By Jose M. Carrera, Frank A. Chervenak, Asim Kurjak
The advent of latest diagnostic applied sciences similar to Doppler expertise and 3-dimensional ultrasonography has replaced the character of perinatal medication. besides the fact that, the frenzy to introduce new tactics has occasionally compromised the rigor precious within the preliminary analyses in their makes use of. the sphere is relocating forward so swiftly that health-care protocols can fast lose their validity and controversy quickly arises.Controversies in Perinatal medication examines the present country of the technological know-how during the lens of evidence-based drugs. With specialist editorial course and contributions from leaders within the box, the ebook courses readers throughout the maze of latest applied sciences and methods and explores the problems they bring up by way of medical method. It specializes in chosen concerns in caliber care of the fetus and the mummy; early analysis and choice making; how and if new diagnostic applied sciences impact results; contributions of ultrasou nd know-how to the physique of information; screening and therapy for prematurity; alterations in cesarean part charges; and moral issues.Controversies in Perinatal drugs offers a transparent photo of the advancements in prognosis and therapy made attainable through new applied sciences and the perception to unravel the problems excited about utilizing them.
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At a time while clinical applied sciences make it ever more uncomplicated to augment our minds and our bodies, a debate has arisen approximately no matter if such efforts advertise a strategy of "normalization," which makes it ever more durable to tolerate the usual anatomical variations between us. the controversy turns into specially complex whilst it addresses the surgical alteration, or "shaping," of kids.
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Additional info for Controversies in Perinatal Medicine: the Fetus as a Patient
1995). These can be genetically analyzed using cytogenetic (FISH, or in vitro culture and determination of the karyotype) or gene (PCR) procedures. THE FOUNDING FATHERS OF FETAL MEDICINE The large number of fetal surveillance techniques, and the long list of names associated with them, may make us lose sight of the key developments in fetal medicine and of the great scientists behind them, those whose work made a decisive impact on the history of fetal surveillance. If we restrict ourselves to the scientific era of medical knowledge, fetal medicine can be said to have five crowning moments: the auscultation and subsequent study of the fetal heart beat by Lejumeau de Kargaradec in 1821; the entering of the amniotic cavity by Bevis in 1952; the introduction of FHR monitoring by Caldeyro-Barcia in 1956 (along with others such as Hon, Sureau and Hammacher); the study of fetal blood sampled through the fetal scalp by Saling in 1962, leading to fetal chemical monitoring; and finally, the use of ultrasonography in obstetrics by Ian Donald in 1965.
Ruoti CHALLENGE OF ACTUALIZATION The daily practice of medicine always lags behind scientific knowledge, since physicians have difficulty in accessing useful information. Diagnostic or therapeutic procedures of proven efficacy are disseminated as slowly as other ineffective techniques are abandoned. In our field, we all remember the long 20 years that passed from the first report of the efficacy of antenatal administration of corticoids in the reduction of neonatal mortality in preterm newborns, to their routine use.
This research group obtained fetal blood by means of an ultrasound-guided direct puncture of cord vessels. The efficacy of this technique was subsequently confirmed by Hobbins and colleagues (1985) and Nicolaides and colleagues (1986). Ultrasound has also proved to have a beneficial effect on the practice of chorionic biopsy, whether transabdominal or transcervical, and the procedure is now safe; the rate of fetal loss is less than 1%, which is similar to the figure for amniocentesis (Brambati and Tulvi, 1998) in both singleton and twin pregnancies (Antsaklis, 2002).