Many challenges facing premature babies are insurmountable despite the recent advancements of Neonatal medicine. Often providers need to decide which patients are the best candidates of the specialized care. Ideally, families are integral parts of the decision-making process. This two part story follows the distressing yet sometimes satisfying journey of a young doctor in two very different situations challenging his own ego, ethics, and motivations as he struggles with tough decisions, tough situations, and sometimes circumstances where his intentions are met with resistance by his colleagues.

Meconium aspiration syndrome (MAS) is a major cause of respiratory morbidity and mortality in the term and post-term new-borns. Aspirated meconium obstructs the airways and subsequently may cause an alveolar atelectasis behind the plug, air-trapping, and air leak. In a very short time after the aspiration, meconium triggers a progressive dysfunction of pulmonary surfactant, chemical pneumonia, and ventilation/perfusion mismatch, which often leads to persistent pulmonary hypertension. Due to complex pathophysiology and multiple interactions between the individual pathomechanisms, MAS is often difficult to treat. Therapeutic protocols usually include airway suctioning, ventilator support or artificial ventilation, in severe cases also administration of exogenous surfactant, inhaled NO, partial liquid ventilation, or anti-inflammatory treatment. Growing information on the role of various pathomechanisms participating in the meconium-induced respiratory, inflammatory, and cardiovascular changes widens the spectrum of drugs which may be perspectively beneficial in the treatment of MAS.

Prenatal diagnosis is a method to detect foetal disease before delivery. Ideally, prevention of foetal exposure to harmful influences begins before conception because all major organ systems develop early in pregnancy, often before a woman realises that she is pregnant. Prenatal diagnosis is composed of non-invasive and invasive methods. This book summarises recent developments in the field of non-invasive prenatal diagnosis (NIPD) through the use of foetal cells and ffDNA in maternal circulation during pregnancy and provides an overview of the possibilities for future clinical applications. The various options for prenatal screening for Down Syndrome (DS) is also outlined, in addition to current research efforts made to improve non-invasive prenatal diagnosis based on foetal cells, cell free foetal DNA and proteins present in maternal circulation. Additionally, this book gives an overview of essential aspects of primary prevention efforts and effecting factors including age and socio-demographical factors, obstetric history, maternal medical conditions, genetic disorders, psycho-social issues and infections and vaccination. Other chapters in this book discuss the close correlation between hypertensive dysfunction in pregnancy and the development of cardiovascular diseases, the various techniques and applications of MRI in foetal imaging, a review of prenatal genetic diagnosis (PGD), the relation between antithrombin congenital deficiency and high risk miscarriages and recurrent abortions, and a review of literature on arthrogryposis multiplex congenita, the occurrence of multiple joint contractures at birth.

Every year in the United States, 12 per cent of all births are preterm births, 5 per cent of all babies need help to breathe at birth, and 3 per cent of neonates are born with at least one severe malformation. Many of these babies are hospitalized in a neonatal intensive care unit. Annie Janvier and her husband, Keith Barrington, are both pediatricians who specialize in the care of these sick babies and are internationally known for their research in this area. In 2005, when their daughter Violette was born extremely prematurely, four months before her due date, they faced the situation "from the other side" as parents. Despite knowing the scientific facts, they knew nothing about the experience itself. "Knowing how a respirator works did not help me be the mother of a baby on a respirator," writes Annie. She did not know how to navigate the guilt, the uncertainty, the fears, the predictions of providers, and the responses of friends and family. In a society obsessed with goals, performance, efficiency, and high percentages, she discovered that the daily lack of control that new parents of sick babies face changes their lives. And that, for physician parents, it also changes the way they practice medicine. Most of the articles and books written about premature babies and neonatal intensive care units examine the technological and medical aspects of neonatology. Breathe, Baby, Breathe!, however, is written in the voice of a parent-doctor and tells the story of Violette and her parents, alongside the stories of other fragile babies and their families with different journeys and different outcomes. With the story of Violette at the core of the book, the interwoven stories and empirical articles provide essential insights into the medical world of premature birth. This original and clever blend of narrative and evidence provides a new, experiential view of the way forward during a parental crisis.

The award-wining Birth Emergency Skills Training is the interface between the world of midwifery and the world of medicine. BEST is designed to improve the midwife's ability to act decisively in an emergency and to see it though until resolved or until mother and baby are under physician management. Topics covered include pain and bleeding in pregnancy, hypertension, preterm labor, malpresentations, undiagnosed twins, abnormal fetal heart rate, neonatal resuscitation, shock, trauma, syncope and cardiac arrest.Richly illustrated with drawings and photographs by the author.

