Medical, Surgical, and Gynecological Complications of Pregnancy [antikvár]

The interplay between obstetrics and the other fields of medicine is more extensive and intimate than found in any other specialty. This stems from the fact that pregnancy represents a unique condition in the health cycle, unique in the first place because pregnancy creates a profound, temporary alteration of physiology which may rapidly deteriorate into a state of pathology; unique in the second place, because pregnancy represents a physiologic state which by the will of man can be prevented, or once begun, acutely terminated. In the third place, it is the only chapter of medicine in which the interests of two patients are so inextricably intertwined, interests occasionally antagonistic. Believing in the existence of an exceptional interplay of medicine and surgery with obstetrics, the Mt. Sinai Hospitál departed from the usual pattern of organization when it opened its first department of obstetrics in November 1952. It created 10 specialty clinics within the framework of the department of obstetrics: cardiac, pulmonary, hypertensive-renal, diabet-ic, hematologic, neurologic, psychosomatic, obstetric-gynecologic endocrine, vaginitis, and varicose vein. Each of the 10 special clinics meets in the prenatal clinic area at a different time than the ordinary antepartum clinic. Each clinic is under the direction of one or more senior staff members from the department representing the particular medical discipline involved. Almost without exception the same senior staff physicians who initiated the special clinics continue to direct them 7 years later. Members of the obstetric-gynecologic resident staff attend the special clinics for the dual purpose of instruction and furnishing routine prenatal care. The less frequent complications of pregnancy which do not justify a separate obstetric clinic are ordinarily seen by a special consultant and once or twice a year he discusses the specific problems involved at an obstetric staff conference. This type of organization has stimulated members from the other departments of the Hospitál to develop particular interest in the pregnant women. It seemed to us that the invaluable knowledge accumulated about pregnancy by such a group of nonobstetric experts should be brought together in one book on the medical, surgical, and gynecologic problems of pregnancy. Each contributor is a member of the active staff of the Mt. Sinai Hospitál. The authors hope that this book will ha ve value not only for the obstetrician, whether speciálist or generál practitioner, and for the internist and surgeon, but alsó for residents, interns, and medical students. In an attempt to keep the material current we have largely excluded references published before 1950. Therapeutic measures have been stressed, not only specific drug therapy but the possible application of abortion and sterilization. This volume is in no instance intended as a substitute for the several excellent, standard textbooks on obstetrics; it is intended, however, to be a valuable supplement to them. Readers may question the repetition of somé of the material, such as the use and dosage of diuretics or antibiotics. We thought this was preferable to a distant page reference which is so apt to disturb continuity of thought.