Neural Tube Defects (NTDs) are congenital malformations of the central nervous system caused by partial or complete failure of the neural tube to close, within 28 days of conception. They represent the second most frequent cause of congenital abnormality. In this book, the authors discuss the prevalence, pathogenesis and prevention of neural tube defects. Topics include preconception folic acid as a primary prevention tool for NTD and its risk assessment; understanding and preventing folic acid-resistant neural tube defects; knowledge of the cellular mechanisms responsible for normal neural tube formation in comprehending and preventing NTDs; developmental delay in interneuron, motor neuron, sensory tract, and synapse formation in chick spina-bifida; and an examination of whether neural tube defects lead to structural alterations in the urinary and genital organs in human foetuses.

This new SpringerBrief in Physiology explores the newest research findings on how exercise influences the fetus in utero and beyond. "Physiology of Prenatal Exercise and Fetal Development" reviews the current findings of how maternal exercise throughout gestation influences fetal development of key organ systems, and also encompasses the relationship between maternal activity level and fetal, birth, and neonatal effects. This information will help researchers and scientists better understand the physiological effects of exercise during pregnancy on offspring development."

A dramatic and worldwide increase is occurring in the prevalence of overweight and obesity in women of childbearing age. Obese women carry a significant excess risk of a variety of serious complications during pregnancy, and in addition, maternal obesity predisposes to obesity in the offspring. This book provides a timely update on the latest knowledge on maternal obesity and pregnancy. A very wide range of issues are covered, including macrosomia and associated shoulder dystocia; the risk of miscarriage, malformations, and complications of pregnancy; the impact of hyperglycemia; clinical management; consequences for anesthesia and ultrasound; impacts on breastfeeding, fertility, and childhood obesity; and pregnancy following gastric surgery. All of the authors are recognized experts in their fields, and the book has been designed to meet the practical needs of obstetricians, gynecologists, internists, and general practitioners.

This practical book provides comprehensive and up to date information of the detection and management of hypertension in pregnant women. Written especially for those at the fromt end of obstetric management - general practitioners, midwives, and junior hospital doctors - it deals with the essentials in a user friendly format. Chapters include:
Definitions and classifications
Epidemiology
Investigation of pregnancy induced hypertensive disorders
Treatment of hypertension in pregnancy
Prevention of the development of pre-eclampsia
Intensive care of the pre-eclamptic and eclamptic patient
Follow up
Rare causes

All those managing pregnant women need to be alert to the development of hypertension and the concomitant risk of full blown pre-eclampsia. This authoritative handbook is an invaluable aid to both prevention and management of all eventualities.

Globally, postnatal depression (PND) is a growing public health problem. PND affects 10 to 15% of women in Western society. It caused by a combination of biological, psychological and social factors. Two models have attempted to define and explain PND; the biomedical and the sociological models. The traditional biomedical model views PND as a medical condition which implies there is individual pathology and abnormality. Whilst the biomedical model has been the dominant model in treating PND, it has been criticized by feminist sociologists and psychologists for its rigidity in defining and explaining PND. In contrast, the psychosocial model of health acknowledges the biological factors that impact on emotional well-being, but places more emphasis on the personal and social factors that impact on emotional well-being, but places more emphasis on the personal and social factors that contribute to depressive symptoms such as gender, poverty, social disadvantage and social class. The central argument throughout this book is the importance of support before and after the birth for women's emotional well-being. This book will also include women's journeys through pregnancy, childbirth, motherhood, postnatal depression, and resolution. To date, literature has focused on women's lived experiences of PND rather than their personal journeys through pregnancy, childbirth and early motherhood. Additionally, the adjustment to fatherhood has received less attention. For example, little is known about the impact of postnatal depression on the partner, what support partners offer when women with the intention to fill the gap in knowledge of cultural and social issues relating to pregnancy, childbirth, and motherhood for woman who were diagnosed with, and had resolved, PND.

