A much-needed overview of the available information now accumulating to indicate that assisted reproductive technologies are generally safe for both babies and mothers. However, the literature abounds with reports of a higher risk of obstetric and perinatal complications; regarding the long term outcomes for both women and children, the data are still scarce. The chapters summarized in this book review the current knowledge on long term safety of assisted reproduction and indicate the need for continued research to cover the lack of data in some specific patient groups and for recently developed treatments that only have a short period of follow-up.

Women's Health Communication explores and shares the stories of women who had a high-risk pregnancy and underwent premature labor or gave birth prematurely. This book discusses how women understand their experiences, cope with trying circumstances, and connect with others. Women's Health Communication provides insight into women's informational and support needs; delves into the range of emotions women experience; and examines how women seek out, avoid, and use the stories they encounter about pregnancy and birth to help them through their own traumatic experiences.

A close look at stories of maternal death in Malawi that considers their implications in the broader arena of medical knowledge. By the early twenty-first century, about one woman in twelve could expect to die of a pregnancy or childbirth complication in Malawi. Specific deaths became object lessons. Explanatory stories circulated through hospitals and villages, proliferating among a range of practitioners: nurse-midwives, traditional birth attendants, doctors, epidemiologists, herbalists. Was biology to blame? Economic underdevelopment? Immoral behavior? Tradition? Were the dead themselves at fault? In Partial Stories, Claire L. Wendland considers these explanations for maternal death, showing how they reflect competing visions of the past and shared concerns about social change. Drawing on extended fieldwork, Wendland reveals how efforts to legitimate a single story as the authoritative version can render care more dangerous than it might otherwise be. Historical, biological, technological, ethical, statistical, and political perspectives on death usually circulate in different expert communities and different bodies of literature. Here, Wendland considers them together, illuminating dilemmas of maternity care in contexts of acute change, chronic scarcity, and endemic inequity within Malawi and beyond.

1. Clinical cases set out as questions that are mapped directly to the curriculum and following the order of the RCoA curriculum 2. A focus on clinical anaesthesia with common cases, that can be used in the clinical environment either for teaching or as a refresher 3. Short, quick-fire cases that enable learning and retention of information with a summary of key points to remember for each question

A critical analysis of white, working class North Americans' motivations and experiences when traveling to Central Europe for donor egg IVF Each year, more and more Americans travel out of the country seeking low cost medical treatments abroad, including fertility treatments such as in vitro fertilization (IVF). As the lower middle classes of the United States have been priced out of an expensive privatized "baby business," the Czech Republic has emerged as a central hub of fertility tourism, offering a plentitude of blonde-haired, blue-eyed egg donors at a fraction of the price. Fertility Holidays presents a critical analysis of white, working class North Americans' motivations and experiences when traveling to Central Europe for donor egg IVF. Within this diaspora, patients become consumers, urged on by the representation of a white Europe and an empathetic health care system, which seems nonexistent at home. As the volume traces these American fertility journeys halfway around the world, it uncovers layers of contradiction embedded in global reproductive medicine. Speier reveals the extent to which reproductive travel heightens the hope ingrained in reproductive technologies, especially when the procedures are framed as "holidays." The pitch of combining a vacation with their treatment promises couples a stress-free IVF cycle; yet, in truth, they may become tangled in fraught situations as they endure an emotionally wrought cycle of IVF in a strange place. Offering an intimate, first-hand account of North Americans' journeys to the Czech Republic for IVF, Fertility Holidays exposes reproductive travel as a form of consumption which is motivated by complex layers of desire for white babies, a European vacation, better health care, and technological success.

The Royal College of Obstetrics and Gynaecologists has recently introduced extended matching questions (EMQs) into the format of their MRCOG Part 1 exam. All candidates need to sit this exam and therefore need to be well rehearsed in the art of answering such EMQs. This book gives the candidate 300 practice EMQs with answers and explanations for these answers. It is divided into 3 sections. The first section provides the essential knowledge each candidate must have - it deals with anatomy, physiology, embryology, endocrinology, epidemiology, molecular biology and genetics, all highly relevant in the RCOG syllabus. This information is supplied with the help of useful figures and illustrations which are included to assist greater understanding and help the candidate revise. Section two contains 300 questions, grouped in clusters per topic, and section three provides the answers, along with the relevant reasons for them. Dr Prabha Sinha is herself an examiner for the DRCOG and MRCOG Part 2 exam, and is therefore the perfect choice for supplying the requisite information in this book. Along with her two colleagues, she has produced an excellent revision guide that will be an invaluable resource for all MRCOG candidates.

