High-risk Pregnancy: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

HIGH-RISK PREGNANCY A 3-IN-1 MEDICAL REFERENCE Medical Dictionary Bibliography & Annotated Research Guide TO I NTERNET ...

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HIGH-RISK PREGNANCY A 3-IN-1 MEDICAL REFERENCE Medical Dictionary Bibliography & Annotated Research Guide TO I NTERNET

R EFERENCES

HIGH-RISK PREGNANCY A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960High-Risk Pregnancy: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00543-3 1. High-Risk Pregnancy-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on high-risk pregnancy. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON HIGH-RISK PREGNANCY .......................................................................... 3 Overview........................................................................................................................................ 3 Federally Funded Research on High-Risk Pregnancy.................................................................... 3 The National Library of Medicine: PubMed .................................................................................. 3 CHAPTER 2. ALTERNATIVE MEDICINE AND HIGH-RISK PREGNANCY .......................................... 23 Overview...................................................................................................................................... 23 National Center for Complementary and Alternative Medicine.................................................. 23 Additional Web Resources ........................................................................................................... 27 General References ....................................................................................................................... 28 CHAPTER 3. BOOKS ON HIGH-RISK PREGNANCY........................................................................... 29 Overview...................................................................................................................................... 29 Book Summaries: Federal Agencies.............................................................................................. 29 Book Summaries: Online Booksellers........................................................................................... 32 CHAPTER 4. PERIODICALS AND NEWS ON HIGH-RISK PREGNANCY ............................................. 35 Overview...................................................................................................................................... 35 News Services and Press Releases................................................................................................ 35 Academic Periodicals covering High-Risk Pregnancy................................................................. 37 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 41 Overview...................................................................................................................................... 41 NIH Guidelines............................................................................................................................ 41 NIH Databases............................................................................................................................. 43 Other Commercial Databases....................................................................................................... 45 APPENDIX B. PATIENT RESOURCES ................................................................................................. 47 Overview...................................................................................................................................... 47 Patient Guideline Sources............................................................................................................ 47 Finding Associations.................................................................................................................... 49 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 51 Overview...................................................................................................................................... 51 Preparation................................................................................................................................... 51 Finding a Local Medical Library.................................................................................................. 51 Medical Libraries in the U.S. and Canada ................................................................................... 51 ONLINE GLOSSARIES.................................................................................................................. 57 Online Dictionary Directories ..................................................................................................... 57 HIGH-RISK PREGNANCY DICTIONARY ............................................................................... 59 INDEX ................................................................................................................................................ 75

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with high-risk pregnancy is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about high-risk pregnancy, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to high-risk pregnancy, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on high-risk pregnancy. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to high-risk pregnancy, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on high-risk pregnancy. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON HIGH-RISK PREGNANCY Overview In this chapter, we will show you how to locate peer-reviewed references and studies on high-risk pregnancy.

Federally Funded Research on High-Risk Pregnancy The U.S. Government supports a variety of research studies relating to high-risk pregnancy. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to high-risk pregnancy. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore high-risk pregnancy.

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3

2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH). 3 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text

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The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with high-risk pregnancy, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “high-risk pregnancy” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for high-risk pregnancy (hyperlinks lead to article summaries): •

A Bull in the China Shop. The internist and the high-risk pregnancy. Author(s): Lee RV. Source: N Y State J Med. 1983 March; 83(3): 304-10. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6574349

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A comparison of qualitative and quantitative evaluation of cardiotocogram in the monitoring of high-risk pregnancy. Author(s): Rondinelli M, Di Lenardo L, Capoti C, Bertasi M, De Salvia D. Source: Clin Exp Obstet Gynecol. 1982; 9(1): 46-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7172433

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A high-risk pregnancy management protocol. Author(s): Crane JP, Sauvage JP, Arias F. Source: American Journal of Obstetrics and Gynecology. 1976 May 15; 125(2): 227-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1266902

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A simplified antepartum high-risk pregnancy scoring form: statistical analysis of 5459 cases. Author(s): Coopland AT, Peddle LJ, Baskett TF, Rollwagen R, Simpson A, Parker E. Source: Can Med Assoc J. 1977 May 7; 116(9): 999-1001. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=858117

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ABR audiometry in evaluation of hearing organ in neonates from high-risk pregnancy. Author(s): Sekula J, Reron E. Source: Otolaryngol Pol. 1994; 48(3): 299-304. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8090496

journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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Active management of high-risk pregnancy. Author(s): Bhattacharyya M, Companywalla R, Shinde S, Purandare VN. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1979 November-December; 17(3): 278-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=42586

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African American women describe support processes during high-risk pregnancy and postpartum. Author(s): Coffman S, Ray MA. Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing : Jognn / Naacog. 2002 September-October; 31(5): 536-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12353732

