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.

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

Innovations in technology and new therapies have changed the face of medicine in the last few decades. These include advances in fetal diagnosis (preimplantation genetics, chorionic villous sampling and amniocentesis), drugs that have been developed to treat unique conditions in neonates such as respiratory distress syndrome (surfactant) and pulmonary hypertension (inhaled nitric oxide), as well as technological advances and interventions resulting in diagnostic (ultrasounds and MRI) and therapeutic interventions (intrauterine transfusion to ECMO). Research in fertility treatments has resulted in test tube babies and cloned animals, and that has also fostered technological advances in diagnostic and therapeutic interventions. The primary purpose of Innovations in Neonatal-Perinatal Medicine is to highlight these innovations in technology and therapy that have not only changed the way doctors deliver care to fetus and neonate but also reduced neonatal mortality thereby saving millions of lives in the process. These issues are addressed by the authors who are experts in their respective fields. The book will be valuable not only to healthcare providers but also to educators and policy makers.

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.

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.

A strikingly effective, one-of-a-kind learning resource This one-of-a-kind learning resource for Neonatal Nurse Practitioner/CNS students in both academic and clinical settings is distinguished by its use of complex case studies to reinforce best practices in treating vulnerable neonatal patients. Based on applications and outcomes, the case study approach is a particularly effective method of enhancing critical thinking and clinical decision-making and fostering effective role transition in practice-based disciplines. Authored by leading NNP educators nationwide, these multi-faceted, unfolding case studies address and synthesize the most important content covered throughout the NNP curriculum. Topics addressed include maternal/neonatal complexities, risk factors, neonatal disorders and emergencies by body system, health promotion/maintenance, communicating effectively with parents, and guidance on handling unexpected outcomes. Case studies progress from basic to complex, and each includes objectives, clinical pearls, and critical thinking questions. A robust instructor toolkit contains pedagogical strategies for facilitating online discussion, chapter conclusion quizzes, a variety of simulation experiences, and more. Key Features: Uses a complex case-based learning approach for neonatal advanced practice nursing - the first book to do so Authored by leading NNP educators nationwide Provides 40-50 case studies synthesizing key content areas Helps prepare students for effective role transition Includes a robust instructor toolkit and can be used in online courses

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

This is the only book to present the evidence-based policies and procedures that medical and non-medical staff can use to develop Mother-Friendly Care in their facilities. The Mother-Friendly Childbirth Initiative (MFCI), developed by the Coalition for Improving Maternity Services (CIMS), is a wellness model designed to improve birth outcomes and substantially reduce costs. It is an evidence-based mother-, baby-, and family-friendly model that focuses on prevention and wellness as alternatives to high-cost screening, diagnosis, and treatment programs. The MFCI is the first and only consensus document on U.S. maternity care and is recognized as an important instrument for change in the U.S. and abroad.

The book is based on research and evidence developed by CIMS and includes 10 protocols, each with detailed policies and procedures and supporting information and resources that help implement the change to Mother-Friendly Care. Each protocol is authored and reviewed by recognized leaders in a variety of childbirth and maternity care arenas. The book traces the development of Mother-Friendly Care and describes its core tenets along with supporting statistical information. These tenets eschew practices not supported by scientific evidence. The manual includes implementation strategies for the evidence-based nursing care training programs of such organizations as Lamaze, ICEA, and AWHONN, and supports the WHO-Unicef "Ten Steps of the Baby-Friendly Hospital Initiative" to promote successful breastfeeding.

Key Features: Provides evidence-based policies and procedures for developing Mother-Friendly Care in maternity care facilities Presents specific guidelines that can be used as a standard to measure Mother-Friendliness and subsequently used for marketing purposes Designed to provide childbirth educators and doulas with guidelines for promoting Mother-Friendly Care to birthing women Assists nurses who want to promote more rapid change on their units toward Mother-Friendly Care Supports the WHO-UNICEF "Ten Steps of the Baby-Friendly Hospital Initiative" to promote successful breastfeeding

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.

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.

Embryology at a Glance is a highly illustrated and innovative introduction to key embryological concepts, with concise, memorable descriptions of major embryological developments. This new edition covers the basic principles of human development, from mitosis and meiosis, before exploring the primary formation of each body system, including the development of the musculoskeletal, circulatory, digestive, reproductive, and nervous systems during the foetal and neonatal periods. Key features include: New chapters on cell signalling genes, stem cells, and antenatal screening for common congenital and genetic defects Full colour photographs and illustrations Links to clinical practice highlighted throughout Timelines of each developmental stage MCQs and EMQs for revision and review A companion website at www.ataglanceseries.com/embryology featuring 15 brand new animations, and podcasts to help clearly explain the processes that occur during development. An additional instructor resource contains an image bank of all the figures from the book to aid teaching this fascinating area Embryology at a Glance provides the perfect alternative to the overwhelming detail seen in conventional embryology texts. It provides just the right level of detail on embryology and congenital abnormalities for all medical students and health professionals to develop a thorough understanding of human development and its implications for clinical practice.