This book is one woman's funny, moving, and sometimes awkward quest to fix her sex life, but it's the story of millions of women everywhere - half of all women have felt pain during sex. During award-winning writer and performer Fran Bushe's journey towards building a better relationship with her genitals, doctors advised her to have a glass of wine to loosen up, and male friends suggested she simply hadn't 'tried' the right penis yet. Unsurprisingly, neither worked. After a visit to Sex Camp and many attempts to fix her 'broken' vagina, Fran decided to share her own hilarious, excruciating, and sometimes upsetting experiences. With the help of her 16 year old self's diary, expert advice, candid and enlightening interviews with others about sex, and some self-care exercises, Fran sets about trying to make herself, and other people, feel like they're not being gaslit by their own vaginas.

The fetus occupies a critical phase during human development. It is at this stage when the body systems that will support us throughout our lives begin to face up to the challenge of life outside the womb. While the fetus can demonstrate a remarkably robust response to challenges in the uterus, it is also an exquisitely sensitive phase of development. It is now well recognized that disturbances to the materno-fetal environment can influence and even undermine our state of health well into adulthood. This exciting new publication provides a valuable insight into fetal growth and development across all the main body systems, and examines the influence of the materno-fetal environment on adult-onset diseases. This text contains additional chapters on the embryo, placenta, and parturition, to insure that this is a fully self-contained introduction. This book is written by world-renowned experts from leading centers of excellence and will be an invaluable introduction for students of medicine, reproductive biology, and human biology.

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 book provides a collective examination of the theoretical, empirical, and clinical perspectives of pregnancy-related anxiety. Pregnancy-related anxiety is a distinct form of anxiety that is experienced by pregnant women and is characterized by pregnancy-specific fears and worries. This form of anxiety has been associated with a range of negative obstetric, neonatal, and maternal outcomes. There has been increased research interest in this form of anxiety, particularly over the last 15 years. The content is organized in three sections. The first section provides a thorough understanding of pregnancy-related anxiety, ranging from its historical development, evidence of its distinctiveness to the antecedents and outcomes of this anxiety for the mother and child. The second section examines key clinical issues around diagnosis and treatment specifically, current diagnosis/screening for this anxiety and approaches for intervention and treatment. The final section considers emerging areas of research such as pertinent issues around culture and acculturation which are key issues in an increasingly multicultural world. Moreover, the effects of pregnancy-related anxiety on the woman's broader psychosocial functioning are considered with specific chapters on body image and sexual abuse, two key areas of concern. A seminal resource, this book provides a broad examination of the topic from multiple frameworks and perspectives which sets this book apart from other books in print. This book intends to inform and stimulate future research studies, as well as increase awareness and understanding of pregnancy-related anxiety. It is a must-read for researchers, educators, clinicians, and higher education students who care about delivering better support and services to pregnant women, particularly those who are vulnerable and distressed.

Pregnancy is the main determinant of some liver diseases in humans: acute fatty liver of pregnancy, cholestasis of pregnancy, and acute liver failure in toxaemia of pregnancy. Pregnancy also modifies the natural history of other more common hepatobiliary diseases, such as cholesterol gallstones. Sex hormones (mainly oestrogens, progesterone and/or some of its metabolites) and prolactin are considered responsible for these pathological consequences and they also appear to be influential in the outcome of several other hepatobiliary disorders, in both sexes and all ages. Although these disorders and their hormonal interrelations have been clinically well characterized, their pathogenesis remains obscure from the biomolecular point of view. In recent years, novel approaches using new technologies have improved our understanding of hormone actions and metabolism, hormone receptors, metabolic pathways and their interrelations with closely related molecules, such as bile acids. This book, the proceedings of the 89th Falk Symposium, held in Santiago, Chile, 10-11 November, 1995, will help research scientists and clinicians to review basic and clinical aspects of these interactions, in order to stimulate biomedical research in a relevant and exciting area.

Based on the experience of two Italian referral centers, the book depicts the characteristic findings obtained when using MR imaging to study the male and female pelvis including the obstetric applications. Each chapter provides a comprehensive account of the use of the imaging technique of examination, including the most recent advances in MR imaging, the anatomy and MR possibilities in the identification, characterization and staging of the different pelvic diseases highlighting its diagnostic possibilities. The advances in fetal MRI, representing the cutting edge of pelvic MR imaging, will also be depicted. The text is complemented by numerous illustrations, as well as clinical cases that make this a very practice-oriented work, presenting the role of diagnostic imaging in every-day clinical activity. The volume will prove an invaluable guide for both residents and professionals with core interest in gynecology, obstetrics and urology.

