diagonal conjugate, pelvis, 15, 147 Doppler ultrasound, fetal growth restric- mitochondrial DNA, 254 dialysis tion, 118–119, 121 delivery, 141, 142 acute renal failure, 360 doses (drug doses), paediatric, 392 abruptio placentae, 113 chronic renal failure, 361 double decidual sign, 400 diabetes mellitus, 91 dialysis cystic kidney, 357 double set-up, placenta praevia, 111 hypertension, 83, 87 diaphragm Down syndrome, 249, 252, 255, 257 infections, 76 embryology, 53 age of mother, 412 multiple pregnancy, 106 hernia, congenital, 71, 73, 81, 387 screening, 74–75 Index / 461 doxycycline Eisenmenger’s syndrome, 310 endomysial antibody, 344 Chlamydia trachomatis, 421 ejaculation, 30 endophytic retinoblastoma, 123 termination of pregnancy, 432 ejaculatory duct, 28 endotracheal intubation drug doses, paediatric, 392 ejection murmurs, 317 neonatal resuscitation, 178 dry eye syndrome, 130 elastin, Marfan syndrome, 96 preterm infant, 191 Duchenne muscular dystrophy, 288–289 electrocardiography energy, pregnancy, 62 ductus arteriosus, 55, 308, see also patent atrial septal defect, 312 engagement, fetal head, 68, 69, 140 ductus arteriosus atrioventricular septal defect, 312 enteral feeds, preterm infant, 192 ductus deferens, 28 congenital complete heart block, 316 entero-hepatic circulation, 186 dumping syndrome, 348 hypocalcaemia, 326 enterocele, repair, 446 duodenum, embryology, 53 long QT syndrome, 316 enterocolitis duplex kidneys, 356 pulmonary embolism, 168 Hirschsprung’s disease, 387 duplications, chromosomes, 253 pulmonary stenosis, 313 necrotising, 160, 192–193 dyad of impairment, 258 supraventricular tachycardia, 316 enteroviruses, incubation period, 293 dye test, tubal patency, 416 ventricular septal defect, 310 enthesis-related arthritis, 379 dysfunctional labour, 146–154 electroencephalography, 284 Entonox®, 144 dyshidrotic dermatitis, 365 electromyography, 288 enzymes, mutations, 329 dyshormonogenesis, hypothyroidism, 324 ellaOne®, 438 epiblast, 40, 52 dyskinetic cerebral palsy, 287 embolisation (therapeutic) epidermolysis bullosa, 372 dysmorphology, 251 caesarean section, 111 epididymis, 26 dyspnoea uterine artery, 166 epidural anaesthesia, 144, 149 children, 334 embryoblast, 39, 40 epiglottitis, 335 pregnancy, 61 embryology, 51–58, 398 epilepsies, 281–285, see also antiepileptic truncus arteriosus, 316 male reproductive system, 29–30 drugs dystocia, 146–154 testes, 26–27, 57 defi ned,245 dystonia, antiepileptic drugs, 383 zygote to blastocyst, 38–42 misdiagnosis, 283–284 dysuria-frequency syndrome, 421 embryonic period, 398 risk after febrile seizures, 285 embryonic pole, 39 epilepsy syndromes, 282–283 ear, paediatric examination, 211 embryonic stem cells, 43–47 epiphyseal plates, 375 early decelerations, fetal heart rate, 119, 120 diff erentiation, 10 epiphyses, 375 early-onset sepsis, 159–160, 201–202 embryos, for research, 46 slipped, femoral head, 376 early pregnancy, 397–408 emergencies episiotomy, 441 Ebstein anomaly, lithium and, 100 law on termination of pregnancy, 429 forceps delivery, 442, 447 echocardiography obstetric, 162–171 Epstein–Barr virus, 295, 334 aortic stenosis, 313 teams, 163 Epstein’s pearls, 181 coarctation of the aorta, 313 emergency contraception, 438 Erb’s palsy, 168, 182 Marfan syndrome, 96 emission (semen), 30 erectile dysfunction, 30 pulmonary stenosis, 313 emotional abuse, 275–276 erection, 30 transposition of the great arteries, 315 empyema, 338–339 ergometrine, 144 ventricular septal defect, 310 enanthems, 368 hypertension and, 87 eclampsia, 83, 107–108 encephalitis, herpetic, 294 obstetric haemorrhage, 165, 171 defi ned,84 encephalopathy erosion, skin, 293 eye, 130, 131 HIV, 297 erythema infectiosum (parvovirus), 79, 80, management, 87 kernicterus, 91, 186 200, 295, 369 ectoderm, 52 Wernicke’s, 405 erythema multiforme, 372 ectopia lentis, 329 end-diastolic fl ow, umbilical artery, 119, erythema nodosum, 372 ectopic pregnancy, 33, 36–37, 401–404 121 erythema toxicum neonatorum, expectant management, 403 endocardial cushions, 312 181, 370 human chorionic gonadotrophin, 401, endocarditis, 310–311 erythroblastosis fetalis, 92, 93 403, 404 endocrinology, 320–329 erythrocytes see red blood cells ectopic testis, 389 endoderm, 52 erythroderma, psoriatic, 367 eczema, 364–365 endometrioma, 424 erythromycin, 422 education endometriosis, 418, 424–427 Escherichia coli, haemolytic-uraemic on diabetes mellitus, 322 surgery for, 426 syndrome, 361 special needs, 246–248, 258 tubal obstruction, 415, 416 essential hypertension Education Act 2002, 246, 247 endometrium defi ned,84 eff acement, defi ned, 140 cancer, HRT on, 451 pregnancy, 86 Ehlers–Danlos syndrome, 377 decidualisation, 39, 398 Essure®, 438 pregnancy, 97 menstrual cycle, 21–22, 35, 36 estimated fetal weight, 118 462 / Index ethics leucocoria, 122–128 feto-pelvic disproportion, 147, 149, 150 embryonic stem cells, 46 pregnancy, 129–135 fetus, see also fetal anomalies extreme preterm birth, 194 toxoplasmosis, 199 anaemia see fetus under anaemia genetics, 251 vitamin A defi ciency, 352 blood sampling, 120 termination of pregnancy, 429 eyewitnesses, fi ts, 281 diabetes mellitus, 91, 187 ethinyloestradiol, Turner syndrome, 269 growth, 214–215, see also intrauterine etonogestrel, 436–437 fabricated and induced illness, 274 growth restriction Eustachian valve, 308 face, examination of neonate, 181 haemorrhage, vasa praevia, 113, 114 evolution, vomiting in pregnancy, 404 face presentation, 148 heart see under heart exaggerated premature adrenarche, facial nerve palsy, 183 heart rate, 119–120 266–267 faeces, Bristol stool chart, 348 hypoxia, 176–177 examination failed induction of labour, 153 immunity, 62–63 antenatal care, 67–69 failure to progress (labour), 146–154 lithium, 100 neonates, 177, 180–183 Fallopian tubes, 18–19 palpation, 68–69 neurological, 211 Chlamydia trachomatis, 421 reduced movements, 114 paediatric, 208, 209–211 ectopic pregnancy, 36–37, 404 risks in multiple pregnancy, 105–106 placenta praevia, 111 obstruction, 19, 23, 415–416 sex determination, 57 postnatal care, 156 sterilisation, 438 size determination, 118 for safeguarding, 276 surgery for, 416 skull moulding, 140 sexual abuse, 274–275 false positives, preterm labour, 150 systemic lupus erythematosus, 95 vagina, labour, 142 faltering growth, 215, 350–352 tests of well-being, 118–120 exanthems, 368 familial exudative vitreoretinopathy, 126 toxoplasmosis, 133 exchange transfusions family history, 209 umbilical artery, 308, 309 haemolytic disease of the newborn, 187 family trees, 253 fever, juvenile idiopathic arthritis, 379 sickle cell disease, 302 fasting, hypoglycaemia, 323–324 FGFR3 gene, 10–11 excitation, cervix, 403 fatty acids, disorders of oxidation, 330–331 fi brillin-1, 96 excretion, drugs, 393 fava beans, 301 fi brinogen, 165 exercise, postnatal, 156 –157 FBN1 gene, 96 levels in pregnancy, 88 exomphalos, 73, 387 febrile seizures, 284–285 fi brinolytic system, 303 exophytic retinoblastoma, 123 feedback, hypothalamic-pituitary-gonadal fi broids, pregnancy, 65–66 expanded repeats (mutations), 251 axis, 411, 412 fi bronectin (fetal), 152, 190 expectant management feedback inhibitor of lactation, 159 fi fth disease (parvovirus),79 , 80, 200, 295, ectopic pregnancy, 403 feet, examination of neonate, 181 369 placenta praevia, 111 female condoms, 434 fi rst breath, 308 expulsive phase, second stage of labour, 140 female reproductive system, 12–23 fi ssures, skin,293 extended oligoarticular arthritis, 378 femoral head, paediatric conditions, 376 fi s t u l a extensively hydrolysed protein, 345 femoral neck fracture, 15 anal canal, 156 external genitalia femur length, fetus, 118 vagina, 423–424 embryology, 57 fertilisation, 32–37 fi ts see seizures female, 19–20 fi rst observation (1555), 410 fi xed splitting, heart sounds, 312 external oblique muscle, 25 timing, 35 fl oppy infants, 289–290 external rotation, 141 fertility fl ow murmur extra-articular complications, JIA, 379 age and, 8, 410, 412, 413, 418 atrial septal defect, 312 extra-embryonic coelom, 41 breastfeeding, 158 innocent, 317 extracellular matrix, 95 factors aff ecting, 412–413 fl ow velocity waveform, umbilical artery, extracellular water, percent body, 393 multiple pregnancies, 104 121 extraintestinal manifestations, Crohn’s dis- fetal anomalies fl uconazole, 420 ease, 346 abdominal wall, 73, 387 fl uids, see also water content extramedullary haematopoiesis, beta thalas- from invasive testing, 75, 76 children, 393 saemia, 303 screening, 72–74 hyperemesis gravidarum, 404–405 exudative retinal detachment, Coats dis- termination of pregnancy, 429–430 preterm infant, 192 ease, 125 twin pregnancy, 105 retention, pregnancy, 61 eye, 122–135, see also orbital cellulitis fetal circulation, 308 fl uorescein angiography, 130–131 albinism, 329 fetal distress fl uorescence in-situ hybridisation (FISH), examination of neonate, 180–181 during induction of labour, 153 254 fi ne motor development,228 second twin, 170–171 amniocentesis, 76 herpetic lesions, 294 fetal fi bronectin, 152, 190 fl uoxetine, 100 infections, 202 fetal period, 398 focal seizures, 282 lens see crystalline lens fetal varicella syndrome, 81 folic acid, 61, 90, 93, 101, 301 Index / 463 folinic acid, toxoplasmosis, 199 embryology, 52–53 glycosaminoglycans, 95 follicle-stimulating hormone, 21, 35, 36, fetal anomalies, 