Obesity, type 2 diabetes mellitus, hypertension, and coronary heart disease are serious diseases affecting asignificantnumberofadults across the globe. Insulin resistance, low-grade systemic inflammation, low-birth weight, maternalproteinmalnutrition, neonatalhighcarbohydratediet, and high fat diet are associated with these diseases. On the other hand, adequatelybreast-fedsubjects are substantially at lowerrisk. Ifso, whatis the linkbetweenthese variousfactors?Onepossibilityisthat humanbreast milk containsfactorsthatconferresistancetothese modemdiseases.Here I present arguments that long-chain polyunsaturated fatty acids (LCPUFAs) presentinthebreastmilkcouldberesponsibleforthisbeneficialaction. Though the entire class of LCPUFAs provided dunng perinatal periodislikelytohavearole inthepreventionofadultdiseases, itshouldbe understoodthateachofthese LCPUFAsexhibitauniqueand insome cases opposing bioactive properties.It is important to note that there is a close interaction between (0-6 and (0-3 fatty acids. Human breast rmlk contains almost twice (0.78 vs 0.43 %w/w)the amountof(0-6LCPUFAs (gamma linolenic acid, dihomo-gamma-linolenic acid and arachidonic acid) comparedto (0-3LCPUFAs(eicosapentaenoicacid, docosapentaenoicacid, and docosahexaenoic acid). Obviously, the best would be to mimic the composition/concentrations in which these fatty acids are present in the breastmilk. The conceptthat LCPUFAs given duringpennatalperiod(and inadultlife)isbeneficialinpreventingadultdiseasescertainlyneedsfurther exploration.Iamconfidentthat someofthe enterprisingreaderswill delve intothepossibilitiessuggestedafterreadingthisbook. UndurtiN.Das, M.D., FAMS. To MyWifeLakshmi and Mytwoeyes DaughterArundhatiandSonAditya Chapter #1 Introduction Fetal/Perinatalimprintingonlaterlife It isbelievedthat stimuliormsults during criticalorsensitiveperiods inearlylifecanhave lifetimeconsequences.Thisconceptiswellestablished in developmental biology and has been termed "programming." The evidence for programming confirmed the critical period for imprinting in animals, more so in birds'. Programming stimuli may be generated endogenously, such as hormonal signals', or they may be environm

Perinatal Stem Cells provides researchers and clinicians with a comprehensive description of the current clinical and pre-clinical applications of stem cells derived from perinatal sources, such as amniotic fluid, placenta and placental membranes, the umbilical cord and Wharton's jelly. It's compiled by leading experts in the field, offering readers detailed insights into sources of perinatal stem cells and their potential for disease treatment. Therapeutic applications of perinatal stem cells include the treatment of in utero and pregnancy related diseases, cardiac disease, liver disease, pulmonary disease, inflammatory diseases, for hematopoietic regeneration, and for neural protection after stroke or traumatic brain injury. In addition, the rapid advance in clinical translation and commercialization of perinatal stem cell therapies is highlighted in a section on Clinical and Industry Perspective which provides insight into the new opportunities and challenges involved in this novel and exciting industry.

Originally published in 1977 and as a second edition in 1988, this book introduces the reader to the women at the top of the midwifery profession up until the 17th Century who attended the aristocracy and Royalty. The author shows how their successors were gradually driven out of the better paid work until in the middle of the 19th Century it appeared that attendance on childbearing women would inevitably become the male monopoly it has virtually become in North America. This downward trend was reversed, thanks to efforts to preserve for women the choice of female attendance in childbirth and also to the labour of philanthropists to improve maternity services to the poor. However, the drive for the institutionalization and mechanization of childbirth during the 20th Century as well as a chronic shortage of midwives, has once again shone a spotlight on the profession. This unique history of developments in midwifery will be of interest to students of medical politics, 19th Century social history, the sociology of the professions and gender studies.

Due to new developments in prenatal testing and therapy the fetus is increasingly visible, examinable and treatable in prenatal care. Accordingly, physicians tend to perceive the fetus as a patient and understand themselves as having certain professional duties towards it. However, it is far from clear what it means to speak of a patient in this connection. This volume explores the usefulness and limitations of the concept of 'fetal patient' against the background of the recent seminal developments in prenatal or fetal medicine. It does so from an interdisciplinary and international perspective. Featuring internationally recognized experts in the field, the book discusses the normative implications of the concept of 'fetal patient' from a philosophical-theoretical as well as from a legal perspective. This includes its implications for the autonomy of the pregnant woman as well as its consequences for physician-patient-interactions in prenatal medicine.

