Biochemical tests of fetal well-being ('placental function tests') have been part of routine obstetric practice for more than twenty years. This book provides an overview of the current status of these tests - the physiological basis for their use, and their advantages and limitations in clinical practice. Considerable attention is given to interpretation, a subject which in the past has led to much confusion both in the scientific literature and in the minds of clinicians. Recent advances are described in detail, in particular the discovery of a whole new generation of placental products some of which offer great promise in the prediction of conditions, such as placental abruption and premature labour, which cannot be identified by any other current parameters. Finally, a set of clear recommendations is put forward for the choice of test in most of the common complications of both early and late pregnancy. The emphasis throughout is on how the basic biology of fetoplacental products dictates their use and interpretation in pathological conditions.

The placenta is fascinating and complex. Basically foreign to the maternal body, it can be thought of as an organ transplanted onto the mother's host tissue. As such it embodies all the principles of tissue acceptance and rejection. Many of the risks of pregnancy and labor have now been eliminated and the placenta is likely to be at the root of many of the dangers to the unborn child that remain. A breakdown of the relationship between the placenta and the maternal tissue may turn out to be the cause of the majority of early lost pregnancies.

A guide to identifying disease processes in the placenta affecting pregnancy outcome, with current diagnostic criteria and clinical consequences.

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.

A fully updated and illustrated handbook providing comprehensive coverage of all curriculum areas covered by the MRCOG Part 1 examination.

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.

Fetal growth restriction (FGR) is a condition that affects 5%–10% of all pregnancies and is the second most common cause of perinatal mortality. Fetuses with FGR present with a greater risk of long-term health defects as impaired neurological and cognitive development and cardiovascular or endocrine diseases in adulthood. Due to its high prevalence and serious long term consequences, an in-depth understating of the diagnosis and management of FGR is essential for all those professionals involved in prenatal care, since it can prevent unwanted outcomes both to the mother and to the newborn. On the last years, the knowledge about fetal growth restriction has evolved considerably, with an increasing number of articles being published on this topic and new concepts being described, including new diagnostic guidelines. Even so, there are no recent books fully dedicated to FGR; this theme has only generally been discussed in chapters in larger obstetrics and neonatology books. This current book intends to present and discuss the state of the art on FGR in a clear and didactical way. It will focus on the main topics related to FGR, including its etiology, classification, prediction, diagnosis, and management, as well as on its neurological complications and maternal cardiovascular involvement. Written by experienced and renowned gynecologists from Brazil, Italy and the US, this book will be a comprehensive guide, directed to all gynecologists, radiologists and general practitioners who are involved in prenatal care, as well as to interns, residents, professors and researchers in the field.

This textbook provides an up-to-date summary of the scientific basis, assessment for and provision of anaesthesia throughout pregnancy and labour. It is divided into nine sections including physiology, assessment, complications and systemic disease.

Respiratory diseases affect a large proportion of the population and can cause complications when associated with pregnancy. Pregnancy induces profound anatomical and functional physiological changes in the mother, and subjects the mother to pregnancy-specific respiratory conditions. Reviewing respiratory conditions both specific and non-specific to pregnancy, the book also addresses related issues such as smoking and mechanical ventilation. Basic concepts for the obstetrician are covered, including patient history, physiology and initial examinations. Topics such as physiological changes during pregnancy and placental gas exchange are discussed for the non-obstetrician. Guidance is practical, covering antenatal and post-partum care, as well as management in the delivery suite. An essential guide to respiratory diseases in pregnancy, this book is indispensable to both obstetricians and non-obstetric physicians managing pregnant patients.