Bringing together the most up-to-date information on congenital Mullerian anomalies, this comprehensive text explores advances in understanding the embryological causes of these malformations, the systems used to classify the many types of malformation that may be seen, and the field's current diagnosis, evaluation and management techniques. Surgical strategies, including minimally invasive techniques, are described in detail, with chapters divided into two sections: vertical anomalies, such as imperforate hymen, transverse genital septum, and cervical and Mullerian agenesis; and lateral anomalies, such as septate, unicornate and bicornate uterus, uterus didelphys and obstructed hemivagina. Aimed at helping to maintain the future reproductive needs of the patient utilizing assisted reproductive technologies, this book is an excellent reference for OB/GYN surgeons and reproductive medicine specialists treating both adolescent or adult patients with these congenital malformations.

Obstetrical emergencies can be among the most stressful events an emergency physician will face in their entire career. The purpose of this book is to provide an evidence-based, practical approach to the wide spectrum of obstetric complications an emergency physician must be prepared to manage throughout all trimesters pregnancy as well as postpartum, including complications of assisted reproductive technology, bleeding, precipitous delivery and preterm labor. Clinical pearls and pitfalls are highlighted throughout. The approach to the pregnant patient with trauma, non-pregnancy-related abdominal pain, or in cardiac arrest is discussed. Updates in the classification and management of the hypertensive disorders of pregnancy are presented. Recent controversies surrounding the use of anti-emetics for first trimester nausea and vomiting and the use of a beta-hCG discriminatory zone for the evaluation of pregnancy of unknown location are also addressed. Obstetrical support services vary widely between different facilities, and Emergency Department Management of Obstetric Complications is written for emergency clinicians in all practice settings. This book provides useful information for daily practice as well as preparation for rarely encountered and potentially life-threatening events.

Bringing together the latest information on the organization, management and quality of in-vitro fertilization (IVF) units, this is the first true field guide for the clinician working in assisted reproductive technologies (ART). Divided thematically into four main sections, part one discussed the establishment and organization of the IVF unit, including location, design and construction, practical considerations for batching IVF cycles, and regulations and risk management. Part two, the largest section, covers the many aspects of overall quality management and its implementation - staff and patient management, cryobank and PGD/PGS management, and data management - as well as optimization of treatment outcomes and statistical process control analysis to assess quality variation. Part three addresses the relationship between IVF units and society at large, including the ethics of IVF treatment, as well as public/low-cost and private/corporate IVF units. Advertising and marketing for IVF units is discussed in part four, including the building and managing of websites and the use of traditional print and social media. With approximately five thousand IVF units worldwide and a growing number of training programs, Organization and Management of IVF Units is a key resource for clinic directors, unit managers, embryologists, quality experts, and students of reproductive medicine and clinical embryology.

This first-of-its-kind volume addresses the myriad of issues relating to-and reviews the plethora of responses to--premature births in the United States, both in national context and compared with other countries. In addition to current clinical data, it examines how preterm births in the U.S. fit in with larger social concerns regarding poverty, racial disparities, reproductive rights, gender expectations, and the business of health care. Comparisons with preterm birth phenomena in Canada, the U.K., and other Western European countries illustrate cultural narratives about motherhood, women's status, differences across social welfare and abortion policies , and across health care financing and delivery sytems, and how these may affect outcomes for newborns. The book sorts out these intersecting complexities through the following critical lenses: * Clinical: causes, treatments, and outcomes of preterm birth * Population: the distribution of preterm births * Cultural: how we understand preterm birth * Health care: delivering care for high-risk pregnant women and preterm infants * Ethical: moral decision-making about preterm births Preterm Birth in the United States synthesizes a wide knowledge base for maternal and child health professionals across diverse disciplines, including public health, social work, nursing, medicine, and health policy. Social scientists with interests in reproduction and gender issues will gain access to historical, clinical and epidemiological knowledge that can support their work. There is also an audience for the book among childbirth activists such as supporters of midwifery and less medicalized childbirth.

