This issue of Clinics in Perinatology reviews Healthcare Associated Infections in the Neonatal Intensive Care Unit. Guest Editors Drs. Karen Fairchild and Richard Polin have assembled a panel of expert contributors to pen articles on Epidemiology and Risk Factors for NICU HAI: Genes and Environment; Strategies to Reduce NICU HAI: Line, Tube, and Hand Hygiene;? Candida in the NICU: Pros and Cons of Prophylaxis; MRSA in the NICU; New Concepts of Microbial Translocation in the Neonatal Intestine: Mechanisms and Prevention; Antibiotic Resistance in NICU Pathogens: Mechanisms, Clinical Impact, and Prevention; Biomarkers for LONS: Cytokines and Beyond; Heart Rate Variability: A Novel Physiomarker for Sepsis Detection in the NICU; Ventilator-Associated Pneumonia; Perinatal Infection and Prematurity; and Meningitis in Neonates: Bench to Bedside.

The rhetoric of choice is much used in UK health policy and home birth is one of the three options that women are entitled to choose between when deciding where to have their baby. However, many women making this choice run into considerable opposition from the maternity service. Home Birth: the politics of difficult choices focuses on the experiences of women whose choices were opposed by health professionals during their pregnancy journey. It confronts why and how women are being denied home birth and raises some challenging issues for current midwifery practice. Using ten women's narratives, this important volume explores why women might want to give birth at home and considers ideas of risk and informed choice in pregnancy and birth. The book includes chapters on communication and language; fear and stress; advocacy and autonomy; fathers' experience of contested place of birth and free birthing. Pointers to best practice are presented whilst the text incorporates women's narratives throughout, making this a practical and relevant read for midwifery students as well as practising midwives and childbirth educators, all of whom have a duty to make home birth a real option for women.

Mindfulness in the Birth Sphere draws together and critically appraises a raft of emerging research around mindfulness in healthcare, looking especially at its relevance to pregnancy and childbirth. Divided into three parts, this reflective book: * Investigates the phenomena of mindfulness through discussions of neuroscience, an indigenous worldview and research methods. * Develops the concept of mindfulness for use in practice with women/and babies across the continuum of childbirth. It includes chapters on birth environments, intrapartum care, mental health, fertility, breastfeeding and parenting among others. * Explores mindfulness as a tool for birth practitioners and educators, promoting self-care, resilience and compassion. Each chapter discusses specific research, evidence and experiences of mindfulness, including practical advice and an example of a mindfulness practice. This is an essential read for all those interested in mindfulness in connection to pregnancy and childbirth, including midwives, doulas, doctors and birth activists, whether involved in practice, research or education.

Early Onset Neonatal Sepsis is covered in this issue of Clinics in Perinatology, guest edited by Drs. Karen Fairchild and Richard Polin. Authorities in the field have come together to pen articles on Innate host defenses and risk for EONS, Group B streptococcus, Diagnosis and management of clinical chorioamnionitis, Molecular diagnostics of sepsis, Use of proteomics in the diagnosis of chorioamnionitis and neonatal sepsis, Adjunct laboratory tests in the diagnosis of EONS, Ureaplasma: role in diseases of prematurity, Meningitis in neonates, Adjunct immunologic therapies in neonatal sepsis, Pathophysiology and treatment of septic shock in neonates, and International perspective on EONS.

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.

This is an ideal evidence based clinical guide to the essential principles and practical points arising from obstetric emergencies for residents, trainees, and obstetricians in practice. The concise text, illustrated with key diagrams, is from experienced educators and practitioners. *Provides a concise illustrated guide to the key principles and practical points involved *Gives trainees, residents, and obstetricians the practical information they need in an emergency *Supplies quick and easy reference to key points with illustrations

