In consultation with Dr. William Rayburn, Dr. Muller has put together an issue designed to educate the reader on the rapid progress in Gynecologic Cancer Care. More than any other field in obstetrics and gynecology, gynecologic oncology has seen an explosion in integrated drug development and technology, including personalized medicine, germline and somatic testing, targeted therapeutics, biologic and immunotherapies, improved robotic technology, and a paradigm shift towards "less is more." Evolving data in quality measures including enhanced surgical recovery, integrative palliative care, and survivorship management has strengthened the need for a seemless team approach to the care of our patients. Despite the complexity and rapid discoveries leading to significant change in practice, the dedication to patients is the driver to stay up to date and participate in the research and clinical trials that lead to the cancer care advances that are substantial in this update. Expert authors have contributed articles on the following topics: Trends in Gynecologic Cancer Care in North America: Safety, Value and Quality; Cancer Screening and Prevention Highlights in Gynecologic Cancer; Germline and Somatic Tumor Testing in Gynecologic Cancer Care; Less is More: Minimally Invasive and Quality Surgical Management of Gynecologic Cancer; Ovarian Cancer: Clinical Trial Breakthroughs and Impact on Management; Endometrial Cancer: Obesity, Genetics and Targeted Trials; Cervical Cancer: A Global and Access to Care Crisis; Vulvar and Vaginal Cancer; Gestational Trophoblastic Neoplasia; Chemotherapy, Biologic and Immunotherapy Breakthroughs in Cancer Care; Palliative Care in Gynecologic Oncology; Personalized Medicine in Gynecologic Cancer: Fact or Fiction; and Survivorship Care in Gynecologic Cancer.

With the advent of Assisted Reproductive Technologies, our understanding of the reproductive system in both men and women has progressed in an exponential manner. Along with this increase in knowledge has emerged new and advanced laboratories performing unique techniques aimed at diagnosing and treating infertility problems. And as these laboratories expand, the need for properly trained technicians has also emerged. But while many ART labs are staffed with biologists well trained in reproductive research techniques, they lack the necessary skills to effectively manage these labs. The Handbook of the Assisted Reproduction Laboratory addresses many of the management issues and basic background information on reproductive biology and medicine needed by the technicians staffing and directing these ART labs. Internationally recognized experts in the field discuss various topics in this handbook, which: Reviews male and female reproductive systems and processes Discusses the clinical diagnosis and management of male and female infertility Provides new information on the state-of-the-art techniques of egg and embryo culture, micromanipulation, and biopsy Presents various aspects of quality control, quality assurance, and clinical laboratory management With its in-depth analysis of management issues, as well as basic background information on reproductive biology and medicine, the Handbook of the Assisted Reproduction Laboratory serves as an ideal guide for current investigation and as a stimulus for future developments in the field.

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.

There are many possible causes of pelvic pain in a non-pregnant female patient, and it has been estimated to be responsible for nearly 40% of all visits by female patients to a family doctor and 10% of all referrals to specialist gynecologists. However, the topic of how to investigate and diagnose has been surprisingly neglected in print. This important and much-needed text from internationally respected experts shows how important ultrasound can be as a tool for physicians caring for women's health.

First published in 1991. Routledge is an imprint of Taylor & Francis, an informa company.

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

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.

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.

Get Through MRCOG Part 2: Short Answer Questions is an essential revision guide for candidates preparing for the MRCOG Part 2 exam. This comprehensive collection of practice Short Answer Questions (SAQs) is designed to help candidates test and assess their own knowledge, aiding thorough preparation for the exam. The book opens with an introduction to the exam and includes advice on how to prepare for it, information on what to expect, and guidance on how to write excellent answers. This is followed by two sections: the first provides a wide range of SAQs divided into obstetric and gynaecological topics, and the second presents six practice exams set out in the format of the actual exam. For each question, the authors highlight the key words in the question, followed by a brief essay plan and then give a worked example answer. The specimen answers indicate how many marks the candidate would obtain for each point made, and are supplemented with valuable extra information and further reading, to enhance understanding and aid further revision.

This comprehensive review of the factors that affect the harvesting and preparation of oocytes and the management of embryos will allow practitioners to make evidence-based decisions for successful IVF. The book reviews and re-considers the value of strategies and outcomes in the management of fertility and conception rates, centred on the production of oocytes, and successful development of the embryo. Authored by leading experts in the field, chapters engage with treatments and strategies that affect the production of oocytes and embryos, optimizing outcomes in the management of female fertility, conception rates, and live births. This vital guide covers controlled ovarian hyperstimulation, the role of AMH in determining ovarian reserve, and primary stimulation agents and the use of adjuncts. Integral for all clinicians and embryologists working in reproductive medicine units, readers are provided with evidence-based, comprehensive advice and review of all factors affecting the management of oocytes and the embryo that are vital for successful IVF cycles.

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.

This study guide offers a systematic, comprehensive and focused approach to preparation for the MRCOG Part 3 Clinical Assessment exam. After an initial introduction, the text divides by OSCE station, beginning with an analysis of what the station is testing and what approaches and preparation are required, supported by tips and examples; this is followed by thoroughly worked practice questions based upon the exam format, with an analysis of how these are likely to be marked. Practice exam 'circuits' with fully worked questions and answers conclude the book.

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.

