There is an increasing demand for high-standard fetal and infant neuropathology examinations. Novel imaging techniques, development of new diagnostic methods and advances in genetics have stimulated the interest in gaining additional knowledge on developmental, perinatal and neonatal neuropathology. Approaching the subject from a practical standpoint, diagnostic templates for reports are provided in this essential guide to aid clinicians with different areas of expertise. Each chapter will includes numerous high-quality images, accompanied by explanatory legends from the authors' own experiences. Covering autopsy and tissue processing techniques, the authors discuss a range of disorders such as neural tube defects, brain tumours, storage disorders and many others. This book provides access to an online version on Cambridge Core, which can be accessed via the code printed on the inside of the cover. Compiling the latest advances in fetal and infant diagnostics and care, this book is a highly valuable educational resource.

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.

Alcohol and other drugs of abuse cause significant physi ological changes, especially during development. The effects on the infant and child range from severe mental retardation to mild changes in activity and neurological functions. Although the level of intake needed to cause fetal damage is not clear, the magnitude of the problem is significant, with many long-term sequelae. As a result, it becomes critical to better diagnose and manage drug and alcohol use during pregnancy. This must involve special training for health care professionals. In addi tion, recognition of the psychosocial factors affecting alcohol use, especially by youth and young adults, is critical to modi fying behavior, and thus reducing fetal alcohol exposure. Cultural considerations can also come into play in modi fying alcohol and drug use by women so as to reduce fetal damage. The trends in alcohol and drug use by youth forecast rising levels of damage to infants. These children will need extensive medical and educational care for years to decades. Clearly, understanding of the role women must take in modifying their alcohol and drug use during pregnancy will facilitate changes in our cultural and educational practices that will help reduce fetal trauma from alcohol.

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

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.

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.

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.

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.

Technology has come to dominate the modern experience of pregnancy and childbirth, but instead of empowering pregnant women, technology has been used to identify the foetus as a second patient characterised as a distinct entity with its own needs and interests. Often, foetal and the woman's interests will be aligned, though in legal and medical discourses the two 'patients' are frequently framed as antagonists with conflicting interests. This book focuses upon the permissibility of encroachment on the pregnant woman's autonomy in the interests of the foetus. Drawing on the law in England & Wales, the United States of America and Germany, Samantha Halliday focuses on the tension between a pregnant woman's autonomy and medical actions taken to protect the foetus, addressing circumstances in which courts have declared medical treatment lawful in the face of the pregnant woman's refusal of consent. As a work which calls into question the understanding of autonomy in prenatal medical care, this book will be of great use and interest to students, researchers and practitioners in medical law, comparative law, bioethics, and human rights.

The contributors to this collection look into the experiences of women in the Western world going through pregnancy and birth over the last hundred years.

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

If you are an obstetrician whose patient has been admitted to ICU, you need to know how she is managed there. If you are an intensivist, you need to adapt to changes in physiology, alter techniques for the pregnant patient and keep the fetus from harm. This book addresses the challenges of managing critically ill obstetric patients by providing a truly multidisciplinary perspective. Almost every chapter is co-authored by both an intensivist/anesthesiologist and an obstetrician/maternal-fetal medicine expert to ensure that the clinical guidance reflects best practice in both specialties. Topics range from the purely medical to the organizational and the sociocultural, and each chapter is enhanced with color images, tables and algorithms. Written and edited by leading experts in anesthesiology, critical care medicine, maternal-fetal medicine, and obstetrics and gynecology, this is an important resource for anyone who deals with critically ill pregnant or postpartum patients.

