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Ethics of Fetal Surgery

Surgeons sometimes operate on the developing fetuses in utero of pregnant women as a medical intervention to treat a number of congential abnormalities, operations that have ethical aspects. A. William Liley performed the first successful fetal surgery, a blood transfusion, in New Zealand in 1963 to counteract the effects of hemolytic anemia, or Rh disease.

Format: Articles

Subject: Ethics

Fetal Programming

Fetal programming, or prenatal programming, is a concept that suggests certain events occurring during critical points of pregnancy may cause permanent effects on the fetus and the infant long after birth. The concept of fetal programming stemmed from the fetal origins hypothesis, also known as Barker’s hypothesis, that David Barker proposed in 1995 at the University of Southampton in Southampton, England.

Format: Articles

Subject: Processes, Theories, Reproduction

Noninvasive Fetal Aneuploidy Detection for Trisomy 21, 13, and 18

Noninvasive fetal aneuploidy detection technology allows for the detection of fetal genetic conditions, specifically having three chromosomes, a condition called aneuploidy, by analyzing a simple blood sample from the pregnant woman. Dennis Lo and Rossa Chiu researched methods of detection of aneuploidies in the early twenty-first century. Their research has been specifically applied to three trisomies, trisomy twenty-one known as Down syndrome, trisomy eighteen known as Edwards Syndrome, and trisomy thirteen known as Patau Syndrome.

Format: Articles

Subject: Technologies

Twin-to-Twin Transfusion Syndrome

Twin-to-Twin Transfusion Syndrome (TTTS) is a rare placental disease that can occur at any time during pregnancy involving identical twins. TTTS occurs when there is an unequal distribution of placental blood vessels between fetuses, which leads to a disproportionate supply of blood delivered. This unequal allocation of blood leads to developmental problems in both fetuses that can range in severity depending on the type, direction, and number of interconnected blood vessels.

Format: Articles

Subject: Disorders, Reproduction

Neonatal Jaundice

Neonatal jaundice is the yellow discoloration of the skin and eyes due to elevated bilirubin levels in the bloodstream of a newborn. Bilirubin is a byproduct of the breakdown of red blood cells. Jaundiced infants are unable to process bilirubin at a normal rate or they have an abnormally high amount of bilirubin in their bloodstream, resulting in a buildup of the yellow colored bilirubin. That build up is called hyperbilirubinemia and is the cause of jaundice.

Format: Articles

Subject: Disorders

“Fetal Programming and Adult Health” (2001), by Kevin M. Godfrey and David J.P. Barker

In 2001, Kevin M. Godfrey and David J.P. Barker published the article “Fetal Programming and Adult Health” in Public Health Nutrition, where they identified the significance of maternal nutrition during pregnancy to healthy offspring development. The authors describe the effects of maternal nutrition on fetal programming of cardiovascular disease. Fetal programming is when a specific event during pregnancy has effects on the fetus long after birth.

Format: Articles

Subject: Publications, Theories

Exchange Transfusion for Jaundiced Newborns in the United States

Exchange transfusion is the replacement of blood from newborn infants with elevated bilirubin level in their blood stream with donor blood containing normal bilirubin levels. Newborn infants that experience jaundice, the yellowing of the skin and eyes, have a buildup of bilirubin, a chemical that occurs during red blood cell breakdown, or hemolysis. Exchange transfusion is a therapy developed throughout the 1940s by Louis Diamond and a group of surgeons at the Children’s Medical Center in Boston, Massachusetts.

Format: Articles

Subject: Technologies

Fetal Surgery

Fetal surgeries are a range of medical interventions performed in utero on the developing fetus of a pregnant woman to treat a number of congenital abnormalities. The first documented fetal surgical procedure occurred in 1963 in Auckland, New Zealand when A. William Liley treated fetal hemolytic anemia, or Rh disease, with a blood transfusion.

Format: Articles

Subject: Disorders, Ethics, Reproduction

Circulatory Changes at Birth

When placental mammals are born their circulatory systems undergo radical changes as the newborns are prepared for independent life. The lungs are engaged, becoming the primary source of fresh oxygen, replacing the placental barrier as a means for blood-gas exchange.