73 mucopolysaccharidoses, 330 320 pregnancy, 62, 98 glycosylated haemoglobin, 321, 322 menopause, 449 gastroschisis, 73, 387 gonadotrophin-dependent precocious pregnancy, 60 gastrulation, 52 puberty, 267 puberty, 264 GBS see streptococcus group B gonadotrophin-independent precocious secretion, 410, 411–412 gene probes, amniocentesis, 76 puberty, 267 subfertility, 418 gene therapy, 250–251 gonadotrophin-releasing hormone, 22, 35, suckling on, 158 General Medical Council, safeguarding 36, 320 follicles, 8, 412, 413 children, 272 analogues follicular phase, menstrual cycle, 35, 411 general practitioners, termination of preg- for central precocious puberty, 267 follow-on milks, 186 nancy, 429 for endometriosis, 416, 425, 426 Fontan circulation, 315 generalised seizures, 282, 283 pregnancy, 60 fontanelles, 216, 382 genes, inheritance, 4 puberty, 264 foramen ovale, 55, 308 genetics, 249–255 secretion, 410, 411–412 atrial septal defect, 311 genu valgum, 375 stimulation test, 265 patent, 311 genu varum, 375 suckling on, 158 transposition of the great arteries, 315 germ cells gonococcal infection, 422 forceps delivery, 442, 447 female, 8 Chlamydia trachomatis vs, 422 birth trauma, 182 male, 7, 27, 57 ophthalmia neonatorum, 202 foregut, 53 germline mutations, retinoblastoma, 123 Gower’s manoeuvre, 288 foreign bodies, vagina, 421 gestational age, 35 Graafi an follicles, 8 formula feeding, 185, 186 termination of pregnancy, 430 Gram-negative infections, 201 Four Ts, obstetric haemorrhage, 164 gestational diabetes, 63, 91–92 granulosa cells, 35 fractures multiple pregnancy, 106 Graves’ disease, 132–133, 325 children, 273 gestational hypertension, 83, 84, 86, see also grief reactions, 99 clavicle, 182–183 pre-eclampsia griseofulvin, tinea capitis, 369 HRT on, 451 multiple pregnancy, 107 Gross Motor Function Classifi cation non-accidental injury, 378 gestational trophoblastic disease, System, 286 pelvis and hip, 15 405–406 group B streptococcus see streptococcus fragile X syndrome, 257 gestational trophoblastic neoplasia, group B fulminating pre-eclampsia, 107 405–406 growing pains, 376 defi ned,84 gingivostomatitis, herpetic, 294 growth, 9–10, 213–216, see also intrauterine fumarylacetoacetase, 329 glandular fever, 295, 334 growth restriction functional abdominal pain, 349 Glasgow screening method, 245 assessment, 244 fundal height, 68 glaucoma, 132 babies, 187 fungal infections, skin, 369–370 gliadin, 344 chronic renal failure, 361 global developmental delay/diffi culties, constitutional delay, 267–268 gabapentin, HRT vs, 452 242, 257 factors aff ecting, 214 gait, limping child, 375–376 glomerular fi ltration rate faltering, 215, 350–352 galactosaemia, 330 drug excretion and, 393 history-taking, 209 gallbladder postnatal, 156 measurement, 215–216 embryology, 53 pregnancy, 62, 91 nutrition on, 214, 239 pregnancy, 62 glomeruloendotheliosis, 85 potential, formulae, 216 gametes, 6 glomerulonephritis, 358 growth charts, 216 gamma-glutamyl transaminase, levels in glucocorticoids see steroids growth hormone, 214, 215, 320 pregnancy, 88 glucose defi ciency, 328 Gaskin manoeuvre, 169 diabetes mellitus, 321 emotional disturbance, 215 gasping, fetal hypoxia, 177 management, 90–91, 92, 322 Turner syndrome, 269 gastroenteritis, 346–347 target ranges, 92 growth hormone-releasing hormone, fl uid replacement, 393 pregnancy, 62, 63 320 gastroesophageal refl ux disease management, 90–91 gubernaculum children, 342 target ranges, 92 female, 18, 57 multiple pregnancy, 106 glucose-6-phosphate dehydrogenase defi - male, 27, 57 pregnancy, 98 ciency, 301 Guedel airways, neonatal, 178 gastrointestinal tract glucose tolerance test, 63, 91–92 gums, pregnancy, 62 bleeding, 349–350 gluten, 344 Guthrie test, 325, 329, 331, 339 children, 341–352, 386–388 glycogen storage disorders, 330 guttate psoriasis, 366 examination, 211 glycoproteins, zona pellucida, 33 gynecoid pelvis, 14 464 / Index haemangiomas, neonates, 370–371 heart heterozygosity, 251 haematogenous spread, osteomyelitis, 380 children, 307–318 hiatal hernia, 387 haematology, children, 299–306 auscultation, 210 hindgut, 53 haematopoiesis, 300 Down syndrome, 252 hip extramedullary, beta thalassaemia, 303 embryology, 54–55 developmental dysplasia, 180, 381 haematopoietic stem cells, 44 fetus, 308 examination of neonate, 180, 181–182 transplantation, 47 anomalies, 73 fracture, 15 haematuria, 358 diabetes mellitus, 91 muscles, 15 haemochromatosis, 331 examination, 68 paediatric conditions, 376 haemoglobin, 300 lithium, 100 Hirschsprung’s disease, 348–349, 387–388 anaemic levels, 300 placenta praevia, 111 historical aspects, assisted reproduction, glycosylated, 321, 322 systemic lupus erythematosus, 95 410 pregnancy, 61, 88 neonate history-taking haemoglobin H disease, 303 examination, 180 antenatal care, 65–67, 99 haemoglobinopathies, 301–303 myocardial depression, 176 child abuse, 276 haemolytic anaemia, 301–303 pregnancy, 61 developmental delay, 244 haemolytic disease of the fetus, 92, 93 Heart and Estrogen/Progestin Replacement epilepsies, 283 haemolytic disease of the newborn, 92, Study (HERS), 451 paediatric, 208–209 186–187 heart block reduced fetal movements, 114 haemolytic-uraemic syndrome, 361 congenital complete, 316 Hodgkin lymphoma, 305, 306 haemophilia, 304 systemic lupus erythematosus, 95, 316 homocystinuria, 329 Haemophilus infl uenzae b, 335 heart failure, 309, 310 homologous recombination, 6 haemorrhage, see also abruptio placentae; heart rate homozygosity, 251 bleeding; bleeding disorders asthma, 336 honeymoon period, diabetes mellitus, 322 antepartum see antepartum haemorrhage fetal, 119–120 hormone replacement therapy, 415, cerebral, 193 maternal collapse, 163 449–451 early pregnancy, 399–401 heart sounds, splitting, 312 with GnRH agonists, 426 ectopic pregnancy, 402–403 heartburn see gastroesophageal refl ux hormones, 10, 320–329 gastrointestinal tract, 349–350 disease for endometriosis, 425–426 liver, 108 heat, subfertility, 413 growth, 214, 215 massive obstetric, 164–166, 171 height pregnancy, 60 postpartum see postpartum measurement, 215, 216 suckling, 158 haemorrhage puberty, 265 human chorionic gonadotrophin, 36, 398 after termination of pregnancy, 431 heliotrope rash, 289 discriminatory zone, 398 haemorrhagic disease of the newborn, 185 HELLP syndrome, 83, 108 ectopic pregnancy, 401, 403, 404 haemorrhoids, pregnancy, 98 retinal detachment, 130 measurement after caesarean section, 112 hair HELPERR (mnemonic), shoulder dystocia, miscarriage, 400–401 disorders, 371–372 169 molar pregnancy, 406 tinea capitis, 369 hemiplegia, 241, 247–248 pregnancy test, 36 hair pulling, 371 cerebral palsy, prognosis, 287 twin pregnancy, 105 hamstrings, avulsion, 15 Henoch–Schönlein purpura, 358 vomiting, 404 hand, foot and mouth disease, 368 heparin, 167 Human Fertilisation and Embryology Act incubation period, 293 low molecular weight (LMWH), 160, 1990, 429 handicap, defi ned,245 167, 168 human herpesvirus 6, 368–369 haploidy, 4, 6 hepatitis B, 77, 200 human immunodefi ciency virus infection Harrison’s sulci, 210–211 hepatitis C, 200 children, 297 head, examination of neonate, 181 hereditary spherocytosis, 301 pregnancy, 79, 200–201 head circumference hernia screening, 77 fetus, 118 congenital, 73, 387 risk from invasive tests, 75 measurement, 216 diaphragm, 71, 73, 81, 387 human normal immune immunoglobulin, head injury, non-accidental, 274 inguinal, 26, 390 measles, 80 head lag, 218 herpes simplex, 294, 369 human papillomavirus, 368 head lice, 370 neonates, 200 human placental lactogen (hPL), 36, 60 head position, neonatal resuscitation, 178 pregnancy, 77–80 Hunter syndrome, 330 headache skin, 365 Hurler syndrome, 330 children, 278, 279–281 herpesviruses, 294, see also roseola hyaline membrane disease see respiratory drugs for, 281 HERS (Heart and Estrogen/Progestin Re- distress syndrome idiopathic intracranial hypertension, 133 placement Study), 451 hyaloid vascular system, eye, 125 hearing loss see sensorineural hearing loss heterotopic pregnancy, 401–402 hydatidiform moles, 405, 406 Index / 465 hydration hypothalamic-pituitary-ovary axis, 21, 411 varicella zoster, 81 eczema, 364 hypothalamic-pituitary-testicular axis, for viral infections, 99 hyperemesis gravidarum, 404–405 411–412 immunomodulatory therapy, IBD, 346 hydrocele, 389 hypothalamus, 320 impairment, defi ned,245 hydrocephalus, 193, 290–291 hypothermia, neonates, 177, 190 impetigo, 367 hydrocortisone therapeutic, 179–180 implantation of embryo, 40–41 asthma, 337 hypothyroidism, 324–325 implants hyperemesis gravidarum, 405 ovulation and, 415 contraceptive, 436–437 hydronephrosis, 357 hypotonia, infants, 289–290 sterilisation, 438 hydrops, 73, 92, 303 hypotonicity impotence, 30 hydrosalpinx, 416 plasma, SIADH, 329 imprinting (genetic), 254 hydroxychloroquine, 96 urine, diabetes insipidus, 328 impulsivity, 260 21-hydroxylase defi ciency, 181, 327–328, hypovolaemia, nephrotic syndrome, 359 ‘in hours’ delivery, twin pregnancy, 106 331–332 hypoxia in-toeing, 375