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Amniotic fluid assays in high-risk pregnancy. Author(s): Rajan R. Source: Clinical Obstetrics and Gynecology. 1973 March; 16(1): 313-28. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4575533

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An overview of high-risk pregnancy. Author(s): Crosby WM, Sheldon RE. Source: J Okla State Med Assoc. 1981 January; 74(1): 12-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7218076

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Anaesthetic considerations in high-risk pregnancy. Author(s): Writer WD. Source: Can Anaesth Soc J. 1986 May; 33(3 Pt 2): S16-27. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3521801

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Anesthetic management of the high-risk pregnancy. Author(s): Alper MH, Roaf ER. Source: Clinical Obstetrics and Gynecology. 1973 March; 16(1): 347-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4709557

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Anesthetic management of the high-risk pregnancy: consequences for the newborn. Author(s): Scanlon JW. Source: Clinical Obstetrics and Gynecology. 1981 June; 24(2): 671-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7307376

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Antepartum assessment in high-risk pregnancy. Author(s): Jones MB. Source: Jogn Nurs. 1975 November-December; 4(6): 23-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=811916

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Antepartum measurement of the preejection period in high-risk pregnancy. Author(s): Sampson MB. Source: Obstetrics and Gynecology. 1980 September; 56(3): 289-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7422166

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Antithrombotic therapy in high-risk pregnancy. Author(s): Heilmann L, Schneider DM, von Tempelhoff GF. Source: Hematology/Oncology Clinics of North America. 2000 October; 14(5): 1133-50, Ix. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11005038

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Assessment of antepartum cardiotocograms in high-risk pregnancy. Author(s): Keirse MJ, Trimbos JB. Source: British Journal of Obstetrics and Gynaecology. 1980 April; 87(4): 261-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7426494

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Asymptomatic bacteriuria in normal and high-risk pregnancy. Author(s): Golan A, Wexler S, Amit A, Gordon D, David MP. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1989 November; 33(2): 101-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2583335

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Bed rest and high-risk pregnancy. Differentiating the effects of diagnosis, setting, and treatment. Author(s): Maloni JA. Source: Nurs Clin North Am. 1996 June; 31(2): 313-25. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8637808

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Benchmarking patient relations within ambulatory care: lessons from a high-risk pregnancy program. Author(s): Smith HL, Piland NF, Burchell RC. Source: The Journal of Ambulatory Care Management. 1999 July; 22(3): 58-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11184881

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Blood velocity in the fetal vein of Galen and the outcome of high-risk pregnancy. Author(s): Dubiel M, Breborowicz GH, Laurini R, Gudmundsson S. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2001 November; 99(1): 14-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11604180

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Case report of ECT during high-risk pregnancy. Author(s): Wise MG, Ward SC, Townsend-Parchman W, Gilstrap LC 3rd, Hauth JC. Source: The American Journal of Psychiatry. 1984 January; 141(1): 99-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6691474

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Clinical application of Hobel's high-risk pregnancy scoring system. Author(s): Tei A, Oiyama H, Okawa S, Saito M. Source: Bull Tokyo Med Dent Univ. 1989 March; 35(4): 81-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2784723

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Colpocytograms and maternal serum placental cystine aminopeptidase, tissue cystine aminopeptidase, alkaline phosphatase and heat stable alkaline phosphatase activity in monitoring the last four weeks before delivery in high-risk pregnancy. Author(s): Stanek J. Source: Acta Cytol. 1977 March-April; 21(2): 229-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=266333

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Combined sonographic and biochemical estimation of fetal maturity in high-risk pregnancy. Author(s): Hamilton LA Jr, Szujewski PF, Patel MK. Source: Obstetrics and Gynecology. 1973 June; 41(6): 837-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4575304

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Comparison of power Doppler and velocimetry in predicting outcome of high-risk pregnancy. Author(s): Dubiel M, Dobek A, Breborowicz G, Marsal K, Gudmundsson S. Source: European Journal of Ultrasound : Official Journal of the European Federation of Societies for Ultrasound in Medicine and Biology. 2001 March; 12(3): 197-202. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11423243

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Cost containment in high-risk pregnancy. Author(s): Cecil LM. Source: Tex Med. 1979 January; 75(1): 83-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=425047

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Cost effectiveness of a high-risk pregnancy program. Author(s): Alexander JW, Mackey MC. Source: Care Manag J. 1999 Summer; 1(3): 170-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10695173

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Detecting the high-risk pregnancy. Author(s): Cudmore DW. Source: Primary Care. 1977 June; 4(2): 311-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=586722

