This is a high-level clinical reference text on sonographic findings in a range of cases of fetal hypoxia. It contains eleven chapters on hypoxic-ischemic events during fetal life, fetal hemodynamics and brain damage, fetal chronic hypoxia from cocaine exposure, fetal hypoxia from malaria, cerebral and umbilical Doppler ultrasonography, fetal placental embolization, cerebral asphyxial encephalopathy, brain damage, integrity of the fetal nervous system, and fetal heart rate, movement, and blood flow velocity waveform patterns. It also contains a case study of fetal hemodynamics and brain damage related to hypoxia. Unique in its field, the book contains original new material by the world's leading experts on fetal medicine and ultrasound, fully illustrated. Includes bibliographic references and index.

The placenta is an organ that connects the developing fetus to the uterine wall, thereby allowing nutrient uptake, waste elimination, and gas exchange via the mother's blood supply. Proper vascular development in the placenta is fundamental to ensuring a healthy fetus and successful pregnancy. This book provides an up-to-date summary and synthesis of knowledge regarding placental vascular biology and discusses the relevance of this vascular bed to the functions of the human placenta.

This practical manual promotes an evidence-based paradigm of fetal heart rate monitoring during labour, moving away from the traditional 'pattern-based' interpretation to physiology-based interpretation. Aimed at obstetricians and midwives, it is useful to all those involved in multiprofessional intrapartum care.

We have all been hypoxic. Fetal tolerance for intrauterine hypoxia arises from evolutionarily conserved physiological mechanisms, the antecedents of which can be learned from diving mammals or species at high altitudes. Understanding fetal hypoxia leads to understanding the huge physiological shifts of neonatal transition and the dangers of perinatal hypoxia. This comprehensive volume of topical review articles by expert authors addresses the origins of hypoxia tolerance, the impact of oxygen on circulatory transition at birth, and the biochemistry of hypoxia in the pulmonary circuit, as well as the classification, diagnosis, and clinical management of hypoxic respiratory failure and persistent pulmonary hypertension in the term neonate. The goal of Hypoxic Respiratory Failure in the Newborn is to connect our understanding of hypoxia from animals in extreme environments, with how the human fetus handles its hypoxic environment; and why the human newborn suddenly cannot. The book will educate health care professionals on how to care for newborns with hypoxic respiratory failure, including the use of up-to-date diagnostic tools and therapies. It also highlights areas of controversy and ongoing research in hypoxic respiratory failure and pulmonary hypertension of the newborn, including challenging case studies. Key Features Explores evolutionary context and comparative physiology of hypoxia tolerance in the fetus and neonate, from basic research to clinical scenarios Provides guidance to trainees, physicians, and allied health professionals engaged in NICU care; pediatricians, cardiologists, pulmonologists, anesthesiologists, neonatologists, and physiologists to effectively manage infants in hypoxic respiratory failure Includes case scenarios emphasizing current diagnostic and therapeutic controversies and algorithmic approaches to decipher difficult clinical cases

This book will serve as a pocket guide, offering rapid advice on appropriate emergency care for a wide range of obstetric situations, including acute fetal hypoxia, uterine rupture, shoulder dystocia, eclampsia, amniotic fluid embolism, pulmonary thromboembolism, retention of the aftercoming head, major postpartum hemorrhage, and uterine inversion. For each emergency, the definition, diagnosis, and recommended management strategy are reviewed from a pan-European perspective. Regular review and training in obstetric emergencies is the only effective way to develop and maintain clinical competence in these rare and life-threatening situations, thus improving their management and the resulting outcomes. Healthcare professionals will find this book offers a practical and reliable source of information for dealing with dangerous and acute complications of pregnancy and childbirth.

The Guide to Investigation of Mouse Pregnancy is the first publication to cover the mouse placenta or the angiogenic tree the mother develops to support the placenta. This much-needed resource covers monitoring of the cardiovascular system, gestational programming of chronic adult disease, epigenetic regulation, gene imprinting, and stem cells. Offering detailed and integrated information on how drugs, biologics, stress, and manipulations impact pregnancy in the mouse model, this reference highlights techniques used to analyze mouse pregnancy. Joining the ranks of much referenced mouse resources, The Guide to Investigation of Mouse Pregnancy is the only manual providing needed content on pregnancy in animal models for translational medicine and research. - Provides instruction on how to collect pre-clinical data on pregnancy in mouse models for eventual use in human applications - Describes the angiogenic tree the mother's uterus develops to support pregnancy and the monitoring of pregnancy-induced cardiovascular changes - Educates readers on placental cell lineages, decidual development including immune cells, epigenetic regulation, gene imprinting, stem cells, birth and lactation - Discusses how stress, environmental toxicants and other manipulations impact upon placental function and pregnancy success