Format: Articles

Subject: Processes

“Maternal Stress Responses and Anxiety During Pregnancy: Effects on Fetal Heart Rate” (2000), by Catherine Monk, William Fifer, Michael Myers, Richard Sloan, Leslie Trien, and Alicia Hurtado

In 2000, Catherine Monk, William Fifer, Michael Myers, Richard Sloan, Leslie Trien, and Alicia Hurtado published “Maternal stress responses and anxiety during pregnancy: Effects on fetal heart rate,” in which the authors conducted a study on how pregnant women’s stress and anxiety affects the health of their fetuses. Previous studies had shown that stress and anxiety during pregnancy could cause fetal abnormalities.

Format: Articles

Subject: Publications, Disorders

“The Intergenerational Effects of Fetal Programming: Non-genomic Mechanisms for the Inheritance of Low Birth Weight and Cardiovascular Risk” (2004), by Amanda J. Drake and Brian R. Walker

In 2004, Amanda J. Drake and Brian R. Walker published “The Intergenerational Effects of Fetal Programming: Non-genomic Mechanisms for the Inheritance of Low Birth Weight and Cardiovascular Risk,” hereafter, “The Intergenerational Effects,” in the Journal of Endocrinology. In their article, the authors assert that cardiovascular disease may develop via fetal programming, which is when a certain event occurring during a critical point of pregnancy affects the fetus long after birth.

Format: Articles

Subject: Publications, Theories, Reproduction

Dissertation: Fetal Risk, Federal Response: How Fetal Alcohol Syndrome Influenced the Adoption of Alcohol Health Warning Labels

In the fifteen years between the discovery of fetal alcohol syndrome, or FAS, in 1973 and the passage of alcohol beverage warning labels in 1988, FAS transformed from a medical diagnosis between practitioner and pregnant women to a broader societal risk imbued with political and cultural meaning. In this dissertation, I examine how scientific, social, moral, and political narratives dynamically interacted to construct the risk of drinking during pregnancy and the public health response of health warning labels on alcohol.

Format: Essays and Theses

Subject: Disorders, Reproduction, Legal

Cord Blood Banking

Cord blood banks are institutions designed to store umbilical cord blood (UCB) stem cells. UCB, a source of hematopoietic stem cells (HSCs), has garnered attention from scientific and medical communities since its first successful use in a hematopoietic stem cell transplant (HSCT) in 1988. The umbilical cord is the lifeline by which the growing fetus is nourished by the mother. Once regarded as medical waste, the umbilical cord has become a source of lifesaving treatment.

Format: Articles

Subject: Technologies, Reproduction

Rh Incompatibility in Pregnancy

Rh incompatibility occurs when a pregnant woman whose blood type is Rh-negative is exposed to Rh-positive blood from her fetus, leading to the mother s development of Rh antibodies. These antibodies have the potential to cross the placenta and attach to fetal red blood cells, resulting in hemolysis, or destruction of the fetus 's red blood cells. This causes the fetus to become anemic, which can lead to hemolytic disease of the newborn. In severe cases, an intrauterine blood transfusion for the fetus may be required to correct the anemia.

Format: Articles

Subject: Processes, Disorders, Reproduction

Albert William Liley (1929–1983)

Albert William Liley advanced the science of fetal physiology and the techniques of life-saving in utero blood transfusions for fetuses with Rh incompatibility, also known as hemolytic disease. Due to his advances, fetuses too young to survive premature delivery, and likely to die in utero if their Rh incompabilities were left untreated, were successfully transfused and carried to term. Liley was as passionate as a clinician and researcher as he was about his views on the rights of the unborn.

Format: Articles

Subject: People, Reproduction

Twice Born–Stories from the Special Delivery Unit (2015), by the Public Broadcasting Service and Trailblazer Studios

In 2015, the Public Broadcasting Service, or PBS, released a three-part documentary series, Twice Born–Stories from the Special Delivery Unit, hereafter Twice Born, that follows several pregnant women and their experiences with fetal surgery. Trailblazer Studios produced the film, which predominantly features two women, although it includes the stories of many women. The two main women are pregnant with fetuses diagnosed with physical deformities. One woman’s fetus is diagnosed with spina bifida, an incomplete closure of the fetus’s spinal column.

Format: Articles

Subject: Publications

William Stewart Halsted (1852-1922)

William Stewart Halsted was a surgeon at Johns Hopkins Hospital in Baltimore, Maryland, during the late 1800s and early 1900s. In 1894 Halsted described his procedure for treating breast cancer by removing the breast tissue, chest muscles, and lymph nodes in the armpit, a procedure he named radical mastectomy, and that became the standard of care for treating breast cancer until 1970.

