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After decades of intensive research and over 10,000 publications, preterm birth remains a major global obstetric healthcare problem. Each year, early birth is responsible for the deaths of more than one million infants worldwide and is a major cause of life-long disability. Preterm birth places an enormous financial burden on our healthcare systems, resulting in long-term adverse health outcomes and lost productivity for many people. Preterm birth is a syndrome, associated with several different aetiologies; hence, potential treatment strategies need to be matched to pathophysiology in order to be effective. There is now unequivocal evidence that inflammation is causally involved in a majority of spontaneous preterm deliveries. However, the triggers of inflammation, and the strategies by which it can be safely and effectively prevented and treated, remain the subject of ongoing investigation and debate. While intraamniotic infection is an important cause of inflammation-associated preterm birth, particularly in very preterm deliveries, ‘sterile’ inflammation is actually a more common finding associated with preterm birth. It is likely that the nature, localisation, timing and extent of the inflammatory insult all determine the obstetric outcome and degree of risk to the fetus. These factors will also influence the success of approaches that might be employed to achieve better pregnancy outcomes. Despite our increased understanding of the causes and significance of intrauterine inflammation, we have yet to translate this knowledge into effective therapeutic strategies for preventing prematurity and mitigating its consequences for the neonate. In this Research Topic we review recent progress in treating and preventing inflammation-associated preterm birth, approaching the topic from both the causal and therapeutic perspectives. With global attention increasingly focused on the need to translate knowledge discovery into clinical translation, we hope this EBook will provide a stimulating and timely discussion that will focus research and lead to improved healthcare outcomes for women and children.
The increasing prevalence of preterm birth in the United States is a complex public health problem that requires multifaceted solutions. Preterm birth is a cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, sociodemographic and neighborhood characteristics, environmental exposure, medical conditions, infertility treatments, and biological factors. Many of these factors co-occur, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. While advances in perinatal and neonatal care have improved survival for preterm infants, those infants who do survive have a greater risk than infants born at term for developmental disabilities, health problems, and poor growth. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems. Preterm Birth assesses the problem with respect to both its causes and outcomes. This book addresses the need for research involving clinical, basic, behavioral, and social science disciplines. By defining and addressing the health and economic consequences of premature birth, this book will be of particular interest to health care professionals, public health officials, policy makers, professional associations and clinical, basic, behavioral, and social science researchers.
Each year in the United States approximately 440,000 babies are born premature. These infants are at greater risk of death, and are more likely to suffer lifelong medical complications than full-term infants. Clinicians and researchers have made vast improvements in treating preterm birth; however, little success has been attained in understanding and preventing preterm birth. Understanding the complexity of interactions underlying preterm birth will be needed if further gains in outcomes are expected. The Institute of Medicine's Roundtable on Environmental Health Sciences, Research, and Medicine sponsored a workshop to understand the biological mechanism of normal labor and delivery, and how environmental influences, as broadly defined, can interact with the processes of normal pregnancy to result in preterm birth. This report is a summary of the main themes presented by the speakers and participants.
After decades of intensive research and over 10,000 publications, preterm birth remains a major global obstetric healthcare problem. Each year, early birth is responsible for the deaths of more than one million infants worldwide and is a major cause of life-long disability. Preterm birth places an enormous financial burden on our healthcare systems, resulting in long-term adverse health outcomes and lost productivity for many people. Preterm birth is a syndrome, associated with several different aetiologies; hence, potential treatment strategies need to be matched to pathophysiology in order to be effective. There is now unequivocal evidence that inflammation is causally involved in a majority of spontaneous preterm deliveries. However, the triggers of inflammation, and the strategies by which it can be safely and effectively prevented and treated, remain the subject of ongoing investigation and debate. While intraamniotic infection is an important cause of inflammation-associated preterm birth, particularly in very preterm deliveries, 'sterile' inflammation is actually a more common finding associated with preterm birth. It is likely that the nature, localisation, timing and extent of the inflammatory insult all determine the obstetric outcome and degree of risk to the fetus. These factors will also influence the success of approaches that might be employed to achieve better pregnancy outcomes. Despite our increased understanding of the causes and significance of intrauterine inflammation, we have yet to translate this knowledge into effective therapeutic strategies for preventing prematurity and mitigating its consequences for the neonate. In this Research Topic we review recent progress in treating and preventing inflammation-associated preterm birth, approaching the topic from both the causal and therapeutic perspectives. With global attention increasingly focused on the need to translate knowledge discovery into clinical translation, we hope this EBook will provide a stimulating and timely discussion that will focus research and lead to improved healthcare outcomes for women and children.
