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Books > Medicine > Clinical & internal medicine > Gynaecology & obstetrics > Materno-fetal medicine
The major objective of our studies in the last decade was a systematic analysis of maternal diseases during pregnancy to reveal their possible adverse effects on birth outcomes. The two most important factors of infant mortality were parti- larly analyzed: structural birth defects, known as congenital abnormalities (CAs) and preterm birth (PB). In general the objectives of scienti c studies might be either to test a new hypothesis or to con rm or confront previously published results. However, less frequently the authors/scientists have personal motivations determined by their professional activities. The authors of this book are practicing physicians and genetic epidemiologist who are mainly interested in the following three practical questions: 1. The possible adverse effects of pharmaceutical products. The possible t- atogenic potential of about 170 drugs has been evaluated very thoroughly using the data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities (HCCSCA) in the last 50 years. These drugs were used to treat maternal diseases and the ndings of our population-based case-control studies will be cited in this book and are shown in the Appendix at the end of the book. However, our long experiences showed two problems in the drug teratology. In general the evaluation of clinical doses of these drugs is a particularly dif- cult challenge due to the modi cation effects of confounders. This problem motivated one of the authors to establish a new model of disaster epidemiology.
As we near the 50th anniversary of the landmark article by C. Henry Kempe and his colleagues entitled "The Battered Child Syndrome", which ushered in the modern era of professional attention by pediatricians and other child health professionals, we have reason for both celebration and concern. We can take heart that over the recent ve decades, a great deal of professional attention focused on the problem of child abuse and neglect. In every state of the country, there are mandatory repo- ing laws that require nurses, physicians, and social workers to report suspicions of maltreatment to the appropriate authorities for investigation. The act of repo- ing provides legal immunity to the reporter except when performed in bad faith. Progress in understanding the factors that place children at risk for harm from ph- ical abuse and neglect now permits prevention and intervention. The peer-reviewed literature dealing with child abuse and neglect has proliferated with high quality work being done and reported on the many dimensions related to the epidemi- ogy, mechanism, treatment, and prognosis of child maltreatment. Efforts are being directed toward developing an evidence-based approach to the prevention of child abuse and neglect. These are some of the positives. However, negatives exist and remain reasons for concern. Despite a tremendous amount of attention to the pr- lem of maltreatment, there are at least 3 million reports of suspected child abuse and neglect made annually, with nearly 1 million cases being substantiated.
Three decades into the HIV pandemic, the goals remain clear: reduce the number of infections,improve the health outcomes of those who are infected, and eliminate disparities in care. And one observation continues to gain credence: families are a powerful resource in preventing, adapting to, and coping with HIV. Recognizing their complex role as educators, mentors, and caregivers, Family and HIV/AIDS assembles a wealth of findings from successful prevention and intervention strategies and provides models for translating evidence into effective real-world practice. Chapters spotlight the differing roles of mothers and fathers in prevention efforts, clarify the need for family/community collaborations, and examine core issues of culture,ethnicity, gender, and diagnosis (e.g., minority families, adolescents with psychological disorders). Throughout, risk reduction and health promotion are shown as a viable public health strategy A reference with considerable utility across the health, mental health, and related disciplines,Family and HIV/AIDS will be a go-to resource for practitioners working with families, researchers studying at-risk populations, administrators seeking to create new (or evaluate existing)prevention and care programs, and policymakers involved in funding such programs.
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.
Ovulation induction and controlled ovarian stimulation lie at the very heart of treatment for infertility, but have been subject to a bewildering variety of variations and improvements over recent years. The Second Edition of this highly successful book updates the reader on the progress and developments in this area. Furthermore, it provides the busy clinician with a reliable overview of the principles involved and the management needed. As with the previous edition, the emphasis throughout this book is on logical evidence and evidence-based solutions supplemented with Professor Homburg's extensive clinical experience gleaned from more than forty years working in the field. A number of highly useful algorithms and explanatory tables reinforce this approach, ensuring that the reader is presented with easy-to-grasp, well-presented information that maximizes clarity and understanding. This book offers a concise, no-nonsense, practical guide to ovulation induction and controlled ovarian stimulation and will be an essential resource for the general gynaecologists, fertility specialists and trainees, health workers and students.