25-hydroxyvitamin D3, 325 perinatal, 176–177 in vitro fertilization (IVF), 46 hyperactivity, 260 preterm infant, 191 age of mother, 412 hyperandrogenism, 414 retina, 124 for endometriosis, 416 hypercalcaemia, 326 hysterectomy, 445–446 historical aspects, 410 hypercyanotic episodes, 314 emergency, 166, 171 multiple pregnancy and, 104 hyperemesis gravidarum, 97–98, 105, 398, hysterosalpingo-contrast sonography, for tubal disease, 416 404–405 415–416 inborn errors of metabolism, 329 hypergonadotrophic hypogonadism, 268, hysterosalpingography, 415, 416 incisions 414–415 hysteroscopy, 444–445 caesarean section, 60, 443–444 hypermobility, 376–377 hysterectomy, 445 hyperopia, pregnancy, 130 idiopathic intracranial hypertension, 133 incomplete miscarriage, 400 hyperparathyroidism, 327 IgA, coeliac disease, 344 incontinence, see also stress incontinence hyperphosphataemia, 361 IgG postnatal, 156 hyperprolactinaemia, 21, 415 CMV-specifi c, 198 incubation periods, 293 hyperstimulation, uterus, 152–153 coeliac disease, 344 incubators, 191 hypertension haemolytic disease of the newborn, Individual Education Plans, 247 children, 361–362 186–187 indometacin, 151 glomerulonephritis, 358 IgM, haemolytic disease of the newborn, induced pluripotent stem cells, 45 hypertensive disorders 186 induction of labour, 69, 115, 152–153 multiple pregnancy, 107 iliac vein thrombosis, diagnosis, 167 inevitable miscarriage, 400 pregnancy, 82–88 iliococcygeus muscle, 16 infantile phase, growth, 215 hyperthyroidism ilium, 13 infections, see also pneumonia children, 325 ill-looking children, 209–210 bone, 380–381 hyperemesis gravidarum and, 398 immune thrombocytopenic purpura, 304 children, 292–298 pregnancy, 132–133 immunisations, 373, see also MMR vaccine from HIV infection, 297 vomiting, 404 chickenpox, 295 perinatal, 197–203 hypertonicity of blood, diabetes insipidus, history-taking, 209 pregnancy, 76–81 328 meningitis, 296 prevention, 202 hypertrophy, 9 after preterm birth, 194 risk from invasive tests, 75 hypoblast, 40, 52 rotavirus, 348 sickle cell disease, 302 hypocalcaemia, 326 UK, 209 termination of pregnancy, 431–432 neonates, diabetes mellitus, 91 immunity, fetus, 62–63 upper respiratory tract, 334–335 hypochloraemia, pyloric stenosis, 343, 388 immunodefi ciency, see also human immu- urinary tract, 20, 62, 77, 354–355, 362 hypoglycaemia nodefi ciency virus infection vaginal discharge, 420–422 children, 323–324 candidiasis, 420 viral see viral infections neonates, 91, 187 children, 296–297 infectious mononucleosis, 295, 334 hypogonadotrophic hypogonadism, 268, leukaemia, 305 infl ammatory bowel disease, 345–346 413–414 severe combined, 296 fi s t u l a , 4 2 3 hyponatraemia, 393 immunoglobulin infl ammatory myopathies, 289 hypoparathyroidism, 326–327 anti-D, 93, 111, 187, 400 infl ation breaths, neonatal resuscitation, hypopituitarism, 132, 328 postnatal, 156 178, 183 hypoplastic left heart syndrome, 315 termination of pregnancy, 430 inguinal canal, 25–26, 57 hypospadias, 29, 181, 388–389 haemolytic disease of the newborn, inguinal hernia, 26, 390 hypothalamic-pituitary-gonadal axis, 264, 186–187 inguinal ligament, 25 410–412 human normal immune, measles, 80 inhalers, asthma, 336, 337, 393–394 466 / Index inheritance, 4, 253–254 intrauterine growth restriction, 101, drug excretion, 393 inherited disorders of coagulation, 304–305 117–121, 187 dysplasia, 357 inhibin, 411, 412 diabetes mellitus, 91 embryology, 56–57 injection contraception, 436 management, 120–121 fetal anomalies, 73–74 inner cell mass, 39, 40 twin pregnancy, 105 nephroblastoma, 306 innervation intrauterine insemination, 414, 417 nuclear medicine, 355 external genitalia, female, 20 intrauterine pressure catheters, 148 pregnancy, 62 ovaries, 19 intrauterine systems lupus fl are, pre-eclampsia vs, 101 penis, 29 contraceptive, 437–438 tests, 91 vagina, 17–18 levonorgestrel, for endometriosis, 425 Kiwi® ventouse cup, 443 innocent heart murmurs, 317 partial replacement for HRT, 452 Klinefelter syndrome, 252 insemination, intrauterine, 414, 417 intravenous route Klumpke’s palsy, 183 insertions (mutations), 251 drugs, 392 knee, Osgood–Schlatter disease, 377 instrumental delivery, 441–443, 447 fl uids via, 393 knock knees, 375 insulin intraventricular haemorrhage, 193 Koplik spots, 293, 373 children, 322 intussusception, 388 Korotkoff sounds, fi fth, 83, 85 excess, 323 invasive moles, 405 Krukenberg spindles, 130 infants of diabetic mothers, 187 invasive tests, antenatal screening, 74–76 kwashiorkor, 351–352 pregnancy, 90–91 inversion, uterus, 170 insulin-dependent diabetes, 321–323 inversion (chromosomal), 253 labetalol, pregnancy, 86, 88, 107 insulin-like growth factors, 214, 215 iodine defi ciency, 325 labia minora, 20 insulin resistance, pregnancy, 62, 63, 92 ipratropium bromide, 337 labour, 139–145, see also preterm labour intellectual disability see learning disability iron abnormal, 146–154 Intelligence Quotient (IQ) overload disorder, 331 abruptio placentae, 112 learning disability, 257 pregnancy, 61 analgesia, 144, 145 tests, 244 supplementing, 301 diagnosis, 147 internal oblique muscle, 25 iron defi ciency anaemia induction, 69, 115, 152–153 internal podalic version, 106, 171 children, 300–301 length, 142 internal rotation, 141 multiple pregnancy, 106 management, 142–144 International Headache Society irritable bowel syndrome, 348 mechanism, 141–142 classifi cation, 279 irritable hip, 376 lacerations, neonates, 182 diagnostic criteria, 280 irritant contact dermatitis, 365 lactate, puerperal sepsis, 160 International League Against Epilepsy ischium, 13 lactation, 158–159 defi nition of epilepsies, 281 isochromosome 21, 252 lactic acidosis, fetal hypoxia, 176, 177 seizure classifi cation, 282 isolated premature thelarche, 267 lactose intolerance, post-gastroenteritis syn- International League of Associations for isotretinoin, 366 drome, 345 Rheumatology, classifi cation of JIA, itching, treatment, 364 lacunae, bone, 375 378 Ladd’s bands, 386 International Liaison Committee on Resus- Janeway lesions, 310 lamotrigine, 101 citation, 176 jaundice (neonatal), 186–187 language, developmental milestones, international normalised ratio, pregnancy, diabetes mellitus, 91 232–234 88 jaw thrust, neonatal resuscitation, 178 laparoscopic salpingectomy, 404 interphase, 5 joint hypermobility syndrome, 376–377 laparoscopy, 445 interruption of the aortic arch, 313 jumping, gross motor development, 223 laparoscopy and dye test, 416 interscapular murmurs, 210 juvenile astrocytomas, 306 larva migrans, visceral, 125 intestinal pseudo-obstruction, 348 juvenile idiopathic arthritis, 378–380, laryngotracheobronchitis see croup intracellular water, percent body, 393 383–384 last menstrual period, 115 intracranial haemorrhage, immune throm- late decelerations, fetal heart rate, 119, 120 bocytopenic purpura, 304 Kallmann syndrome, 264, 268, 414 late-onset sepsis, 202 intracranial hypertension, idiopathic, 133 karyotyping, 250, 254 late preterm babies, 190 intracytoplasmic sperm injection, 417 premature ovarian failure, 449 latent phase, fi rst stage of labour, 140 intramuscular route, drugs, 392 Kawasaki’s disease, 372 law intraocular pressure, pregnancy, 130, 132 Kayser–Fleischer rings, 331 embryonic stem cells, 46–47 intraosseous route, drugs, 392 kernicterus, 91, 186 termination of pregnancy, 429–430 intrauterine contraceptive devices, 39, Kernig sign, 296 laxatives, 348 437–438 ketoacidosis, diabetic, 321, 322–323 learning disability, 257–258 after molar pregnancy, 406 fl uid replacement, 393 causes, 243 pregnancy, 66 kidneys, see also urinary tract Duchenne muscular dystrophy, 289 intrauterine death, twin pregnancy, 106 children, 353–362 grading, 244, 257 Index / 467

Leeuwenhoek, Anton van, 410 pregnancy, 61 meconium ileus, 339 left-to-right shunts, 309–312, 317–318 ventilation/perfusion scanning, 168 meconium-stained liquor, 179 legislation see law lupus anticoagulants, 96 listeriosis, 201 Leigh syndrome, 331 luteal phase, menstrual cycle, 35, 411 mediastinum, transposition of the great lens (eye) see crystalline lens luteinising hormone, 21, 35, 36 arteries, 315 Lesch–Nyhan syndrome, 331 pregnancy, 60 medical termination of pregnancy, surgical leucocoria, 122–128 puberty, 264 vs, 430 leucocyte esterase, 354 secretion, 410, 411–412 medium-chain acyl-CoA dehydrogenase leucocytes suckling on, 158 defi ciency, 330 pregnancy, 61, 88 lymphatic drainage medroxyprogesterone urinary tract infections, 354 ovaries, 19 Depo-Provera, 436 leukaemia, children, 47, 305, 306 testes, 28 for endometriosis, 425, 426 levator ani muscle group, 16, 17 vagina, 17 Women’s Health Initiative, 450–451 Levonelle®, 438 lymphomas, 305–306 medullary sponge kidney, 357 levonorgestrel lysosomal storage diseases, 330 medullary uraemic kidney, 357 combined oral contraceptives, 435 medulloblastomas, 306 emergency contraception, 438 machinery murmur, 311 megacolon, toxic, 346 for endometriosis, 425, 426 venous hum vs, 317 megaloblastic anaemia, 301 partial replacement for HRT, 452 macrocephaly, 216 meiosis, 6–7, 8, 33 Leydig cells, 26 macrosomia, 91, 148, 187 melanin, defect, 329 lice, 370 macula melasma, 130 lichenifi cation, skin, 293 central serous retinopathy, 130 membrane sweep, 115, 140 lidocaine, perineal infi ltration,144 diabetes mellitus, 131 menarche, age at, 264 lie (fetus), 148 macules, 293, 364 Mendelian inheritance, single gene defects, defi ned, 140 MAG3 scan, urinary tract infections, 355 253–254 second twin, 171 magnesium sulphate meningitis, 295–296 life, beginning of (ethics), 46 eclampsia, 87, 107–108 brain injury from, 241, 247–248 ligaments tocolysis, 151 meningocele, 54, 58 pelvis, 13, 14 magnetic resonance