The Guest Editors have assembled expert authors to provide current clinical views and recommendations for patients with medical disorders in pregnancy. Clinical reviews are devoted to the following topics: Obstructive sleep apnea in pregnancy; Pregestational Diabetes; Gestational Diabetes; Maternal mortality in the 21 century; Infections in pregnancy and the role of vaccines; Peripartum cardiomyopathy; Update on HIV in pregnancy: Thromboprophylaxis; Opiate abuse in pregnancy.

Get Through MRCOG Part 2: SBAs provides 3 exams' worth of questions mapped to the RCOG syllabus in the newly introduced SBA style. With detailed explanations and relevant references to guidelines, this is the definitive resource for those taking the MRCOG Part 2 examination.

This issue provides a timely update for for the ob/gyn on genetics in reproductive medicine. Dr. Dugoff has created an issue with the goals of providing the most currently clinical information on genetic screening and prenatal genetics. Top authors have written reviews on the following topics: Genetic counseling overview for the ob/gyn; Cell-free DNA screening for aneuploidy; Cell-free DNA screening for single gene disorders; The use of microarray in prenatal diagnosis; Whole exome sequencing: Applications in prenatal diagnosis; Screening for aneuploidy in multiple gestations: The challenges and available options; Expanded carrier screening; Ethnicity-based carrier screening overview; Prenatal genetic diagnosis and prenatal genetic screening; Ethical issues in prenatal genetics; Ultrasound findings and associated genetic syndromes; Hereditary cancers in gynecology: and What physicians should know about genetic testing, screening and risk reduction. Readers will come away with the knowledge they need to diagnose, treat, and manage patients based on the most current evidence and data.

This casebook profiles exceptional traumatic injury prevention programs from all over the globe. Its detailed description and analysis employ a multi-stage process of identifying, evaluating, and casing effective prevention practices. The case studies reflect how legislative and regulatory information impact prevention efforts and provide insight into how national centers for injury prevention and control inform prevention practices on countrywide levels. The authors work with outcome-based research criteria to select and develop their comprehensive and contextually aware profiles of the programs. All included case studies follow the BRIO approach (Background, Resources, Implementation, and Outcome) - a model designed to provide a consistent way of describing programs that have been evaluated and found to be exceptional practices. The scope of the Casebook ranges across: The challenge of traumatic injury prevention Sports and recreation-related traumatic injury prevention Fall-related traumatic injury prevention Road traffic-related traumatic injury prevention Traumatic injury prevention within complex systems In its recognition of traumatic injury prevention across the lifespan as a critical and complex public health challenge, the Casebook of Traumatic Injury Prevention promises to be an influential and authoritative resource for professionals and students in public health, safety, injury prevention, medicine, psychology, sociology, nursing, and engineering. Government agencies and institutions such as the Centers for Disease Control and Prevention (CDC), public health departments, and safety associations also would find the Casebook relevant to their work.

Gives a convenient summary of trials in Gynecologic Oncology Supplies an invaluable revision primer for those undertaking certification Provides a uniquely up-to-date resource

This practical, two volume handbook provides a critical look at state-of -the-art ultrasound techniques and equipment. It is a comprehensive reference with numerous black/white and color ultrasonograms, tables and graphs. The volumes include extensive literature citations which assist the investigator in finding more in-depth references. This work focuses on the recent remarkable expansion in both diagnostic techniques and clinical applications. It reports findings based on an unusually large patient population over al long time period. It presents the accuracy and limitations of various aspects of ultrasound.

This practical, two-volume handbook is the first to illustrate the use of transvaginal color doppler in obstetrics and gynecology. It provides a critical look at state-of-the-art ultrasound techniques and equipment and serves as a comprehensive reference with numerous black/white and color ultrasonograms, tables and graphs. The volumes include extensive literature citations which assist the investigator in finding more in-depth references. This work focuses on the recent remarkable expansion in both diagnostic techniques and clinical applications. It reports findings based on an unusually large patient population over a long period of time. It presents the accuracy and limitations of various aspects of ultrasound. This important publication is especially helpful for clinicians and researchers.