This pocket-sized book, presented in an easy-to-follow format, is designed as a tool for students and professionals to carry in any setting, providing a quick reference guide to antenatal care and related anatomy and physiology. Used as a platform for wider reading, this text is an ideal reference point for any student or professional involved with the care of childbearing women.

The objective of this book is to review specific haematologic disorders that commonly present in the new-born period. It summarises and presents the topics specifically relating to the haematological disorders in neonates.

This pocket-sized book, presented in an easy-to-follow format, is designed as a tool for students and professionals to carry in any setting, providing a quick reference guide to supporting women during labour. Used as a platform for wider reading, this text is an ideal reference point for any student or professional involved with the care of childbearing women.

Birth defects are defined as abnormalities of structure, function, or body metabolism that are present at birth. These abnormalities lead to mental or physical disabilities or are fatal. There are more than 4,000 different known birth defects ranging from minor to serious, and although many of them can be treated or cured, they are the leading cause of death in the first year of life. This book presents leading research in this field from around the world.

Birth defects are defined as abnormalities of structure, function, or body metabolism that are present at birth. These abnormalities lead to mental or physical disabilities or are fatal. There are more than 4,000 different known birth defects ranging from minor to serious, and although many of them can be treated or cured, they are the leading cause of death in the first year of life. This book presents leading research in this field from around the world.

Mientras que mas de catorce millones de norteamericanos sufren de diabetes, la proporcion se incrementa de manera considerable entre la poblacion hispana, ya que los hispanos tienen dos veces mayor propension de desarrollar esta enfermedad que otros grupos. Las estadisticas senalan que al llegar a los cuarenta y cinco anos de edad, uno de cada diez hispanos estara enfermo de diabetes. Despues de los cuarenta y cinco anos, uno de cada cuatro hispanos habra sido diagnosticado con este padecimiento.

La diabetes es un padecimiento complicado que amenaza la vida misma, pero hoy en dia los diabeticos pueden reducir sus riesgos y llegar a tener una vida mas duradera, feliz, y productiva si cuentan con un plan para el manejo y control de su tratamiento. El "Manual Joslin para la Diabetes, " elaborado por el famoso Centro Joslin para la Diabetes, es el libro mas adecuado para la atencion personal, indispensable para todos aquellos que padecen esta enfermedad.

El Centro Joslin para la Diabetes es considerado como el instituto de investigacion y clinica mas importante del mundo en el estudio y el tratamiento de este mal, lo que hace al "Manual Joslin para la Diabetes" el libro mas actual en la materia. Escrito bajo la direccion del doctor Richard Beaser, en colaboracion con Joan Hill y un equipo de expertos, en este libro se presentan todos los aspectos esenciales para que los propios pacientes sean quienes controlen su enfermedad. Se trata de un libro practico, actualizado, y accesible, escrito en un lenguaje claro y sencillo. Se apoya en graficas y cuadros sobre que, como y cuando comer; como verificar el contenido de los azucares en la sangre; como administrar insulina y medicamentos por via oral; como controlar las alzas y bajas de azucar; y como y cuando hacer ejercicio.

An essential new text for genetic counseling's most sought-after skills Foundations of Perinatal Genetic Counseling is a practical introduction to the concepts and skills in genetic counseling with clients before and during pregnancy. Authored by genetic counselors at the forefront of contemporary perinatal practice, this all-in-one reference provides an accessible yet comprehensive overview of: * the basics of pregnancy, including assisted reproductive technologies and high-risk pregnancy management * preimplantation and prenatal genetic screening and diagnosis * the structure and goals of a genetic counseling appointment * common clinical scenarios and best-practice approaches Distilling the most pertinent information for new learners and practicing counselors, Foundations of Perinatal Genetic Counseling is an essential companion for both classroom and clinic. Perinatal genetic counselors will find themselves returning to this unique resource long after their training has come to an end.