The spectrum of cardiovascular disease affecting women in pregnancy and postpartum is changing and differs between countries. In the western world, the risk of cardiovascular disease in pregnancy has increased due to the increasing age at the first pregnancy and the worldwide obesity epidemic leading also to early diabetes and hypertension. In addition the treatment of congenital heart disease has improved leading to an increased number of women with residual heart disease reaching childbearing age. In the western world maternal heart disease is now the major cause of maternal death during pregnancy. In the developing world rheumatic heart disease and the cardiomyopathies dominate. Those women often need anticoagulation as they might have had a valve replacement or formed a thrombus in the left heart. Drugs during pregnancy and the breastfeeding period is a complex subject and there is a profound shortage of evidence based recommendations. As drug treatment in pregnancy concern the mother and the fetus optimum treatment of both must be targeted. This book aims at discussing the most important indications of drug usage in pregnancy and postpartum with the aim of weighing the potential risk of a drug and the possible benefit against each other.
Mental health problems during and immediately after pregnancy are a major concern across the world. As well as affecting the health of the mother, they can have significant, harmful, and long term effects on the infant if not dealt with effectively. Perinatal Psychiatry honours the work of Channi Kumar, one of the seminal figures in the history of perinatal psychiatry, and presents a comprehensive multidisciplinary review of the field. Bringing together the leading researchers in the area, it covers the causes of perinatal mental health problems, the biology of perinatal depression and its more extreme form, puerperal psychosis, as well as psychosocial and psychological interventions, hormonal and neural substrates of perinatal depression, and risk factors and epidemiology.
An infection that occurs during pregnancy presents a constellation
of problems above and beyond those normally associated with the
disease. Even a relatively minor infection can threaten the lives
of both mother and fetus and cause serious birth defects; and many
conventional treatments can produce disastrous side effects during
pregnancy. Over the past half-decade, enormous strides have been
made in our ability to understand, diagnose, and treat infections
in pregnant women.
Fundamentals of Clinical Practice is an introductory textbook focusing on the patient physician relationship. Formerly closeted behind closed doors, this most intimate of healing relationships is coming under increasing scientific scrutiny. Physicians and other healthcare providers are beginning to understand the critical importance of this relation ship to the health of patients, as well as to larger societal relationships, systems, and values. To facilitate the reader's exploration of the patient-physician relationship, all chap ters include numerous illustrative cases and conclude with cases for discussion that allow small groups of learners to tackle these difficult issues. Our hypothesis is that through discussion a deeper understanding of the dynamics of the patient-physician relationship will allow medical students and other future healthcare providers to form more effective therapeutic relationships with their patients. Part I of this textbook, "The Patient," explores the relationship through the patient's perspective, with chapters on human health and disease and individual and family devel opment. Understanding the patient's perspective is critical to establishing a sound thera peutic relationship. The day when a physician could maintain solely a disease or techno logical perspective is fading fast under the weight of patient criticism, particularly in primary care fields. Patients judge such a disease or technological perspective as less humane and frequently vote with their feet, finding other physicians who are much better able to balance the caring aspects of medicine with the curing.
The phenomenon of bleeding has been shown to appear in up to 22% of all pregnancies and is associated with significant maternal and fetal morbidities, and even mortality. Although vaginal bleeding occurs mainly during the first trimester, it can appear at any stage of pregnancy and in the postpartum period. This sometimes life-threatening event requires an extensive work-up in order to recognize its cause and establish a rapid and effective therapeutic approach. This book is a comprehensive appraisal of this critical condition. It draws on evidence-based data and brings together, in a single volume, updated information on all aspects of pregnancy-related bleeding. A global group of interdisciplinary experts contributed chapters on: bleeding during early pregnancy (early pregnancy loss, ectopic pregnancy, gestational trophoblastic disease, and cancer of the reproductive tract during pregnancy); bleeding in late pregnancy (preterm delivery, placental abruption, placenta previa, vasa previa and uterine rupture); and postpartum hemorrhage.
Originally published in 2006, this book provides an in-depth account of trophoblast: the tissue derived from the fertilised egg that nourishes and protects the developing fetus. The cells of the trophoblast have many unique qualities, and exhibit great variability across different species. It has a fascinating role in the development of the placenta and as a regulator during early growth of the embryo. These aspects are all fully covered as well as studies on why it is not rejected by the mother as 'foreign' tissue. Disorders of trophoblast during development also manifest themselves in several clinical conditions during pregnancy, including gestational trophoblastic disease and pre-eclampsia. From stem cells through to epigenetics, implantation and X-chromosome inactivation, there is a lot to be learned about trophoblast, this volume provides a detailed summary of knowledge regarding the subject.
During the past several years, there has been an extensive reappraisal of the physiologic changes of pregnancy and their associated disorders, along with a refinement of diagnostic procedures and evaluation of the therapeutic approaches that are of primary concern to the physician. In Shoulder Dystocia and Birth Injury: Prevention and Treatment, Third Edition, noted authority James A. O'Leary, M.D., with 40 years experience as an M.D. academician, lecturer, practitioner and clinical researcher with almost 200 contributions to the OB-GYN literature and textbooks, shares his insight on treatment techniques, identification and treatment of predisposing risk factors, current statistical data, ultrasound diagnosis and the necessary steps toward prevention, along with a thorough review of the important medical-legal issues. Shoulder Dystocia and Birth Injury: Prevention and Treatment, Third Edition supplements the limits of personal experience with the accumulated experience of many talented clinicians to aid physicians, midwives, and professionals in training with the most current information in this vital field.