With an increased capacity to analyze fetal cells in the laboratory and the present possibility of monitoring human embryonic development using advanced diagnostic technique, prenatal diagnosis (PND) has become widely diffused in medical practice. The Fetus as Medical Patient emphasizes, however, that PND results are not unambiguous: they may either lead to a continuation of the pregnancy, or to an abortion. Cioffi engages the reader in a comprehensive examination of the state of the question regarding diagnosis and possible treatment of human illness in utero. The book deals with biomedical consideration in prenatal human life, presents a survey of the literature of ten North American Catholic theologians who have written on the topic of moral dilemmas in PND over the past twenty years, and critically analyzes the writings of these ten authors.

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.

Numerous issues confront women's healthcare today, among them the medicalization of women's bodies, cosmetic genital surgery, violence against women, HIV, perinatal mental health disorders. This volume uniquely explores such difficult topics and others at the intersection of clinical practice, policy, and bioethics in women's health care through a feminist ethics lens. With in-depth discussions of issues in women's reproductive health, it also broadens scholarship by responding to a wider array of ethical challenges that many women experience in accessing health care. Contributions touch on many themes previously tackled by feminist ethics, but in new, contemporary ways. Some chapters expand into new fields in the bioethics literature, such as the ethical issues related to the care of Indigenous women, uninsured refugees and immigrants, women engaged in sex work, and those with HIV at different life stages and perinatal mental health disorders. Authors seek to connect theory and practice with users of the health system by including women's voices in their research. Bringing to bear their experience in active clinical practice in medicine, nursing, and ethics, the authors contemplate new conceptual approaches to important issues in women's healthcare, and make ethical practice recommendations for those grappling with these issues. Topical and up-to-date, this book provides a valuable resource for physicians, nurses, clinical ethicists, and researchers working in some of the most critical areas of women's health and applied ethics today.

The subject of medicalisation of childbirth in colonial India has so far been identified with three major themes: the attempt to reform or 'sanitise' the site of birthing practices, establishing lying-in hospitals and replacing traditional birth attendants with trained midwives and qualified female doctors. This book, part of the series The Social History of Health and Medicine in South Asia, looks at the interactions between childbirth and midwifery practices and colonial modernities. Taking eastern India as a case study and related research from other areas, with hard empirical data from local government bodies, municipal corporations and district boards, it goes beyond the conventional narrative to show how the late nineteenth-century initiatives to reform birthing practices were essentially a modernist response of the western-educated colonised middle class to the colonial critique of Indian sociocultural codes. It provides a perceptive historical analysis of how institutionalisation of midwifery was shaped by the debates on the women's question, nationalism and colonial public health policies, all intersecting in the interwar years. The study traces the beginning of medicalisation of childbirth, the professionalisation of obstetrics, the agency of male doctors, inclusion of midwifery as an academic subject in medical colleges and consequences of maternal care and infant welfare. This book will greatly interest scholars and researchers in history, social medicine, public policy, gender studies and South Asian studies.

In the last decades, major advances have been made in assisted reproductive technologies (ART) and the public demand for these procedures has increased globally. All ART clinics, from those just starting out to the well established, must employ the latest equipment and implement the best practices, while ensuring that their resources are effectively engaged to optimize patient outcomes. This is a tenet of the fiduciary role of physicians and it is increasingly recognized as a quantifiable goal regulated by formal certifications and accreditations. Quality management protocols such as those proposed by the International Organization for Standardization (ISO) are being rapidly adopted as standards of measure. Quality Management in ART Clinics: A Practical Guide provides easily adoptable ways to implement and improve formalized quality management systems. Essential to any clinic to achieve best practices and maintenance of formal regulatory certifications, this book brings together the know-how of experienced opinion leaders operating in key areas worldwide. The book offers an overview of primary regulations in the ART field, with attention to quality management demands, and links specific requirements to practical steps for implementation. Filled with process and procedure examples, flow diagrams and administrative form templates, this book is the first of its kind, gathering the necessary elements for optimizing practice, management, and quality assurance.