Some 20-million low-birth-weight babies are born each year because of either preterm birth or impaired prenatal growth mostly in less developed countries. For many small preterm infants receiving prolonged medical care is important. However kangaroo mother care is an effective way to meet baby's needs for warmth breastfeeding protection from infection stimulation safety and love. Kangaroo mother care is care of preterm infants carried skin-to-skin with the mother. It is a powerful easy-to-use method to promote the health and well being of infants. This document describes the kangaroo mother care method for care of stable preterm/low-birth-weight infants who need thermal protection adequate feeding frequent observation and protection from infection. It provides guidance on how to organize services at the referral hospital and on what is needed to introduce and carry out kangaroo mother care focusing on settings where resources are limited. Evidence for the recommendations are provided whenever possible. This book has been prepared for health professionals in charge of low-birth-weight and preterm newborn infants in first referral hospitals in settings with scarce resources. It is also aimed at decision-makers and planners at national and local levels.

This book on obstetrics provides a fundamental knowledge on embryology, and foetal and placental physiology. It emphasizes the importance of antenatal supervision throughout pregnancy and discusses complications and high risk pregnancies. Further, it has sections on normal and abnormal labour and their management, and also on foetal growth and neonatal management. In the present era of 'safe motherhood' and childcare, this book aims to enable practitioners to maintain positive health of pregnant women, leading to the delivery of healthy children, and making the experience of pregnancy and childbirth joyful and gratifying. The procedures and precautions described in this book, if followed, should help in achieving reduced maternal and perinatal mortality.

Who decides, and on what basis, how to treat a child with severe birth defects? Any decisions made on such cases are painful and complex, and have far-reaching consequences for society at large. Addressing the medical, legal, and ethical aspects of the issue, Robert Weir presents the first serious survey of the major arguments regarding selective non-treatment, which have been advanced by physicians, attorneys, and the judicial system.

The new edition of this authoritative review of the clinical approach to diagnostic and therapeutic obstetric, maternal-fetal and perinatal procedures will be welcomed by all professionals involved in childbirth as a significant contribution to the practice of maternal-fetal medicine and surgical obstetrics.

Pkg: Safe Maternity & Ped Nsg Care Textbook 2e & Study Guide 2e

Co-authored by an interprofessional collaborative team of physicians and nurses, Merenstein & Gardner's Handbook of Neonatal Intensive Care, 9th Edition is the leading resource for interprofessional, collaborative care of critically ill newborns. It offers comprehensive coverage with a unique interprofessional collaborative approach and a real-world perspective that make it a practical guide for both nurses and physicians. The new ninth edition features a wealth of expanded content on delivery-room care; new evidence-based care "bundles"; palliative care in the NICU; interprofessional collaborative care of parents with depression, grief, and complicated grief; and new pain assessment tools. Updated high-quality references have also been reintegrated into the book, making it easier for clinicians to locate research evidence and standards of care with minimal effort. These additions, along with updates throughout, ensure that clinicians are equipped with the very latest clinical care guidelines and practice recommendations - all in a practical quick-reference format for easy retrieval and review. UNIQUE! Core author team of two physicians and two nurses gives this internationally recognized reference a true interprofessional collaborative approach that is unmatched by any other resource. Consistent organization within clinical chapters include Physiology/Pathophysiology, Etiology, Prevention, Data Collection (History, Signs and Symptoms, and Laboratory Data), Treatment/Intervention, Complications, and Parent Teaching sections. UNIQUE! Color-highlighted point-of-care clinical content makes high-priority clinical content quick and easy to find. UNIQUE! Parent Teaching boxes outline the relevant information to be shared with a patient's caregivers. Critical Findings boxes outline symptoms and diagnostic findings that require immediate attention to help the provider prioritize assessment data and steps in initial care. Case studies demonstrate how to apply essential content to realistic clinical scenarios for application-based learning. NEW! Updated content throughout reflects the latest evidence-based practice, national and international guidelines, and current protocols for interprofessional collaborative practice in the NICU. NEW! Up-to-date, high-quality references are now reintegrated into the text for quick retrieval, making it easier for clinicians to locate research evidence and standards of care with minimal effort. NEW! Expanded content on delivery-room care includes the impact of staffing on quality of care, delayed cord clamping, resuscitation, and more. NEW! Coverage of the new evidence-based care "bundles" keeps clinicians up to date on new guidelines that have demonstrated improved outcomes of very preterm infants. NEW! Coverage of new pain assessment tools equips NICU providers with essential resources for maintaining patient comfort. NEW! Expanded coverage of palliative care in the NICU provides the tools needed to ensure patient comfort. NEW! Expanded coverage of interprofessional collaborative care of parents with depression, grief, and complicated grief prepares clinicians for this essential area of practice.

