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Manual of Fetal Medicine
Dilip Kumar Dutta
SECTION A:
1:
Fetal Growth and Development
2:
Maternal Infection — Its Impact on Fetal Growth and Development
SECTION B:
3:
Prenatal Diagnosis and its Impact in Obstetrics
SCREENING TEST
DIAGNOSTIC TESTS
Prenatal Diagnosis
General
Obstetric
Procedure
Laboratory Methods
Chorionic Villus Sampling (CVS)
Procedures
Risks
Amniocentesis
Procedure
Indications
Risks
Fetal Blood Sampling and Other Techniques
4:
How to Assess Fetal Size and Growth Rate Abnormalities?
5:
How to Assess Fetal Well Being?
GESTATIONAL AGE ASSESSMENT
ANTEPARTUM TEST
INTRAPARTUM ASSESSMENT OF FETAL WELL-BEING IS IMPORTANT IN THE MANAGEMENT OF LABOR
6:
How to Assess Pulmonary Surfactant?
PHYSIOLOGIC BASIS
Procedure
Guidelines for Interpretation
THE LECITHIN-SPHINGOMYELIN (L/S) RATIO
Clinical Significance of Specific Results
Interpretation of Contaminated Samples
Exceptions
Definite Exceptions
Possible Exceptions
Predicting Lung Maturity in the IDM (See chap. 2, diabetes mellitus)
TDX-FETAL LUNG MATURITY (FLM II)
Limitations
OTHER MEASURES OF SURFACTANT
COMBINATION TESTING
SECTION C:
7:
Congenital Abnormalities–Diagnosis and Management
CHROMOSOMAL ABNORMALITIES
Down's Syndrome (Trisomy 21)
Incidence
Antenatal Diagnosis
Etiology
Clinical Features
Edwards' Syndrome (Trisomy 18/E)
Incidence
Etiology
Clinical Features
Patau's Syndrome (Trisomy 13/D)
Incidence
Etiology
Clinical Features
Turner's Syndrome (45, XO)
Incidence
Etiology
Clinical Features
Prognosis
CONGENITAL ABNORMALITIES
Neural Tube Defects (NTD)
Types
Incidence
Etiology and Prevention
Antenatal Diagnosis
Hydrocephalus
Definition
Etiology
Antenatal Diagnosis
Prognosis
Microcephaly
Definition and Antenatal Diagnosis
Etiology
ABDOMINAL WALL DEFECTS
Gastroschisis and Exomphalos
Pathology
Features
Management
Prune Belly Syndrome
Incidence
Features
Management
RENAL TRACT ANOMALIES
Potter's Syndrome
Incidence
Etiology
Features
Course
Ectopia Vesicae
Incidence
Features
Management
Urinary Obstruction
Etiology
Features
Management
SKELETAL ABNORMALITIES
Osteogenesis Imperfecta
Incidence
Features
Prognosis
Short-limbed Dwarfism
Incidence
Features
Prognosis
Limb Reduction Deformities
GASTROINTESTINAL ANOMALIES
Diaphragmatic Hernia
Incidence
Features
Tracheo-esophageal Fistula
Incidence
Features
Prognosis
Intestinal Obstruction
8:
Maternal Infection – Diagnosis and Management
RUBELLA
Mother
Baby
TOXOPLASMOSIS
Mother
Baby
CYTOMEGALOVIRUS
Mother
Baby
HERPES SIMPLEX
Mother
Baby
Parvovirus
LISTERIOSIS
Mother
Baby
SYPHILIS
Mother
Baby
9:
Hydrops Fetalis – Diagnosis and Management
10:
Diabetes Mellitus – Diagnosis and Management
SECTION D:
11:
Twin Pregnancy – Diagnosis and Management
12:
Intrauterine Growth Retardation – Diagnosis and Management
ETIOLOGY
INVESTIGATION
DIAGNOSIS
Medical History
Clinical Evaluation
USG
SENSITIVE INDICATOR OF IUGR
Femur-to-Abdomen Ratio
Fetal Ponderal Index
MANAGEMENT
Maternal Management
Bed Rest
Diet
Minerals
L-arginine
Aspirin
Heparin
Amnioinfusion
Parenteral Nutrition
Fetal Management
Fetal Kick Count
Fetal Biometry
Amniotic Fluid Index
NST (Non Stress Test)
Biophysical Profile
Doppler Studies
Delivery
Principle Adopted During the Time of Delivery
Delivery in Good Neonatal Unit
CONCLUSION
13:
Preterm Premature Rupture of Membranes – Diagnosis and Management
ROLE OF ANTIBIOTICS
ROLE OF CORTICOSTEROIDS
ROLE OF TOCOLYSIS
SUMMARY
14:
Rhesus Alloimmunization—What is New?
DIAGNOSTIC APPROACH
Genetics
Maternal Titer
Ultrasonography
Amniocentesis
Fetal Blood Sampling
Clinical Management
First Affected Pregnancy
Previously Affected Fetus or Infant
Therapeutic Approach
Intrauterine Transfusion
OUTCOME
Short Term
Long Term
Future Treatment – RH Alloimmunization
SUMMARY
15:
Screening for Down Syndrome – New Concept
ULTRASONOGRAPHY
Fetal Nuchal Translucency
Ultrasound Criteria To Maximize Quality of Nuchal Translucency Ultrasonography
Nasal Bone in the First Trimester
FIRST-TRIMESTER SERUM MARKERS
Serum Markers
Combined Testing With First-and Second
Cystic Hygroma
Multiple Gestations
Implementing Nuchal Translucency into Clinical Practice
Quality Control
Implications for Second-trimester Ultrasonography
Availability of Early Prenatal Diagnosis
How to Choose Correct Combination of Screening Tests
SECTION E:
16:
Medical Therapy
RHESUS ISOIMMUNIZATION
HYPOTHYROIDISM AND HYPERTHYROIDISM
Hypothyroidism
Management
Hyperthyroidism
Treatment
ALLOIMMUNE THROMBOCYTOPENIA
Therapy
INBORN ERRORS OF METABOLISM
Maternal Phenylketonuria
Treatment
3-Phosphoglycerate-dehydrogenase [3-PGDH) deficiency]
Treatment
NONIMMUNE HYDROPS
CONGENITAL ADRENAL HYPERPLASIA
CONGENITAL COMPLETE HEART BLOCK
CARDIAC MALFORMATIONS
FETAL ARRHYTHMIAS
FETAL INFECTIONS
TOXOPLASMOSIS
17:
Surgical Therapy
PREOPERATIVE ASSESSMENT
CASE SELECTION
Multiple Pregnancy
Twin-Twin Transfusion Syndrome (TTTS)
Fetal Surgery
Umbilical Cord Ligation/Occlusion
Twin Reversed Arterial Perfusion (TRAP)
Lung Defects
Congenital cystic adenomatoid malformations
Microcystic CCAM
Macrocystic CCAM
Urinary Tract Obstructive Defect
Percutaneous Vesicoamniotic Shunt
Percutaneous Fetal Cystoscopy
Fetal Endoscopic Ablation of Ureteral Valve
Endoscopic Fetal Cystotomy (EFC) – Fetal Hydrolaparoscopy (FHL) Ablation of PUV
Retrograde Urethral Catheterization (RUC)
Congenital Diaphragmatic Hernia
Exit (Ex utero Intrapartum/Therapy)
Fetal Tumors
Treatment
Sacrococcygeal Teratoma
Open Fetal Surgery
Neural Tube Defects
Open Spina Bifida
Hydrocephalus
SECTION F:
18:
Fetal Gene Therapy
INDEX
TOC
Index
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