When a patient is diagnosed with a gynecological malignancy, she and her doctors must make urgent, high-risk decisions about her course of treatment. In selecting an appropriate plan of care, physicians must weigh the patient's individual needs, the tumor's specific characteristics, and the treatment's potential side effects. Because there is no one-size-fits-all treatment solution, a plethora of clinical trials have been performed on ovarian cancer patients, but clinicians may struggle to keep up with this ever-growing body of research. Collecting and synthesizing research findings from a wide array of medical journal articles and book chapters, Clinical Trials in Ovarian Cancer provides physicians with an invaluable resource. Gynecologic oncologist Christine S. Walsh systematically outlines each of the seminal Phase III trials that have shaped the treatment of ovarian cancers, detailing the rationale for the trial, the patient population studied, treatment delivery methods, efficacy, toxicity, and trial conclusions. She provides a clear overview of established treatments, as well as still-controversial experimental approaches. The first book to organize this cutting-edge research into an easy-to-use reference, Clinical Trials in Ovarian Cancer should help medical personnel at all levels provide their patients with the highest standard of care.

There is general consensus regarding threshold levels that describe the gray zone on the limits of viability, and gestational age alone should not be used solely in making a decision. This issue will bring light to the latest thoughts and clinical recommendations for delivery during the periviable period. Top thought leaders and clinicians have submitted articles in the following areas: Consequences of Birth at Periviable Gestions on Organ Systems; Medical and Surgical Interventions Before Birth; NICU Care: Nutrition/NEC; Pulmonary Care and Circulatory Support; NICU Stay and Microbiome; and Ethical Considerations and Counseling, to name a few. Readers will come away with the most current content written on this topic and details that can be incorporated into clinical care.

Since 2006, when the "morning-after pill" Plan B was first sold over the counter, sales of emergency contraceptives have soared, becoming an $80 million industry in the United States and throughout the Western world. But emergency contraception is nothing new. It has a long and often contentious history as the subject of clashes not only between medical researchers and religious groups, but also between different factions of feminist health advocates. The Morning After tells the story of emergency contraception in America from the 1960s to the present day and, more importantly, it tells the story of the women who have used it. Side-stepping simplistic readings of these women as either radical feminist trailblazers or guinea pigs for the pharmaceutical industry, medical historian Heather Munro Prescott offers a portrait of how ordinary women participated in the development and popularization of emergency contraception, bringing a groundbreaking technology into the mainstream with the potential to alter radically reproductive health practices.

Nominated for the Foundation of Sociology of Health and Illness Book Prize 2018 In the UK and beyond, Down's syndrome screening has become a universal programme in prenatal care. But why does screening persist, particularly in light of research that highlights pregnant women's ambivalent and problematic experiences with it? Drawing on an ethnography of Down's syndrome screening in two UK clinics, Thomas explores how and why we are so invested in this practice and what effects this has on those involved. Informed by theoretical approaches that privilege the mundane and micro practices, discourses, materials, and rituals of everyday life, Down's Syndrome Screening and Reproductive Politics describes the banal world of the clinic and, in particular, the professionals contained within it who are responsible for delivering this programme. In so doing, it illustrates how Down's syndrome screening is 'downgraded' and subsequently stabilised as a 'routine' part of a pregnancy. Further, the book captures how this routinisation is deepened by a systematic, but subtle, framing of Down's syndrome as a negative pregnancy outcome. By unpacking the complex relationships between professionals, parents, technology, policy, and clinical practice, Thomas identifies how and why screening is successfully routinised and how it is embroiled in both new and familiar debates surrounding pregnancy, ethics, choice, diagnosis, care, disability, and parenthood. The book will appeal to academics, students, and professionals interested in medical sociology, medical anthropology, science and technology studies (STS), bioethics, genetics, and/or disability studies.

Drs. Robert Gaiser and Oni Onuoha have assembled an expert team of authors on the topic of "Obstetric Anesthesia". Article topics include: Epidural Analgesia for Labor: Continuous Infusion vs Programmed Intermittent Bolus; Prophylaxis and Management of Obstetric Hemorrhage; The Use of Ultrasound in Obstetric Anesthesia; Huddles and Debriefings: Improving Communication on Labor and Delivery; General Anesthesia during the Third Trimester: Any Link to Neurocognitive Outcomes; Obstetric and Anesthetic Approaches to External Cephalic Version; Update in the Management of Patients with Pre-Eclampsia; Optimal Pain Management After Cesarean Delivery; Should Nitrous Oxide be Used for the Laboring Patient?; Tilts and Full Stomach: Changes in Anesthesia for Cesarean Delivery; and Post-Dural Puncture Headache: An Evidence Based Approach.