Ensure you're referencing the most accurate information surrounding nursing practice in today's neonatal intensive care unit with AWHONN's Core Curriculum for Maternal-Newborn Nursing, 6th Edition. Developed by one of the most authoritative associations in neonatal intensive nursing care, AWHONN, this renowned guide provides in-depth coverage of the most common neonatal disorders and their management - focusing on the latest evidence-based practice for preterm infants, medications, and antepartum-intrapartum complications. Additionally, the concise outline format makes information easy to find as it highlights the essentials of each condition including the definition, etiology, pathophysiology, signs and symptoms, diagnostic tests, treatments, and outcomes. With timely content that sets the standard for neonatal nursing practice, this trusted reference is an excellent resource for practicing nurses working in any NICU worldwide. Content developed by AWHONN, one of the most authoritative associations in neonatal intensive care nursing, ensures the information is both accurate and relevant. Concise outline format provides access to important nursing considerations associated with the management of the most common conditions in the neonate. Full-scope coverage of neonatal nursing practice provides information on families, ethics, legal issues, research, case management, the transition to home, and more. Focus on evidence-based practice related to preterm infants, medications, and antepartum-intrapartum complications sets the standard for neonatal nursing practice. Strategies to promote inclusionary care better reflect today's nursing care today with a focus on family-centered care, comprehensive perinatal records, health care teams in the NICU, and infant care best practices. NEW! Expanded information on breastfeeding and acquired opioid dependency keep you informed with the latest best practices related to these two everchanging areas. NEW! Updated neonatal resuscitation guidelines ensures you follow the most up-to-date protocols and procedures in this critical skill area. NEW! Additional tables and boxes help you quickly find important information.

This book clearly explains the basics of cranial ultrasonography in the neonate, from patient preparation through to screening strategies and the classification of abnormalities. The aim is to enable the reader consistently to obtain images of the highest quality and to interpret them correctly. Essential information is provided both on the procedure itself and on the normal ultrasound anatomy. The standard technique is described and illustrated, and emphasis is placed on the value of supplementary acoustic windows. Attention is also drawn to maturational changes in the neonatal brain and to the limitations of cranial ultrasonography. Frequently occurring abnormalities are described and classifications for these abnormalities are provided. A new classification for neonatal cerebellar hemorrhages is introduced. In this third edition, all ultrasound images have beena replaced, reflecting the improvements in image quality. An entirely new chapter is devoted to Doppler ultrasonography. The illustrations have been improved and new illustrations were added. The reader will have access to highly informative videos on the cranial ultrasound procedure, available online via SpringerLink. The compact design of the book makes it an ideal and handy reference that will guide the novice in understanding the essentials of the technique while also providing useful information for the more experienced practitioner.

Die sich rasch wandelnde Lehre in der studentischen Ausbildung machte es erforderlich, das K- zept der ersten Auflage grundlich zu uberdenken. Die Texte der ersten Auflage wurden von Wissen, welches sich eher an Facharztanwarter richtete, befreit und inhaltlich uberarbeitet und damit auf ein studentisches Publikum ausgerichtet. Zusatzliche Kapitel sprechen die wichtigen Notfalle, die Infektionen in der Schwangerschaft und gerade auch die Leitsymptome an, die in keinem Stud- tenlehrbuch fehlen durfen. Gerade die Leitsymptome als auch das Fallquiz, welches das diagn- tische Denken vom Leitsymptom zur Diagnose bis hin zur daraus folgenden Therapie schulen soll, spiegeln den problemorientierten Lehransatz, welcher mittlerweile in den meisten Universitaten in Deutschland nach Einfuhrung der jetzt gultigen Approbationsordnung Einzug gefunden hat, wider . Naturlich dient das Buch auch in besonderem Masse den Kolleginnen und Kollegen in der Weiterbildung sehr gut als Unterstutzung, basiert es doch auf den klassischen drei Saulen unseres Faches: 1. Reproduktionsmedizin und gynakologische Endokrinologie 2. Pranatalmedizin und Geburtshilfe und 3. Onkologie und operative Gynakologie. Die Didaktik wurde grundlegend erneuert. UEbersichten, Merke- und Cave-Auszeichnungen und die jedem wichtigen Krankheitsbild folgenden Zusammenfassungen bilden einen Rahmen, uber den sich dem Lernenden das Wissen leicht erschliessen kann. Zusatzliche Praxistipps bieten nutzliche H- weise zur praktischen Handhabung, die spater am Patienten sehr nutzlich sein koennen. Die bewahrten Fallbeispiele in den Kapiteln geben einen ersten Einblick in den Alltag im Krankenhaus. Wir moechten allen Kolleginnen und Kollegen danken, die mit ihrer entsprechenden Fachk- petenz als Autoren die entsprechenden Kapitel verfasst haben.