Technological developments in the life sciences confront us with new facets of a Faustian seduction. Are we "playing God" more and more, as claimed by critical authors of modernity? Achievements in genetic research produce ethical dilemmas which need to be the subject of reflection and debate in modern societies. Denial of ambivalences that ethical dilemmas arouse constitutes a threat to societies as well as to individuals. The book presents a compilation of some of the results of the interdisciplinary European study "Ethical Dilemmas Due to Prenatal and Genetic Diagnostics" (EDIG), which investigated some of these dilemmas in detail in a field which is particularly challenging: prenatal diagnosis. When results from prenatal diagnosis show fetal abnormalities, women and their partners are confronted with ethical dilemmas regarding: the right to know and the right not to know; decision-making about the remainder of the pregnancy and the desire for a healthy child; responsibility for the unborn child, for its well-being and possible suffering; life and death. This book provides answers from an ethical, psychoanalytical and medical viewpoint.

In recent years, increasing attention and resources have been brought to bear on the relationship between the environment and congenital diseases. These diseases were previously thought to be mostly due to genetic causes. Even though the importance of genes as factors in causation is accepted, environmental factors seem to be implicated just as strongly. This book explores some further concepts that have arisen from more recent perceptions of environmental effects and their possible interactions with living systems. Amongst the topics discussed are:

-effects of prenatal exposure to toxic chemicals

-intra-uterine exposure to drugs

-effects of endocrine disrupters

-environmental risk and sex ratio in newborns

-surveillance of environmental impact

-research and policy

Discussion and presentation of old and novel ideas is targeted at developing a more holistic and united perception of the interaction between congenital diseases and the environment.

presented in the Introduction (Chapter 1). The focus of Chapter 1 is twofold: (1) to present the research foundations for the psychophysiological correlates of prenatal psychosocial adaptation and the seven prenatal personality dimensions with progress in labor and birth outcomes, and particularly (2) to present the theory underlying the seven dimensions of prenatal psychosocial adaptation, which are further analyzed in the following seven chapters. Chapters 2-8 present a content analysis of the interview responses to the seven significant prenatal personality dimensions that are predictive of pregnancy adap- tion, progress in labor, birth outcomes, and postpartum maternal psychosocial adaptation, and they include: (1) Acceptance of Pregnancy, (2) Identification with a Motherhood Role, (3) Relationship with Mother, (4) Relationship with Husband, (5) Preparation for Labor, (6) (Prenatal) Fear of Pain, Helplessness, and Loss of Control in Labor, and (7) (Prenatal) Fear of Loss of Self-Esteem in Labor. There is no other comparable comprehensive, in-depth, prenatal personality research or empirical and content analysis of pregnancy-specific dimensions of maternal psychosocial adaptation to pregnancy.

This is an easy-to-use handbook written for the clinician and other healthcare professionals who treat and counsel pregnant women and women of child-bearing age. The authors provide historical perspective and background to support recommendations which are provided in each chapter. Importantly for the practitioners, recommendations and guidelines have been summarized and provided in tables that are easy to locate and interpret. This book discusses relevant topics in the scientific community such as determining to what extent prenatal and perinatal environmental factors are linked to childhood and adult obesity and chronic diseases.

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.

Congenital malformations are worldwide occurrences striking in every condition of society. These severe physical abnormalities which are present at birth and affecting every part of the body happen more often than usually realized, once in every 33 births. The most common, after heart defects, are those of the neural tube (the brain and spinal cord) which happen in as many as one in every 350 births. They have been noted as curiousities in man and beast throughout recorded history and received great attention in our time by various fields of study, for example, their faulty prenatal development by embryologists, familial patterns by geneticists, causation by environmentalists and variability by population scientists.

Attention turned much in recent years to the relation of these malformations to deficiency of a particular dietary ingredient, folic acid, a subject this book analyzes in depth. The greatest conundrum of all, which this latest matter like so much else hinges on, is the amazing fact of the tremendous, almost universal decrease in the frequency of these anomalies since early in the 20th century. The puzzle is 'What can this downward trend possibly mean?' and at bottom 'Whether it is part of a long-term cyclical pattern'. This fascinating biological phenomenon is explored in the book together with various other topics.