For many years there has been growing concern about the culture of fear that is penetrating maternity services throughout the world, and that the fear felt by maternity care workers is directly and indirectly being transferred to the women and families they serve. The consequences of fear includes increased risk of defensive practice, where the woman and her family become potential enemies to those providing her care. In addition, the prevailing risk management and 'tick box' culture in maternity services encourages maternity workers to give priority to the records instead of the childbearing woman. These factors contribute to the dissatisfaction felt by those using and providing maternity services, and the apparent lack of kindness and respect. There is however increasing evidence that kindness, compassion and mutual respect improves efficiency, effectiveness, experience and staff morale within healthcare settings. The Roar Behind the Silence provides information, inspiration and practical suggestions to support maternity care workers, policy makers, and maternity care funders across the world in their quest to deliver sensitive, compassionate and high quality maternity services. The book highlights examples of good practice, and practical tools for making change happen, using evidence and stories where appropriate. Edited by Sheena Byrom & Soo Downe, with contributions by Hana Ruth Abel, Maria Helena Bastos, Dean Beaumont, Dianne Bowser, Anna Byrom, Sheena Byrom, Penny Campling, Michael Clift, Hannah Dahlen, Raymond de Vries, Soo Downe, Ngai Fen Cheung, Julie Frohlich, Kathryn Guttridge, Jennifer Hall, Shelagh Heneghan, Milli Hill, Billie Hunter, Mavis Kirkham, Mande Limbu, Amali Lokugamage, Kerstin Uvnas Moberg, Mercedes Perez-Botella, Gill Phillips, Elizabeth Prochaska, Progress Theatre Group, Rineke Schram, Anna Ternovszky, Lucie Warren and Robin Youngson.

The rates are on the decline worldwide. But adolescent pregnancies still occur, placing millions of girls each year at risk for medical complications and social isolation, and their babies for severe health problems--especially when prenatal care is inadequate or nonexistent.

But as the opportunity for young women and girls increases around the world, adolescent pregnancy will continue to decline. Featuring reports from countries across the developed and developing worlds, the" ""International Handbook of Adolescent Pregnancy" analyzes the scope of the problem and the diversity of social and professional responses. Its biological/ecological perspective identifies factors influencing childhood pregnancy, as well as outcomes, challenges, and needs of very young mothers as they differ across nations and regions. Salient comparisons are made as cultural contexts and community support vary widely, and attention is paid to issues such as child marriage, LGBT concerns, and the impact of religion and politics on health care, particularly access to contraception, abortion, and other services. This global coverage heightens the understanding of readers involved in care, education, and prevention programs, and otherwise concerned with the psychosocial development, reproductive health, and general well-being of girls. Included in the "Handbook"

Biological influences of adolescent pregnancy.Adolescent maternal health and childbearing.Adolescent pregnancy and mental health.International perspectives on adolescent fathers.Adolescent pregnancy as a feminist issue.Adolescent pregnancy as a social problem.Plus viewpoints from more than thirty countries.

As a unique source of up-to-date findings and clear-headed analysis, the "International Handbook of Adolescent Pregnancy" is a go-to reference for practitioners and researchers in maternal and child health, pediatrics, adolescent medicine, and global health."

This edited collection looks at the experiences of women going through pregnancy and birth over the last 100 years. The essays explore the impact of the professionalization of the medical services, the factors that influenced women's decisions over their choice of healthcare and whether childbirth was seen as a natural or a medical event.

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.

Postpartum depression has become a more recognized mental illness over the past decade as a result of education and increased awareness. Traumatic childbirth, however, is still often overlooked, resulting in a scarcity of information for health professionals. This is in spite of up to 34% of new mothers reporting experiencing a traumatic childbirth and prevalence rates rising for high risk mothers, such as those who experience stillbirth or who had very low birth weight infants.

This ground-breaking book brings together an academic, a clinician and a birth trauma activist. Each chapter discusses current research, women s stories, the common themes in the stories and the implications of these for practice, clinical case studies and a clinician s insights and recommendations for care. Topics covered include: mothers perspectives, fathers perspectives, the impact on breastfeeding, the impact on subsequent births, PTSD after childbirth and EMDR treatment for PTSD.

This book is a valuable resource for health professionals who come into contact with new mothers, providing the most current and accurate information on traumatic childbirth. It also presents mothers experiences in a manner that is accessible to women, their partners, and families.

This book deals with the following important legal questions related to childbirth. When a woman is pregnant, does the law have any part to play in protecting the fetus from harm? Should it intervene, for example, if she is taking illegal drugs or has, at the time of delivery, declined to accept medical advice? And how does---and should---the law respond when something goes wrong and the baby is born injured or disabled? Do damages claims provide outcomes, which are fair to the woman, her child, and the doctors, and midwives who have cared for them?