Format: Articles

Subject: People

ABO Blood Type Identification and Forensic Science (1900-1960)

The use of blood in forensic analysis is a method for identifying individuals suspected of committing some kinds of crimes. Paul Uhlenhuth and Karl Landsteiner, two scientists working separately in Germany in the early twentieth century, showed that there are differences in blood between individuals. Uhlenhuth developed a technique to identify the existence of antibodies, and Landsteiner and his students showed that humans had distinctly different blood types called A, B, AB, and O.

Format: Articles

Subject: Theories, Legal, Technologies

Social Implications of Non-Invasive Blood Tests to Determine the Sex of Fetuses

By 2011, researchers in the US had established that non-invasive blood tests can accurately determine the gender of a human fetus as early as seven weeks after fertilization. Experts predicted that this ability may encourage the use of prenatal sex screening tests by women interested to know the gender of their fetuses. As more people begin to use non-invasive blood tests that accurately determine the sex of the fetus at 7 weeks, many ethical questions pertaining to regulation, the consequences of gender-imbalanced societies, and altered meanings of the parent-child relationship.

Format: Articles

Subject: Reproduction, Ethics, Legal

Dissertation: A Fetus By Any Other Name: How Words Shaped the Fetal Personhood Movement in US Courts and Society (1884-1973)

The 1973 Supreme Court case Roe v. Wade was a significant event in the story of fetal personhood—the story of whether embryos and fetuses are legal persons. Roe legalized abortion care in the United States (US). However, the story of fetal personhood began long before the 1970s. People have been talking about embryos, fetuses, and their status in science, the law, and society for centuries.

Format: Essays and Theses

Subject: Reproduction, Ethics, Legal

Hypertensive Disorders in Pregnancy (1978), by Leon Chesley

Leon Chesley published Hypertensive Disorders in Pregnancy in 1978 to outline major and common complications that occur during pregnancy and manifest in abnormally high blood pressures in pregnant women. The book was published by Appleton-Century-Crofts in New York, New York. Chesley compiled his book as a tool for practicing obstetricians and teachers.

Format: Articles

Subject: Publications

Using Digital PCR to Detect Fetal Chromosomal Aneuploidy in Maternal Blood (2007)

In 2007, Dennis Lo and his colleagues used digital polymerase chain reaction or PCR to detect trisomy 21 in maternal blood, validating the method as a means to detect fetal chromosomal aneuploidies, or an abnormal number of chromosomes in a cell. The team conducted their research at the Chinese University of Hong Kong in Hong Kong, Hong Kong, and at the Boston University in Boston, Massachusetts.

Format: Articles

Subject: Experiments

Karl Landsteiner (1868-1943)

Karl Landsteiner studied blood types in Europe and in the United States in the late nineteenth and early twentieth centuries. Landsteiner won the Nobel Prize in Physiology or Medicine in 1930 for detailing immunological reactions in the ABO blood group system. The ABO blood group system divides human blood into one of four types based on the antibodies that are present on each cell. Landsteiner's work with blood types led physicians to safely perform blood transfusions and organ transplants.

Format: Articles

Subject: People

"Transfer of Fetal Cells with Multilineage Potential to Maternal Tissue" (2004), by Kiarash Khosrotehrani et al.

In 2004, a team of researchers at Tufts-New England
Medical Center in Boston, Massachusetts, investigated the fetal
cells that remained in the maternal blood stream after pregnancy.
The results were published in Transfer of Fetal Cells with
Multilineage Potential to Maternal Tissue. The team working on that
research included Kiarash Khosrotehrani, Kirby L. Johnson, Dong
Hyun Cha, Robert N. Salomon, and Diana W. Bianchi. The researchers
reported that the fetal cells passed to a pregnant woman during

Format: Articles

Subject: Experiments, Reproduction

William Thornton Mustard (1914-1987)

William Thornton Mustard was a surgeon in Canada during the twentieth century who developed surgical techniques to treat children who had congenital heart defects. Mustard has two surgeries named after him, both of which he helped to develop. The first of these surgeries replaces damaged or paralyzed muscles in individuals who have polio, a virus that can cause paralysis. The other technique corrects a condition called the transposition of the great arteries (TGA) that is noticed at birth.

Format: Articles

Subject: People, Disorders, Disorders

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