Significant changes have taken place in the policy landscape surrounding cannabis legalization, production, and use. During the past 20 years, 25 states and the District of Columbia have legalized cannabis and/or cannabidiol (a component of cannabis) for medical conditions or retail sales at the state level and 4 states have legalized both the medical and recreational use of cannabis. These landmark changes in policy have impacted cannabis use patterns and perceived levels of risk. However, despite this changing landscape, evidence regarding the short- and long-term health effects of cannabis use remains elusive. While a myriad of studies have examined cannabis use in all its various forms, often these research conclusions are not appropriately synthesized, translated for, or communicated to policy makers, health care providers, state health officials, or other stakeholders who have been charged with influencing and enacting policies, procedures, and laws related to cannabis use. Unlike other controlled substances such as alcohol or tobacco, no accepted standards for safe use or appropriate dose are available to help guide individuals as they make choices regarding the issues of if, when, where, and how to use cannabis safely and, in regard to therapeutic uses, effectively. Shifting public sentiment, conflicting and impeded scientific research, and legislative battles have fueled the debate about what, if any, harms or benefits can be attributed to the use of cannabis or its derivatives, and this lack of aggregated knowledge has broad public health implications. The Health Effects of Cannabis and Cannabinoids provides a comprehensive review of scientific evidence related to the health effects and potential therapeutic benefits of cannabis. This report provides a research agendaâ€"outlining gaps in current knowledge and opportunities for providing additional insight into these issuesâ€"that summarizes and prioritizes pressing research needs.

Whether you offer comprehensive pregnancy care in your primary care facility, or provide prenatal and postpartum care, this book delivers the guidance you need to optimize health for both mothers and their babies. It covers all aspects of birth care, from preconception counseling and prenatal care, through labor and delivery (both low-risk and complicated), to postpartum care and the first month of life. The completely revised third edition includes the most up-to- date, evidence-based standards of care. It offers information that is patient centered, prevention oriented, educational, and sensitive to the care of the whole woman and her family. Features a reader-friendly outline/narrative format for ease of use in daily clinical practice. Describes how to care for patients with a wide range of medical conditions during pregnancy as well as pregnancy-related conditions. Takes a whole-family approach to maternity care, with discussions of maternal and paternal adjustment, marital adjustment, sibling adjustment, single-parent families, and return-to-work issues. Provides patient and family education materials on a full range of topics, from nutrition in pregnancy to breastfeeding. Features a section on alternative medicine in maternity care. Provides detailed instruction for a wide array of procedures, including cesarean delivery, perineal repair of simple and complex lacerations, circumcision, assisted deliveries, and amnioinfusion. A continued strong emphasis on evidence-based medicine includes an ongoing summary of Level A recommendations throughout the text. A new chapter summarizes practical applications of how to incorporate continuous quality improvement and enhanced medical safety into the maternity care setting. A new section details which immunizations can be used safely during pregnancy. A section on "Centering Pregnancy" discusses this new model of care and how it incorporates longitudinal group.

Fetal heart rate monitoring affects the lives of millions of women and infants every year in the United States alone. Used by all members of the obstetric team - nurses, students, midwives, and physicians – it is the primary method to assess fetal oxygenation in both the antepartum and intrapartum setting. Improving outcomes and promoting patient safety depends upon correct use and interpretation of fetal heart rate monitoring, and is crucial to daily obstetric practice. This fourth edition provides the obstetrical team a framework within which to interpret and understand fetal heart rate tracings and their implications. The text covers key issues as the physiological basis for monitoring, a discussion of fetal hypoxemia and neonatal encephalopathy, instrumentation and pattern recognition. In addition to an in-depth review of the standardized NICHD nomenclature and three-tiered FHR Category approach, there are chapters on intrapartum and antepartum management as well as fetal central nervous system effects on monitor patterns. Since fetal monitoring is primarily a screening tool there are also discussions on the use of backup methods for evaluation of abnormal patterns. This 4th edition also brings the addition of Lisa A. Miller CNM, JD, who provides a nursing and midwifery perspective as well an enhanced legal and risk management review. This new fourth edition includes: Review of neonatal encephalopathy and recent studies on CP Currentinformation and discussion of most recent NICHD panel recommendations, both antepartum and intrapartum New chapter on Pitfalls in EFM Detailed chapter on risk management, liability & documentation New section on fetal maternal hemorrhage Update on new instrumentation Crucial information on maternal/fetal coincidence and FDA warnings All chapters include updated practice tips and clinical implications for the entire obstetric team Plus, with this edition clinicians have access to a companion website with full text and an image bank for fast & simplified clinical review.

Global and national confidential inquiry reports show that 60 to 80% of maternal and neonatal morbidity and mortality are due to avoidable errors. This comprehensive and illustrated second edition offers a practical guide to the management of obstetric, medical, surgical, anaesthetic and newborn emergencies in addition to organisational and training issues. The book is divided conveniently into nine sections and updated throughout in line with modern research and practice. Several new chapters cover setting up skills and drills training in maternity services to reduce avoidable harm, managing obstetric emergencies during 'home births' and in low-risk midwifery units, and minimizing maternal and fetal morbidity in failed operative vaginal delivery. Each chapter includes a practical algorithm for quick reference, the scientific basis for proposed actions, a case-based practical exercise and useful learning tools such as 'Key Pearls' and 'Key Pitfalls'. An invaluable resource for obstetricians, neonatologists, midwives, medical students, anesthesiologists and the wider perinatal team.