Increasingly more and more children with developmental disabilities survive into adulthood. Pediatricians and other clinicians are called upon to care for an increasing number of children with developmental disabilities in their practice and thus there is a need for a practical guide specifically written for paediatricians and primary care clinicians that addresses major concepts of neurodevelopmental pediatrics. In the United States, the specialty training leading to a conjoint board certification by the American Board of Pediatrics and American Board of Psychiatry and Neurology, requires a total of 6 years of training (2 years of pediatrics, 1 year of neurology, 18 months of child neurology, 18 months of neurodevelopmental disabilities). As of December 2006, in the US, there were 241 pediatricians and 55 child neurologists certified in the subspecialty of Neurodevelopmental Disabilities. Thus most of the children with developmental disabilities are seen by pediatricians and therefore it is important for these pediatricians to be well informed of common issues in the field. The 60,000 or so pediatricians in the United States (and hundreds more in other countries) are the main target audience for a practical book on neurodevelopmental pediatrics.

This proposed book draws on the expertise of 35 experts in the field of Addiction Medicine to provide the reader with a current and comprehensive view of addiction as related to women, pregnancy, newborns, infants and children. The volume begins by placing current attitudes towards addicted women in a historical context, and continues with contributions on the relationship of gender to substance abuse research, addiction as a general health issue in women, and ethical dilemmas faced when approaching drug use during pregnancy. The volume discusses high-risk pregnancies and HIV infection related to maternal drug abuse. It details specific pharmacotherapy such as methadone and buprenorphine, and assesses society's punitive view toward illicit drug using women. Finally, the book describes outcomes of newborns, infants and children born following intrauterine drug exposure. Health providers in many related disciplines, specialists in Addiction Medicine, social workers and ethicists are among those who will gain insight into the complex interdisciplinary matrix of abuse in women, its unique relationship to pregnancy, and its impact on drug-exposed children. This book was published as a special issue in the Journal of Addictive Diseases.

APPRAISAL AND REVALIDATION SERIES The new Appraisal and Revalidation Series helps doctors demonstrate their competence to the standard expected by the General Medical Council and to the standard expected if they are recognised as having 'special clinical interests'. It helps doctors gather evidence of their performance for appraisal and revalidation portfolios. This fifth book in the series examines the practical ways to identify learning and service needs within the areas of substance abuse palliative care musculoskeletal conditions and prescribing practice. It also provides guidance on how to collect data to demonstrate learning competence performance and service delivery standards. All general practitioners and those with special clinical interests and primary care organisation leads will find this book essential reading. For more information on other titles in this series please click here

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.

Based on the protocols in use at the highly acclaimed King's College Hospital in London, Clinical Protocols in Labour presents a consensus of the best and most appropriate techniques for standard delivery and uncommon clinical scenarios. Each chapter is written as a stand-alone unit making the information easy to find. Coverage ranges from a general approach to care, normal labour, and care of the baby to specific issues such as eclampsia and pre-eclampsia, uterine rupture, and postpartum bleeding. In addition, the book includes protocols for emergency closure of the labour ward, communication among members of the labour team, and more. A compact, authoritative volume, Clinical Protocols in Labour provides practical templates for the perinatal management of women and their babies during labour and delivery.

This book presents both theoretical contributions and empirical applications of advanced statistical techniques including geo-additive models that link individual measures with area variables to account for spatial correlation; multilevel models that address the issue of clustering within family and household; multi-process models that account for interdependencies over life-course events and non-random utilization of health services; and flexible parametric alternatives to existing intensity models. These analytical techniques are illustrated mainly through modeling maternal and child health in the African context, using data from demographic and health surveys. In the past, the estimation of levels, trends and differentials in demographic and health outcomes in developing countries was heavily reliant on indirect methods that were devised to suit limited or deficient data. In recent decades, world-wide surveys like the World Fertility Survey and its successor, the Demographic and Health Survey have played an important role in filling the gap in survey data from developing countries. Such modern demographic and health surveys enable investigators to make in-depth analyses that guide policy intervention strategies, and such analyses require the modern and advanced statistical techniques covered in this book. The text is ideally suited for academics, professionals, and decision makers in the social and health sciences, as well as others with an interest in statistical modelling, demographic and health surveys. Scientists and students in applied statistics, epidemiology, medicine, social and behavioural sciences will find it of value.

Covering both the pharmacological and the more controversial non-pharmacological management of pain relief, this comprehensive text, edited by an internationally renowned specialist, provides practical guidance to all involved in this aspect of labour care.