Obstetric Vasculopathies: latest best-seller in Obstetrics & Gynecology world
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About the author:
About the author:
Dr. Pankaj Desai is one of the best known academicians and teachers in Obstetrics and Gynecology in India. All his eight books have proved to be best-sellers, one of which was awarded the best book award in the subject. A prolific writer, he has contributed 38 chapters to different text books internationally and nationally. His outstanding academic contributions in the subject have been acknowledged and honored with 7 gold medals and 50 orations. An extremely popular teacher that he is, he has delivered 597 guest lectures in different parts of India and the world at the time of this book going for print. He has published 103 research papers till date, 9 of which have been awarded best research paper prizes. His website www.drpankajdesai.com has become an extremely popular portal for students and practitioners of the subject seeking references and up-to-date knowledge of the subject. It has invited more than 1, 50,000 hits by the time of this publication. His blogs on different academic and non-academic aspects being published on the net as Dr. Pankaj Desai's blogs have also become very popular inviting more than 14,000 reads as of now.
The contents outline of this book is thus:
1. GENERAL ASPECTS OF OBSTETRIC VASCULOPATHIES
This chapter introduces the reader to the concept of obstetric vasculopathies and prepares a ground for understanding the approach to the different obstetric conditions listed under obstetric vasculopathies.
2. CARDIOVASCULAR CHANGES IN NORMAL PREGNANCY
This chapter covers the normal physiological changes in CV system of a pregnant subject. Obstetric vasculopathies being a predominantly vascular condition this aspect of physiology is separately handled.
3. IMMUNOLOGY OF OBSTETRIC VASCULOPATHIES
Immunology is now accepted to play a very important role in a healthy pregnancy outcome. Aberrations in immunological response can have profound effect on the pregnancy. Both alloimmune changes and autoimmune conditions affecting pregnancy clinically result as obstetric vasculopathies. This is extensively discussed in this chapter.
4. ENDOTHELIAL CELL DYSFUNCTION & OBSTETRIC VASCULOPATHIES
Endothelial cell dysfunction is an important change in the series of events that take place in causation of obstetric vasculopathies. This chapter goes in depth of these changes and their clinical results.
5. OXIDATIVE STRESS & OBSTETRIC VASCULOPATHIES
This chapter covers this critical aspect of etiopathology of obstetric vasculopathies. It explains what is oxidative stress, what is a free radical, oxidative stress and health, the mischief of free radicals in vascular walls, lipid peroxides as agents of oxidative stress, lipid metabolism in normal pregnancy and its bearings in abnormal pregnancy, placental lipid peroxidation, transition metals in lipid peroxidation, clinical manifestations of oxidative stress & obstetric vasculopathies, reperfusion damage in obstetric vasculopathies, role of innate maternal reducing systems, inefficient second wave of trophoblastic invasion and its bearings, VEGF in obstetric vasculopathies, nitric oxide in obstetric vasculopathies, placental atherosis in obstetric vasculopathies, extracellular reducing systems, uric acid: one of the most power house reductant, limitations of reducing systems, exercise & prevention of obstetric vasculopathies, treatment bearings and the beauty of lysophosphotidyl choline.
6. THE PLACENTA, THE TROPHOBLASTS AND OBSTETRIC VASCULOPATHIES
This chapter covers the basic process of normal placenta & placentation, role of oxygen tension in trophoblastic invasion, oxygenation and trophoblastic differentiation, faults in fetomaternal linkage at placenta & obstetric vasculopathies, maternal environment preventing trophoblastic invasion and bearings of these in obstetric vasculopathies.
7. THE GENETICS OF OBSTETRICS VASCULOPATHIES
This chapter covers the basis for reviewing the role of genetics in obstetric vasculopathies, challenges to the genetic studies in obstetric vasculopathies, application of genetic models, examining associations of these models in obstetric vasculopathies, fetal contributions, immunology, genetics and epigenetic features in preeclampsia
8. OBSTETRIC VASCULOPATHIES AND THEIR EFFECTS ON HEART
This chapter covers hemodynamics in normal pregnancy and during obstetric vasculopathies and effect of preeclampsia on the offspring besides covering the effects of obstetric vasculopathies on the heart
9. OBSTETRIC VASCULOPATHIES AND THEIR EFFECTS ON THE RENAL SYSTEM
This chapter covers the vulnerability of renal system, special features of renal failure in obstetric vasculopathies, kidney lesions and doubts on veracity of “pathognomonic lesions”, gross changes in the kidneys, changes on microscopy, preeclampsia – a renal pathogenic model for understanding other forms of hypertension, renal function alterations, renal handing of proteins, handling of urinary excretion of proteins, renin-angiotensin system in obstetric vasculopathies in general and preeclampsia in particular.