imaging meningococcal septicaemia, 295–296 uterus, 18 cerebral palsy, 287 Menkes syndrome, 331 limping child, 375–376, 383 epilepsies, 284 menopause, 448–453 osteomyelitis, 380 herpes encephalitis, 294 menstrual cycle, 21–22, 35–36, 411 linea nigra, 67 after neonatal resuscitation, 180 natural family planning and, 434 lipids, disorders of metabolism, 331 major praevia, 110 menstrual phase, menstrual cycle, 22 listeriosis, 78, 201 malabsorption, 344 menstruation, retrograde, 424 lithium, 100, 157 megaloblastic anaemia, 301 MEOWS (Modifi ed Early Obstetric Warn- liver malaria, 79 ing Scores), 163, 165 embryology, 53 male factor subfertility, 417, 418 mesoderm, 52 heart failure, 309 male reproductive system, 24–31, 57 splanchnic, 56 obstetric cholestasis, 99 malnutrition, 351–352 mesonephroi, 56 oedema, 85 malposition, 148 metabolic alkalosis, pyloric stenosis, 343, patent ductus arteriosus, 318 malpresentation, 148, see also version 388 subcapsular haemorrhage, 108 placenta praevia, 110 metabolic disease, 329–331 lobar pneumonia, 338 malrotation, 386 metabolic myopathies, 289 lochia, 156 Manchester operation, 446 metabolism long-acting insulin, 322 maple syrup urine disease, 329 of drugs, 393 long-acting reversible contraception, marasmus, 351 pregnancy, 62 436–438 Marfan syndrome, 96, 377 metals, disorders of metabolism, 331 long QT syndrome, 316 marijuana, subfertility, 413 metamorphopsia, 131 long rotation, 141 massive obstetric haemorrhage, 164–166, metanephroi, 57 long sight, pregnancy, 130 171 metaphase, 5 low molecular weight heparin (LMWH), mastitis, 159 metaphase I, meiosis, 6 160, 167, 168 maternal collapse, 163, 164 metaphase II, meiosis, 7 lower oesophageal sphincter, 342 McCardle disease, 330 metformin, 90 lubricants, condoms, 434 McCune–Albright syndrome, 267, 327 for subfertility, 414 lumbar puncture, meningitis, 296 McRoberts’ position, 168 methotrexate lungs, see also respiratory system measles, 80, 81, 293, 373 ectopic pregnancy, 403–404 embryology, 55–56 incubation period, 293 juvenile idiopathic arthritis, 379–380 fetal anomalies, 73 Meckel’s diverticulum, 350, 388 methylxanthines, 191 468 / Index metoclopramide, 405 monochorionic twins, 41–42 pregnancy, 61 metopic suture, 382 diamniotic, 104 pulmonary stenosis, 313 metronidazole, 421, 422 early delivery, 106 ventricular septal defect, 309–310 termination of pregnancy, 432 monoamniotic, 104–105 muscles microcephaly, 216 selective termination of pregnancy, 106 disorders, 288–290 microtubules monophyletic theory, haematopoiesis, 300 neuromuscular diseases, 288 meiosis, 6 monospot test, infectious mononucleosis, muscular dystrophies, 288–289 mitosis, 5 295 musculoskeletal embryology, 56 micturition, postnatal, 156 monozygotic twins, 41, 42, 104 musty odour, phenylketonuria, 329 midazolam, febrile seizures, 285 fetal anomalies, 105 mutations, 251 midgut, 53 Montevideo units, 148 Angelman syndrome, 254 midwives, examination of neonate, 180 monthly HRT, 450 enzymes, 329 mifepristone morning stiff ness, 378 mycophenolate mofetil, pregnancy and, 96 miscarriage, 401 Moro refl ex, 181, 183, 239 myelinated nerve fi bres, eye, 126–127 termination of pregnancy, 431 morphogenesis, 10 myelomeningocele, 54, 58 migraine, 278, 279, 280, 291 mortality myocardial depression, neonates, 176 mild hypertension amniotic fl uid embolism, 169–170 myocardial infarction, heartburn vs, 98 management, 86 perinatal, prolonged pregnancy, 115 myocarditis, systemic lupus erythematosus, measurement range, 84 psychiatric disorders, 157 95 milestones, 217–240 puerperal sepsis, 159–160 myoclonic seizures, 283 delay, 242 pulmonary embolism, 160 myometrium, 60 puberty, 265 venous thromboembolism, 166 myopathies, 289–290 milia, 370 morula, 39 myotomes, 56 milk, see also breast milk; cow’s milk mosaicism, 252 myotonic disorders, 289 iron, 300 motor development, see also cerebral palsy myotonic dystrophy, 289 for older infants, 185–186 disorder, 261 quantities required, 185 fi n e ,228 –232, 237–238 nails Million Women study, 451 gross, 218–227, 237–238 alopecia areata, 372 minor praevia, 110, 111 moulding, defi ned, 140 psoriasis, 366 Mirena® coils, 437–438 mouth, examination of neonate, 181 nappy candidiasis, 370 miscarriage, 40, 88, 397, 399–401, 402, mucopolysaccharidoses, 330 nasal route, drugs, 392 407 mucus, cervix, 420 National Patient Safety Agency alert, fl uid age of mother, 67, 412 natural family planning, 434 therapy, 393 history-taking, 65 Müllerian ducts see paramesonephric ducts natural family planning, 434 intrauterine contraceptive multicystic dysplastic kidney, 357 nausea, pregnancy, 404, 407 devices, 66 multidisciplinary teams necrotising enterocolitis, 160, 192–193 risk from invasive tests, 75 autism spectrum disorder, 259 neglect, 275, 276 twin pregnancy, 105 complex regional pain syndrome, 377 Neisseria gonorrhoeae, 422, see also gonococ- misoprostol cystic fi brosis, 339 cal infection induction of labour, 152 learning disability, 258 neonate miscarriage, 401 neurodevelopmental disorders, 246 acne, 370 termination of pregnancy, 431 multifactorial inheritance, 254 cardiopulmonary resuscitation, 175–180 missed miscarriage, 400, 407 multiparous cervix, 140 diabetes mellitus, 91 missense mutations, 251 multiparous women, labour, 149 examination, 177, 180–183 mitochondrial disorders, 254, 331 multiple endocrine neoplasias, 327 neurological, 211 mitosis, 4–6 multiple pregnancy, 42, 103, 104–108 fi ne motor development,228 mitral valve, atrioventricular septal defect, fetal distress, 170–171 gastrointestinal bleeding, 350 312 on infants’ growth, 214 gastrointestinal tract, 386–388 MMR vaccine, 293, 373 risks to fetus, 105–106 gross motor development, 218 postnatal, 156 risks to mother, 106–107 haemoglobin levels, 300 pregnancy, 77, 80 mumps, 293, 294 haemolytic disease, 92, 186–187 moderate hypertension incubation period, 293 hyperthyroidism, 325 management, 86 Munchausen syndrome by proxy, 274 hypothyroidism, 324–325 measurement range, 84 murmurs infections, 197–203 Modifi ed Early Obstetric Warning Scores aortic stenosis, 313 jaundice, 186–187 (MEOWS), 163, 165 atrial septal defect, 312 diabetes mellitus, 91 molar pregnancy, 405–406 innocent, 317 organisms causing pneumonia, 338 molluscum contagiosum, 368 paediatric examination, 210 orthopaedic conditions, 381–383 Mongolian blue spot, 181 patent ductus arteriosus, 311, 318 osteomyelitis, 380–381 Index / 469

posseting, 342 nonoxynol-9, 434 pregnancy, 98 screening, 180, 250 nonsense mutations, 251 refl ux see gastroesophageal refl ux disease skin conditions, 370–371 norethisterone, combined oral contracep- oestradiol, hypogonadotrophic hypog- social behaviour, 235 tives, 435 onadism, 413 vaginal discharge, 420 Noristerat®, 436 oestriol, 60 ventricular septal defect, 309 normal variants, 74 oestrogen-only HRT, 450, 451 warming, 177, 190 normogonadotrophic hypogonadism, 414 oestrogens, 8, 21–22, 35, 265, 411 nephroblastoma, 306 NPSA alert, fl uid therapy, 393 on cervical mucus, 420 nephrogenic diabetes insipidus, 328 nuchal oedema, 74 combined oral contraceptives, 435, 436 nephropathy, refl ux-associated, 356 nuchal translucency screening, 72 creams, 452 nephrotic syndrome, 91, 359, 360 nuclear medicine, urinary tract infections, HRT, 450–451 nerve conduction studies, 288 355 on lactation, 158 nerve fi bres, see also innervation nucleic acid amplifi cation technique phytoestrogens, 104 regeneration, embryonic stem cells and, Chlamydia trachomatis, 421 pregnancy, 60 45 gonococcal infection, 422 reduction, 449 retina, 126–127 nucleotides, disorders of metabolism, 331 off -label use, drugs, 392 neural crest cells, 53–54 nulliparous cervix, 140 Offi ce of National Statistics (UK), on prev- neural tube, 54 nulliparous women, labour, 149 alence of subfertility, 410 neural tube defects, 73, 290–291 numerical chromosomal disorders, 252 olanzapine, 101 neuroblastomas, 306 nutrition, see also diet oligoarticular arthritis, 378, 383–384 neurodevelopmental disorders, 256–262 babies, 185–186 oligohydramnios, 119, 356–357 features by age, 242 diabetes mellitus, 322 omphalocele (exomphalos), 73, 387 multidisciplinary teams, 246 on growth, 214, 239 oncology see cancer neuroembryology, 53–54 history-taking, 209 ondansetron, 405 neuromuscular diseases, children, 287–288 iron, 300 onycholysis, 366 neuromuscular junction disorders, 290 pregnancy, 62 oocytes, 8 neuropathies, 290 preterm infant, 192, 195 age of mother, 412 neuropores, 54, 58 donation, 415 Newborn and Infant Physical Examination obesity fertilisation, 33 programme, 180 antiphospholipid syndrome, 167 fi rst discovery, 410 Newborn Life Support, courses, 176 children, 320–321 oogenesis, 8, 9 Nexplanon®, 436–437 pregnancy, 66–67, 69 oogonia, 8 NICE guidelines, depression, 100 subfertility, 413, 414 open comedones, 365 nifedipine object permanence, 235 operative laparoscopy, 445 pregnancy, 86 obstetric cholestasis, 99 operative vaginal delivery, 441–443, 447 tocolysis, 151 obstetric conjugate, 14–15, 147 ophthalmia neonatorum, 202 night-time feeds, 158 obstetric emergencies, 162–171 ophthalmoplegia, Sheehan syndrome, 132 Nikolsky’s sign, 367 teams, 163 optic nerve, hyperthyroidism, 133 nipples, cracked, 188 obstructed labour, 150 optic nerve sheath fenestration, 133 Nissen fundoplication, 342 obstructive azoospermia, 417 oral glucose tolerance