This issue of Clinics in Perinatology, guest edited by Drs. Alan Spitzer and Dan Ellsbury, examines Quality Improvement in Neonatal and Perinatal Medicine. The first part of the issue addresses Tools of Quality Improvement and includes articles on The Quality Chasm in Neonatal and Perinatal Medicine; Evaluating the Medical Evidence; The Vermont Oxford Network Database; The Pediatrix Clinical Data Warehouse; Role of Regional Collaboratives: The California Perinatal Quality Care Collaborative Model; A Primer on Quality Improvement Methodology; Using Statistical Process Control Methodology; Human Factors in Quality Improvement, Random Safety Audits, Root Cause Analysis, and Failure Mode and Effects Analysis; Collaboration Between Obstetricians and Neonatologists: Perinatal Safety Programs and Improved Clinical Outcomes; and Pay for Performance: A Business Strategy for Quality Improvement in Neonatal-Perinatal Medicine. The second part of this issue addresses Specific Applications of Documented Quality Improvement Methodology in Neonatal and Perinatal Medicine and includes articles on Delivery Room Intervention-Improving the Outcome, Reducing Retinopathy of Prematurity, Improving Breast Milk Use During and After the NICU Stay, Decreasing Catheter Related Bloodstream Infection, and Decreasing Bronchopulmonary Dysplasia.

Fetal Neurology is covered in this issue of Clinics in Perinatology, guest edited by Dr. Adre du Plessis. The genetic basis of normal brain development and its disorders is explored, including reviews on the prosencephalon, the cerebral cortex, and the cerebellum. Next, normal and abnormal circulatory support of the fetal brain is covered, with articles on normal fetal cerebral substrate supply, disorders of placental circulation and the fetal brain, and disorders of fetal circulation and the fetal brain. Toxic-metabolic causes of disturbed brain development is reviewed, including articles on primary disorders of metabolism and disturbed fetal brain development and maternal drug abuse and impaired fetal brain development. Next, a section on infectious-inflammatory causes of disturbed brain development includes articles on fetal viral infections and impaired brain development and fetal inflammation and impaired brain development. A section on disorders of labor and delivery covers fetal hypoxia insults and patterns of brain injury, the fetal heart rate response to hypoxia, and non-asphyxial hypoxic-ischemic brain injury during prolonged labor. The issue closes with a section on advances in fetal neurodiagnostic testing, including reviews on imaging the fetal brain, quantitative fetal heart rate techniques, and fetal magnetoencephalography for assessment of fetal neurologic function.

Current Controversies in Perinatology is covered in this issue of Clinics in Perinatology, guest edited by Drs. Michael Uhing and Robert Kliegman. Authorities in the field have come together to pen articles on Strategies to prevent bacterial and fungal infection in the NICU, Drugs of choice for sedation and analgesia in the NICU, Iron therapy for preterm infants, Management of fetal arrhythmias, Inhaled nitric oxide for preterm infants, Racial disparity in low birth weight and infant mortality, Evaluation and treatment of hypotension in the preterm infant, Indications for home apnea monitoring, Short bowel syndrome: how short is too short?, Anemia in the preterm infant: the role of transfusions and erythropoietin, Evaluation and management of stroke in the neonate, Screening for postpartum depression in the NICU, Treatment of gastroesophageal reflux in the preterm and term infant, Optimizing growth in the preterm infant, The role of postnatal steroids in the treatment of bronchopulmonary dysplasia, and The role of genomics in the NICU.

Providing essential knowledge and understanding that midwives, health visitors, nursery nurses and lay birth and early parenting educators need to deliver effective and evidence-based education to all new parents and families, this book explores key issues in perinatal education. Bringing together research and thinking around preconception and birth, infant sleep, nutrition, attachment and development, it also includes chapters on topics of growing importance, such as preconception education, LGBTQ+ parent education, the role of parenting advice, parent education across different cultures and teaching antenatal classes online. Each chapter includes a key knowledge update and pointers for practice. This wide-ranging and practical text is an important read for all those supporting new parents from pregnancy through the first 1000 days, especially those delivering antenatal care and birth and early parenting education.

