Tim Chard - Böcker

This important new volume in the series Cambridge Reviews in Human Reproduction provides a wide-ranging and authoritative account of the uterus and its physiological role in fertility, normal pregnancy and delivery. Acknowledged authorities from around the world provide a detailed and timely account of uterine physiology. The volume encompasses a wealth of material including cell and developmental biology, structure, function, anatomy and endocrinology, and then goes on to cover clinically important issues such as the cervix during pregnancy, measurement of uterine contractions and initiation of labour. It will prove of particular value to those involved in the management of women with pre-term labour, as well as those concerned with the development of new procedures for the prevention or amelioration of this condition.

A variety of new techniques that promise to revolutionize the clinical management of early pregnancy are fully detailed in this state-of-the-art book. Leading international researchers describe fast-moving topics such as embryo manipulation and the diagnosis of congenital abnormalities. The technology of assisted reproduction has made it possible to study living embryonic material for the first time, which has led to rapid advances in our understanding of the human embryo's early development. For example, study of the embryo in the test tube has pointed to early pregnancy loss as a possible cause of later infertility. Even more important, diagnostic tests using sophisticated techniques of molecular biology can be run on single cells before the embryo is replaced in the uterus. Another area of advance is the diagnosis of congenital abnormalities in the first and second trimesters of pregnancy. Great improvements have been made in the techniques of chorion villus biopsy and ultrasound imaging. A spectrum of simple biochemical tests performed on the mother's blood can greatly improve the detection of Down syndrome and other chromosome defects. Together with other developments in the fields of molecular biology and endocrinology, these new diagnostic techniques are the beginning of a new age in clinical human genetics and embryology.

Sixteen British specialists pool their extensive knowledge of spontaneous abortion in one source. Their discussion is directly applicable to clinical situations and helps identify areas of debate and alternative methods.

Several aspects of clinical medicine are poised on the edge of a new era with the introduction of therapeutic antibodies. This revolution has been made possible by major advances in immune technology, which are now beginning to mature into clinical practice. This volume is aimed at all clinicians involved with this form of treatment, especially accident and emergency physicians, clinical immunologists, and pharmacologists. It covers both the basic technology, and also all the main clinical areas of application: septic shock, auto-immune disease, and cancer. The future of therapeutic antibodies is also discussed, including exciting new developments in "catalytic antibodies". This is the first occasion on which all these topics have been brought together in a single volume, thus making it an important reference source for physicians and researchers in this fast-moving area.

The advent of assisted conception procedures such as in-vitro fertili­ sation (IVF) has provided the impetus for exploration of the factors that lead to the establishment of pregnancy. This collection of papers from leading research workers brings together current concepts of the processes which may be of importance in implantation. The complex signals from the embryo to the ovary, endometrium and myometrium are now being revealed through studies in both primates and other mammalian species. This book addresses the interrelationship of pituitary and ovarian hormones in controlling ovulation and the preparation of the intrauterine environment for implantation. Once fertilisation has occurred and trophoblast has formed, the next vital step is the production of materials which signal the presence of the pregnancy to the rest of the body. Trophoblastic proteins and other early-pregnancy factors are prime candidates for this role. Recent studies have emphasised the importance of the intrauterine environment in implantation. Specific secretory products of the endometrium have great potential in this process. The prostaglandins also play an essential part. Immunological adjustments are now considered a condition for the successful establishment of pregnancy. The possible use of immuno­ therapy in the treatment of recurrent abortion has highlighted interest in this area. The use of immunological techniques for contraception are in their infancy but offer much hope for the future.

The aim of this book is to provide a straightforward summary of the knowledge required for examinations in specialist Obstetrics and Gynaecology. Part Two of the examination for Membership of the Royal College of Obstetricians and Gynaecologists would be a good example. The volume is intended as a·companion to the highly successfulBasicSciencesforObstetricsandGynaecology which covers the knowledge required for preliminary examinations. Increasingly, examinations ofall types are based on multiple choice questions (MCQ) or structured answer questions (SAQ). No apology is made for the fact that the present book addresses the sort of "fact" which lends itself to testing by this approach. Thus, there is little discussion of speculative or contentious areas, no account of present or future research, and no references. Numerous excellent books are available which cover these topics in a much fuller and more discursive manner, and the present volume does not seek to emulate them. Even the most apparently immutable facts are subject to periodic revision. We have attempted to present the "state-of-the-art": most of the material is generally if not universally accepted. A particular problem arises with numerical information. Frequencies of diseases, frequency of clinical findings, efficiency of diagnostic tests and therapies, have almost always been the subject ofnumerous different studies, each of which yields somewhat different results.

Basic Sciences for Obstetrics and Gynaecology has become the standard revision aid for students preparing for examinations in obstetrics and gynaecology, particularly those candidates for the MRCOG Part I. The authors present a wealth of information in a concise, didatic format, focussing on those facts that are generally considered non-contentious. The fifth edition includes both new and revised material, reflecting the current understanding of the basic sciences underpinning the practice of obstetrics and gynaecology. This book will be of value to the student and also those professionals wishing to refresh their basic scientific knowledge.