This unique textbook is designed to provide a summary of state of the art developments in both male and female fertility and its association with cancer for both new and experienced practitioners. Clear, concise and readable, the text allows the reader to obtain rapid answers to this challenging medical issue. Special emphasis is placed on diagnostic and treatment algorithms. Topics covered include demographics of cancer in the reproductive age male, fertility conditions which predispose to cancer development, the role of assisted reproduction for fertility management, as well as fertility preservation strategies for the male and female cancer patients. Cancer and Fertility will be of great value to general urologists, uro-oncologists, gynecologists, medical oncologists, obstetricians, primary care providers, allied health providers.

There are approximately 55,000 practicing ob/gyns in the United States. The obstetrics and gynecology residency training authority (the Accreditation Council for Graduate Medical Education) has now pushed ambulatory primary and preventative care to the top of its list for residency training. Interest in the area of ambulatory gynecology is not just growing in the field of ob/gyn, however; family and primary care practitioners, emergency room physicians, and advance practice nurses all must know how to diagnose, manage, and treat gynecological conditions. Since office technology has expanded and decision-making has become increasingly complex, physicians need a guide through the endless list of treatment options for commonly presenting gynecologic disorders. Ambulatory Gynecology gives practitioners tools for diagnosis, investigation and management of these disorders, including decision-making algorithms. The text is evidence-based. From endocrine disorders to breast disease, preventative measures for osteoporosis to management of an abnormal pap smear, from adolescent gynecology to menopause, this book is crucial for office-based physicians to feel confident practicing in all areas of gynecology.

Preeclampsia: Risk Factors, Pathogenesis and Potential Treatments investigates the clinical, anamnestic, and biochemical predictors of preeclampsia. As such, a prognostic model based on the co-use of the studied predictors has been developed for the early prediction of late-onset moderate preeclampsia. The authors summarize some theories suggested to explain the pathogenesis of preeclampsia. The pathogenesis of preeclampsia has not yet been fully clarified and it remains a disease of theories. Furthermore, as it is a human-specific disease, the lack of one-on-one animal modeling and many other factors contribute to poor understanding of the disease pathophysiology. Additionally, this collection explores the possibilities of the maternal and fetal heart rate variability usage at all stages of management among pre-eclamptic women in a three-stage system. The concluding review includes sources of literature on the pathogenesis, management and long-term consequences of pre-eclampsia.

Providing the latest evidence-based information on etiology, evaluation and treatment, this unique text provides an in-depth, comprehensive discussion of the epidemiology, genetic and endocrinologic factors and medical and surgical management of recurrent pregnancy loss (RPL). Taking a multidisciplinary approach including psychological treatment and patient perspectives, all aspects of current RPL prevention and treatment are elucidated. Detailed chapters provide real-world illustrative material and cover the set-up and management of RPL clinics and databases, containing practical tips. Recurrent Pregnancy Loss will be an excellent resource for OB-GYN specialists, general and reproductive endocrinologists, radiologists, hematologists, psychiatrists, psychologists, and any other investigators or clinicians treating patients confronted with this emotionally and physically trying condition.

Providing a comprehensive review of the interactions between exercise and human reproduction, this unique text focuses on both the positive and negative consequences of sport and physical activity on male and female fertility and infertility and the biological mechanisms and processes behind them. Beginning with a review of the structure and function of the male and female reproductive systems as well as fertilization and gestation, the discussion then turns to the physiology and endocrinology of sport and exercise, which is further elaborated in subsequent chapters on the impact of physical activity, hormonal changes, pathologies, and consequences of drug use for active men and women. Additional chapters address related topics, such as the impact of sport on young athletes and developing reproductive potential, physical activity and pregnancy, the use of oral contraceptives in athletes, oxidative stress, and the impact of nutritional deficiencies on athletes' fertility, with a final chapter providing recommendations and therapeutic guidelines for exercise-related reproductive disorders. Covering everything from the fundamental principles of sports physiology and human reproductive potential to the interaction between physical exercise and the endocrinology of the reproductive system, Exercise and Human Reproduction is an authoritative resource for helping clinicians understand how the reproductive system adapts to activity and exercise and offers strategies to avoid potential harm to human reproduction.