test, 63, 91–92 nitrite, urine, 354 obstructive hydrocephalus, 290–291 oral rehydration, gastroenteritis, 347 nitrofurantoin, 354–355 obturator foramen, 13, 15, 25 oral route, drugs, 392 nitrous oxide, 144 obturator internus muscle, 15 orbital cellulitis, 367 no-bleed HRT, 450, 452 occipito-frontal head circumference, 216 orchidometer (Prader), 265, 266 nodules, skin, 293, 364 occipito-transverse position, 148 orchidopexy, 390 non-accidental injury, 277 occlusive vasculopathies, retina, 131 orchiectomy, 27, 390 fractures, 378 occupational factors, subfertility, 413 orchitis, mumps, 293 head injury, 274 ocular torticollis, 383 organic acids, disorders of metabolism, 329 non-disjunction, 252 oedema, see also pulmonary oedema organisation, cells, 10 non-epileptic attack disorder, 282 cerebral, pre-eclampsia, 130 ornithine transcarbamylase defi ciency, 330 non-Hodgkin lymphoma, 305–306 kwashiorkor, 351 oropharyngeal airways, neonatal resuscita- non-insulin-dependent diabetes, 321, 323 liver, 85 tion, 178 non-penetrance, 253 nephrotic syndrome, 359 orthopaedics, 374–384 non-reassuring decelerations, fetal heart nuchal, 74 Ortolani test, 181–182 rate, 119–120 pregnancy, 69, 83 Osgood–Schlatter disease, 377 non-steroidal anti-infl ammatory drugs oesophagus Osler’s nodes, 310 endometriosis, 425, 426 atresia, 386 osmolality pregnancy, 96 children, 342 diabetes insipidus, 328 puerperal sepsis and, 160 embryology, 53 SIADH, 329 470 / Index osmotic diarrhoea, 347 Pajot’s manoeuvre, 442 pelviureteric junction obstruction, 356 ossifi cation, 9–10 palivizumab, 194, 338 pemphigoid gestationis, 99 osteoblasts, 375 pallid syncopal attacks, 282 penicillin osteoclasts, 375 palmar grasp, 238 glomerulonephritis, 358 osteocytes, 375 palpation, pregnancy, 68–69 syphilis, 199 osteogenesis imperfecta, 383 pampiniform plexus penis, 29 osteoid, 375 female, 19 percussion, myotonic disorders, 289 osteomyelitis, 380–381 male, 27–28 perimortem caesarean section, 163 osteoporosis, 15 pancolitis, 346 perinatal hypoxia, 176–177 HRT on, 451 pancreas perinatal mortality, prolonged pregnancy, ostium secundum, heart embryology, 55 cystic fi brosis, 339 115 O’Sullivan’s technique, 170 embryology, 53 perineal body, 19 out-toeing, 375 panhypopituitarism, 324 perineal membrane, 19 ovaries, 19 papilloedema, 133 perineum cancer, HRT on, 451 papules, 364 female, 19, 20 cysts, pregnancy, 65 psoriasis, 366 infi ltration (lidocaine),144 embryology, 57 paramesonephric ducts, 57 peripheral cyanosis, 313 ligaments, 18 anomalies, 416–417 peripheral precocious puberty, 267 premature failure, 449 paraphimosis, 389 peritoneum, 18 resistant, 449 parathyroid glands, 326 peritonsillar abscess, 334 oviducts see Fallopian tubes disorders, 326–327 periurethral injections, 446 ovulation neonates, 91 periventricular leucomalacia, 193–194, 287 date vs last menstrual period, 115 parathyroid hormone, 326 peroxisomal disorders, 331 disorders, 413–415 parenteral nutrition, preterm infant, 192 persistent fetal vasculature, eye, 125 natural family planning and, 434 parity persistent oligoarticular arthritis, 378 premature ovarian failure, 449 on cervix, 140 Personal Child Health Records, 182, 209, suckling on, 158 on labour, 149 242–243 timing, 35 Parkinson’s disease, embryonic stem cells personhood, beginning of, 46 oxygen and, 45 Perthes disease, 376 consumption, pregnancy, 61 parotitis, mumps, 294 pessaries desaturations, 191 paroxetine, 100 clotrimazole, 420 neonatal resuscitation, 178 paroxysmal events, see also seizures prostaglandins, 152 retinopathy of prematurity, 124 non-epileptic, 281, 282 pesticides, on spermatozoa, 413 saturations, asthma, 336 partial AVSD, 312 petechiae, 364 oxytocic drugs, 144, 149 partial mole, 406 petechial rash, Henoch–Schönlein purpura, abruptio placentae, 113 partograms, 142–143, 147, 154 358 at delivery, 142 parvovirus, 79, 80, 200, 295, 369 pethidine, 144 hyperstimulation, 153 past medical history, paediatric, 209 hypertension and, 87 hypertension and, 87 Pastia’s lines, 367 Pfannenstiel incision, 443, 445 obstetric haemorrhage, 165, 171 patent ductus arteriosus, 311, 318 pH, oesophagus, 342 for prolonged labour, 149 hypoplastic left heart syndrome, 315 pharmacodynamics, 393 oxytocin, 21, 320 transposition of the great arteries, 315 pharmacokinetics, 392–393 breastfeeding, 158–159 venous hum vs, 317 pharyngitis, 160, 334 patent foramen ovale, 311 phenylketonuria, 329 packing, uterus, 166 transposition of the great arteries, 315 phimosis, 389 paediatric examination, 208, 209–211 patient-controlled analgesia, 144 phototherapy, 186 paediatric history-taking, 208–209 Pavlik harness, 381 physical abuse, children, 272–274, 276 pain, see also analgesia peak expiratory fl ow rate, 336, 340 physiological jaundice, 186 abdomen, children, 349 Pearson syndrome, 331 phytoestrogens, 104 abruptio placentae, 112 peas and carrots diarrhoea, 348 pica, 300 back, 97, 377–378 pedigrees, 253 pigmentation, congenital adrenal hyperpla- breastfeeding, 159 pelvic fl oor, 15, 17 sia, 327 ectopic pregnancy, 402 exercises, 156 pincer grip, fi ne motor development,228 endometriosis, 425–426 pelvic infl ammatory disease, 415, 422–423 piriformis muscle, 15 legs, 376–377 pelvic inlet, 13–14 pituitary gland, 20–21, 132, 320 multiple pregnancy, 106 pelvic outlet, 14 placenta, 41, 62–63 nerve fi bres, female reproductive system, 19 pelvis, 13–16, 25 abruption, 112–113, 115–116 pneumonia, 338 dimensions, 147 adherent, 111–112 pregnancy, 68, 69, 407 fractures, 15 blood circulation, 308 Index / 471

cutting at caesarean section, 111 positive-pressure ventilation cardiac output, 163 development, 398 neonatal resuscitation, 178 Chlamydia trachomatis, 421–422 on growth, 214 preterm infant, 191 cholestasis, 99 increased tissue, 85 positron emission tomography, epilepsies, connective tissue disorders, 95–97 intrauterine growth restriction, 187 284 constipation, 98 postpartum haemorrhage, 60 posseting, 342 diabetes mellitus, 89–92, 93, see also pre-eclampsia, 83 post-gastroenteritis syndrome, 345 gestational diabetes retained tissue, 142 post-haemorrhagic ventricular dilatation, retinopathy, 131, 132 separation at delivery, 142 193 early, 397–408 placenta accreta, 111 post-renal acute renal failure, 360 eye complications, 129–135 placenta increta, 111, 112 post-streptococcal glomerulonephritis, 358 gastroesophageal refl ux disease, 98 placenta percreta, 111, 112 post-term pregnancy, 114–115 gonococcal infection, 422 placenta praevia, 110–111, 116 post-traumatic stress disorder, 157 haemorrhoids, 98 plantar grasp, 238 post-vagotomy syndrome, 348 hormones, 60 plaques, skin, 293, 364 postcoital contraception, 438 HRT and, 452 plasma volume, pregnancy, 61 posterior colporrhaphy, 446 hyperemesis gravidarum, 97–98, 105, plastic bags, babies in, 190, 195 posterior fontanelle, 382 398, 404–405 platelets posterior urethral valves, 74, 356, 357 hypertensive disorders, 82–88 defi ciency, 303–304 posthitis, 389 kidneys, 62 pregnancy, 61 postmaturity syndrome, 115 lupus fl are, pre-eclampsia vs, 101 levels, 88 postmortem caesarean section, 444 tests, 91 pleural eff usions, 338–339 postnatal baby check, 180 late, 109–116 fetus, 73 postnatal care, 156–157, see also puerperium polymorphic eruption of, 99 ploidy, 4 gestational diabetes, 92 prolonged, 114–115 pluripotency, 44, 300 hypertension, 87, 108 psychiatric diseases, 99–101 ‘Plus’ disease, retinopathy of prematurity, postnatal depression, 106, 157, 161 risk factors, 65 194 postnatal exercise, 156–157 skin, 67, 98–99 pneumatosis, 192 postnatal review, antenatal screening, 181 ocular adnexa, 130 pneumococcal infection see Streptococcus postpartum haemorrhage, 142, 164, 171, see symptoms, 65 pneumoniae also massive obstetric haemorrhage systemic lupus erythematosus, 95–96, pneumocytes, 191 abruptio placentae, 113 101–102 pneumonia, 338–339 placental siting, 60, 111 timings, 35 aspiration, risk factors, 163 secondary, 159, 164 Trichomonas vaginalis, 422 cystic fi brosis, 339 posture, examination of neonate, 181 of uncertain viability, 400 point mutations, 251 potassium, levels in pregnancy, 88 of unknown location, 400, 401 polar bodies, 33–34 potassium hydroxide, tinea capitis, 369 varicose veins, 98 pollution, on prevalence of Potter’s syndrome, 357 pregnancy-associated plasma subfertility, 410 Prader orchidometer, 265, 266 protein A, 118 polyarticular arthritis, 378 Prader–Willi syndrome, 254 preload, 309 polycystic kidney disease, 357 pre-conceptual care premature birth, see also preterm polycystic ovary syndrome, 22, 414, 415 antiepileptic drugs, 101 infant puberty, 267 diabetes mellitus, 90 defi ned, 187 polycythaemia, diabetes mellitus, 91 psychiatric diseases, 100 premature ovarian failure, 449 polyhydramnios, 119 pre-eclampsia, 69, 83–85, 101–102, 107, premutation, 254 polymerase chain reaction, 255 108 prenatal diagnosis, 71–81, 250, see also an- polymorphic eruption of pregnancy, 99 eye complications, 130, 134 tenatal screening polymorphisms, 251 incidence, 83 prepuce, 29 polyploidy, 252 management, 86–87 presentation (fetus), 141, 148, see also Pompe disease, 330 multiple pregnancy, 107 malpresentation pompholyx, 365 pre-eclamptic toxaemia, 102 breech see breech presentation Ponseti method, 382 precipitate labour, 147 defi ned, 140 population screening, genetic, 250 precocious puberty, 267 malposition, 148 