It's natural... It's unsightly... It's normal... It's dangerous. To breastfeed or not? For millions of women around the world, this personal decision is influenced by numerous social, cultural, and health factors. Infant Feeding Practices is the first book to delve into these factors from a global perspective, revealing striking similarities and differences from country to country. Dispatches from Asia, Australia, Africa, the U.K., and the U.S. explore as wide a gamut of salient issues affecting feeding practices as traditional beliefs about colostrums, "breast is best" campaigns, partner attitudes, workplace culture, direct government intervention, and the pressure to be a "good mother." Throughout these informative pages, women are seen balancing innovation and tradition to nurture healthy, thriving babies. A sampling of topics covered: * Policy versus practice in infant feeding. * Infant feeding in the age of AIDS. * Managing the lactating body: the view from the U.S. * Motherhood, work, and feeding. * The effects of migration on infant feeding. * From breastfeeding tradition to optimal breastfeeding practice. Infant Feeding Practices is a first-of-its-kind resource for researchers and practioners in maternal and child health, public health, global health, and cultural anthropology seeking empirical findings and culturally diverse information on this sensitive issue.

Novel Approaches into the Origins of Neurodevelopmental Disorders: The Fetal Physiology Foundation Over the past two decades, autism, a neurodevelopmental disorder that is defined by behavior and was once believed to be rare, became recognized in increasing numbers of children and recently received distinction as an "epidemic" [1]. While numbers of affected children have steadily increased, our knowledge is still ins- ficient to explain autism's diverse causes and broad range of presentations. Despite remarkable progress in research, available medical diagnostic testing applies only to a small minority of affected children. Thus, scientifically based explanations with which physicians can diagnose and treat the majority of children with autism and advise their parents are quite limited. Our society and scientific community were unprepared for the rise in autism, which explains our present inability to understand most of its causes. Researchers in neurodevelopmental disorders have long been aware of other disorders that, despite extensive efforts, have not yielded clear genetic or environmental origins, and autism has become symbolic of the need for new approaches to research into these complex conditions. Although autism has captured our attention in recent years, the prevalence of other neurodevelopmental disorders such as attention de- cit hyperactivity disorder (ADHD) and bipolar disorder, among others, also has been increasing [2-4].

There are many changes in the skin, hair, and nails during and after pregnancy. Patients are certainly aware that those changes are occurring, but few physicians and even fewer patients know how to predict the course of those changes. Pigmentary changes occur, but are they permanent? Can they be prevented or reversed? Hair may become thicker during pregnancy, only to fall out in the postpartum period. When will hair stop falling out? Will it grow back? What hormonal changes are occurring to produce these effects on the skin, hair, and nails? Will those hormonal changes affect other organs? Some cutaneous manifestations of pregnancy are common and recognized by most physicians. Abdominal striae, for example, are easily identified, but physicians have many questions about them. Why do they develop? Can they be prevented or treated? Other cutaneous manifestations of pregnancy are less common and recognized by few. For example, pruritic urticarial papules and plaques of pregnancy is a debilitating condition that is treatable once diagnosed. Even more important than the treatment, the knowledge imparted to a worried mother that her child will be fine and that the condition is se- limited is priceless; but the condition must first be recognized by the patient's physician. All of these questions and conditions are addressed in this extraordinary book. Pigm- tary disorders are addressed in detail in Chap. 2.

An estimated 35 million people worldwide are displaced by conflict, and most of them are women and children. During their time away from their homes and communities, these women and their children are subjected to a horrifying array of misfortune, including privations of every kind, sexual assaults, disease, imprisonment, unwanted pregnancies, severe psychological trauma, and, upon return or resettlement, social disapproval and isolation.

Written by the world's leading scholars and practitioners, this unique collection brings these problems - and potential solutions - into sharp focus. Based on extensive field research and a broad knowledge of other studies of the challenges facing women who are forced from their homes and homelands by conflict, this book offers in-depth understanding and problem-solving ideas. Derived from a project to advise U.N. agencies, it speaks to a broad array of students, scholars, NGOs, policymakers, government officials, and international organizations.