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

This is a highly illustrated, practical book covering the obstetric and surgical procedures used in intrapartum care, including commonly used procedures and more rare techniques. The authors take a step-by-step approach to each technique and includes 'tips' and 'pointers', whilst contextualising this with the history of obstetric practice. Authoritative, world-known editors and author team. Presents a contemporary and pragmatic summary ofrecent developments in operative obstetrics. Contextualises practice in the history of obstetric practice. Accurate line drawings throughout clearly demonstrating relevant procedures and equipment. Advice and management for obstetricians working in resource-limited areas New chapter to cover labour and delivery in high-BMI women Extensive coverage of Caesarean section to reflect current critical thinking New chapters exploring assisted vaginal delivery in greater depth Management areas and guidelines fully updated (e.g. for fetal monitoring in labour). Covers significant new research, e.g. the WOMAN trial. New editor, Michael Robson

This book presents expert opinions on a variety of key topics related to the management of breast cancer, with a focus on the implications of recent advances and research findings for clinical practice. It also explores the controversy regarding mammography screening and reviews the contribution of new imaging modalities. Considerable attention is paid to developments in surgical procedures, including the potential for the safe and effective use of sentinel lymph node dissection alone-even in patients with positive nodes-and to the advantages and contraindications of new radiotherapy techniques. Genetic aspects are discussed in detail, including an assessment of the role of genetic testing and the potential impact of genetic signatures on breast cancer management. New systemic strategies, such as anti-HER2 therapy, endocrine agents, and agents to reverse endocrine resistance, are considered, and the optimal use of chemotherapy for early-stage and advanced-stage disease is addressed. In closing, the book shares important new insights into lifestyle risk factors, risk reduction strategies, and survivor issues, including sexual dysfunction and fertility maintenance.

The menopause is a natural event, but for many women it represents a time of hormonal upheaval and uncomfortable symptoms. It can happen at any age, and the journey through it may feel a bit rocky.

Menopause: The One-Stop Guide explains the changes which are occurring and advises on steps one can take to make life easier during this time of change. With clear and sensible information about recognising symptoms, getting help, treatment and staying positive, this guide will help those who are going through menopause, and family members who wish to better understand and offer their support.

This book evaluates the best approaches to the menopause and offers women all the information they need to determine whether medication, holistic remedies or other forms of treatment will work best for them, and helps them to take charge of their health.

Kathy Abernethy is the chair of the British Menopause Society with over 20 years of clinical experience.

This practical resource has easily accessed emergency management plans to deal with critical conditions in obstetric care, in which maternal health or life is threatened. Decision algorithms and summary boxes are featured throughout for ease of reading.

This volume offers the most comprehensive coverage on fetal programming. Chapters are written by authors of international and national standing, leaders in the field and trendsetters. The clinical relevance of the current research is emphasized in each chapter, which also contains key points, key words, and concise summaries for ease of learning. Fetal programming affects conditions in the immediate postnatal period, as well as in later life and adulthood. These conditions include cardiovascular disease, frank hypertension, stroke, dyslipidemia, coagulopathy, increased insulin resistance-metabolic syndrome, type-2 diabetes, leukemia, testicular cancer, prostate cancer, breast cancer, polycystic ovary syndrome, precocious puberty, impaired immune function, renal disease, lung disease, and osteoporosis. Neuropathologies, behavioral and mental deficiencies, schizophrenia, and depression have also been reported in adults who were exposed to nutritional inadequacies in utero. Diet, Nutrition and Fetal Programming provides an overview on the effects of fetal programming on disease, and comprehensive looks at maternal nutrition factors and fetal programming effects on brain and behavior, and physiology and disease. It also provides an in depth look at specific nutrient restrictions and supplements on physiology and disease, the effects of maternal disease on fetal programming, mechanisms of programming, and a special section on the international aspects and policies on fetal programming.