porencephalic cyst, 287 prednisolone preterm delivery, 151 porphyrins, disorders of metabolism, 331 asthma, 337 presenting complaints, history-taking, 208 port wine stain, 371 hyperemesis gravidarum, 405 preterm birth position (fetus), defi ned, 140 nephrotic syndrome, 359 defi ned, 190 positional talipes, 382 pregnancy, 59–63, see also antenatal care; extreme, outcomes, 194 positive end-expiratory pressure, preterm antenatal screening preterm delivery, 151 infant, 190 antiphospholipid syndrome, 96, 167 twin pregnancy, 106, 108 472 / Index preterm infant, 189–195 propylthiouracil, 325 transposition of the great arteries, 314 bruising, 182 prostaglandin F2α analogue, 166 truncus arteriosus, 315 discharge from hospital, 194 prostaglandins, induction of labour, 152 pulmonary blood fl ow, patent ductus arte- patent ductus arteriosus, 311 prostate gland, 28 riosus, 318 retinopathy, 124 benign hypertrophy, 29 pulmonary embolism, 160, 167–168 thyroid hormones, 324 prostate-specifi c antigen, 28 pulmonary fl ow murmur, 317 preterm labour, 150–152, 190 protein binding, drugs, 392 pulmonary hypertension, 192 prevention, 151–152 protein/creatinine ratio, urine, 83 atrial septal defect, 312 preterm pre-labour rupture of membranes protein hydrolysate, 345 ventricular septal defect, 310 (PPROM), 151 proteins pulmonary hypoplasia, 387 primary apnoea, fetus, 176–177 intake, pregnancy, 62 pulmonary oedema, 317 primary dysfunctional labour, 149, 153 urine, pregnancy, 62, 91 steroids with tocolytics, 151 primary immune defi ciencies, children, proteinuria, 358–359 ventricular septal defect, 309 296–297 pregnancy, 83–85 pulmonary oligaemia, 314 primary postpartum haemorrhage, 164 signifi cant, 84 pulmonary plethora, 310 primiparous cervix, 140 testing, 85 pulmonary stenosis, 312–313 primitive refl exes, 217, 238–239 proteinuric gestational hypertension see pulmonary vasospasm, amniotic fl uid em- primitive yolk sac, 41 pre-eclampsia bolism, 170 primordial follicles, 8 proteoglycans, 95 pulmonary veins, total anomalous connec- probiotics, for necrotising enterocolitis, 193 prothrombin time, pregnancy, 88 tion, 315 processus vaginalis, 26 pruritus, treatment, 364 pulsatility, gonadotrophin-releasing hor- prochlorperazine, 405 pseudo-obstruction, intestinal, 348 mone, 22 progenitor cells, 44–45 pseudoglandular stage, lung development, pulsatility index, umbilical artery, 119 progestagens 55 pulse pressure, 318 combined oral contraceptives, 435 pseudohypoparathyroidism, 327 pulse rate see heart rate for endometriosis, 425, 426 pseudomembranous croup, 335 purpura implants, 436–437 pseudopseudohypoparathyroidism, 327 Henoch–Schönlein purpura, 358 progesterone, 22, 35–36, 411 pseudosacs, ectopic pregnancy, 403 immune thrombocytopenic, 304 combined oral contraceptives, 435 pseudotumour cerebri, 133 skin lesions, 364 early pregnancy, 399 psoriasis, 366–367 Purtscher-like retinopathy, 131 ectopic pregnancy, 403 arthritis, 379 pustules, 293, 364 on gastrointestinal tract, 62, 98 psychological aspects pyelonephritis, 354 HRT, 450 adolescence, 268–269 pyloric stenosis, 342–343, 388, 390 injection contraception, 436 postnatal care, 157 pyloromyotomy, 343, 390 on lactation, 158 pregnancy, 99–101 pyrexia, sepsis, 159 Mirena® coils, 437 multiple, 106–107 pyridoxine, hyperemesis gravidarum, 405 pregnancy, 60 termination, 432 pyrimethamine, toxoplasmosis, 199 subfertility, 418 psychosis, puerperal, 157 progesterone-only pills, 436 psychosocial short stature, 215 QT interval, 316 prolactin, 21, 158, 320 psychostimulants, ADHD, 260 quad test, trisomy 21, 74 excess, 21, 415 ptyalism, pregnancy, 62 quantitative FISH, amniocentesis, 76 prolapse, vagina, 17 puberty, 215, 263–270 quinsy, 334 repair, 446 abnormal, 266–268 proliferation, cells, 9 diabetes mellitus, 323 rachitic rosary, 326 proliferative phase, menstrual cycle, 21–22 growth, 215 radioactive iodine, 325 prolonged labour, see also abnormal labour pubis, 13 radionuclide imaging, urinary tract infec- causes, 149 muscles attached, 16 tions, 355 prolonged pregnancy, 114–115 rami, fractures, 15 Ramsay Hunt syndrome, 369 prometaphase, 5 pudendal nerve block, 144 rashes, 293, 294–295, 363–370, 373 prometaphase II, meiosis, 7 puerperal psychosis, 157 amoxicillin, 334 promethazine, 405 puerperal sepsis, 159–160 dermatomyositis, 289 PROMPT, training for emergencies, 163 puerperium, 155–161, see also postnatal care Henoch–Schönlein purpura, 358 pronephros, 56 pulmonary angiography, computed tomog- juvenile idiopathic arthritis, 379 prophase raphy, 168 meningococcal septicaemia, 295–296 meiosis, 6 pulmonary arteries pregnancy, 80–81, 98–99 mitosis, 5 banding, 310 syphilis, 199 prophase II, meiosis, 6–7 branch stenosis, 317 re-entry circuits, supraventricular tachycar- propulsive phase, second stage of labour, embryology, 55 dia, 316 140 fetus, 308 reaching, fi ne motor development,228 Index / 473 reassuring cardiotocography, 120 resuscitation, 163 rubella, 78, 80, 198, 368 recessive inheritance neonates, 175–180, 183 antenatal screening, 77 autosomal, 254 retained products of conception, 142, 159, 164 incubation period, 293 X-linked, 254 retina Rubin manoeuvres, 168 reciprocal translocation, 253 astrocytoma, 125–126 rupture of membranes, 149 recombination, homologous, 6 central serous retinopathy, 130–131 preterm pre-labour (PPROM), 151 rectocele, 17, 446 detachment rupture of uterus, termination of preg- rectum Coats disease, 125 nancy, 431 drugs via, 392 disseminated intravascular coagulop- Ruth Griffi ths Developmental Assessment, Hirschsprung’s disease, 349 athy, 131 244 rectus abdominis muscle, 25 pre-eclampsia, 130 recurrent abdominal pain, 349 toxocariasis, 125 sacrocolpopexy, 446 recurrent miscarriage, 400, 402, 407 diabetes mellitus, 131, 132 sacroiliac joint, 13 red blood cells, 300 eclampsia, 130 sacrospinous ligament fi xation, 446 destruction, 186–187 hypoxia, 124 sacrum, ligaments from, 13 disorders, 301 myelinated nerve fi bres, 126–127 safeguarding children, 272, 276 Red Book (Personal Child Health Records), occlusive vasculopathies, 131 salbutamol, 337, 393–394 182, 209, 242–243 preterm infant, 124 salicylic acid, psoriasis, 366 red degeneration, fi broids, 65–66 toxoplasmosis, 133, 134 saline, neonatal resuscitation, 179 red refl ex, 180, see also white pupil retinal pigment epithelium, embryonic stem salpingectomy, 36–37, 404 REDCAT (mnemonic), hypertension, 361 cells and, 45 salpingitis, 19 redcurrant jelly stools, 388 retinoblastoma, 123, 127, 181 salpingostomy, 404 reduced penetrance, 254 deletion at chromosome 13, 253 Sandifer syndrome, 383 refeeding, 352 retinoids, acne vulgaris, 366 SANDS, teardrop logo, 65 referrals, for child abuse, 276 retinopathy of prematurity, 124, 194 Sanfi lippo syndrome, 330 refl ex anoxic seizures, 282 retractile testis, 389 scabies, 370 refl ex sympathetic dystrophy, 377 retrograde menstruation, 424 scalds, 273–274 refl ux see gastroesophageal refl ux disease reversal of sterilisation, 416 scales, 293 refl ux-associated nephropathy, 356 reverse Wood’s screw, 169 psoriasis, 366 Refsum disease, 331 rhesus disease, 92–93, 187, see also anti-D scalp, tinea capitis, 369 regression, 242 immunoglobulin scarlet fever, 367 remifentanil, 144 invasive tests and, 75–76 incubation period, 293 renal failure termination of pregnancy, 430 Schedule of Growing Skills Assessment, abruptio placentae, 113 rheumatoid factor, polyarticular arthritis, 378 243–244 acute, 359–361 rheumatology, 374–384 School Action, 247 chronic, 361 rhythm methods (natural family planning), School Action Plus, 247 renal lupus fl are, pre-eclampsia vs, 101 434 Schwann cells, from embryonic stem renal osteodystrophy, prevention, 361 rib notching, 313 cells, 45 reproductive system rickets, 326 scoliosis, 377–378 female, 12–23 right-to-left shunts, 313–315 screening, see also antenatal screening male, 24–31, 57 right ventricle aneuploidy, twin pregnancy, 105 resistance index, umbilical artery, 119 patent ductus arteriosus, 318 autism spectrum disorder, 259 resistant ovarian syndrome, 449 ventricular septal defect, 310 breasts, Million Women study, 451 respiratory distress, 334 right ventricular outfl ow tract, tetralogy of Chlamydia trachomatis, 421 respiratory distress syndrome, 191, 195 Fallot, 314 cystic fi brosis, 339 diabetes mellitus, 91 ripening, cervix, 152 developmental delay, 245, 257 respiratory rates, asthma, 336 Ritter’s disease, 367 developmental dysplasia of hip, 381 respiratory syncytial virus, bronchiolitis, Robertsonian translocation, 252, 253 fetal growth restriction, 118 prevention, 194 rolling over, gross motor development, 219 genetic, 250 respiratory system, see also lungs; rooting refl ex, 238 gestational diabetes, 92 tachypnoea rosacea, 366 gestational trophoblastic disease, 406 embryology, 55–56 rosary, rachitic, 326 Guthrie test, 325, 329, 331, 339 fetal anomalies, 73 roseola, 368–369 hepatitis B, 200 paediatric disorders, 333–340 rotational forceps, 442 hypothyroidism, 325 paediatric examination, 210–211 rotavirus, immunisation, 348 neonates, 180, 250 pregnancy, 61 Roth spots, 310 postnatal depression, 157 restitution (fetal movement), 141 round ligament, uterus, 18 psychiatric diseases, 100 restraint, paediatric examination, 210, 211 Royal College of Obstetricians and Gynae- retinopathy of prematurity, 194 Resuscitaire®, 177, 195 