Talkowski ME, Ordulu Z, Pillalamarri V, et al: Clinical diagnosis by wholegenome sequencing of a prenatal sample. N EnglJ Med 367(23):2226, 2012 Tavenise S: Maternal mortality rate in U.S. rises, deying global trend, study finds. New York Times, September 21,r2016
Testa G, Koon EC, Johannesson L, et al: Living donor uterus transplantation: a single center's observations and lessons leaned from early setbacks to technical success. Am J Transplant, April 22, 2017 [Epub ahead of print]
Towers Watson: Update of U.S. tort cost trends. Available at: towerswatson. com. Accessed July 30,r201
Yan der Kooy J, Poeran J, de Graaf JP, et l: Planned home compared with planned hospital births in the Netherlands. Obstet Gynecol 118(5): 1037, 2011 Yoelker R: US preterm births: "0" is for dismal. JAMA 303(2):116,r2010 Wapner RJ, Martin CL, Levy B, et al: Chromosomal microarray versus karyo typing for prenatal diagnosing. N Engl J Med 367(23):2175, 2012
Wasden S, Perlman J, Chasen S, et al: Home birth and risk of neonatal hypoxic ischemic encephalopathy. Am J Obstet Gynecol 21 0:S251, 2014
Wax JR, Lucas FJ, Lamont M, et al: Maternal and newbon oLltcomes in planned home birth vs planned hospital births: a metaanalysis. Am J Obstet GynecoIr203(3):243,r2010
Yuko E: Weighing the ethics of artiicial wombs. New York Times, May 8,r2017
ANTERIOR ABDOMINAL WALL . . . . . . . . . . . . . . . . . . . . . 14
EXTERNAL GENERATIVE ORGANS ... .... .. 16
INTERNAL GENERATIVE ORGANS .......... ..... . 23
LOWER URINARY TRACT STRUCTURES ... . 28
MUSCULOSKELETAL PELVIC ANATOMY . .. 29
As the mechanism of labour is essentialy a process of accommodation between the oetus and the passage through which it must pass, it is apparent that obstetrics lacked a scientiic oundation until the anatomy of the bony pelvis and of the sot parts connected with it was cleary understood -J. Whitridge Williams (1903) • Skin, Subcutaneous Layer, and Fascia he anterior abdominal wall confines abdominal viscera, stretches to accommodate the expanding uterus, and provides surgical access to the internal reproductive organs. hus, a comprehensive knowledge of its layered structure is required to surgically enter the peritoneal cavity.
Langer lines describe the orientation of dermal fibers within the skin. In the anterior abdominal wall, they are arranged transversely. As a result, vertical skin incisions sustain greater lateral tension and thus, in general, develop wider scars. In contrast, low transverse incisions, such as the Pfannenstiel, follow Langer lines and lead to superior cosmetic results.
The subcutaneous layer can be separated into a superficial, predominantly fatty layer-Camper fascia, and a deeper membranous layer-Scarpa fascia. Camper fascia continues onto the perineum to provide fatty substance to the mons pubis and labia majora and then to blend with the fat of the ischioanal fossa. Scarpa fascia continues inferiorly onto the perineum as Colles fascia, described on page 19.