This comprehensive volume covers all aspects of nutrition in different scenarios of maternal diabetes, including the Type 1 or Type 2 diabetic mother, gestational diabetes, and postpartum diabetes. The volumes offer a comprehensive, yet thorough, overview of the subject, from the prevalence, risk factors, and insulin requirements of the mother; to possible outcomes and effects on the infant; to dietary advice in general and specific scenarios; and information on macro and micronutrient supplements. There is also a special section on international perspectives on maternal diabetes, with ten chapters that each focus on a different country. Nutrition and Diet in Maternal Diabetes: An Evidence-Based Approach offers an overview of the Type 1 and type 2 diabetic mother, maternal and offspring aspects of gestation diabetes, and breastfeeding and maternal gestational diabetes.

This book presents an overview of the diagnostic performance of non- or semi-invasive tests for endometriosis in peripheral blood, endometrium, saliva, peritoneal fluid and urine. The value of existing and emerging systems biology technologies for biomarker development is addressed in several chapters on genetics, microarrays, proteomics and metabolomics. Although tests with high sensitivity and acceptable specificity have been developed, sometimes validated in independent populations and seem promising, more research is needed to translate these data into clinical benefit for patients and coordinate efforts internationally to standarize analysis, reports and operating procedures. The gold standard to diagnose endometriosis is currently through laparoscopic inspection with histological confirmation, a surgical procedure with rare but significant potential risks for the patients. A non-invasive test for endometriosis would be critical for the early detection of endometriosis of symptomatic women with pelvic pain and/or subfertility with normal ultrasound. This would include nearly all cases of minimal-mild endometriosis, some cases of moderate-severe endometriosis without a clearly visible ovarian endometrioma and cases with pelvic adhesions and/or other pelvic pathology, who might benefit from surgery to improve pelvic pain and/or subfertility. Such a test would also be useful in symptomatic women with ultrasound imaging suspicious for endometriosis, since it may be difficult to differentiate an ovarian endometrioma from other ovarian cysts and since the quality of ultrasound imaging is highly variable worldwide.

This new edition is a comprehensive and updated resource on antiphospholipid syndrome (APS), which is an autoimmune disorder. In APS, the body recognizes certain normal components of blood and/or cell membranes as foreign substances and produces antibodies (antiphospholipid antibodies) against them. APS is associated with recurrent clotting events (thrombosis) including premature stroke, repeated miscarriages, phlebitis, venous thrombosis, and pulmonary thromboembolism. It is also associated with low platelet or blood elements that prevent bleeding. Recently, however, even more disease states have been linked with APS, including premature heart attack, various cardiac valvular abnormalities, skin lesions, kidney disease, abnormal involuntary movement/chorea, diseases that mimic multiple sclerosis, and vascular diseases of the eye that can lead to visual loss and blindness. The International Congress on Antiphospholipid Antibodies, held every 3 years, is the venue where representatives from different disciplines gather to discuss the recent advances in APS. The conference intends to cover basic aspects of APS, such as pathogenesis, origins, genetics, intracellular and molecular events, the role of infections, as well as traditional and non-traditional clinical manifestations associated with antiphospholipid antibodies. The 15th Congress took place in September 2016. A novel aspect of the Congress was that multiple teams, chaired by Scientific Planning Committee members, used evidence-based literature reviews and expert discussions to answer specific pre-defined APS-related questions. These teams included points of view from experts in rheumatology, hematology, cardiovascular medicine, obstetrics, neurology, and immunology. The Scientific Planning Committee members also chaired the congress sessions and supervised completion of the reports that are the bases of the chapters of this book. In addition, there are two chapters included specifically written for APS patients. Much like the previous volume, dedicated to the 13th International Congress on Antiphospholipid Antibodies (April 2010), this up-to-date and comprehensive work gathers invaluable insights from a multidisciplinary team of world-renowned experts and represents the authoritative resource on causes, symptoms, diagnosis, and treatment of APS.

