Fibrin sealant is used for numerous indications in gynecology, especially for the McIndoe Operation and Cohn biopsy, the Marshall-Marchetti-Krantz-Hirsch-Stoll-Operation, urethrocysopexy, or in vitro fertilization for embryo transfer. The use of fibrin sealant in urology has also been extended, especially in operations of the spermatic cord, reconstruction of the urethra and closing of nephrotomies.

In Manufacturing Babies and Public Consent, Jose Van Dyck sketches a map of the public debate on new reproductive technologies as it has evolved in the USA and Britain since 1978. Many people have participated in heated discussions on test-tube babies and in vitro fertilization, particularly medical researchers and feminists. The new technologies have been both embraced as the cure to infertility and condemned as the exploitation of women's bodies. Reconstructing this debate, Van Dyck juxtaposes a variety of textual material, from scientific articles to newspaper articles and works of fiction.

On the occasion of the symposium on Hypertension in Postmenopausal Women (Monte Carlo, January 19-22, 1994), international scientists and clinicians discussed the various aspects of high blood pressure in older women. This volume presents an overview of this important aspect of both cardiology and gynecology. Special emphasis is given to the different approaches to antihypertension treatment.

In this issue of Surgical Pathology Clinics, guest editor Dr. Carlos Parra-Herran brings his considerable expertise to the topic of Gynecologic and Obstetric Pathology. Top experts cover emerging topics in gynecologic pathology that are relevant to clinical practice, including information on classification, terminology, diagnostic criteria, and ancillary testing. This issues also includes a review of the pathologic findings in specimens from patients undergoing gender-affirming surgery. Contains 14 practice-oriented topics including placental pathology: integrating consensus recommendations into practice; gestational trophoblastic neoplasia: contemporary diagnostic approach; homologous recombination deficiency and BRCA testing in pelvic high-grade serous carcinoma; ovarian sex cord stromal tumors and their mimickers; and more. Provides in-depth clinical reviews on gynecologic and obstetric pathology, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

This book is a hands-on guide for facilitating treatment of anxiety and depression during pregnancy and the postpartum period. Readers will learn about why anxiety and related difficulties can increase during pregnancy and the postpartum period, the critical roles that thoughts and behaviors play in maintaining symptoms, and how to apply practical cognitive and behavioral strategies to reduce distress and increase coping skills. Chapters are integrated with the latest research, and clinicians and individuals alike are presented with customizable cognitive behavioral therapy-based handouts, exercises, and worksheets proven to meet the unique needs of the perinatal population.

Here, the author clearly guides you through the necessary steps to controlling your gestational diabetes and reducing the risks for both you and your child.

The task of updating the classification was given to the Classification and Nomenclature Committee of the International Society of Gynecological Pathologists and its four subcommittees. This classification reflects the present state of knowledge and modifications are almost certain to be needed as experience accumulates. Since many of the tumours and tumour-like conditions in the classification occur in several sites in the female genital tract, cross-referencing from one site to another has been done in illustrating these lesions.

Female genital plastic surgery has become an increasingly sought-after option for women seeking improvement in genital appearance, relief from discomfort, and increased sexual pleasure. These surgeries are a combination of gynecologic, plastic, and cosmetic procedures. Every year sees a higher demand for physicians properly trained and able to perform them. This unique text from the acknowledged experts in the field covers; * the anatomy of the area * the specific surgical procedures and all their variations * patients' rationales for surgery * training guidelines and ethical issues * outcome statistics * sexual issues * patient selection * potential risks and complications. Examining the issues from individual patient's perspectives, it is written in an academic but easy-to-read style with understandable and unambiguous drawings and photographs. It contains a step-by-step surgical approach, how to best select the right surgical candidates, how to treat this select group of patients, the sexual issues involved, how to individualize techniques for each specific patient, how to deal with criticism from colleagues or journalists, psychosexual issues, and patient protection.

Why is it that women suffer far more than men from insomnia? What is the connection between the hormonal changes that a woman undergoes during her lifetime, and difficulty in falling asleep? What is the effect of cell phones on sleep? Should women engage in sports before going to sleep? What do women primarily dream about? In which country do people sleep the most? How do depression and anxiety affect sleep? And why is it inadvisable to resort to a "little pill" to provide unworried sleep? This clear and readable book, illustrated with short quotations of poetry and prose about sleep and dreams, provides a glimpse into the wonderful mechanism of sleep, explains how correct treatment of sleep disturbances results from understanding their causes, and shows the right path to a pleasant and satisfying night's sleep; it will be of great interest for all women and clinicians dealing with female patients. In particular, because of the connection between sleep and hormones, problems with sleep have repercussions for women's reproductive life cycle. This pioneering text will therefore be of particular interest to gynecologists working in Reproductive Medicine.

