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Due to new developments in prenatal testing and therapy the fetus is increasingly visible, examinable and treatable in prenatal care. Accordingly, physicians tend to perceive the fetus as a patient and understand themselves as having certain professional duties towards it. However, it is far from clear what it means to speak of a patient in this connection. This volume explores the usefulness and limitations of the concept of ‘fetal patient’ against the background of the recent seminal developments in prenatal or fetal medicine. It does so from an interdisciplinary and international perspective. Featuring internationally recognized experts in the field, the book discusses the normative implications of the concept of ‘fetal patient’ from a philosophical-theoretical as well as from a legal perspective. This includes its implications for the autonomy of the pregnant woman as well as its consequences for physician-patient-interactions in prenatal medicine.
It is now possible for physicians to recognize that a pregnant woman's fetus is facing life-threatening problems, perform surgery on the fetus, and if it survives, return it to the woman's uterus to finish gestation. Although fetal surgery has existed in various forms for three decades, it is only just beginning to capture the public's imagination. These still largely experimental procedures raise all types of medical, political and ethical questions. The Making of the Unborn Patient examines two important and connected events of the second half of the 20th century: the emergence of fetal surgery as a new medical specialty and the debut of the unborn patient.
The second edition of this quick reference handbook for obstetricians and gynecologists and primary care physicians is designed to complement the parent textbook Clinical Obstetrics: The Fetus & Mother The third edition of Clinical Obstetrics: The Fetus & Mother is unique in that it gives in-depth attention to the two patients – fetus and mother, with special coverage of each patient. Clinical Obstetrics thoroughly reviews the biology, pathology, and clinical management of disorders affecting both the fetus and the mother. Clinical Obstetrics: The Fetus & Mother - Handbook provides the practising physician with succinct, clinically focused information in an easily retrievable format that facilitates diagnosis, evaluation, and treatment. When you need fast answers to specific questions, you can turn with confidence to this streamlined, updated reference.
This book offers a comprehensive and clinically practical approach to ethics in the everyday practice of obstetrics and gynecology. The topics the authors address include: contraception, abortion, selective termination of multifetal pregnancies, gynecologic cancer, in vitro fertilization, surrogacy, prenatal diagnosis, fetal therapy, cephalocentisis, prematurity, HIV infection, and court ordered cesarean delivery. The issues involved in making decisions in many of these areas are a source of conflict, and lead to crisis between the physician and patient. One of the book's strengths is its emphasis on prevention and, if prevention fails, management, of the conflicts and crises which arise in these areas of medicine. The authors develop their preventative and management strategies on the basis of a framework for bioethics in the clinical setting. This framework is rigorously established and defended. The authors argue that four virtues -- self effacement, self sacrifice, compassion, and integrity -- generate the physician's obligation to protect and promote the patient's interest. They then identify the three types of patient's interests -- social role interests, subjective interests, and deliberative interests -- and they reinterpret the ethical principles of beneficence and respect for autonomy in terms of these. The concept of the fetus as patient, the physician's obligation to third parties, and the moral standing of fathers and family members are also addressed. The implications of their argument sets the stage for the discussions of prevention and management in the remaining sections of the book. Ethics in Obstetrics and Gynecology is a unique addition to the literature in both biomedical ethics and obstetrics and gynecology. It demonstrates that ethics should be regarded as an essential part of obstetrics and gynecology, and that clinical practice is incomplete without i
The first book to synthesize relevant, critically reviewed data for application to the diagnosis and treatment of prenatal patients—updated and in full color A Doody's Core Title for 2011! 5 STAR DOODY'S REVIEW! "The book is comprehensive, concise, well illustrated, and an extremely valuable resource for perinatal healthcare providers....This book has rapidly become a go-to reference in the perinatal field and this new edition confirms its place as the gold standard in the field. Perinatologists will find this to be an essential part of their library. As more obstetric practitioners do investigative sonographic procedures in their offices, this book will be a valuable resource for them as well. The new edition is overdue and most welcome."--Doody's Review Service "This invaluable up-to-date reference is a must have guide especiallyin non-tertiary care centers where the various experts may not be readily available tofurther guide the family and plan the rest of the antepartum, peripartum and postpartum care."--Center for Advanced Fetal Care Newsletter Fetology: Diagnosis and Management of the Fetal Patient offers a cross-disciplinary approach that goes beyond the traditional boundaries of obstetrics, pediatrics, and surgery to help you effectively diagnose and treat fetal patients. Fetology considers the full implications of a fetal sonographic or chromosomal diagnosis—from prenatal management to long-term outcome—for an affected child. Here, you’ll find all the insights you need to answer the questions of parents faced with a diagnosis of a fetal abnormality—and present them with a coordinated therapeutic plan. Features NEW! Full-color design NEW! Five new chapters on Adrenal Masses, Abdominal Cysts, Overgrowth, Mosaic Trisomy, and DiGeorge Syndrome NEW! Chapters summarizing contemporary approaches to first and second trimester screening for aneuploidy NEW! 3D ultrasound and MRI images: over 450 images clearly illustrate the diagnosis of anomalies with the latest, most precise imaging technology NEW! Key Points open each chapter, providing rapid review of a particular condition Highlighted treatment/management guidelines deliver quick access to practical, what-to-do information Each chapter, which covers a single anomaly, includes description of the medical condition, incidence, characteristic sonographic findings, differential diagnosis, best treatment during pregnancy, treatment of the newborn, expected outcome, and more Addresses gaps in our knowledge that highlight unmet clinical needs and areas for future research
This is an interdisciplinary clinical reference text on improving all aspects of fetal diagnosis and therapy. The opening chapter focuses on the clinical ethics of appreciating the fetus as a patient. Section 1 presents new dimensions in fetal imaging, emphasizing Doppler ultrasound, three-dimensional ultrasound, tissue echogenecity, and fetal radiology. Section 2 covers the rapidly evolving science of molecular genetics and screening for fetal abnormalities. Section 3 contains the latest information about fetal surgery. Section 4 describes the various modalities available to obstetricians for assessing the fetal condition. Section 5 provides the latest information on the clinical management of especially controversial areas in perinatology, both before and after birth.
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.
The progress of medical profession in treating and diagnosing fetal disorders has brought the concept of the fetus as a patient from science fiction to science fact. This book covers topics such as ethics, assisted conception techniques, embryology, pathology, obstetric ultrasound, methods of assisting the fetal condition, Doppler ultrasound and its clinical uses, and innovative approaches to fetal therapy.