This book contains the proceedings of the Serono Symposia USA interna tional symposium on Genetic Models of Immune and Inflammatory Dis eases held on October 20 to 23, 1994, in Savannah, Georgia. The advent of methods for introducing genes into the germlines of mice, and for targeted disruption of particular genes by homologous recombination, has provided scientists in many disciplines with an extraordinarily powerful set of analyti cal tools. Some of the most informative applications of transgenic and gene knockout technology have been in studies of lymphocyte development and activation. The goal of this symposium was to bring together investigators using these genetic approaches for analyzing the immune system, with a view to defining common themes and novel directions. Transgenic mice have a wide variety of important applications in immu nology. Defined proteins can be expressed in selected tissues throughout development, thus acquiring the essential characteristic of "self" antigens. Such models have been used to study how immune responses to these artificially created "self" antigens are controlled. Antigen receptors of lym phocytes have been expressed as transgenes, and because lymphocytes are endowed with the unique property of allelic exclusion, such transgenic mice become essentially monospecific. Immunomodulatory agents have been expressed in defined tissues or throughout the body, providing tools for studying the functional consequences of dysregulated expression of biologi cal response modifiers."

Hypertension: from basic research to clinical practice" contains a unique collection of selected chapters written by experts and enthusiasts engaged in research and treatment of hypertension, a condition that affects around a billion people in the world. The chapters describe fundamental researches at cellular and molecular levels to the science, and art of treatment of the condition in clinical practice. The topics included ranges from pathophysiology of hypertension, through monitoring of hypertension, to the treatment of hypertension in different patient categories. It contains essential background information as well as cutting edge research, and state of the art treatment alternatives in this broad field. From the beginners, and research students to the expert clinicians, and established scientists, everybody has something to learn from this book.

This compact resource presents current data on health literacy as it affects child health outcomes, with a sharp focus on improving communication between healthcare providers and pediatric patients and their families. A frequently overlooked social determinant of health in children, health literacy is shown as a critical skill for patients and families and a key aspect of patient engagement. The authors' evidence-based survey pinpoints common problems in healthcare providers' verbal and written communication with pediatric patients, their parents, and/or caregivers. Readers will learn about practical health literacy strategies for addressing and preventing miscommunication at the individual and systems levels. These improvements are linked to immediate results (e.g., greater compliance, fewer medication errors) as well as improved long-term child health outcomes, including reduced health disparities and enhanced quality of life into adulthood. This transformative guide: Defines optimum health communication as necessary for working with all patients Identifies common barriers to clear health communication Traces the relationship between health literacy and child health outcomes, from the prenatal period and into young adulthood Offers guidelines for creating effective patient education materials and a safe, health literacy oriented patient-centered environment Integrates health literacy into health systems' quality improvement plans Health Literacy and Child Health Outcomes informs students in MPH programs as well as public health scientists and scholars, and can also serve as an introductory text for students in public health ethics or a general applied ethics course. Public health professionals in diverse contexts such as local health departments and nonprofit organizations will appreciate its robust approach to ethical practice, professional development, and systems improvement. This will be a helpful guide for introducing health communication topics in medical education and allied health. Lastly, clinicians taking care of pediatric patients will find concise information and practical advice to apply in the clinical setting.

Translational Advances in Gynecologic Cancers straddles the bench and bed divide by highlighting important and interesting research that is translatable to the clinic. The contents of this book cover the entire spectrum, from promising laboratory based research, to clinical trial efforts. Further, new therapeutic indications based upon randomized phase III trials are also included. Clinicians will learn about lab-based science that is about to enter the clinic, along with the rationale behind translational endpoints in trials. Researchers will be able to identify and understand the clinical needs of patients with these types of tumors to improve their research focus.

This comprehensive, case-based title takes a practical approach to treating the pregnant patient by illustrating common and less common issues that arise during pregnancy. Outlining how difficult it often is to discern normal changes from pathological changes in the pregnant patient, Medical Problems During Pregnancy addresses not only this core dilemma but also a full array of specific, challenging issues to consider when pregnant patients present with conditions like epilepsy, hypertension, cardiac arrhythmias and renal disease - disorders requiring medication despite some risks. Although standard best practices generally determine medication use, the practicality of medication at various stages of pregnancy is highly variable. Medical Problems During Pregnancy outlines key points to consider when prescribing medication and additionally offers a range of practical suggestions that can greatly improve the physician-patient interaction. A unique and invaluable addition to the literature, Medical Problems During Pregnancy will be of great interest to practicing obstetricians, primary care clinicians, family practice physicians, nurse practitioners, and other allied health professionals.