cologists, prevention of VTE, 167 before termination of pregnancy, 430 474 / Index scrotum, 26, 28 sex hormones, see also specifi c hormones McCune–Albright syndrome, 327 hydrocele, 389 puberty, 215, 264, 265 pregnancy, 67, 98–99 seborrhoeic dermatitis, 365 sexual abuse, 274–275, 276 ocular adnexa, 130 cradle cap, 370 Sexual Abuse Referral Centres, 274–275 skull, fetus, moulding, 140 second polar body, 33 sexual reproduction, 4 slapped cheek syndrome, 80, 200, 369 secondary apnoea, fetus, 176, 177 sexually transmitted diseases, 421–422 sleep cycles, fetus, 114 secondary arrest of labour, 149–150 Sheehan syndrome, 113, 132, 414 slipped capital femoral epiphysis, 376 secondary headaches, 279 Sher and Statland classifi cation, abruptio small for gestational age, 118, 121, 187 secondary postpartum haemorrhage, 159, placentae, 112 smoking, subfertility, 413 164 shift work, subfertility, 413 snowstorm appearance, 406 secretory diarrhoea, 347 shin splints, 376 snuffl es, syphilis, 199 secretory phase, menstrual cycle, 22 shingles (varicella zoster), 78, 81, 99, 200, social aspects, fertility, 410 Section 47 enquiries, 276 294–295, 369 social behaviour, developmental milestones, sedation, termination of pregnancy, 431 shock 235–238 seizures abruptio placentae, 113, 179 social history, paediatric, 209 children, 281 gastroenteritis, 347 sodium eclampsia, 87, 107–108 neonates, 179 pregnancy, 62 epilepsies, 281–282, 283 short-acting insulin, 322 levels, 88 febrile, 284–285 short rotation, 141 renal loss, SIADH, 329 hypertension, 358 short stature, psychosocial, 215 secretory diarrhoea, 347 selective laser trabeculoplasty, 132 short tandem repeat probes, amniocentesis, sodium bicarbonate, neonatal resuscitation, selective noradrenaline reuptake inhibitors, 76 179 HRT vs, 452 shoulder diameter, 141 SOGS Assessment, 243–244 selective serotonin reuptake inhibitors, 100 shoulder dystocia, 168–169 somatic cell nuclear transfer, 46 HRT vs, 452 fetal weight, 91 somatic retinoblastoma, 123 semen, 33 shoulder tip pain, ectopic pregnancy, 402 somatostatin, 214, 215, 320 analysis, 8 shunts somites, 56 subfertility, 418 left-to-right, 309–312, 317–318 soya protein, cow’s milk protein allergy seminal vesicles, 28 right-to-left, 313–315 and, 345 seminiferous tubules, 26 shunts (ventriculo-peritoneal), 193 space-occupying lesions, 280 sensorineural hearing loss (SNHL), 245 sibling donors, beta thalassaemia cure, 303 spacers, inhalers, 336, 337 CMV, 198 sick day management, diabetes mellitus, spasmodic croup, 335 sepsis 322 spasticity, 287 early-onset, 159–160, 201–202 sickle cell disease, 302 special educational needs, 246–248, 258 late-onset, 202 parvovirus and, 80 Coordinators, 246–247 puerperal, 159–160 signalling, cells, 10 Statements of, 247, 258 septic arthritis, 381 signifi cant proteinuria, defi ned,84 Special Educational Provision, 247 septic miscarriage, 400 Singer alkali denaturation test, 114 speech, developmental milestones, septicaemia, meningococcal, 295–296 single deepest vertical pool, amniotic fl uid, 232–234 septo-optic dysplasia, 328 119 spermatic cords, 26 septostomy, 315 single gene defects, 253–254 spermatids, 7, 8 septum, uterus, 416 single-photon emission computed tomogra- spermatocytogenesis, 7 septum primum, heart embryology, 55 phy, epilepsies, 284 spermatogenesis, 7–8, 26 septum transversum, 53 single system defects, 251 spermatogonia, 7 sequences, abnormalities, 251 sinusoids, syncytiotrophoblast, 41 spermatozoa, 33, see also asthenozoospermia sequential HRT, 450 sister chromatids, 4, 34 discovery by Leeuwenhoek, 410 sequestrations, pulmonary, 73 sitting, gross motor development, 219, 220 natural family planning and, 434 Sertoli cells, 26 sixth disease, 368–369 pesticides on, 413 sertraline, 100 sixth nerve palsy, 133 transport, 33 severe combined immunodefi ciency, 296 skeletal dysplasias, 74 spermicides, 434, 435 severe hypertension skills, developmental, 217–240 spermiogenesis, 7, 8 management, 86 skills-and-drills (training for emergencies), spherocytosis, hereditary, 301 measurement range, 84 163 sphingolipidoses, 330 severe pre-eclampsia skin sphygmomanometers, 85 defi ned,84 children, 363–373 spider angiomas, 130 management, 87 examination of neonate, 181 spina bifi da, 58, 73 sex chromosomes, 34 histology, 44 spina bifi da occulta, 54 on growth, 214 infective lesions, 293 spinal anaesthesia, 144 sex cords, 29, 57 markers of neurological disorders, 211 spinal cord, embryology, 53–54 Index / 475 spinal nerves, embryology, 56 stool see Bristol stool chart syncytiotrophoblast, 40, 41 spine, examination of neonate, 181 stoop and retrieve, gross motor develop- hormones, 60 spinnbarkeit, 434 ment, 222 syndrome of inappropriate antidiuretic hor- spiramycin, toxoplasmosis, 133, 199 strategy meetings, for child abuse, 276 mone secretion, 329 splanchnic mesoderm, 56 strawberry haemangiomas, 370, 371 syndromes, defi ned, 251 splenectomy, hereditary spherocytosis, 301 strawberry tongue, 367 synovial fl uid, septic arthritis, 381 splints, developmental dysplasia of hip, 381 streptococcus group A synovitis, transient, 376 splitting, heart sounds, 312 glomerulonephritis, 358 Syntocinon, 144, 165 squatting, 314 puerperal sepsis, 160 Syntometrine, 144, 165, 447 SRY gene, 29 streptococcus group B, 201 syphilis, 77, 79, 199 St John’s wort, 157 pregnancy, 77 systemic lupus erythematosus stages, labour, 140 Streptococcus pneumoniae, 338 heart block, 95, 316 stairs, gross motor development for, 222– sickle cell disease, 302 pregnancy, 95–96, 101–102 223, 224 stress, subfertility, 23 systemic-onset JIA, 378–379 Stallworthy sign, 111 stress incontinence, surgery for, 446 staphylococcal scalded skin syndrome, 367 striae gravidarum, 67 T-incision, caesarean section, 444 Staphylococcus aureus, eczema, 365 stridor, 334 T-Safe® 380, 437 Statements of Special Educational Needs, string of beads appearance, 414 tachycardia 247, 258 structural chromosomal disorders, 252 sepsis, 159 station of fetal head, 140 Sturge–Weber syndrome, 371 supraventricular, 316 steatorrhoea, 339, 344 subacute sclerosing panencephalitis, 293 tachypnoea stem cells, 10, 44, 300, see also embryonic subcapsular haemorrhage, liver, 108 maternal collapse, 163 stem cells subfertility, 22–23, 409–418 respiratory distress syndrome, 191 stercobilin, 186 endometriosis, 424, 426 sepsis, 159 sterilisation, 438 prevalence, 410 tachysystole, 152 reversal, 416 types, 413–417 tacrolimus, topical, 364–365 sternocleidomastoid tumour, 382–383 subluxable DDH, 381 talipes, 382 sternum suboccipito-bregmatic diameter, 141 tamponade, uterus, 166 chest compressions, 178 subpubic angle, 25 Tanner staging, puberty, 265, 266 recession, 211 subtotal villous atrophy, 344 tapes, stress incontinence surgery, 446 steroid-resistant glomerulopathy, 359 sucking refl ex, 238 tasks of adolescence, 268–269 steroid-sensitive nephrotic syndrome, 359 suckling, 159 teardrop logo (SANDS), 65 steroids hormone release, 158 telangiectasia, retina, 124–125 for adrenal crisis, 328 suction, airway, neonates, 177–178 telophase, 5, 6 asthma, 337, 340 suction evacuation, miscarriage, 401 telophase I, meiosis, 6 diabetes mellitus and, 91 sudden unexpected death in epilepsy, 284 telophase II, meiosis, 7 Duchenne muscular dystrophy, 289 suicide risk, postnatal, 157 temperature charts, natural family plan- eczema, 364 sulphonamides, toxoplasmosis, 199 ning, 434 excess, 328 superimposed eclampsia, pre-eclampsia, 83 tenesmus hyperemesis gravidarum, 405 supraventricular tachycardia, 316 ectopic pregnancy, 403 infl ammatory bowel disease, 346 surfactant, 56, 191 ulcerative colitis, 345 intrauterine growth restriction, 121 diabetes mellitus, 91 tension-free vaginal tape, 446 juvenile idiopathic arthritis, 379, 380 endotracheal intubation, 178, 191 tension-type headaches, 279, 280 nephrotic syndrome, 359 surgical termination of pregnancy, medical terbinafi ne, tinea capitis, 369 placenta praevia, 111 vs, 430 terbutaline, 151, 337 pre-eclampsia, 87 suspensory ligament of the ovary, 18 terminal apnoea, fetus, 176, 177 preterm labour, 151, 190 sustained-release pessaries, prostaglandins, termination of pregnancy, 428–432 systemic lupus erythematosus, 96 152 selective, twin pregnancy, 105–106 urticaria, 366 sutures, cranial, 216, 382 testes, 26–28 Stevens–Johnson syndrome, 372 sutures (surgical) embryology, 26–27, 57 sticky eye, 202 B-Lynch, 166 examination of neonate, 181 sticky umbilicus, 201 caesarean section, 444 torsion, 28, 389 stillbirth, 88 sweat test, 339 undescended, 30, 181, 389–390 age of mother, 67 symmetric fetal growth restriction, 118 testicular arteries, 27 history-taking, 65 symphysis pubis dysfunction, 68, 97 testicular veins, 28 Still’s disease, 378–379 symphysis–pubis height, 68 testosterone, 264, 265, 412 Still’s murmur, 317 Synacthen test, 327 for constitutional delay of growth and stimulants, ADHD, 260 synaptic pruning, 269 puberty, 268 stomach, embryology, 53 syncope, 282, see also refl ex anoxic seizures tetralogy of Fallot, 314 476 / Index thalassaemia, 302–303 transient tachypnoea of the newborn, dia- hysterosalpingo-contrast sonography, theca lutein cysts, molar pregnancy betes mellitus, 91 415–416 and, 406 translocations, chromosomes, 252, 253 intussusception, 388 therapeutic hypothermia, 179–180 transmural infl ammation, Crohn’s disease, miscarriage, 400 thermoregulation, neonates, 