Perinatology

This book presents the latest evidence-based guidelines for perinatal management and is designed to help obstetricians and neonatologists minimize complications and offer patients the best possible care. Since 1960, there has been a significant increase in basic and clinical investigations on normal and pathological pregnancy in the developed world. This has provided insights into the physiopathology of pregnant women, fetuses and newborns and led to the development of new technologies, bringing about a new medical subspecialty: perinatal medicine. The book is divided into eight main sections: The first examines basic periconceptional care and discusses the ethical aspects of perinatology. The next section focuses on prenatal considerations, such as the nutritional aspects of gestation and puerperium, physical exercise during pregnancy, routine laboratory tests, prenatal care of multiple gestations and the role of the neonatologist in prenatal care. The third and fourth sections then explore fetal evaluation, and clinical intercurrences in pregnancy, respectively. The next section addresses pregnancy complications: prevention, diagnosis and management. The sixth section covers the basic aspects of congenital infections and the seventh examines labor and delivery aspects. Lastly, the final section includes chapters on neonatal assistance. Written by leading experts in obstetrics, neonatology, and perinatology, this thoroughly updated, comprehensive resource reflects the latest information in all areas, including genetics and imaging.

Along with Consulting Editor, Dr. Lucky Jain, Dr. Goudy has created a current issue that looks at ENT issues with newborns. Expert authors from top institutions have submitted clinical reviews on the following topics: Airway anomalies; Fetal evaluation and airway management; Hearing loss and failed NBHS; Aspiration and dysphagia in the new born; Cleft lip and palate; Microtia and facial anomalies; Cranial synostosis; Pierre Robin sequence; Vascular malformations; Choanal atresia and other nasal masses; Congenital neck masses; Subglottic stenosis; Tracheostomy in the newborn; and Stridor. Readers will come away with the information they need to make informed clinical decisions to improve patient outcomes.

In this issue of Clinics in Perinatology, Guest Editors Anup Katheria and Lisa Stellwagen bring their considerable expertise to the topic of Care for the Term Newborn. Top experts in the field cover key topics such as delivery room triage and transitions of care; early onset sepsis; congenital infections; postnatal screening & testing; and more. Provides in-depth, clinical reviews on Care for the Term Newborn, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field; Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews. Contains 14 relevant, practice-oriented topics including Umbilical Cord Management for vigorous and non-vigorous infants; Fetal Circulation and Critical Congenital Cardiac Disease; Alternative Birth Practices, Refusal, and Therapeutic Hesitancy; Prenatal Substance Exposure; and more.

In this issue of Clinics in Perinatology, guest editors Joseph B. Cantey and Andi Shane bring their considerable expertise to the topic of Perinatal and Neonatal Infections. Provides in-depth, clinical reviews on Perinatal and Neonatal Infections, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field; Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.

Fetal Physiology and Medicine: The Basis of Perinatology, Second, Revised Edition documents many of the major advances in fetal medicine, including developmental physiology, pathology, and therapy. This book covers the most important areas of maternofetal medicine and presents different views of the critical problems of development. The various components of fetal metabolism are highlighted to demonstrate how animal experimentation has given a clear view of the interrelationship of the mother, placenta, and fetus. This text is comprised of 24 chapters; the first of which describes the use of ultrasound in antenatal diagnosis of congenital structural anomalies. This topic is followed by a discussion on sexual differentiation, acquired immunity, and endocrine changes, as well as the physiology of breathing, the control of the fetal cardiovascular system, lung maturation, fetal infections, and the effects of hypoxia on the fetal brain. This book also provides comprehensive reviews of fetal regulatory mechanisms, such as the reninangiotensin system, water metabolism, and fetal and placental hormone production. Other chapters focus on clinical applications, such as antenatal fetal heart rate monitoring, the technical aspects of fetal and uterine pressure measurements, fetal acid-base balance, and the prevention of preterm delivery. A section that explores the transition from intrauterine to extrauterine life concludes this book. This source is of great potential value to all students and practitioners of reproductive medicine.

Current Perinatology, II, explores the most recent major research techniques utilized in the evaluation, diagnosis, and management of the high-risk mother and her newborn. The volume should be a major reference for pediatricians, perinatologists, and neonatologists, as well as for nurses and allied health personnel closely involved with the care of the high-risk mother, fetus, and newborn. Topics presented include perinatal Doppler; Doppler echocardiography of the human fetus; invasive fetal assessment by fetal blood sampling; prediction, prevention, and treatment of preterm labor; percutaneous umbilical blood sampling and intravascular fetal therapy; current and future perspectives for fetal genetic diagnosis; current concepts of substance abuse during pregnancy; newer methods of diagnosis and treatment of neonatal sepsis; clinical applications of neonatal pulmonary function testing; and current management of hypoplastic left heart syndrome. Discussions of stabilization and transportation of the critically ill obstetric patient and of pain management in the neonatal intensive care unit will be of interest to both physicians and nurses.

The rapid development of new technology used in obstetrics and neonatology has been accompanied by new moral problems presented by the choices this technology generates. Ethics and Perinatology is a timely examination of the moral problems caused by clinical and research practices in perinatology. 14 major issues are each addressed by a leading clinician whose writing is then critically reviewed by a medical ethicist, a legal theorist, or an economist. Thus each chapter embodies the independent perspectives of international experts from different disciplines. This book offers a new approach to the presentation of ideas in medical ethics concerning obstetrics and perinatology that will benefit all physicians, nurses, philosophers, and medical ethicists, as well as the interested lay reader.

Perinatal medicine, which is concerned with the problems of the fetus and newborn, has rapidly developed in the last two decades as an important and challenging specialty. Rapid advances in the field, coupled with tech nological advances, now are making survival of infants with weights as low as 500 grams possible. Ventilator care for severe respiratory problems is on the verge of being replaced by surfactant replacement therapy; on the other hand, development of such technologies as extracorporeal mem brane oxygenation and jet ventilation has revolutionized the care of these sick infants. The advances taking place today in the field of perinatal medicine make periodic updates, like the one provided by this volume, a virtual necessity for clinicians and paramedical personnel alike. A distinguished group of specialists in various aspects of perinatal medicine has contributed to this book. Their wide-ranging experience and points of view should make this book a valuable reference for all physicians and allied health personnel involved in the care of the high-risk fetus and newborn. MANOHAR RATHI, M.D. Acknowledgements. I am grateful to the contributors for their cooperation in preparing the manuscripts, to my associates for their help and support, and to the publishers for their continued interest in this work. Above all, I thank Ms. Rose Aiello-Lech and Ms. MaryAnn Cichowski for their hard work in making this publication possible.