This is the first international study of maternal care and maternal mortality. Over the last two hundred years, different countries developed quite different systems of maternal care. Death in Childbirth is a meticulously researched analysis, firmly grounded in the available statistics, of the evolution of those systems between 1800 and 1950 in Britain, the USA, Australia and New Zealand, and on the continent of Europe. Irvine Loudon examines the effectiveness of various forms of maternal care by means of the measurement of maternal mortality - the number of women who died as a result of childbirth. His scholarly and comprehensive study sets out to answer a number of important questions. What was the relative risk of a home or hospital delivery, or a delivery by a midwife as opposed to a doctor? What was the safest country in which to have a baby, and what were the factors which accounted for enormous international differences? Why, against all expectations, did maternal mortality fail to decline significantly until the late 1930s? Death in Childbirth makes an invaluable contribution to medical and social history.

This multi-disciplinary resource provides an overview of perinatal mental and physical health issues within the military population. Perinatal mental health has far-reaching implications for military readiness. The text provides insights to the effects of military culture on identification, evaluation, and treatment of perinatal mood and anxiety disorders and is an invaluable resource for military and civilian primary and behavioral health providers.

Preterm birth interrupts the normal developmental progression of most organs, particularly when birth occurs at the lowest level of viability. An immediate task is to successfully transition to a post-natal life without a placental circulation. To do this demands careful management of the cardiorespiratory systems. To best help the fragile preterm infant at this demanding time, care-givers must remember two most pressing goals. These are first to maintain adequacy of gas exchange and delivery, while simultaneously minimizing any secondary injury to the fragile preterm lung. However, after these immediate priorities in the delivery room, the longer term effects of an immature lung development and its associated problems come to the forefront. These problems include the inflammation of perinatal infection, oxygen, and invasive mechanical ventilation. Both the immaturity itself, and secondary lung injury and its inflammation - collectively will often lead to the condition termed bronchopulmonary dysplasia (BPD). Although many of these infants may eventually be discharged to home without a need for oxygen supplementation or pulmonary medications, the long-term impact of interrupted lung development and secondary lung injury remain serious concerns. It is now well recognized that mechanical ventilation is pivotal to developing secondary lung injury and BPD. Consequently, a great deal of time and effort has been put into the development and application of non-invasive ventilator (NIV) approaches to supporting respiratory function in neonates. Since the landmark publication by Gregory and colleagues in 1967, nasal continuous positive airway pressure (nCPAP) has been the most commonly applied approach to NIV. This approach has been supported by the recent generation of randomized controlled trials. However, cumulatively these trials have shown only a small reduction in rates of BPD. Outside of the trial data, despite the wider application of nCPAP, rates of BPD remain relatively unchanged over recent years. This has led to investigations of other NIV approaches including nasal ventilation and high flow nasal cannula therapy. Not only have available modes increased, but so have the interfaces through which these modes may be applied. In the issue of Clinic in Perinatology, readers will find an up-to-date review of non-invasive approaches to supporting preterm respiratory function. This draws on the expertise of leading investigators in the field. This issue reviews the physiologic mechanisms by which the various approaches to NIV may support respiratory function; the evidence base supporting different NIV approaches; and adjunctive aspects of NIV therapy including their use during neonatal transport and the application of other supportive therapies such as inhaled NO.

This issue of the Surgical Pathology Clinics, edited by Drs. Blaise Clarke and Glenn McCluggage, focuses on Gynecologic Pathology. Topics covered in the issue include, but are not limited to: Gynecologic manifestations of the DICER1 syndrome; Prophylactic gynecologic specimens from hereditary cancer carriers; Lynch syndrome associated endometrial cancer; Peutz-jeghers syndrome associated gynecologic tumors; Gynecologic manifestations of less commonly encountered hereditary syndromes; and Clinical testing for hereditary predisposition.