Medical professionals are often involved in the management of the pregnant patient without necessarily being experts on all the complications surrounding pregnancy. The Handbook of Obstetric Medicine addresses the most common and serious medical conditions encountered in pregnancy, including heart disease, thromboembolism, diabetes, skin problems, gastrointestinal disease, neurological problems, hormonal diseases, hypertension and pre-eclampsia, and more. For each condition, the handbook includes a description of incidence, clinical features, pathogenesis, diagnosis, the effect of pregnancy, and management of the condition. The book also includes a detailed section focusing on the differential diagnosis of common symptoms including hypertension, chest pain, palpitations, breathlessness, headaches, dizziness, abdominal pain, and more. The symptoms and differential diagnoses are presented in an easy-to-read tabular format and include a description of important clinical features and potential areas of investigation. For those clinicians understandably reluctant to prescribe drugs during pregnancy, a useful appendix includes a section on prescribing in pregnancy and a list of contra-indicated drugs. In addition, to assist in the interpretation of laboratory tests, a second appendix lists normal laboratory values in pregnancy, broken down by trimester. Pre -pregnancy counselling and postnatal follow up are vital in the holistic management of women with medical problems and this includes appropriate contraceptive advice. A third appendix has therefore been added as a ready reference for clinicians not familiar with effective contraception. The new edition remains a pragmatic and easy-to-use design by including tables, bullets, and "Points to remember" boxes for ease of reference. It is an essential on-the-spot guide for obstetricians, physicians, general practitioners, and midwives in both practice and training. Catherine Nelson-Piercy, MA, FRCP, FRCOG Past President, International Society of Obstetric Medicine, Professor of Obstetric Medicine, King's College London, Co-founding Editor-in-Chief, Obstetric Medicine Praise for previous editions: "This is an excellent handbook of obstetric medicine, which deserves to be on the shelves of all actively practicing obstetricians."-British Medical Association Medical Book Awards "This book gets it just right and is a true handbook, easy to read, accessible and is not too large but packs in a lot of useful and relevant information." - Glycosmedia

The subject of medicalisation of childbirth in colonial India has so far been identified with three major themes: the attempt to reform or 'sanitise' the site of birthing practices, establishing lying-in hospitals and replacing traditional birth attendants with trained midwives and qualified female doctors. This book, part of the series The Social History of Health and Medicine in South Asia, looks at the interactions between childbirth and midwifery practices and colonial modernities. Taking eastern India as a case study and related research from other areas, with hard empirical data from local government bodies, municipal corporations and district boards, it goes beyond the conventional narrative to show how the late nineteenth-century initiatives to reform birthing practices were essentially a modernist response of the western-educated colonised middle class to the colonial critique of Indian sociocultural codes. It provides a perceptive historical analysis of how institutionalisation of midwifery was shaped by the debates on the women's question, nationalism and colonial public health policies, all intersecting in the interwar years. The study traces the beginning of medicalisation of childbirth, the professionalisation of obstetrics, the agency of male doctors, inclusion of midwifery as an academic subject in medical colleges and consequences of maternal care and infant welfare. This book will greatly interest scholars and researchers in history, social medicine, public policy, gender studies and South Asian studies.

At one time, many children born with congenital heart disease (CHD) suffered from issues that carried fatal prognoses. But that's changing, thanks to technological advances. Interventions in Structural, Valvular, and Congenital Heart Disease, Second Edition guides you throught the interventional treatment of congenital, valvular, and structural heart disease in the children and adults. The book emphasizes the practical aspects of procedures and covers other important areas such as indications and patient selection, potential pitfalls, and complications. See What's New in the Second Edition: Contributions from new authors who are pioneers in structural interventions in adults and transcatheter aortic valve replacement Expanded emphasis on the importance of imaging alongside the technical details of equipment and its safe and effective delivery Coverage of emerging techniques at the forefront of interventional treatment such as fetal interventions, hybrid procedures, and mitral valve repair Greater understanding, technical knowhow, and wider availability of catheters, balloons, delivery systems, and devices have spread intervention into the realm of acquired valve disease, degenerative disease of the aorta, paravalve leakage, postinfarction ventricular septal defects, and closure of the left atrial appendage. The book draws together expert interventionists from throughout the world to present approaches to congenital and structural heart disease that results in better outcomes for patients.