The Gunner Goggles Series is the first exam prep resource written by a high-scoring peer group of medical students, ensuring the most practical and efficient study guidance. It organizes topics around the USMLE and NBME content outlines for the required shelf exams and features state-of-the-art Augmented Reality (AR) mobile application to extend learning beyond the book. This innovative series features AR opportunities throughout the text for an integrated print-mobile experience that maximizes learning and test preparation. The Gunner Goggle function allows you to scan pages for integrated AR links, unlocking animations, visuals, and 3D models that clarify complex anatomy, conditions, and concepts in a remarkably effective and unique manner. Gunner Goggles Series: Ob-Gyn is one of seven authoritative exam preparation guides that use cutting-edge AR technology to fully prepare you for the NBME clinical shelf exams, the USMLE Step 2 Clinical Knowledge (CK) exam, and successful clinical rotations. Topics are organized around the USMLE and NBME content outlines for specific shelf exams, and information is presented in a highly templated, concise manner. The Augmented Reality application allows you to efficiently study and learn using an integrated print-mobile approach. In addition to unlocking animations and other visuals, AR app access also includes additional content, links to provide feedback to the authors, community pages, and more. All test topics are covered in just enough detail to help you hone in on key points you must know for exam success. Unique! Every disease is described by its stem clues (buzzwords that appear in question stems) and prophylactic measures (PPx), mechanism (MoD), diagnostic tests (Dx) and treatment/management principles (Tx/Mgmt) - the four "Physician Tasks" that the NBME requires students to know about each disease. You'll also get real-world tips for your clinical rotations from your peers - information that won't show up on the shelf exam but is ideal for maximum impact when on rounds (knowing the prognosis for a specific disease, for example). Plus . effective study techniques, sample study schedules, tips and tricks to better retain information learned from review questions, and methods to self-generate mnemonics. Edited, written, and crowdsourced by high-performing medical students and residents and reviewed by experts in the field to ensure accuracy, relevancy, and accessibility. Titles in the Gunner Goggles series: Family Medicine . Print ISBN: 978-0-323-51034-9 . e-Book ISBN: 978-0-323-52756-9 Medicine . Print ISBN: 978-0-323-51035-6 . e-Book ISBN: 978-0-323-52758-3 Neurology . Print ISBN: 978-0-323-51036-3 . e-Book ISBN: 978-0-323-52760-6 Ob-Gyn . Print ISBN: 978-0-323-51037-0 . e-Book ISBN: 978-0-323-52768-2 Pediatrics . Print ISBN: 978-0-323-51038-7 . e-Book ISBN: 978-0-323-52763-7 Psychiatry . Print ISBN: 978-0-323-51039-4 e-Book ISBN: 978-0-323-52765-1 Surgery . Print ISBN: 978-0-323-51040-0 . e-Book ISBN: 978-0-323-52767-5

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.

Despite its universality in human female ageing, the menopause and its biology are not completely understood. New biologic mechanisms by which sex hormones may be detrimental or confer protection are continually being discovered. We are now starting to understand that the role of the oestrogen receptor is not identical in all tissues. Important nongenomic effects for sex hormones have also been described. Hormone replacement therapy (HRT) has produced effects on health risks: some are reduced, some are increased, and the rest remain uncertain. HRT is being used by an increasing number of women to alleviate climacteric symptoms in the perimenopausal period and to prevent osteoporosis and cardiovascular disease later. Positive effects on Alzheimer's disease and dementia on the one hand, and an increase in venous thrombosis on the other, are currently being reported by several groups. Both the preventive benefits and the risk of breast cancer seem to be linked to long-term and current use. HRT requires further testing through specific clinical trials, currently underway in the United States, before confident recommendations may be made about the full range of benefits and risks.

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.

Grieving Reproductive Loss: The Healing Process acknowledges the devastating impact these losses can have. Written in ""plain language"", the book attempts to bring about a greater understanding of the grief associated with reproductive loss and, through the Healing Process Model[copyright], offers a holistic approach for constructive healthy grieving and healing of body, mind, and spirit.

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.

*Offers a practical guide to treating one of the most complex and challenging clinical events *Equips the entire team of those responding to a maternal cardiac arrest event with the proper evidence-based approaches and techniques to implement *Presents a thorough review, detailed algorithms, and a consolidated discussion of the practical aspects of implementation

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.

First Edition Named a 2013 Doody's Core Title! First Edition Second Place AJN Book-of-the-Year Award Winner in Maternal and Child Health! With more women than ever seeking obstetric triage and emergency services in obstetric triage units, obstetric providers need to be aware of triage assessment and evaluation protocols. This prize-winning pocket guide, containing management guidelines for obstetric triage/emergency settings, delivers critical information on obstetrics, midwifery, emergency, and family care for both students and seasoned clinicians. As with the first edition, all of the newly revised chapters take a strong collaborative and interprofessional approach to clinical conditions in the obstetric triage setting. With specific clinical protocols for more than 30 clinical situations, this fully updated second edition includes two completely new chapters on sepsis in pregnancy and triage acuity tools, along with updated guidelines for hypertension, sepsis, and postpartum complications. Each protocol comprises presenting symptomatology, patient history and data collection, physical exam findings, laboratory and imaging studies, differential diagnosis, and clinical management protocol/follow up. Plentiful figures and images, reference tables and standardized forms for reference and usage, algorithms, and clinical pathways illustrate chapter content. Esteemed contributors include midwives, nurse practitioners, obstetricians, gynecologists, and maternal fetal medicine faculty who evaluate nearly 30,000 OB visits per year. New to the Second Edition: New chapters on sepsis in pregnancy and triage acuity tools Key updates on ectopic pregnancy, nausea and hyperemesis in pregnancy, severe preeclampsia, sexually transmitted and other infections, substance abuse, and psychiatric disorders in pregnancy Expanded information on periviable obstetric management Information on Zika and Ebola Clinical callouts in each chapter highlighting key points Enhanced narrative protocols Key Features: Provides interprofessional triage protocol guidance for ED and OB triage settings Delivers protocols and guidelines for over 30 emergent care situations Includes plentiful diagnostic and imaging guidelines with accompanying figures Formatted consistently for quick access Offers algorithms, protocols, diagnostic imaging, and best evidence for each condition

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.