Multiple pregnancies are associated with higher risks for both mother and babies. Women with multiple pregnancies have an increased risk of miscarriage, anemia, hypertensive disorders, haemorrhage, and postnatal illness. These pregnancies are more likely to need an operative delivery, and maternal mortality is generally 2.5 times that of singleton births. Fetuses are at increased risk for anatomic and genetic anomalies, growth abnormalities, prematurity, and several physiological problems related to monochorionicity. This book provides a much needed, up-to-date guide to the management of multiple pregnancies. Presented with a uniform approach to all chapters, information is easily navigable, evidence-based, and highly practical. Heavily illustrated, particularly with ultrasound images - the cornerstone of management of multiple pregnancies - this book will appeal to obstetricians and specialists in maternal-fetal medicine, midwives and ultrasonographers and will improve outcomes for mothers and babies.

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.

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.

Find real-world, clinically useful information on all aspects of electronic fetal monitoring! Written by clinicians for clinicians, Mosby's Pocket Guide to Fetal Monitoring: A Multidisciplinary Approach, 9th Edition provides an evidence-based, collaborative approach to fetal heart monitoring during labor and in the antepartum period. It covers the physiologic basis for FHR monitoring, methods and instrumentation, standardized terminology, pattern recognition and interpretation, and management of care. Authored by a nurse-midwife, a perinatologist, and a nurse, this compact guide prepares you for success on the EFM certification exam and for success in today's clinical practice. Pocket-sized format makes this guide ideal to carry and use in the clinical setting, and a colorful design makes information easier to find. Coverage of fetal heart rate assessment, evaluation, interpretation, and management is supported by evidence-based practice and literature, helping you prioritize care and make clinical decisions. Patient safety and risk management strategies include case studies and legal commentary, plus guidelines for providing safe and competent care. Information on the relationship between fetal heart rate patterns and neonatal outcomes provides a guide to the correct use of fetal monitoring. Illustrations, tables, and fetal monitor tracings highlight critical information. Coverage of innovative practices supports patient safety and improved outcomes through the use of a common language for fetal heart rate patterns, a standardized approach to interpretation, a discussion of emergency preparedness, and a discussion of human factor issues such as improved communication, situational awareness, no-fault/just culture, and teamwork. Practical appendices offer a guide to FHR tracings and interpretation as well as self-assessment questions for credentialing and certification exam preparation. Expert author team provides clinical insight along with international presence. NEW information on Category II tracing management is included. NEW! Expanded section on common misconceptions and myths includes evidence supporting factual EFM characteristics. NEW! Detailed information on documentation and legal issues is added. NEW EFM tracings with interpretation are added.

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.

Since the middle of the twentieth century, the development of plastics has been one of the main factors influencing the history of medicine. For example, an anaesthesiologist was formerly an expert in delivering drugs by inhalation. Today, this expert delivers drugs through plastic catheters, in particular via intravenous and epidural routes. Traditionally, the scalpel was the symbol of surgery. Today, surgeons operate on internal organs with flexible plastic endoscopes - without cutting the skin. A typical modern woman in labour has one of her arms connected to a plastic bag through a plastic tube, while a plastic catheter is inserted in the epidural space in her spine. Focusing on obstetrics, this first book about the history of medicine in relation to the plastic revolution asks vital questions about childbirth today - and tomorrow - and demonstrates that the current turning point in the history of childbirth is also a turning point in the history of humanity. Introduced as a medical student to the surgical unit of a Paris hospital in 1949, and still involved in several fields of medicine, Michel Odent has the authority to study contemporary history from this new perspective.

Frank Lake was a British psychiatrist and lay theologian who substantially influenced the interplay of psychology and theology in the United Kingdom over the last several decades. Even though he died in 1983, his ideas continue to be debated through his books and the organization he founded, the Clinical Theology Association. Lake called his discovery and formulation of 'a new paradigm for psychodynamics with revolutionary implications' the 'Maternal-Fetal Distress Syndrome.' He wrote that this 'new perspective changes almost everything in counseling, ' constituting 'a radical departure from all that has gone before.' Furthermore, he noted that the 'understanding of psychodynamics can never be the same again. Nor its practice.' The description and analysis of this 'new paradigm' and its 'revolutionary implications' are the topics of this work.

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.