This first-of-its-kind volume addresses the myriad of issues relating to-and reviews the plethora of responses to--premature births in the United States, both in national context and compared with other countries. In addition to current clinical data, it examines how preterm births in the U.S. fit in with larger social concerns regarding poverty, racial disparities, reproductive rights, gender expectations, and the business of health care. Comparisons with preterm birth phenomena in Canada, the U.K., and other Western European countries illustrate cultural narratives about motherhood, women's status, differences across social welfare and abortion policies , and across health care financing and delivery sytems, and how these may affect outcomes for newborns. The book sorts out these intersecting complexities through the following critical lenses: * Clinical: causes, treatments, and outcomes of preterm birth * Population: the distribution of preterm births * Cultural: how we understand preterm birth * Health care: delivering care for high-risk pregnant women and preterm infants * Ethical: moral decision-making about preterm births Preterm Birth in the United States synthesizes a wide knowledge base for maternal and child health professionals across diverse disciplines, including public health, social work, nursing, medicine, and health policy. Social scientists with interests in reproduction and gender issues will gain access to historical, clinical and epidemiological knowledge that can support their work. There is also an audience for the book among childbirth activists such as supporters of midwifery and less medicalized childbirth.

One new mother in twenty is diagnosed with traumatic stress after childbirth. In Birth Crisis Sheila Kitzinger explores the disempowerment and anxiety experienced by these women. Key topics discussed include:

• increasing intervention in pregnancy
• the shift in emphasis from relationships to technology in childbirth
• how family, friends and professional caregivers can reach out to traumatized mothers
• how women can work through stress to understand themselves more deeply and grow in emotional maturity
• how care and the medical system needs to be changed.

Birth Crisis draws on mothers' voices and real-life experiences to explore the suffering after childbirth which has, until now, been brushed under the carpet. It is a fascinating and useful resource for student and practising midwives, all health professionals, and women and their families who want to learn how to overcome a traumatic birth.

When a woman is denied all choice - feels as if she has been swallowed up by a vast machine and spat out at the other end with a baby - how can she come to terms with that ordeal? One new mother in twenty is diagnosed with traumatic stress after childbirth. In Birth Crisis Sheila Kitzinger explores the disempowerment and anxiety experienced by these women. Key topics discussed include: increasing intervention in pregnancy; the shift in emphasis from relationships to technology in childbirth; how family, friends and professional caregivers can reach out to traumatized mothers; how women can work through stress to understand themselves more deeply and grow in emotional maturity; how care and the medical system needs to be changed. Birth Crisis draws on mothers' voices and real-life experiences to explore the suffering after childbirth which has, until now, been brushed under the carpet. It is a fascinating and useful resource for student and practicing midwives, all health professionals, and women and their families who want to learn how to overcome a traumatic birth.

Midwives are encountering more and more women whose pregnancies are complicated by medical conditions, including cardiac disease, obesity and diabetes. This new edition is completely up-to-date and offers highly practical solutions for everyday midwifery practice, acknowledging the importance of promoting normality where possible. This text includes physiology, explanations of conditions and principles of care for preconception, pregnancy, labour, birth and the postnatal period. Each chapter brings together the basic knowledge of a condition and how it changes during pregnancy in an integrated and accessible way, including a new chapter dedicated to obesity. Explanations of laboratory tests, diagnostic tests, common drugs and illustrative colour pictures are included in relevant chapters. Medical Conditions Affecting Pregnancy and Childbirth is a vital guide for student midwives, as well as a useful reference for practising midwives.

Containing over 10,000 citations from the literature, Chemically Induced Birth Defects, Third Edition deserves a place on the bookshelves of all toxicologists, teratologists, pediatricians, obstetricians, gynecologists, environmentalists, biochemists, oncologists, pharmacologists, endocrinologists, and upper-level undergraduate, graduate, and medical school students in these disciplines.

Cardiac disease is one of the leading causes of maternal morbidity and mortality. Catastrophic outcomes typically encountered are due to gaps in knowledge and communication between health care providers. There is a great need for a standardized approach for care of this very high-risk group of pregnant women. The book encompasses detailed obstetrics and cardiology perspectives that are crucial in the management of the commonly encountered cardiac conditions in pregnancy. This text aims to provide guidance to the whole team caring for a pregnant cardiac patient consisting of obstetricians, maternal-fetal medicine, hospitalists, cardiologists, obstetric anaesthesiologists, emergency physicians, primary care providers and nurses. Features: Cardio-Obstetric team organization Preconception counselling and family planning considerations Cardiovascular disease screening and risk stratification of a pregnant cardiac patient Management of a wide spectrum of cardiovascular diagnoses through use of checklists and algorithms in a simple format Essential key points for each cardiac diagnosis

The first reports of the successful use of mechanical ventilation to treat respiratory disorders in the neonate were published in the 1960s. Subsequent decades have seen the widespread use of ventilation technology, the development of high-frequency ventilation and extracorporeal support, and, most recently, the use of surfactant replacement therapy and synchronized ventilation. Neonatal and pulmonary clinicians now have a wide range of diagnostic and therapeutic tools from which to select a customized management strategy. As a result, the modern neonatal intensive care unit has become a technological wonder, and an occasional source of confusion.

