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.

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.

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.

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.

Major advances in ultrasound, prenatal diagnosis and therapy, and fetal assessment are furthering fetal medicine and clinical perinatology. These developments include: progress in 3-dimensional and color Doppler ultrasound for insights into early embryonic structure and function, counseling for pre-embryonic research, genetic counseling and prenatal informed consent, the use of cardiotocograms (CTGs), ultrasound imaging, Doppler ultrasound, analysis of nucleated red blood cells, and a broad range of clinical topics ranging from the Internet to neonatal intensive care. Under the editorship of Dr. Frank Chervenak and Professors Asim Kurjak and Zoltan Papp, authors and editors of many respected books in this field, The Fetus as a Patient: The Evolving Challenge provides detailed, authoritative coverage of the latest developments in fetal medicine and clinical perinatology. Following an introductory chapter on the moral foundations of leadership in fetal medicine, the book presents 38 chapters in four sections dealing with new developments in ultrasound, the state of the art of prenatal diagnosis and therapy, the challenge of fetal assessment and current perspectives on clinical perinatology. The volume is extensively illustrated throughout and includes bibliographic references and index. The Fetus as a Patient elucidates the current work of the Board of Directors and invited speakers of the International Society of the Fetus as a Patient, which is dedicated to improving all dimensions of fetal diagnosis and therapy.

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.