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.

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.

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.

Since the first edition went to press in 1989, there have been many important developments concerning different aspects of maternity care. To take account of these, much needs to be added to this history. Late 1989 saw the publication of the double volume set of studies, Effective Care in Pregnancy and Childbirth, in which all the then existing evidence on all the associated procedures was considered and evaluated by well-informed and impartial authors representing many countries. This informative collection has since been followed by a flow of single reports of new research findings about specific subjects within the field. To incorporate the new material has involved, in particular, a consider able enlargement and rearrangement of the text and reference lists for Chapters 3 and 4, which deal with antenatal and intranatal care. Then in 1990-1 the House of Commons Health Committee, under its chairman Nicholas Winterton, undertook a further enquiry into the maternity services in Britain. A wide range of people concerned as pro viders or users of the service, as well as researchers concerned to find out how well the service was meeting needs, chose to submit testi monies, written and oral. These testimonies were all later published in six volumes which offered a most valuable depiction of the maternity service from many points of view."

The work looks at all human aspects of new prenatal technology. It includes the view of both parents involved in making difficult decisions about their pregnancy, and clinicians and counsellors involved in diagnosis and discussion of results of investigations, as well as the view of prenatal diagnosis by society as a whole - the ethical, legal and public health aspects. As genetic and ultrasound technology is developing rapidly, it is likely that more couples, their clinicians and counsellors will be faced with complex decisions and that the debate about ethics, legal aspects and rationing of health services will increase. This book aims to lay the foundation to those debates.;This book should be of interest to ultrasonographers; midwives; genetic counsellors; doctors specialising in obstetrics; genetic nurses; genetic social workers; clinical geneticists; general practitioners; psychotherapists; public health doctors; and purchasing managers.

Offering an authoritative collection of chapters from clinicians and researchers in the United States, Canada, and Europe, this reference comprehensively covers the latest understanding in the etiology, pathophysiology, diagnosis, and treatment of sexual dysfunction.

This book provides those studying for the MRCOG Part 2 examination with welcome practice in answering Extended Matching Questions (EMQs). Updated throughout to map onto the MRCOG syllabus from September 2016, the book is designed to test the candidate's theoretical and practical knowledge of obstetrics and gynaecology. An introductory section on exam techniques is followed by a collection of 41 EMQ themes, split into obsterics and gynaecology. The questions are based on common clinical scenarios and cover a variety of topics. Answers are included after each topic, and these include explanatory material and useful references.

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.

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.

Birth is a sudden, traumatic transition of environments. Once the placental oxygen supply ceases, the foetus has only minutes to establish pulmonary oxygen transport, which requires not only inflation of the lungs, but also sudden and sustained changes in the lung circulation. Not long ago, research in this field was largely restricted to morphology and physiology. Now the powerful new tools of cellular and molecular biology have begun to
shed light on the physiological processes in the developing lung and its supporting vasculature.

In 22 chapters, three main sections explore lung growth and development, vascular cell growth and differentiation, and the mechanisms of hemodynamic control in the neonate; extensive illustrations give a comprehensive picture of pulmonary circulatory development. Factors controlling vasculogenesis and angiogenesis are described by the scientists who pioneered the field. Similarly, the intracellular signaling cascades that determine proliferation or growth inhibition of fibroblasts, smooth muscle cells, and endothelial cells are also presented in an understandable manner. Finally, the role of
substances, such as nitric oxide and endothelin, that control the hemodynamics of the fetal and neonatal circulations are discussed in detail, particularly in relation to the changes occurring at birth.

This book will inform basic scientists as well as the clinician and student, and should be of particular interest to pediatric cardiologists, pulmonary medicine physicians, and vascular biologists.

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).

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.

The third volume of this successful Series brings together studies of particular relevance to the care provided by midwives for childbearing women and their families. midwifery research is essential for sound practice and is of importance as a basis for education and management. Topics in this volume include: care during pregnancy, tabour and delivery, and the post natal period midwifery education midwives responsibilities midwives careers.;The maternity services' continue to be in the public eye in the UK and the West. Debate on consumer satisfaction with the experience of pregnancy and childbirth and perinatal mortality is increasing.;This Series is intended primarily for midwives but it will be of interest to other health professionals involved in the provision of maternity care and members of social science disciplines concerned with women's health.;Sarah Robinson is Senior Research Fellow, Nursing Research Unit, King's College, London, England. Ann M Thomson is Senior Lecturer in Midwifery, School of Nursing Studies, University of Manchester and Director, Health Care Research Unit, Stockport, Tameside & Glossop College of Nursing, England.

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."