177 346 polycystic ovary syndrome, 414, 415 thiamine, hyperemesis gravidarum, 405 transposition of the great arteries, 314–315 posterior urethral valves, 356, 357 threatened miscarriage, 400 transvaginal ultrasound pregnancy, 68, 72–74, see also dating three monthly HRT, 450 ectopic pregnancy, 403 scans throat, paediatric examination, 211 placenta praevia, 111 abruptio placentae, 113 thrombocytopenia, 303–304 preterm labour, 152 amniotic fl uid volume, 119 thromboembolism transversalis fascia, 25 cyanotic heart lesions, 314 HRT and, 450, 451 transversus abdominis muscle, 25 fetal growth restriction, 118–119, 121 multiple pregnancy, 106, 107 trauma, childbirth, 164, 168, see also birth molar pregnancy, 406 postnatal, 156, 160 trauma placenta praevia, 110, 111 pregnancy, 61, 69, 166–168 Trichomonas vaginalis, 422 renal abnormalities, 356–357 thrombophilia, miscarriage, 399 tricuspid atresia, 315 twin pregnancy, 105, 106 thrush, 370, 420 tricuspid valve, atrioventricular septal de- preterm labour, 152 thyroid gland, see also hyperthyroidism; fect, 312 urinary tract infections, 355 hypothyroidism triggers, asthma, 335 ultraviolet light, psoriasis, 367 hyperemesis gravidarum and, 398 triiodothyronine, 324 umbilical artery ovulation and, 414, 415 trimethoprim, 354–355 Doppler ultrasound, 118–119, 121 pregnancy, 62 triplets, 105 fetus, 308, 309 vomiting, 404 triploidy, partial hydatidiform moles, 406 umbilical cord thyroid-stimulating hormone, trisomies, 252 clamping, 142 320, 324 trisomy 21, 249, 252, 255, 257 controlled traction, 142 thyrotrophin-releasing hormone, 320, age of mother, 412 entanglement, 105, 106 324, 415 screening, 74–75 prolapse, 169 thyroxine, 324 trophoblast, 39, 40 umbilical venous catheters, 179 tibolone, 450 invasion failure, 84 umbilicus tics, 282 trophoblastic disease examination of neonate, 181 timings, pregnancy, 35 gestational, 405–406 exomphalos, 387 tinea capitis, 369 human chorionic gonadotrophin, 398 infection, 201–202 tinea corporis, 370 trophoblastic screening centres, 406 undescended testes, 30, 181, 389–390 tissue transglutaminase, antibodies, 344 true conjugate, 147 undiff erentiated arthritis, 379 tocolysis, 151 truncus arteriosus, 55, 315–316 unexplained subfertility, 417 toddler diarrhoea, 348 tuberculosis, tubal obstruction, 415 uniparental disomy, 254 tonic-clonic seizures, 283 tuberous sclerosis, retinal astrocytoma, 125 United Kingdom tonic seizures, 283 tumour lysis syndrome, 305 immunisations, 209 tonsillitis, 334 tumour necrosis factor inhibitors, JIA, 380 medical eligibility criteria, combined oral topical route, 392 tunica albuginea, 26 contraceptives, 435–436 tacrolimus, 364–365 tunica vaginalis, 26 subfertility, 413 torsion, testes, 28, 389 Turner syndrome, 252, 263, 269 United Nations Convention on the Rights torticollis, 382–383 twin-to-twin transfusion syndrome, of the Child, 272 total anomalous pulmonary venous 104–105 unopposed oestrogen, HRT, 450, 451 connection, 315 twins, 41–42, 104–108 unsafe abortions, WHO on, 430 total parenteral nutrition, hyperemesis fetal distress, 170–171 upper airway disorders, 334–335 gravidarum, 405 type 1 diabetes, 321–323 upper respiratory tract infections, totipotency, 44 type 2 diabetes, 321, 323 334–335 toxic epidermal necrolysis, 367, 372 tyrosinaemia, 329 urea, levels in pregnancy, 88 toxic megacolon, 346 urea cycle disorders, 330 toxocariasis, 125 UK medical eligibility criteria, combined urethra, 16–17 toxoplasmosis, 78, 80, 133, 134, 199, 202 oral contraceptives, 435–436 fetal anomalies, 74 trabecular bone, 375 ulcerative colitis, 345–346 injections round, 446 tracheitis, bacterial, 335 ulcers, skin, 293 obstruction, 355 tracheo-oesophageal fi stula, 386 ulipristal, 438 posterior valves, 74, 356, 357 training for emergencies, 163 ultrasound uric acid, levels in pregnancy, 88 trans-obturator tape, 446 abdominal pain, children, 349 urinary tract, see also kidneys transdermal preparations, HRT, 450 developmental dysplasia of hip, 180 children, 353–362, 388–390 transient synovitis, 376 ectopic pregnancy, 403 fetal anomalies, 73–74 Index / 477

infections, 20, 62, 77, 354–355, 362 variable decelerations, fetal heart rate, 119 pregnancy, rashes, 99 pregnancy, 62 varicella zoster, 78, 81, 99, 200, 294–295, skin, 368–369, 373 urination, postnatal, 156 369 wheeze, 335 urine varicose veins, pregnancy, 98 Virchow’s triad, 166 collection, 354 varus alignment, gait, 375 virilisation, 327, 332 hypotonicity, diabetes insipidus, 328 vas deferens, 28 visceral larva migrans, 125 protein/creatinine ratio, 83 vasa praevia, 113–114 vision, developmental milestones, proteins, pregnancy, 62, 91 vascular complexes, retina, 124 228–232, 237–238 urobilinogen, 186 vascular Ehlers–Danlos syndrome, 97 vitamin A defi ciency, 352 urogenital embryology, 56–57 vascular endothelial growth factor vitamin B1, hyperemesis gravidarum, 405 urogenital fi stula, 423 decidualisation, 39 vitamin B6, vomiting in pregnancy, 404 urorectal septum, 53 retinopathy of prematurity, 194 vitamin B12 urticaria, 366 vasectomy, 438 defi ciency, 301 USA, legislation on embryonic stem cells, vasoconstriction pregnancy, 61 46–47 hypertensive disorders, 84 vitamin D, 158, 185, 325–326 uterine arteries left-to-right shunt, 317–318 supplementing, 327 Doppler ultrasound, 118 retina, eclampsia, 130 vitamin K, 185, 303

embolisation (therapeutic), 166 vasomotor symptoms, menopause, 449 vitamin K1, 101 uteroplacental apoplexy, 113 alternatives to HRT, 452 vitreoretinal dysplasia, 127 uterovaginal primordium, 57 vasopressin, 21, 320 vitreous membrane dragging, toxocariasis, uterovaginal prolapse, surgery, 446 defi ciency, 328 125 uterus, 18, see also hysterectomy for von Willebrand’s disease, 305 volvulus, 386 abruptio placentae, 112, 113 VATER association, 386 vomiting atony, 164, 171 VDRL test, 77 children, 342–343 compression and massage, 165, 166 venous drainage neonates, 386 congenital abnormalities, 66, 402, ovaries, 19 pregnancy, 65, 404, 407 416–417 vagina, 17 hyperemesis gravidarum, 97–98, 105, fi xed retroverted, 425, 427 venous hum, 317 398, 404–405 hyperstimulation, 152–153 venous thromboembolism see von Gierke disease, 330 inversion, 170 thromboembolism von Hippel–Lindau syndrome, 327 postnatal, 156 ventilation von Willebrand’s disease, 305 pregnancy, 60 bronchopulmonary dysplasia, 192 vulnerable groups, children, 272 eff ect on cardiac output, 163 preterm infant, 190–191 vulvovaginal candidiasis, 420 rupture, termination of pregnancy, 431 ventilation breaths, neonatal resuscitation, subfertility, causes, 416–417 178, 183 walking, gross motor development, uveitis, 132 ventilation/perfusion lung scanning, 168 221–222, 225 ventouse, 442–443, 447 warfarin, 167 vaccination see immunisations birth trauma, 182 warming, neonates, 177, 190 VACTERL association, 386 twin pregnancy, 106 warning haemorrhages, placenta praevia, vacuum aspiration, termination of preg- ventricular septal defect, 309–311 110, 111 nancy, 431 tetralogy of Fallot, 314 warts, 368 vacuum extraction, see also ventouse ventriculo-peritoneal shunts, 193 water content, body, 392, 393 twin pregnancy, 171 ventriculomegaly, 74 water deprivation test, 328 vagal manoeuvres, supraventricular tachy- verotoxin, 361 weakness, 290 cardia, 316 verruca vulgaris, 368 weaning, 185–186 vagina, 17–18 version, internal podalic, 106, 171 weight discharge, 420–424 vertical transmission, infections, 76 faltering growth, 350 endometriosis, 425 vesicles measurement, 215 labour, examination, 142 chickenpox, 294–295 puberty, 265 pregnancy, 60 skin, 293, 364 weight loss, subfertility, 413, 414 examination, 69, 111 vesicoureteric junction obstruction, 356 weight reduction, diabetes treatments for dryness, 452 vesicoureteric refl ux, 355–356, 362 mellitus, 90 vaginal fornix, 18 villi, trophoblast, 41 Wernicke’s encephalopathy, 405 vaginal hysterectomy, 445, 446 villous atrophy, 344 wheals, 293, 366 valgus alignment, gait, 375 viral infections, see also specifi c viruses wheeze, children, 335–337 valproate, 101 bronchiolitis, 337–338 whiff test, 421 valvular disease, atrioventricular septal immune thrombocytopenic purpura, 304 white cell count defect, 312 meningitis, 296 pregnancy, 61, 88 variability, fetal heart rate, 119, 120 pneumonia, 338 urinary tract infections, 354 478 / Index white matter injury (periventricular leu- defi nition of adolescence, 268 Y-linked inheritance, 254 comalacia), 193–194, 287 partograms, 147 yams, 104 white pupil, 122–128 on prevalence of subfertility, 410 Yoruba people, 104 Wilms’ tumour, 306 on unsafe abortions, 430 Wilson’s disease, 331 Zavanelli’s manoeuvre, 169 window of opportunity, HRT, 451 X-linked agammaglobulinaemia, 297 Zellweger syndrome, 331 withdrawal bleeds X-linked dominant inheritance, 254 zinc defi ciency, 352 combined oral contraceptives, 435 X-linked recessive inheritance, 254 zona fasciculata, adrenal cortex, 327 HRT, 450 X-rays, see also chest X-rays zona glomerulosa, adrenal cortex, 327 withdrawal method, contraception, 434 hysterosalpingography, 415 zona pellucida, 8, 33 Women’s Health Initiative, 450–451 intussusception, 388 zona reticularis, adrenal cortex, 327 Wood’s light, 369 Perthes disease, 376 zoster infection, 78, 81, 99, 200, 294–295, Wood’s screw, 168–169 scoliosis, 377 369 World Health Organization subfertility, 413 zygotes, 34, 39