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.
Master the effective evaluation, analysis and management of placental-fetal growth restriction (PFGR), reducing the risk of perinatal mortality and morbidity in patients worldwide. Extensively researched by international experts, this manual provides practitioners with a detailed, hands-on approach to the practical 'pearls' for direct patient management. This authoritative volume advises on matters such as the correct evaluation and management of high-risk patients in danger of PFGR through to delivery. Extensive and wide-ranging, this book is an invaluable companion to the developing research interest and clinical applications in PFGR, including developmental outcomes in early childhood. Featuring a critical evaluation of a variety of abnormal conditions, such as fetal hypoxia, which are clearly displayed through extensive illustrations. This essential toolkit ensures that practitioners of all levels can effectively limit the risk of mortality and morbidity, and reach the correct diagnosis, first-time.
The Book. It is in two sections, the first describing the author's experiences as a government medical officer in southern Africa in the middle of the last century, which led to his finding the long-hidden secrets of the foetal circulation. The second describes how he uncovered the secrets, and gives an account of each part which completely demolishes the long-held orthodox accounts. The foetal heart sounds are described which may be heard with a Doppler foetal heart monitor. The birth changes, which no one has ever seen, and probably never will, are guessed at in full detail.
Understand the anesthetic management challenges of the obstetric patient with this complete primer and review Obstetric Anesthesia is a clear, concise, and practical manual covering the basics of obstetric anesthesiology and the principles of basic management at the point of care. This essential introductory text covers the fundamental topics in an efficient and highly clinical manner. Numerous tables, bulleted lists, and text boxes highlight key issues such as common co-existing diseases and conditions that may affect anesthetic management. Obstetric Anesthesia features thirty chapters grouped into six logical sections: Pregnancy Providing Anesthesia Anesthetic Complications Obstetric Complications Common Co-Morbidities During Pregnancy Trauma During Pregnancy Enriched by contributions from practicing obstetrical anesthesiologists and renowned instructors, Obstetric Anesthesia includes the most up-to-date practice guidelines. It is a valuable clinical refresher and an outstanding board review.
The Hepatic circulation is unique among vascular beds. The most obvious unique features include the dual vascular supply; the mechanism of intrinsic regulation of the hepatic artery (the hepatic arterial buffer response); the fact that portal blood flow, supplying two thirds of liver blood flow, is not controlled directly by the liver; the fact that 20% of the cardiac output rushes through the most vascularized organ in the body, driven by a pressure gradient of only a few millimeters of mercury; the extremely distensible capacitance and venous resistance sites; the unidirectional acinar blood flow that regulates parenchymal cell metabolic specialization; and the high concentration of macrophagic (Kupffer) cells filtering the blood. The liver is the only organ reported to have regional blood flow monitored by the autonomic nervous system. This mechanism, when dysfunctional, accounts for the hepatorenal syndrome and offers a mechanistic therapeutic target to treat this syndrome. The trigger for liver regeneration is dependent on hepatic hemodynamics so that chronic liver blood flow regulates liver cell mass. In severe liver disease, the whole body circulation is reorganized, by forming portacaval shunts, to accommodate the increased intrahepatic venous resistance. These shunts protect the venous drainage of the splanchnic organs but lead to loss of major regulatory roles of the liver. The development of knowledge of the hepatic vasculature is presented from a historical perspective with modern concepts summarized based on the perspective of the author's four decades of devotion to this most marvelous of organs. Table of Contents: Acknowledgements / Historical Perspectives / Overview / Fluid Exchange / Capacitance / Resistance in the Hepatic Artery / Resistance in the Venous System / Fetal and Neonatal Hepatic Circulation / In Vivo Pharmacodynamic Approaches / Nitric Oxide / Adenosine / Hepatic Nerves / Hepatic Circulation and Toxicology / Hepatorenal Syndrome / Integrative Hepatic Response to Hemorrhage / Blood Flow Regulation of Hepatocyte Proliferation / Multiple Mechanisms Maintaining a Constant Hepatic Blood Flow to Liver Mass Ratio / Pathopharmacology and Repurposing Drugs as a Research Strategy / References
This comprehensive atlas is unique in combining information on the embryological development of the human with detailed presentation of the congenital malformations encountered in clinical practice. As a consequence it will not only assist practitioners and trainees in recognizing and evaluating malformations, but also enable them to understand how a malformation has developed and to explain the mystery of congenital malformations to relatives and patients. The book is organized according to anatomic region, with additional chapters on hernias, tumors, lymphogenesis and lymphatic malformations. According to WHO statistics, each year congenital anomalies result in approximately 3.2 million birth defect-related disabilities worldwide. All too often, however, training in embryology is now a neglected area, and medical graduates frequently lack confidence in their knowledge of the field. Clinical Embryology: An Atlas of Congenital Malformations will help to rectify this deficit and to ensure that malformations are comprehended and managed appropriately. It will be of value for postgraduate trainees in pediatric surgery, pediatrics, and neonatology, undergraduate medical students, and general practitioners/family physicians.
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.