The main focus of this new edition remains the practical assessment and management of people presenting with psychiatric symptoms in late life. The core of the book describes the common presentations of depression, confusion, somatic preoccupation, hallucinations and delusions. Case vignettes are used to illustrate the approach to clinical problems. There is special emphasis on the complex interaction of social, psychological and medical factors and the need for close multi-disciplinary teamwork. The new edition has been revised to: update the clinical approach, update patient management under new policies, provide a precise diagnostic system and structure the book in keeping with today's practice.;This book should be of interest to postgraduate students in psychiatry or geriatrics; medical students; clinical psychologists; and nurses and other health professionals.

Biochemical monitoring of the fetus has been in the back of every perinatologist's mind. Technological advancements have been made in the last ten years but not to the expected level. A continued interest in the subject can only be maintained by symposiums of this nature where perinatologists from different countries can share their experience. Laserspectroscopy of the fetus is a valuable addition to this volume. The future of biochemical monitoring of the intrapartum fetus depends on the continued collection of scientific data and further technological advances. This successful symposium was held in October, 1990, in Albuquerque, New Mexico, USA. I would like to thank Hewlett Packard for their generous support without which this publication would not have been possible. My sincere thanks goes to my secretary, Nancy Whalen, who has done a tremendous job with the word processing, organization, and layout of the chapters. Molly S. Chatterjee, M. D. Associate Professor University of New Mexico Department of Obstetrics & Gynecology CLINICAL IMPORTANCE OF BIOCHEMICAL MONITORING OF THE FETUS DURING LABOR WITH DEMONSTRATION OF TYPICAL CASES E. SALING, J. BARTNICKI Institute of Perinatal Medicine, Free University of Berlin, Berlin, Germany The biochemical monitoring of the fetus during labor is historically the oldest part of prenatal medicine. The very first direct approach to the human fetus took place on June 21, 1960 when the first blood samples were taken from the fetal scalp in our labor room (3).

Each of the 6 units of PROLOG addresses a major area in obstetrics and gynecology and consists of two parts - an assessment book and a critique book. Put your knowledge to the test and earn 25 CME credits for this volume! On completion, users of this unit should be able to: Screen with appropriate diagnostic tests for endocrinology and infertility conditions. Determine the appropriate medical management to address infertility. Understand the hypothalamic-pituitary-ovarian-uterine axis. Apply concepts of the hypothalamic-pituitary-ovarian-uterine axis when considering medical therapy. Understand the basics of assisted reproductive technology. Counsel women regarding treatment options for primary and secondary amenorrhea and infertility.

This book grew out ofmy interest in what is often called "the immunological paradox ofpregnancy." How is it possible that the fetus-halfofwhosegenetic apparatuscomesfrom thefather and is foreign to the mother-can survive to term? This is a question that intrigues all immunologists. For me, it has been of interest ever since I heard a lecture on the subject in medical school, long before I thought ofbecoming a "professional immunologist." Indeed, the question ofthe immunological aspect of fetal survival (or demise) should be of interest to any biologist or physician. The question becomes broader ifone considers the immunologic relations between motherand fetus, because they represent a unique symbiotic union. Whatimmunologic problemsinthemothermayaffecttheoffspring, and isitpossiblethatfetal immunology willaffectthe mother? Finally, there is the question ofwhether immunology is important in recur- rent spontaneous abortion. Every authorowes the reader a general oversightofthe book in hand, indicating the terrain to be covered, and, by inference, the territory that will not be explored. 1. This is primarily a book for clinicians. I will only men- tion animal experiments and data in passing, and as they may illuminate a clinical problem or observation. 2. The interest here is the immunology ofmaterno--fetal re- lations, once a pregnancy has begun. Therefore, I will notcover immunological aspects ofsterility, nor touch on the immunological approaches to controlling fer- tility, i.e., "contraceptive vaccines." 3. This is a book mainly concerned with pathogenesis.

Fibroids are benign growths of the uterus. They are the most common tumours found in women (20-30% of women), usually in later reproductive years. This book covers evidence-based indications for treatment of uterine fibroids in gynecology, the management of fibroids in pregnancy, surgical treatments and outcomes, rare fibroid syndromes, and more.