Endometriosis is a chronic health complaint that is experienced by up to 10% of women of reproductive age. Endometriosis results in significant psychological and financial burden. Surgical and pharmacological management can alleviate symptoms, but recurrence of endometriosis within one year is common. Many women use complementary and alternative therapies when the response to conventional medical treatments is inadequate.The latest book in the Evidence-based Clinical Chinese Medicine series uses a 'whole evidence' approach to summarise the management of endometriosis with Chinese medicine treatments. The current understanding of endometriosis - including symptoms, diagnosis and treatment - is summarised from conventional medicine and Chinese medicine perspectives. Next, a systematic approach is used to understand how endometriosis was treated with Chinese medicine in past eras.Internationally recognised scientific methods are used to identify and evaluate the clinical evidence for Chinese herbal medicine, acupuncture and related therapies. The potential mechanisms of herbal medicines are identified from experimental studies. The final chapter synthesises the evidence from the different literature sources and offers suggestions for contemporary clinical practice and future research.This book is a handy desktop reference for both clinicians and students of Chinese and integrative medicine. It provides a comprehensive synthesis of both traditional and contemporary knowledge that can inform clinical decision-making.

Endometriosis is a chronic health complaint that is experienced by up to 10% of women of reproductive age. Endometriosis results in significant psychological and financial burden. Surgical and pharmacological management can alleviate symptoms, but recurrence of endometriosis within one year is common. Many women use complementary and alternative therapies when the response to conventional medical treatments is inadequate.The latest book in the Evidence-based Clinical Chinese Medicine series uses a 'whole evidence' approach to summarise the management of endometriosis with Chinese medicine treatments. The current understanding of endometriosis - including symptoms, diagnosis and treatment - is summarised from conventional medicine and Chinese medicine perspectives. Next, a systematic approach is used to understand how endometriosis was treated with Chinese medicine in past eras.Internationally recognised scientific methods are used to identify and evaluate the clinical evidence for Chinese herbal medicine, acupuncture and related therapies. The potential mechanisms of herbal medicines are identified from experimental studies. The final chapter synthesises the evidence from the different literature sources and offers suggestions for contemporary clinical practice and future research.This book is a handy desktop reference for both clinicians and students of Chinese and integrative medicine. It provides a comprehensive synthesis of both traditional and contemporary knowledge that can inform clinical decision-making.

Leading gender and science scholar Sarah S. Richardson charts the untold history of the idea that a woman's health and behavior during pregnancy can have long-term effects on her descendants' health and welfare. The idea that a woman may leave a biological trace on her gestating offspring has long been a commonplace folk intuition and a matter of scientific intrigue, but the form of that idea has changed dramatically over time. Beginning with the advent of modern genetics at the turn of the twentieth century, biomedical scientists dismissed any notion that a mother-except in cases of extreme deprivation or injury-could alter her offspring's traits. Consensus asserted that a child's fate was set by a combination of its genes and post-birth upbringing. Over the last fifty years, however, this consensus was dismantled, and today, research on the intrauterine environment and its effects on the fetus is emerging as a robust program of study in medicine, public health, psychology, evolutionary biology, and genomics. Collectively, these sciences argue that a woman's experiences, behaviors, and physiology can have life-altering effects on offspring development. Tracing a genealogy of ideas about heredity and maternal-fetal effects, this book offers a critical analysis of conceptual and ethical issues-in particular, the staggering implications for maternal well-being and reproductive autonomy-provoked by the striking rise of epigenetics and fetal origins science in postgenomic biology today.

