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This book discusses the importance of umbilical cord and umbilicus as a unique structure, in health and in different diseases. All congenital anomalies of the umbilical cord as well as acquired diseases are explained and discussed with illustrations and animations. Starting from complications during and after birth, the book then covers childhood and adolescent umbilical abnormalities. Conditions such as umbilical stump diseases and anomalies, gastroschisis, omphalocele and urachal anomalies are discussed and explained, highlighting recent advances in their management. Among the contents are also chapters offering a cultural and historical perspective to the topic. Written by a top pediatric surgeon this book brings decades of practical knowledge to readers, highlighting the importance of the umbilicus in development and childhood health.
"An unborn child writes back to his father via email. A witty, fiction depiction of contemporary life in the fast lane."--Provided by publisher.
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.
With an estimated 8,000 deaths per year in the United States from complications of UCA, an initial goal of 50% reduction of loss is possible. To achieve this goal requires the recognition by the obstetrical community of the issue. Recent research into circadian rhythms may help explain why UCA stillbirth is an event between 2:00 a.m. and 4:00 a.m. Melatonin has been described as stimulating uterine contractions through the M2 receptor. Melatonin secretion from the pineal gland begins around 10:00 p.m. and peaks to 60 pg at 3:00 a.m. Serum levels decline to below 10 pg by 6:00 a.m. Uterine stimulation intensifies during maternal sleep, which can be overwhelming to a compromised fetus, especially one experiencing intermittent umbilical cord compression due to UCA. It is now time for the focus to be on screening for UCA, managing UCA prenatally, and delivery of the baby in distress defined by the American College of Obstetricians and Gynecologists as a heart rate of 90 beats per minute for 1 minute on a recorded nonstress test. The ability of ultrasound and magnetic resonance imaging (MRI) to visualize UCA is well documented. The 18 20 week ultrasound review should include the umbilical cord, its characteristics, and description of its placental and fetal attachment. The American Association of Ultrasound Technologists has defined these parameters for umbilical cord abnormalities: B.1.4 Abnormal insertion B.1.5 Vasa previa B.1.6 Abnormal composition B.1.7 Cysts, hematomas, and masses B.1.8 Umbilical cord thrombosis B.1.9 Coiling, collapse, knotting, and prolapse B.1.10 Umbilical cord evaluation with sonography includes the appearance, composition, location, and size of the cord Cord Events: Although many stillbirths are attributed to a cord accident, this diagnosis should be made with caution. Cord abnormalities, including a Nuchal Cord, are found in approximately 30% of normal births and may be an incidental finding. (American College of Obstetrics and Gynecology Practice Bulletin 2009) According to NICHD's recent stillbirth study, UCA is a significant cause of mortality (10%). This finding is in agreement with other international UCA studies. (Bukowski et al. 2011) These histologic criteria identify cases of cord accident as a cause of stillbirth with very high specificity. (Dilated fetal vessels, thrombosis in fetal vessels, avascular placental villi.) (Pediatr Dev Pathol 2012) Finally, defining the morbidity (injury) of cord compression, such as fetal neurologic injury or heart injury identified with umbilical cord blood troponin T levels or pulmonary injury, is the next major area of investigation.
Winner of the National Book Critics Circle Award for Nonfiction, this brilliantly reported and beautifully crafted book explores the clash between a medical center in California and a Laotian refugee family over their care of a child.
'Manuals' for new parents illustrating many models of babyhood, shaped by different values and cultures.
A guide to identifying disease processes in the placenta affecting pregnancy outcome, with current diagnostic criteria and clinical consequences.