Reproductive tract infections (RTis) have become a silent epidemic that is devastating women's lives. Each year, thousands of women die needlessly from the consequences of these infections, including cervical cancer, ectopic pregnancy, acute and chronic infections of the uterus and the fallopian tubes, and puerperal infections. For many women, this happens because they receive medical attention too late, if at all. The terrible irony of this tragedy is that early diagnosis of and treatment for many RTis do not require high-technology health care. For the hundreds of millions of women with chronic RTis acquired from their sexual partners, life can become a living hell. Infection is a major cause of infertility, and it leads to scorn and rejection in many countries. These women may experience constant pain, have festering lesions of the genital tract, be at enhanced risk of second ary diseases, and endure social ostracism. The problems associated with RT s have grown even greater in the past decade with the emergence of human immunodeficiency virus (HIV) and AIDS. Preexisting sexually transmitted disease, particularly when associated with genital tract ulcers, raises women's vulnerability to the transmission of HIV 3-5 fold."

This work attempts to sketch a coherent picture of the amniotic fluid com partment, its borders, and the interactions occurring between fetus and amniotic fluid, for it is this compartment which for 10 months provides the habitat in which the fetus and its functions develop. As a matter of course, our mor phological studies had to be limited to the situation prevailing at the full term of pregnancy. This portrayal purposely neglects the placenta, which is already the subject of an extraordinary profusion of literature. The other aspects of the embryonic sac have been overshadowed to date by the preeminent role 2 of the placenta, although they represent around 1200cm of contact surface in the maternal compartment. From our point of view, the fetal membranes not only act as a seal or simply a diffusion barrier, but actively participate in the exchange processes between compartments. The author also took pains to compile (albeit incompletely) the widely scattered findings reported in clinical journals in order to present them as a well-rounded summary of the mor phological picture and the functional happenings involved in fetal develop ment. The author's own studies of a specifically histomorphological nature provided the groundwork for this synopsis. A special branch of embryology, embryonal physiology, is treated only incidentally in today's embryology textbooks. This work offers several encounters with this field, which should help make it the focus of greater interest. 2 Definition of Terms Fig. 1.

This book was prepared to present an integrated review of selected topics in Human Embryology. It is designed specifically for students who completed stan dard courses in the various anatomical disciplines and who wish to review the developmental history of the major organ systems. This book will provide medical students with a highly suitable review for Step 1 of the United States Medical Licensing Exam (USMLE, Step 1). R. E. Coalson J. J. Tomasek Acknowledgments We wish to acknowledge the invaluable assistance provided by our colleagues at the University of Oklahoma Health Sciences Center during preparation of this review. In particular, we would like to thank Ms. Nancy Halliday for proofread ing, Mr. Shawn Schlinke for preparation of the illustrations, Mr. Melville Vaughan for assistance with mounting the illustrations, and Ms. Trenda Tanner for assis tance with the typing. Contents Preface to the Oklahoma Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii 1. Gametogenesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2. Female Reproductive Cycle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 3. Fertilization and Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 4. Implantation and Formation of the Deciduae . . . . . . . . . . . . . . . . . . . . 15 5. Formation of the Placenta . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 6. Fetal Membranes and Umbilical Cord . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 7. Early Development of the Conceptus 26 8. Development of General Body Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 9. Nervous System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 10. Musculoskeletal System . . . . . . . . . . .: . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 11. Integumentary System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 12. Oral Cavity and Development of the Branchial Apparatus . . . . . . . . 62 13. Differentiation of the Branchial Apparatus . . . . . . . . . . . . . . . . . . . . . . . 66 14. Face and Palate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 15. Digestive System and Mesenteries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 16. Diaphragm and Body Cavities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 17. Respiratory System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ."

This text draws together the principal issues related to the identification of language difficulties in pre-school children. Factors closely associated with the development of language such as cognitive skills, play, behaviour and hearing are discussed. The basic principles underlying early identification, the role of the parent and the issue of early identification within the context of public health are also included.;To reflect the range of related professionals involved with language impaired children, there are chapters written by a health visitor, a psychiatric social worker and speech and language therapists specializing in hearing loss. This book should be a useful reference for all those professionals working with children in the health and education setting.;This book should be of interest to practising and student speech therapists, nurses, health visitors, paediatric nurses, nursery leaders, play group leaders, clinical medical officers, educational and clinical psychologists.