A growing body of research identifies strong links between children's health, social and educational outcomes; it also notes the reciprocal benefits of access to quality education on individual and family health status. In response to these findings, the World Health Organization developed the concept of the Health-Promoting School (HPS), a living catalyst for healthy lives, and for positive changes that students can take home and into the community. Case Studies in Global School Health Promotion provides readers with a theoretical and research base needed to understand the methods used in communities all over the world to put this captivating concept in place. Case examples from over two dozen countries (representing urban and rural areas in developing and developed nations) outline the strategies taken to implement HPS programs in individual schools, municipalities, and nations. For each program, case study authors explain the problems they tackled, their motivation and supports to respond creatively; and the barriers they faced. In the cases, authors describe the capacities and infrastructure they created and mechanisms for cooperation; as well as the personnel, financial, and time requirements involved. Case studies were drawn from the following regions:
Case Studies in Global School Health Promotion offers a world of insights, ideas, and guidance to those addressing social determinants of health at this formative stage, including: education and health policy makers; professionals and administrators; and researchers in national governments, universities, local schools, community, non-governmental organizations and civil society. The material provides interesting and useful information to those dedicated to these issues within WHO, FRESH Partners and other United Nations agencies. It is also an instructive text for graduate students in public health, education, allied health professions and social sciences.
This volume examines the role of steroids and peptides in the regulation of pregnancy and pregnancy outcome, and their long-term effects including possible influences on adult-onset diseases. During pregnancy the placenta acts as a central regulator and coordinator of maternal and fetal physiology, and the onset of labor, through its production and regulation of steroids and peptides. Perturbations to this regulatory system can result in poor pregnancy outcome, such as preterm birth and low birth weight. These in turn are linked to diseases in later life. Intriguingly, many of these regulatory actions of steroids and peptides also occur in the brain. The induction and suppression of peptides by steroids appears to be key to regulatory function in both brain and placenta. These interweaving strands, linking basic science with obstetrics, are all reviewed in depth here producing a fascinating account of an important area of materno-fetal medicine.
Improving clinicians' understanding of effects nutrition can have on maternal health and fetal and neonatal development can have considerable impact on achieving a healthy pregnancy and reducing childhood morbidity. This book defines the nutritional requirements with regard to each stage of fetal development and growth, placing scientific developments into a clinical context. Clinicians and scientists discuss: how the fetus grows and what macro- and micronutrients it requires; what happens when there is nutrient deficiency and when placental development is abnormal; aspects of infant feeding, both with breast milk and formula milk. Specific problems encountered in pregnancy that pose a nutritional challenge are also considered, including pregnancy in teenagers, multiple pregnancies and pregnancy in those who are vegetarians or vegans. All doctors, health-care workers or scientists who either care for women, their newborn and growing infants, or who are involved in research in these areas, will find this to be essential reading.
Updated by a team of internationally renowned experts, this book gives a thorough overview of fetal pathophysiology and an evidence base for in utero: both medical (non-invasive) and surgical treatments. Many topics are expanded to cover recent advances, including: stem cell transplantation; tissue scaffolding; minimally invasive approaches to 'open fetal surgery'; the etiology, prevention and treatment of preterm birth and PROM; the genetic etiologies of fetal disease; and gene therapy. In addition, there are in-depth discussions as to the role of open fetal myelomeningocele repair and several fetoscopic approaches to therapy. The international editors have added important new chapters on reducing stillbirth and prenatal counselling. This book is an invaluable reference guide to the latest fetal therapy options, and an essential, in-depth study book for maternal-fetal and neonatology specialists.
Collectively known as the alloimmune cytopenias, hemolytic disease of the fetus and newborn, alloimmune thrombocytopenia and alloimmune neutropenia are all consequences of maternal immunisation to fetal blood cells. The effective prevention, diagnosis and management of these disorders has become a team effort involving haematologists, obstetricians, paediatricians, immunologists, laboratory technicians, midwives and research scientists. This book has been written by experts in their respective fields to bring together the issues of pathogenesis, epidemiology, prevention, diagnosis and clinical management. This comprehensive but accessible account is extensively cross-referenced to emphasise the links between pathogenesis and clinical sequelae, between epidemiology and the rationale for screening programmes, and between diagnosis and therapeutic intervention. This is an authoritative overview suitable for trainees in obstetrics, materno-fetal medicine, transfusion medicine and clinical immunology.