Titles in the Pocket Tutor series give practical guidance on subjects that medical students and foundation doctors need help with 'on the go', at a highly-affordable price that puts them within reach of those rotating through modular courses or working on attachment. Topics reflect information needs stemming from today's integrated undergraduate and foundation courses: Common presentations Investigation options (e.g. ECG, imaging) Clinical and patient-orientated skills (e.g. examinations, history-taking) The highly-structured, bite-size content helps novices combat the 'fear factor' associated with day-to-day clinical training and provides a detailed resource that students and junior doctors can carry in their pocket. Key points Logical, building-block approach to content: initial chapters outline the basic approach to gynaecological history and examination, and essential pelvic anatomy Subsequent chapters describe physiology and pathology of women at all stages of life from puberty, to reproductive age, to menopause; and associated disorders such as congenital disorders, menstrual disorders, genital diseases, and pelvic organ prolapse Concludes with chapter on gynaecological oncology Disorders are accompanied by medical images, examination photos and practical artworks Focuses on the conditions medical students and junior doctors are most likely to see

Maha Nasrallah-Babenko presents a culturally sensitive and uniquely accessible guide that equips clinicians, student sex therapists, and female clients with the tools to confidently treat genito-pelvic pain and penetration disorders (GPPPD). Addressing the issue from an integrated approach, the book provides evidence-based information and sensate, solo and partner practical exercises derived from the author's experience to help clinicians support women in redefining their relationship with sex, their bodies, and their partners. With a special focus on those from conservative and religious backgrounds, this beautifully illustrated text emphasizes the psychological, emotional, and relational factors that may increase shame and fear surrounding sex. The book defines GPPPD before outlining the author's ABCs approach, awareness, body, control, and safety, where she examines topics such as sexual abuse, how to communicate with you partner, sexual beliefs and messages, the importance of arousal, vulnerability and assertiveness, and shifting the significance of penetration for an enjoyable sex life. This book is essential reading for training and established sex therapists, family therapists, and couple therapists looking to support those struggling with sexual intimacy, as well as the couples seeking their help.

Key Features Explains normal physiology of pregnancy in addition to the physiology, evaluation, and management of endocrine diseases in pregnancy, and in the pre- and post-partum periods. Explores from a clinical standpoint with practical applications, useful for students, residents, fellows, mid-level providers, and practicing physicians. Discusses special considerations and emerging topics including pregnancy in transgender men, obesity and metabolism, and endocrine emergencies.

This book examines the role of psychopharmacological treatment in a range of disorders that may be encountered during pregnancy, including major depressive disorders, anxiety disorders, bipolar affective disorder, schizophrenia, eating disorders and substance abuse. The natural history of each condition pre and post-partum is analyzed and the evidence for the efficacy of drug treatments, evaluated. Special attention is paid to the potential dangers of different treatment options for both mother and fetus, covering risks of malformation, pregnancy and obstetric risks, neonatal risks and possible long-term consequences. The risks of not treating a particular condition are also analyzed. On the basis of the available evidence, management guidelines are provided that additionally take into account non-pharmacological options. Closing chapters consider the value of complementary and alternative medicine and ECT and explore future research directions.

The HIV pandemic continues to levy a heavy burden on the human race world-wide. The estimated number of people who became newly infected with HIV in 2009 was 2.6 million; most of these individuals live in Sub-Saharan Africa, followed by India and Southeast Asia. An estimated 370,000 new cases of pediatric infections occurred globally in 2009 (or more than 1,000 new infections every day), practically all of them through mother-to-child transmission. Up to 40% of all new infant HIV infections occur during breastfeeding. While breastfeeding by HIV-infected mothers is not recommended in the U.S. and other resource-rich settings where safe replacement feeding is easily available, the situation is different in many resource-limited settings, where replacement feeding is not safe or available and carries a high risk of infections (diarrhea, pneumonia) and infant malnutrition. Mothers in such settings are faced with a difficult dilemma: to breastfeed their infants in order to provide their infants with its many benefits (nutritional, immunologic, cognitive), but to also risk transmitting HIV. These challenges have prompted an intensive search for new prophylactic and therapeutic strategies in order to prevent infants from acquiring HIV infection through breastfeeding. In this book, expert HIV researchers critically review every aspect of this highly evolving and topical subject. The opening chapters deal with the epidemiology, global magnitude and biologic mechanisms of HIV-1 transmission from mother to child through breastfeeding and include considerations of the virus (quantity, compartments, characteristics) and the host (genetic, immunity-innate, cellular, humoral). The effects of breastfeeding on the HIV-infected mother's health and nutritional status, and the social and cultural issues associated with the practice of breastfeeding are also discussed. The next few chapters provide cutting-edge reviews of the latest approaches to prevention of HIV transmission to the infant through breastfeeding, including antiretroviral strategies, nutritional and immune-based approaches, and treatment of expressed breast milk. The remaining chapters provide a fascinating review of the many iterations this subject has received, as reflected in the several different sets of guidelines for infant feeding by HIV-infected mothers issued by the World Health Organization, and a debate by leading scientists on whether HIV-infected mothers should breastfeed their infants-in resource-limited and in resource-rich settings. A comprehensive overview of the current state of implementing the new evidence for prevention of breastfeeding transmission of HIV all over the world is also presented. Essential reading for the many disciplines of scientists and clinicians working on HIV/AIDS and other retroviruses, pediatricians, obstetricians/gynecologists, as well as all health-care professionals interested in expanding their understanding on the subject.