In the USA, severe psychiatric illness after childbirth strikes one woman for every 1000 births, or about 3500 women each year. An unrecorded number of new mothers experience lesser degrees of postpartum illness, and two distinct forms of severe illness can be distinguished. One form, called postpartum psychosis, is an agitated, very changeable condition, often characterized by confusion, hallucinations, delusions and sometimes episodes of violent behaviour. The other condition, major postpartum depression, begins two or three weeks after childbirth, and is characterized by confusion, depression of mood, and often with exhaustion, headache and digestive upset. Mixtures of the two severe disorders occur frequently. This volume contains a number of essays which support the position that postpartum disorders are primarily organic and are mainly disorders of hormonal deficit. They develop as the endocrine system falls back from the hyperactivity of pregnancy toward or beyond the levels of the prior non-pregnant state. Tremendous therapeutic opportunities exist or are imminent for both the organic and the psychological components of postpartum mental illness.

Gynecologists cannot fulfill the commitments of their profession without being psychosomatically oriented. Nevertheless, this field needs methodology and scientific thinking just as does any other subspeciality in clinical medicine. Although practiced by all gyne cologists, creative work is needed in order to develop the various aspects properly and to establish postgraduate training on a firm and sound basis. For this purpuse the European Symposia have been planned by several European Researchers on Psychosomatic Obstetrics and Gynecology in order to stimulate and integrate clinical scientific data and therapeutic skills in the bio-psycho-social field of obstetrics and gynecology. The first European Symposium in Leuven 1985 concentrated on the psychosomatic aspects of infertility and high risk pregnancies. This second European Symposium in Bad Sackingen centered around disturbed body perception, disturbances of the menstrual cycle, climacteric syndrome, and senium. These topics were elaborated in main lectures and workshops held by outstanding researchers in this rapidly expanding field. The second European Symposium on Psychosomatic Obstetrics and Gynecology was organized by the German Society of Psycho somatic Obstetrics and Gynecology, supported by the University Hospital Freiburg/Br., the University Hospital Basel, and the Women's District Hospital in Bad Sackingen."

Lipids and Women's Health is an up-to-date critical review of pertinent scientific and clinical issues connected with lipid disorders in women. Topics discussed include the public health significance of cardiovascular disease in women, lipoprotein and lipid metabolism, effects of estrogens and progestins on lipid metabolism, metabolic changes of menopause, and the paradox of obesity, a curable disease that is rarely cured, as well as those conceptual advances in our understanding of diabetes mellitus that have clarified diagnosis and may have improved treatment. The relationship of diet and lipid intake to the development of breast and uterine cancer; dietary and drug treatment of lipid disorders; effects of exercise, smoking, and stress; and repercussions of lipid disorders on the family are explored. The volume should prove of use to gynecologists, internists, family practitioners, and pediatricians, as well as to all other professionals with a major concern for the health of female patients.

Endorphins and other endogenous opioids appear to be the connecting link between reproductive functions and stress adaption of the human organism. This book contains the con- tributions of an international group of biologists, bioche- mists, and endocrinologists on the opioidergic control me- chanisms in reproduction and stress physiology. Main topics covered are: endogeneous opioids and the pituitary-gonadal system; ovarian endorphinsecretion; pregnancy-associated changes of plasma endorphin; and opioid control of the hypo- thalamo-pituitary-adrenal axis. Although all chapters give an excellent review on various studies in basic opioid re- search, there are numerous clinical implications mentioned in this book.

During the past 20 years, endometrial carcinoma has continued to increase in frequency and it is quite possible that this carcinoma will become the major gynecologic malignancy in the future. For many years, endometrial carcinoma was considered less malignant than other gynecologic malignancies, simple hysterectomy and bil ateral salpingo-oophorectomy or surgery combined with radiation being effective in certain circumstances. It is unfortunate to note that the global 5-year survival rate for patients with advanced or recurrent endometrial carcinoma has improved only slightly. Therefore any complacency regarding this 'benign malignancy' should be reconsidered. There is a growing awareness of the nature of end ometrial carcinoma, with advances in our knowledge ranging from its etiology through its epidemiology to its clinical findings. This volume has been designed to fill a hiatus in the literature in China. To achieve this aim, we have attempted to review the world-wide advances on endometrial carcinoma and summarize systematically and comprehensively this common gynecologic malig nancy, including the clinical experiences gathered at the Cancer Institute (Hospital) of the Chinese Academy of Medical Sciences since 1958 as well as a brief description of the psychological problems in patients with gyneco logic cancers."