10. OBSTETRIC VASCULOPATHIES AND THEIR EFFECTS ON THE CENTRAL NERVOUS SYSTEM
Amongst the critical involvements of different systems and organs, CNS involvement seems to be more covert than overt in obstetric vasculopathies. This chapter covers the privileged status of CNS, pathological lesions in obstetric vasculopathies, effects on the brain and psychiatric complications following obstetric vasculopathies
11. OBSTETRIC VASCULOPATHIES AND THEIR EFFECTS ON HEMATOLOGICAL SYSTEM
This chapter covers the alteration in coagulation factors (other than platelets) and procoagulants, alteration in other cellular components of blood, review of coagulation alterations in obstetric vasculopathies, platelets in normal and preeclamptic pregnancies, concept of competence alteration (efficiency) of platelets, platelet activation and thromboxane A2 production in obstetric vasculopathies
12. OBSTETRIC VASCULOPATHIES AND THEIR EFFECTS ON THE LIVER
This chapter covers the pathological changes in the liver and liver in HELLP syndrome in reference to obstetric vasculopathies.
13. OPHTHALMIC FEATURES IN OBSTETRIC VASCULOPATHIES
This chapter covers retinal edema, central and peripheral cause of visual alterations and visual alterations of special mention – recurrent and unilateral, in obstetric vasculopathies
14. VASCULAR RESPONSES IN OBSTETRIC VASCULOPATHIES
This chapter covers blunted vascular response, placental ischemia, animal experiments in on this aspect of obstetric vasculopathies, dietary deficiency and animal experiments, quantification of fetomaternal interface vascular activity, salient results emerging from animal experiments, some intriguing observations from animal experiments, preeclampsia: a price for two legged humans, gene variation and preeclampsia, the exclusivity of human pregnancy and hard facts emerging from animal experiments vis-à-vis obstetric vasculopathies.
15. CLINICAL PROFILE OF OBSTETRIC VASCULOPATHIES
This chapter covers hypertension, what BP is hypertension, concept of competence of reducing systems, proteinuria, edema, clinical bearings of laboratory parameters including understanding of plasma urea in obstetric vasculopathies
16. DIFFERENTIAL DIAGNOSIS
This chapter covers conditions that require to be differentiated including preeclampsia and chronic hypertension, transient hypertension, renal diseases and hepato-hematological involvements
17. PREDICTING OBSTETRIC VASCULOPATHIES
This chapter covers the amorphous characterizations of pathogenesis and clinical features, overview of the types of tests, negative to positive predictive value, conditions based tests, an ideal test, clinical tests including midtrimester B.P, the roll-over test, hand-grip test, weight gain, urinary tests including microalbuminuria, kallikrein, hematological cellular and non-cellular indices, platelet and platelet activation, platelet count and cd63 and uric acid in prediction of obstetric vasculopathies
18. PREVENTION OF PREECLAMPSIA & OTHER OBSTETRIC VASCULOPATHIES
This chapter includes the difference between disease and derangement, preventing obstetric vasculopathy is a challenge, which subjects may benefit out of preventive measures prevent occurrence or prevent worsening, salt restriction, diuretics, antihypertensives, calcium supplementation, other trace elements like magnesium and zinc, preventive measures of obstetric vasculopathies, progesterone in prevention of obstetric vasculopathies, hCG in prevention of obstetric vasculopathies, antithrombotic agents (aspirin with or without heparin) for prevention of obstetric vasculopathies and prevention of eclampsia
19. COLOUR DOPPLER IN OBSTETRIC VASCULOPATHIES
This chapter includes colour Doppler in early pregnancy, inconsistent notch, depth of the diastolic notch, colour Doppler indices in early pregnancy and its role in prediction, third trimester colour Doppler in obstetric vasculopathies, umbilical artery flow, middle cerebral artery, venous Doppler, limitations of venous Doppler, umbilical venous flow, venous Doppler for deciding the route of delivery, colour Doppler for discontinuation of antithrombotic agents, and fetal aortic Doppler studies in management of obstetric vasculopathies
20. CARDIOTOCOGRAPHY (CTG) IN OBSTETRIC VASCULOPATHIES
This chapter includes physiology and CTG, hypoxia and FHR, CTG in subjects with APA Syndrome, colour Doppler and CTG correlation, the two together in preeclampsia, the two together in IUGR
21. TREATMENT OF OBSTETRIC VASCULOPATHIES: RECURRENT MISCARRIAGES
In this chapter the role of folic acid, low dose aspirin including teratogenicity of aspirin, FAQs on aspirin, heparin, progesterone is treatment of immunological miscarriages, difficulties in interpreting scientific data, treatment of a subject of miscarriage always for prevention are discussed
22. TREATMENT OF PREECLAMPSIA
In this chapter aspects related to limitations of blood pressures as an indicator of severity, early diagnosis and alert surveillance, do subjects of preeclampsia need admission, management on hospitalization, antihypertensives: which antihypertensive, challenges before any antihypertensive in PIH, monotherapy v/s multidrug therapy, dosage schedules, nifedipine, atenolol, labetalol, alpha methyldopa, hydralazine and when to stop antihypertensives, induction of labour in PIH: when to induce labour in PIH will be discussed
23. MANAGEMENT OF OBSTETRIC VASCULOPATHIES: ACCIDENTAL HEMORRHAGE
In this chapter the etiopathology of accidental hemorrhage, the clinical effects of accidental hemorrhage, CTG changes in accidental hemorrhage, USG in accidental hemorrhage, obstetric management of accidental hemorrhage, why labour in accidental hemorrhage doesn’t follow the partogram, cesarean section in accidental hemorrhage and medical management of this obstetric vasculopathy will be discussed
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