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Sixteen British specialists pool their extensive knowledge of
spontaneous abortion in one source. Their discussion is directly
applicable to clinical situations and helps identify areas of
debate and alternative methods.
The advent of assisted conception procedures such as in-vitro
fertili sation (IVF) has provided the impetus for exploration of
the factors that lead to the establishment of pregnancy. This
collection of papers from leading research workers brings together
current concepts of the processes which may be of importance in
implantation. The complex signals from the embryo to the ovary,
endometrium and myometrium are now being revealed through studies
in both primates and other mammalian species. This book addresses
the interrelationship of pituitary and ovarian hormones in
controlling ovulation and the preparation of the intrauterine
environment for implantation. Once fertilisation has occurred and
trophoblast has formed, the next vital step is the production of
materials which signal the presence of the pregnancy to the rest of
the body. Trophoblastic proteins and other early-pregnancy factors
are prime candidates for this role. Recent studies have emphasised
the importance of the intrauterine environment in implantation.
Specific secretory products of the endometrium have great potential
in this process. The prostaglandins also play an essential part.
Immunological adjustments are now considered a condition for the
successful establishment of pregnancy. The possible use of immuno
therapy in the treatment of recurrent abortion has highlighted
interest in this area. The use of immunological techniques for
contraception are in their infancy but offer much hope for the
future.
Several aspects of clinical medicine are poised on the edge of a
new era with the introduction of therapeutic antibodies. This
revolution has been made possible by major advances in immune
technology, which are now beginning to mature into clinical
practice. This volume is aimed at all clinicians involved with this
form of treatment, especially accident and emergency physicians,
clinical immunologists, and pharmacologists. It covers both the
basic technology, and also all the main clinical areas of
application: septic shock, auto-immune disease, and cancer. The
future of therapeutic antibodies is also discussed, including
exciting new developments in "catalytic antibodies". This is the
first occasion on which all these topics have been brought together
in a single volume, thus making it an important reference source
for physicians and researchers in this fast-moving area.
A variety of new techniques that promise to revolutionize the
clinical management of early pregnancy are fully detailed in this
state-of-the-art book. Leading international researchers describe
fast-moving topics such as embryo manipulation and the diagnosis of
congenital abnormalities. The technology of assisted reproduction
has made it possible to study living embryonic material for the
first time, which has led to rapid advances in our understanding of
the human embryo's early development. For example, study of the
embryo in the test tube has pointed to early pregnancy loss as a
possible cause of later infertility. Even more important,
diagnostic tests using sophisticated techniques of molecular
biology can be run on single cells before the embryo is replaced in
the uterus. Another area of advance is the diagnosis of congenital
abnormalities in the first and second trimesters of pregnancy.
Great improvements have been made in the techniques of chorion
villus biopsy and ultrasound imaging. A spectrum of simple
biochemical tests performed on the mother's blood can greatly
improve the detection of Down syndrome and other chromosome
defects. Together with other developments in the fields of
molecular biology and endocrinology, these new diagnostic
techniques are the beginning of a new age in clinical human
genetics and embryology.
The aim of this book is to provide a straightforward summary of the
knowledge required for examinations in specialist Obstetrics and
Gynaecology. Part Two of the examination for Membership of the
Royal College of Obstetricians and Gynaecologists would be a good
example. The volume is intended as a companion to the highly
successful Basic Sciences for Obstetrics and Gynaecology which
covers the knowledge required for preliminary examinations.
Increasingly, examinations of all types are based on multiple
choice questions (MCQ) or structured answer questions (SAQ). No
apology is made for the fact that the present book addresses the
sort of "fact" which lends itself to testing by this approach.
Thus, there is little discussion of speculative or contentious
areas, no account of present or future research, and no references.
Numerous excellent books are available which cover these topics in
a much fuller and more discursive manner, and the present volume
does not seek to emulate them. Even the most apparently immutable
facts are subject to periodic revision. We have attempted to
present the "state-of-the-a.rt": most of the material is generally
if not universally accepted. A particular problem arises with
numerical information. Frequencies of diseases, frequency of
clinical findings, efficiency of diagnostic tests and therapies,
have almost always been the subject of numerous different studies,
each of which yields somewhat different results.
This text provides a quick reference to all the important facts in the clinical sciences for candidates aiming at a postgraduate qualification in obstetrics and gynaecology, including those candiadtes studying for the MRCOG Part II examination. The text has been revised and updated, but the concise style and comprehensive coverage of all the essential aspects of the subject are retained. Written by a highly expert team of authors, this text will be an invaluable reference for students and will also be of value to clinicians as a brief guide. This volume serves as a companion to the highly successful "Basic Sciences for Obstetrics and Gynaecology" by Chard and Lilford, which is now in its Fifth Edition.
Basic Sciences for Obstetrics and Gynaecology has become the
standard revision aid for students preparing for examinations in
obstetrics and gynaecology, particularly those candidates for the
MRCOG Part I. A wealth of information is presented in a concise,
didactic format, focusing on those facts that are generally
considered to be neither contentious nor speculative. The fifth
edition has been substantially updated to reflect the current
understanding of the basic sciences underpinning the practice of
obstetrics and gynaecology. This book will also be of value to
professionals wishing to refresh their basic scientific knowledge.
Cell Biology, Embryology and the Placenta Anatomy General
Physiology and biochemistry Endocrinology Pathology Microbiology
Pharmacology Tim Chard is Professor of Obstetrics and Gynaecology
at St Bartholomew's Hospital in London. Richard Lilford is
Professor of Health Services Research at the University of
Birmingham.
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