Obesity has reached epidemic proportions globally and presents a major challenge to policy makers and clinicians alike. Recent research has suggested that obesity has its origins in early life and that early diet can programme a developing fetus and young infant s future susceptibility to obesity. This volume contains recent findings presented at the International Conference on Early Nutrition Programming and Health Outcomes in Later Life: Obesity and Beyond - a satellite meeting of the 15th European Congress on Obesity, held in Budapest in April 2007. Basic scientific research, data from epidemiological studies and clinical trial results were all presented during the programme.

This volume includes articles discussing the evidence for an effect of early nutrition programming on later obesity and cardiovascular risk; the growing evidence for an intergenerational cycle of obesity; the role of maternal leptin in programming appetite; possible cellular mechanisms for altered energy balance, including mitochondrial programming and the effects of regulators of metabolism; and how epigenetic changes might be the fundamental underlying mechanism explaining programming effects. Consumer understanding of the concept of early nutrition programming and the extent to which early nutrition programming is taken into account in infant feeding policies are also discussed.

Congenital malformations are worldwide occurrences striking in every condition of society. These severe physical abnormalities which are present at birth and affecting every part of the body happen more often than usually realized, once in every 33 births. The most common, after heart defects, are those of the neural tube (the brain and spinal cord) which happen in as many as one in every 350 births. They have been noted as curiousities in man and beast throughout recorded history and received great attention in our time by various fields of study, for example, their faulty prenatal development by embryologists, familial patterns by geneticists, causation by environmentalists and variability by population scientists.

Attention turned much in recent years to the relation of these malformations to deficiency of a particular dietary ingredient, folic acid, a subject this book analyzes in depth. The greatest conundrum of all, which this latest matter like so much else hinges on, is the amazing fact of the tremendous, almost universal decrease in the frequency of these anomalies since early in the 20th century. The puzzle is 'What can this downward trend possibly mean?' and at bottom 'Whether it is part of a long-term cyclical pattern'. This fascinating biological phenomenon is explored in the book together with various other topics.

The concomitance of cancer and pregnancy is a biological paradox and one of the greatest challenges in the lives of young patients, their partners, and their families. It is also a challenge to oncologists, because the management of the pregnant cancer patient involves both mother and fetus. Ideally, oncologists, reproductive endocrinologists, obstetricians and neonatologists, nurses, and psychologists work within a dedicated multidisciplinary team to deliver optimal cancer therapy to the mother, while assuring fetal well-being.

This book, written by oncology experts with knowledge and clinical expertise on diagnosis, treatment, and follow-up of women with different types of cancer during pregnancy, provides a comprehensive review of existing data on cancer during pregnancy and a general overview of its psychological, ethical, and social aspects. Chapters address the diagnosis, treatment, and follow-up of young women with specific solid or hematologic cancers during pregnancy. The safety of subsequent pregnancy after cancer treatments and the alternatives to maintain or enhance fertility in women undergoing cancer therapy are also addressed. While not intended as a practical guideline, the book contains clinical suggestions, bibliography, and references to available online sources about referral centers, ongoing clinical trials, and tumor registries to help oncologists in the clinic.

Congenital malformations are worldwide occurrences, they know no national borders, do not distinguish between races, ethnicities, rich or poor. These severe physical abnormalities, present at birth, happen more often than is usually realized, once in every 33 births. They strike every part of the body, limbs, head, heart, and all others.

The most frequent of them all are the many types of malformations of the cardiovascular system, the heart and its blood vessels, which happen in about once in every 250 births. Study of these conditions during the twentieth century took many forms, revolving about examination and analysis of their causes, genetic, nongenetic, and complex. To aid in unraveling the complexities of this causation, various influences on their frequency are considered, among them social conditions, maternal health, birthweight, newborn maturity. And of course the known and possible environmental bases of their occurrence are fully described.
The relation of infant death to cardiovascular malformation is noted; and puzzlement that the level of such deaths had not kept pace with the reduction of infant death itself and of that associated with other kinds of malformations during this period.

An introductory record of the history of perinatal mortality in the last three centuries gives foundation for the discussion of death in contemporary decades.