This time honoured classic has been re-built completely: after sixeditions the editor has decided that a radical revision isnecessary. The new edition has been developed as a result ofintensive consultation with trainees in OB/GYN as to what theywant, what they need and how they learn. The book is organised into two halves covering obstetrics andgynaecology. Within each, the chapters are structured into sectionscontaining pedagogic features such as boxes, highlights and keypoints for the first time. It contains everything the clinicianneeds to practice the art of obstetrics and gynaecology andsufficient information to help sub-specialists develop theirspecific interests. This text is recommended reading for the RoyalCollege of Obstetrics and Gynaecology membership examination. This seventh edition contains 21 new chapters: Anatomy of the Pelvis and Reproductive Tract Placenta and Fetal Membranes Antenatal Care Anaesthesia and Analgesia Recurrent Miscarriage Ectopic Pregnancy Trophoblastic Disease Genetics and Prenatal Diagnosis Drugs and Pregnancy Obstetric Emergencies Prolonged Pregnancy Renal Disease Termination of Pregnancy Imaging in Gynaecology PMS Assisted Reproduction Hysteroscopy and Laparoscopy Sexual Dysfunction Psychological Aspects of Pregnancy Domestic Violence and Sexual Assault - now on MRCOG curriculum Ethical Dilemmas This seventh edition has been significantly updated with a widerange of internationally renowned contributors who are all expertsin their field, bringing this book to the cutting edge of knowledgein obstetrics and gynaecology. "It was my favourite textbook when I was working for myexaminations and I am still using it. I can recommend this editionto current trainees wholeheartedly. It is certainly worth buying."Journal of Obstetrics and Gynaecology
This book examines the toxicological and health implications of environmental epigenetics and provides knowledge through an interdisciplinary approach. Included in this volume are chapters outlining various environmental risk factors such as phthalates and dietary components, life states such as pregnancy and ageing, hormonal and metabolic considerations and specific disease risks such as cancer cardiovascular diseases and other non-communicable diseases. Environmental Epigenetics imparts integrative knowledge of the science of epigenetics and the issues raised in environmental epidemiology. This book is intended to serve both as a reference compendium on environmental epigenetics for scientists in academia, industry and laboratories and as a textbook for graduate level environmental health courses. Environmental Epigenetics imparts integrative knowledge of the science of epigenetics and the issues raised in environmental epidemiology. This book is intended to serve both as a reference compendium on environmental epigenetics for scientists in academia, industry and laboratories and as a textbook for graduate level environmental health courses.
The emphasis of the manual is on rapid assessment and decision making. The clinical action steps are based on clinical assessment with limited reliance on laboratory or other tests and most are possible in a variety of clinical settings.
This book is designed to be concise with a consistent format so that the clinician can focus on a specific area. This edition has had major modifications and embraces evidence-based medicine. The format includes the CPT codes for billing purposes, short description of the condition, etiology/incidence, course/prognosis, laboratory findings, differential diagnosis; prophylaxis, treatment (local and systemic, surgical or other), miscellaneous (names and addresses of support groups) and key references. Incorporates evidence-based medicine so you feel confident that you're formulating the best treatment plans for your patients.Color photos allow you to read about and actually see a picture of select disease entities.Clear, concise format can be photocopied and distributed to patients in some cases, reducing your time spent explaining problems to patients and caregivers.
Covers the latest insights any fetal specialist needs and provides essential knowledge for professionals caring for women with high-risk pregnancies.