Given the rapid increase in the worldwide incidence of gestational diabetes, the need for defining the risks and effects associated with raised glucose concentrations in pregnancy is great. Recent large studies are helping to define the risks, as well as identify the benefits of reducing glucose intolerance. Written by an esteemed list of international authors, Gestational Diabetes: Origins, Complications, and Treatment presents timely reviews relating to some of the most important aspects of gestational diabetes, specifically its causes, consequences, and treatments. Divided into five sections, the book begins with a section on metabolism in pregnancy and gestational diabetes, dealing with maternal and foetal glucose metabolism and the controversial area of what actually constitutes gestational diabetes. The next section examines risk factors and causes of gestational diabetes, including the obvious but often overlooked factors-being female and pregnant. The text also outlines environmental and genetic risk factors. The third section deals with the potential complications of gestational diabetes for both mother and offspring, considering short-term and long-term effects. The largest section in the book addresses treatments in an effort to improve the outcome for the mother and the baby. Chapters describe the nutritional approach, considered the cornerstone of treating gestational diabetes, as well as evidence for the role of exercise in its treatment and a useful strategy for treating gestational diabetes pharmacologically. The final section discusses future prospects in screening, diagnosis, prevention, pathophysiology, and treatment of gestational diabetes.

This book is an obstetric formulary, for doctors and others concerned with the medical care of pregnant women and their newborn babies. It provides specific prescribing information on the drugs necessary to the obstetric management of antenatal patients, women in labour and the puerpurium, and the newborn. It aims to be a readily available source of information for resident obstetric staff and family practitioners who undertake obstetrics. It is also intended to provide guidelines for specialist obstetricians in training their juniors in the safest and most effective ways of using drugs during pregnancy, and for midwives, nurses and pharmacists, who need to understand the drug treatment of pregnant women.;The prescribing sections of this handbook are restricted to agents of known safety and proven efficacy and as well as covering the use of drugs in pregnancy the book includes sections on the transfer of drugs into breast milk. Advice on diet, nursing care and physiotherapy are mentioned where relevant and an account of the procedures involved in providing an epidural service are included. Doses of drugs used for newborn babies are given in the last chapter.;A section on preconception counselling has been added to the second edition and the drugs included in the volume have been revised, some preparations which have become of value to obstetric practice have been added and some which have been found to have limited clinical value have been withdrawn. This edition has been adjusted so that the prescribing procedures are in line with those used in North America.

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.

Doppler ultrasound is a hot topic at the present time. This is because studies of the uteroplacental and fetal circulation give fundamental information as to the physiology or pathology of placental function and the response of the fetal circulation to hypoxaemia. Dr. Arabin's clinical studies which are described in this book are an important contribution to knowledge in this field and will be of enormous interest not only to researches but also to clini cians interested in learning how this latest technology can be integrated into their clinical practice. London STUART CAMPBELL Foreword Although only three decades old, the field of perinatal medicine is marked by continuous new advances. Ultrasound diagnostic techniques comprise an important element of this new field. Dr. Arabin has taken the initiative to investigate the functional-diagnostic aspects of ultrasound. Among other things, she has further developed and refined the concept of "oxygen-con serving adaptation of fetal circulation" which originated in the Department of Obstetrics and Gynecology at the Neukolln Hospital Center in 1966. She thus has been able to show that the most reliable Doppler blood flow meas urement predictors of a high risk to the fetus are (1) a decrease in the flow volume of the descending thoracic aorta and the umbilical artery and (2) an increase in the flow volume of the common carotid arteries."

Postnatal PTSD, often referred to as birth trauma, is an underdiagnosed and misunderstood condition. Often mistaken for postnatal depression and with 4% of women developing the condition after giving birth, it is essential that health professionals learn to recognise and prevent postnatal PTSD. The book supports professionals to better understand, recognise, treat and help prevent birth trauma. It covers the impact of postnatal PTSD on bonding and relationships, birth trauma in Black, Asian and minority ethnic communities, how to support women having another baby and more. An accessible guide to supporting parents with postnatal PTSD, this book is essential reading for healthcare professionals and those involved with the birthing process.

Global and national confidential inquiry reports show that 60 to 80% of maternal and neonatal morbidity and mortality are due to avoidable errors. This comprehensive and illustrated second edition offers a practical guide to the management of obstetric, medical, surgical, anaesthetic and newborn emergencies in addition to organisational and training issues. The book is divided conveniently into nine sections and updated throughout in line with modern research and practice. Several new chapters cover setting up skills and drills training in maternity services to reduce avoidable harm, managing obstetric emergencies during 'home births' and in low-risk midwifery units, and minimizing maternal and fetal morbidity in failed operative vaginal delivery. Each chapter includes a practical algorithm for quick reference, the scientific basis for proposed actions, a case-based practical exercise and useful learning tools such as 'Key Pearls' and 'Key Pitfalls'. An invaluable resource for obstetricians, neonatologists, midwives, medical students, anesthesiologists and the wider perinatal team.