An A-Z practical guide on the pharmacology and toxicology of pregnancy and nursing

"Medication Safety in Pregnancy and Breastfeeding: The Evidence-Based, A-to-Z Clinician's Pocket Guide" gives you comprehensive, authoritative coverage on the effects of prescription and over-the-counter drugs as well as herbals, chemicals, and radiologicals, on the mother, fetus, and nursing child. Organized A-Z for ease of use, this hands-on resource also includes evidence-based recommendations from the renowned Motherisk Program at the Hospital for Sick Children in Toronto.

Prominent scientists from perinatal medicine, paediatrics, psychology and sociology will meet in Modena, Italy to explore birth as a complex psychological experience for mother, father and child. The proceedings of this interdisciplinary congress are here published in English to reach the broadest possible scientific audience. The goal is to create a dialogue between humanistic and medical perspectives with regard to conception, pregnancy and birth in an era of rapid biotechnological progress, taking different social and cultural contexts into account.

A collection of cutting-edge laboratory techniques for the study of trophoblast and placental biology. The techniques presented range from experimental animal models, to animal and human placental organ and cell culture systems, to morphological, biochemical, and molecular strategies for assessing trophoblast/placental growth, differentiation and function. Volume 1 provides readily reproducible protocols for studying embryo-uterine implantation, trophoblast cell development, and the organization and molecular characterization of the placenta. Highlights include strategies for the isolation and culture of trophoblast cells from primates, ruminants, and rodents, and precise guidance to the molecular and cellular analysis of the placental phenotype. A companion second volume concentrates on methods for investigating placental function.

A concise clinical reference that facilitates the diagnosis of intrauterine and perinatally acquired infections was the goal in creating the Congenital and Perinatal Infections: A Concise Guide to Diagnosis. Information about the natural history, m- agement, and outcome of these infections is well detailed in many other sources and so has not been included. Rather, the focus of the book is diagnosis. The initial chapters provide general information about serological and nonserological assays that are used for the diagnosis of infections, and a chapter about the placenta includes details about histopathological findings that can be helpful with the diagnosis of congenital inf- tions. The remainder of the book is devoted to the diagnosis of specific congenital and/ or perinatal infections. As illustrated in the chapters about specific infections, the approach to diagnosis of a congenital or perinatally acquired infection in the neonate begins, when possible, with consideration and diagnosis of infection in the pregnant woman, knowledge of how the infection is transmitted, and the risk of that infection for the woman and her fetus or neonate. The possibility of congenital or perinatal infection in neonates is usually considered because of the diagnosis of, or concern about a s- cific infection in, a mother during pregnancy that can be transmitted to the neonate or because of clinical findings in the neonate at birth that suggest an infectious cause.

This volume of the Handbook of Systemic Autoimmune Diseases series represents a medical collaboration focusing primarily on female aspects of rheumatic diseases. This collaboration recognizes the need to understand and optimally manage the care of women with autoimmune conditions that may affect their reproduction and hormonal status. This handbook will prove useful to clinicians and researchers alike. It covers practical points, ranging from which anti-rheumatic medications are safe in pregnancy to how to counsel women with scleroderma contemplating pregnancy.
* Authors share an academic interest in the unique relationship between being a woman and having an autoimmune disease
* Touches on controversial topics, such as the mechanism of antiphospholipid-related fetal loss and whether or not non-steroidal anti-inflammatory agents should be used in pregnancy
* Includes critical and balanced reviews of the controversial association between autoimmune disease and female infertility

"Dangerous Motherhood" is the first study of the close and complex relationship between mental disorder and childbirth. Exploring the relationship between women, their families and their doctors reveals how explanations for the onset of puerperal insanity were drawn from a broad set of moral, social and environmental frameworks, rather than being bound to ideas that women as a whole were likely to be vulnerable to mental illness. The horror of this devastating disorder which upturned the household and turned gentle mothers into disruptive and dangerous, mad women, was magnified by its occurrence at a time when it was anticipated that women would be most happy in the fulfillment of their role as mothers.