Most neurologists, fellows, and residents are familiar with adult EEG, but have not developed a similar understanding of pediatric EEG. There are fewer resources covering pediatric electroencephalography and existing books are either too comprehensive or lack the main details that differentiate the EEG in childhood. This accessible text includes the most recent classification and nomenclature published by the International League Against Epilepsy. It provides a practical and well illustrated text of value to residents, fellows, and neurologists in need of an update on pediatric EEG.

The goal of nutritional management in VLBW and ELBW infants is the achievement of postnatal growth at a rate that approximates the intrauterine growth of a normal fetus at the same postconceptional age. In reality, however, growth lags considerably after birth; although non-nutritional factors are involved, nutrient deficiencies are critical in explaining delayed growth. This practical clinically-oriented pocketbook reviews and summarises all available clinical evidence. It enables the reader to implement parenteral or enteral feeding plans, with the goals of reducing postnatal weight loss, earlier return to birthweight, and improved catch-up growth. Both nutrient balance and growth and the impact on neurodevelopment and health outcomes are evaluated. With many tables and algorithms to summarise key data and management strategies, Nutritional Strategies for the Very Low Birthweight Infant is an invaluable guide for all healthcare professionals caring for premature babies.

This study examines the organization of social responsibility in the USA, in particular of critically ill newborn children. Drawing on medical records and interviews with parents and medical staff, the book investigates two neonatal intensive care units, showing the traumas of extreme medical measures, and the sufferings of infants. The accounts are by turns disturbing and heroic, as parents and staff attempt to take charge of the infants' care, redefining their roles as adults and parents, and coping with sometimes awful contingencies. Rather than treating responsibility as an ethical issue, the book focuses on how responsibility is socially produced and sustained. It questions how staff members encourage parents to take responsibility, but keep them from interfering in medical matters, and how parents encourage staff vigilance when they are novices attempting to supervise the experts. The authors conclude that it is not sufficient simply to be responsible individuals. Instead, people must learn to be responsible in an organizational world, and organizations must learn how to support responsible individuals.

Henshaw (psychiatry, University of Keele, UK) and Elliott (consultant clinical psychologist, St Thomas' Hospital, UK) provide guidance for health care professionals on the controversies surrounding screening for perinatal depression and on good practice in the use of screening tools. International contributors, with backgrounds in psychiatry, psychology, medicine, nursing, midwifery, and social work, discuss the advantages and drawbacks of the available screening methods, and investigate women's perceptions of the usefulness of screening. Ethnic minority experiences and screening programs in developing countries are also considered.' - Book News 'The book considers a variety of issues and identifies agreement in ideas and continuing debates. Whether the reader is concerned with women's views of screening, the role of the midwife, screening in the US, Australia or developing countries, screening of women with serious mental illness, Black Caribbean women's views of screening, health visitor intuition and much more, there is something here for them. Each chapter, often drawing on the author's own work, stands on its own. Tutors, researchers, practitioners and students should be able to use the relevant parts to challenge their thinking, reflect on their practice and ask yet more questions about this significant subject.' - Community Practitioner Screening for perinatal depression is now widely undertaken in the UK and Europe and is attracting increasing attention. This much-needed text provides guidance for health care professionals on the issues and controversies surrounding screening and on good practice in the use of screening tests. An international author team with backgrounds in psychiatry, psychology, medicine and nursing has been brought together to discuss the available screening methods, their advantages and drawbacks. The authors investigate women's perceptions of the accessibility and usefulness of screening and of the roles of professionals (e.g. primary care staff and health visitors), and also look at ethnic minority women's experiences of health services. The role of the UK National Screening Committee is explored, along with the problems faced when implementing screening programmes in developing countries. This comprehensive and practical book will enable mental health professionals, social workers and health visitors to provide sensitive and informed services to women at risk of perinatal depression.