This is an ideal evidence based clinical guide to the essential principles and practical points arising from obstetric emergencies for residents, trainees, and obstetricians in practice. The concise text, illustrated with key diagrams, is from experienced educators and practitioners. *Provides a concise illustrated guide to the key principles and practical points involved *Gives trainees, residents, and obstetricians the practical information they need in an emergency *Supplies quick and easy reference to key points with illustrations

Fetal Cardiovascular Imaging, edited by Drs. Rychik and Tian, is the most complete video atlas available in this field - providing the detailed visual guidance you need to successfully identify a full range of fetal heart disorders. Complied by the team at the Cardiac Center at Children's Hospital in Philadelphia, this Expert Consult site and accompanying atlas-style text guide the acquisition and interpretation of fetal images for accurate diagnosis and effective management. Vivid color images, drawings, pathologic specimens and diagnostic algorithms facilitate tracking the progress of development of over 100 fetal heart problems. Enhance your cardiac imaging skills with a video library demonstrating imaging of the normal heart, and the imaging presentation of more than 100 different fetal heart problems. Recognize potential problems using views of the normal heart in development for comparative diagnosis. Get comprehensive coverage of cardiac anatomy, pathophysiology, natural history and disease management. See developing and existing problems as they appear in practice thanks to an abundance of vivid color images, drawings, pathologic specimens, and diagnostic algorithms. Track the progress of development in the fetal heart by using the best imaging modalities & techniques for more accurate diagnosis.

In order to bridge the lack of information on child labour and to stimulate policy interventions the IREWOC Foundation (International Research on Working Children) has undertaken action-based research in the field of the worst forms of child labour in Latin America. In 2006 and 2007 a comparative study on the Worst Forms of Child Labour was carried out in 7 different economic sectors in Bolivia, Guatemala and Peru focussing on the hazardous worst forms. The central research objectives were as follows: * to map the working and living situations of children who are working in specific economic sectors and what the consequences of this work are for their physical and emotional wellbeing. * to investigate the reasons why these children are working in these worst forms sectors. The research results were expected to give important insights into the currently polarised debate between those who state child labour is above all related to cultural considerations and those who state that economic reasons are fundamental to the phenomena of child labour. * to map the existing policy initiatives for child labourers in the worst forms and to identify the best practices. In the face of challenges imposed by achieving the Millennium Development Goals (MDGs) set by the UN, specific attention was paid to educational initiatives. Is education a useful tool in combating child labour, and vice versa, is child labour a significant obstacle to achieving universal primary education? Although the evidence from the various cases discussed in the book illustrate positive trends in terms of the worst forms of child labor, thousands of children were still found to be engaged in activities that form a direct threat to their physical, mental and moral health and jeopardize their education. This book proposes several practical recommendations for possible interventions.

Endometriosis is a complex gynecological disorder with multifactorial etiology. An estrogen-dependent condition, it affects 6% to 10% of women in the general population, and in 35% to 50% of these women often experience pain, and sometimes infertility. Exploring this benign but chronic disease, the book covers the different aspects of endometriosis from basic to advanced levels, including diagnoses, management, treatment modalities, complications, and fertility. Features Provides an overview of the guidelines, expert opinions, and ethical dilemmas involved with endometriosis. Covers the various complications that these women can experience Presents informative illustrations that complement the text discussion An overview of surgery, hormone therapy, and other options is provided In-depth coverage of novel treatments, including alternative medicine, diet, nutrition, and lifestyle modifications

Recurrent pregnancy loss (RPL) includes recurrent first- and second-trimester abortions and recurrent preterm delivery, second- or third-trimester intrauterine fetal death, intrapartum stillbirth, and early neonatal death. This book includes protocols for case scenarios of early and late pregnancy loss as well as instances of poor obstetric history. Key Features Explores the management of different clinical presentations of RPL Includes preeclampsia, intrahepatic cholestasis of pregnancy, and hypertension-related disorders in pregnancy Includes clinical protocols with flowcharts Features tip boxes with learning points for easy reference