This study brings together two important literatures together in the one volume. One concerns the role of quality assessments in social policy, especially health policy. The second concerns ethical and social issues raised by prenatal testing for disability. Hitherto, these two literatures have had little contact with each other: few scholars have written about both, or have compared the two domains in a systematic way, while people with disabilities and disability scholars are underrepresented in recent discussion on health policy and quality of assessment. This book turns the perspectives of disability scholars on issues that have largely been the province of health methodology, policy and philosophy, while angling philosophical policy analysis on problems that have largely been the province of disability scholarship. This volume will be sought after by bioethicists, philosophers, and specialists in disability studies and healthcare economics.
This study brings together two important literatures together in the one volume. One concerns the role of quality assessments in social policy, especially health policy. The second concerns ethical and social issues raised by prenatal testing for disability. Hitherto, these two literatures have had little contact with each other: few scholars have written about both, or have compared the two domains in a systematic way, while people with disabilities and disability scholars are underrepresented in recent discussion on health policy and quality of assessment. This book turns the perspectives of disability scholars on issues that have largely been the province of health methodology, policy and philosophy, while angling philosophical policy analysis on problems that have largely been the province of disability scholarship. This volume will be sought after by bioethicists, philosophers, and specialists in disability studies and healthcare economics.
This forward-looking resource shines needed light on-and offers realistic solutions for eliminating-health disparities affecting one of the most vulnerable populations: children. Its multilevel framework identifies sources of pediatric health inequities in developmental, societal, familial, financial, and service delivery contexts and sets out innovations for breaking down and addressing longstanding concerns. Plentiful opportunities are described for reducing gaps and promoting equity at various service platforms, from locally-based improvements to systemwide tech upgrades, that can be used as models for revamping larger health policy. And the authors' long-term perspective emphasizes screening, wellness care, early intervention, and prevention strategies to support young patients in the transitions between childhood, adolescence, and young adulthood. Included in this compact idea book: Disparities in child health: a review Quality of care in pediatrics and health disparities: the increasing role of quality improvement science Community health worker interventions Technology-based interventions to address pediatric health disparities Place-based strategies in promoting health equity Future directions for a solutions-based approach With its clear delineation of issues and priorities, and its workable recommendations for addressing them, Disparities in Child Health is a ready source of ideas and advocacy for practitioners and researchers in pediatrics, maternal and child health, and general practice/family medicine.
This volume brings together an unusually broad range of experts from reproductive medicine, medical ethics, and law to address the important ethical problems in maternal-fetal medicine which impact directly on clinical practice. The book is divided into parts by the stages of pregnancy, within which the authors cover four main areas: the balance of power in the doctor-patient relationship and the justifiable limits of paternalism and autonomy; the impact of new technologies and new diseases; disability and enhancement; and difference--to what extent should the clinician respect the tenets of other faiths in a multicultural society.
The effective prevention, diagnosis, and management of alloimmune cytopenias has become a team effort involving hematologists, obstetricians, pediatricians, immunologists, laboratory technicians, midwives, and research scientists. This book has been written by experts in their respective fields to bring together the issues of pathogenesis, epidemiology, prevention, diagnosis, and clinical management. This comprehensive but accessible account is extensively cross-referenced to emphasize the links between pathogenesis and clinical sequels, between epidemiology and the rationale for screening programs, and between diagnosis and therapeutic intervention.
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.
This textbook is a comprehensive reference providing clinicians with the latest advances in the management of diabetes in pregnancy and the role of ultrasound. Beginning with an overview of the diagnosis and basic treatment of diabetes in pregnancy, the next chapter discusses foetal behaviour in normal pregnancy and in diabetic pregnancy. The following sections cover the role of ultrasound in diabetic pregnancy and for diabetes-related congenital anomalies. The final chapter covers diabetes and obesity in pregnancy. Authored by recognised experts in the field, the book is further enhanced by ultrasound images and other illustrations. Key points Comprehensive guide to management of diabetes in pregnancy and the role of ultrasound Examines foetal behaviour in both normal and diabetic pregnancy Includes chapter on diabetes and obesity in pregnancy Authored by recognised experts in the field
This immensely practical handbook provides the busy clinician with a self-contained account of the diagnosis and management of ectopic pregnancy. Such pregnancies, which develop outside the uterine cavity, are an increasingly common occurrence. The focus throughout is on diagnosis and management issues, and the author provides rapid solutions to the most difficult problems posed by ectopic pregnancy. The text is fully supported by numerous and helpful ultrasound images, line diagrams illustrating surgical techniques, and by highlighted summaries of key facts and decision trees. |
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