Divided into twenty main sections, this book offers a wealth of information to those providing intensive respiratory care to the newborn. Eighty-three separate chapters, written by leaders in their respective fields, cover a comprehensive range of material, including lung development and function, the principles of mechanical ventilation, available diagnostic and therapeutic equipment, strategies for treating various respiratory disorders, alternative treatments, outcomes, and ethical considerations pertaining to the care of newborns. The outline-style presentation is clinically focused, ensuring that all subjects are described in a manner that is easily understood and easily applied to bedside treatment.

This manual will be of immense value to all those who come in contact with a neonatal intensive care unit, including pediatricians, neonatologists, pulmonary specialists, respiratory therapists, neonatal nurses and nurse practitioners, fellows, residents, interns, and medical students.

This text analyses the pathophysiology, diagnosis, treatment and control of respiratory disorders in the newborn infant. It explores the mechanisms, patterns and factors influencing respiratory activity and dysfunction, as well as the aetiology, management and evaluation of conditions such as respiratory distress syndrome, bronchopulmonary dysplasia, airway disorders, and congenital hypoventilation syndromes.

This book contains a series of clinical cases that address and illustrate difficult problems in obstetric ultrasound. The approach is strongly didactic and will aid trainees in maternal-fetal medicine and obstetrics to appreciate potential pitfalls and recognize rare presentations. Each case sets out one page of text, then one of treatment algorithms, and then presents sample ultrasound scans. Learning objectives are given for each case, together with a short list of references and background reading.

This is the ninth edition of a well-established, introductory text providing in-depth information on the care of the newborn, both normal and abnormal, full-term and pre-term, from minor to major abnormalities and illnesses. It provides an introduction to neonatology, concentrating on common conditions,for all health professionals concerned with care of the newborn.The concise, readable text facilitates the comprehension of content. The content is firmly evidence-based to ensure best practices. Key points listed throughout the text assist in learning and comprehension. Color photos illustrate important clinical conditions. Fully referenced to provide a current evidence base. Updated content reflects recent guidelines, developments in intensive care, pharmacology, and hepatitis C. A discussion of current issues includes vitamin K administration. Additional information is provided on the care of normal babies, including the parents' perspective. It provides an increased emphasis on the nursing/midwifery aspects.

This is a complete, medically reliable dictionary of congenital malformations and disorders. As the authors explain, Down syndrome is the only common congenital disorder; the other defects and disorders are rare or very rare, some having been reported fewer than 20 times worldwide.This dictionary covers them all. Examples: Aagenaes syndrome is due to congenital hypoplasia of lymph vessels, which causes lymphedema of the legs and recurrent cholestasis in infancy, and slow progress to hepatic cirrhosis and giant-cell hepatitis with fibrosis of the portal tracts. Acrocallosal syndrome is characterized by total or partial absence of the corpus callosum, craniofacial dysmorphism, polydactyly, and severe mental retardation. Other features can be retinal pigmentation anomalies, optic atrophy, strabismus, nystagmus, cleft lip and palate, cardiovascular anomalies, hernia, abnormal nipples, and fits. Acrodysostosis is characterized by prenatal growth deficiency, brachycephaly, de formities of the humerus, radius and ulna, short and broad hands, hypoplastic maxilla, and mental retardation.

Contents:
Introduction 1. Biology of Twinning 2. Twin Pregnancy and the Twin Fetus 3. Intrauterine Behaviour 4. Antecedents and Forerunners of Postnatal Life 5. Still in Hospital: Birth and Soon After Birth 6. Back Home 7. The Initial Stages of Twinship 8. 'Twinning' 9. Becoming 'Twinned' - The Couple Effect 10. Change in the Twins 11. Different Types of Twins 12. Changes in the Family 13. Conclusions