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Determination of fetal lung maturity from amniotic fluid microviscosity in high-risk pregnancy. Author(s): Barkai G, Mashiach S, Lanzer D, Kayam Z, Brish M, Goldman B. Source: Obstetrics and Gynecology. 1982 May; 59(5): 615-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7070735

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Domiciliary midwifery support in high-risk pregnancy incorporating telephonic fetal heart rate monitoring: a health technology randomized assessment. Author(s): Dawson A, Cohen D, Candelier C, Jones G, Sanders J, Thompson A, Arnall C, Coles E. Source: Journal of Telemedicine and Telecare. 1999; 5(4): 220-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10829372

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Electroconvulsive therapy during high-risk pregnancy. Author(s): Walker R, Swartz CM. Source: General Hospital Psychiatry. 1994 September; 16(5): 348-53. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7995506

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Erythrocyte filterability in normal and high-risk pregnancy. Author(s): Rodgers BD, Hreshchyshyn MM, Lee RV, Rodgers D, Ambrus CM. Source: Obstetrics and Gynecology. 1988 February; 71(2): 192-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3336555

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Estrogen assessments in the high-risk pregnancy. Author(s): Lundy LE, Wu CH, Lee SG. Source: Clinical Obstetrics and Gynecology. 1973 March; 16(1): 279-97. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4575531

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Estrogen excretion in high-risk pregnancy. A comparison of two assay procedures. Author(s): Sims FH, Giesbrecht E, Taylor J. Source: American Journal of Clinical Pathology. 1974 December; 62(6): 759-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4432833

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Expectant fathers' response to pregnancy: review of literature and implications for research in high-risk pregnancy. Author(s): Conner GK, Denson V. Source: The Journal of Perinatal & Neonatal Nursing. 1990 September; 4(2): 33-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2391646

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Fetal adrenal and middle cerebral artery Doppler velocimetry in high-risk pregnancy. Author(s): Dubiel M, Breborowicz GH, Marsal K, Gudmundsson S. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2000 October; 16(5): 414-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11169324

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Fetal and placental power Doppler imaging in normal and high-risk pregnancy. Author(s): Dubiel M, Kozber H, Debniak B, Breborowicz GH, Marsal K, Gudmundsson S. Source: European Journal of Ultrasound : Official Journal of the European Federation of Societies for Ultrasound in Medicine and Biology. 1999 July; 9(3): 223-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10657597

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Fetal heart rate acceleration: fetal movement ratio in the management of high-risk pregnancy. Author(s): Arias JW, Saldana LR, Rivera-Alsina M, Ali V. Source: Obstetrics and Gynecology. 1982 October; 60(4): 427-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7121928

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Fetal monitoring in high-risk pregnancy. Author(s): McCrann DJ Jr, Schifrin BS. Source: Clin Perinatol. 1974 September; 1(2): 229-52. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4470056

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Fetal monitoring in high-risk pregnancy. Author(s): Tchilinguirian NG. Source: Clinical Obstetrics and Gynecology. 1973 March; 16(1): 329-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4709556

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Fetal movement monitoring in normal and high-risk pregnancy. Author(s): Ehrstrom C. Source: Acta Obstetricia Et Gynecologica Scandinavica. Supplement. 1979; 80: 1-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=283683

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Fetal superior mesenteric artery blood flow velocimetry in normal and high-risk pregnancy. Author(s): Korszun P, Dubiel M, Breborowicz G, Danska A, Gudmundsson S. Source: Journal of Perinatal Medicine. 2002; 30(3): 235-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12122906

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Foetal outcome in primarily high-risk pregnancy. Author(s): Pal SK, Chakravarty BN, Bhattacharjee SK. Source: J Indian Med Assoc. 1979 April 1; 72(7): 153-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=512389

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Gestational meconium in the high-risk pregnancy. Author(s): Mandelbaum B. Source: Obstetrics and Gynecology. 1973 July; 42(1): 87-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4198270

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High-risk pregnancy and neonatal care. Author(s): O'Brien P. Source: Critical Care Nursing Clinics of North America. 1998 September; 10(3): 347-55. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9855897

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High-risk pregnancy in beta-thalassemia major women. Report of three cases. Author(s): Perniola R, Magliari F, Rosatelli MC, De Marzi CA. Source: Gynecologic and Obstetric Investigation. 2000; 49(2): 137-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10671824

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High-risk pregnancy screening techniques: a nursing overview. Author(s): Diamond F. Source: Jogn Nurs. 1978 November-December; 7(6): 15-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=252550

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High-risk pregnancy. Author(s): Pearse WH. Source: J Am Med Womens Assoc. 1968 July; 23(7): 609-14. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4247127

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High-risk pregnancy. Identification and monitoring to improve outcome. Author(s): Field CS. Source: Postgraduate Medicine. 1984 September 15; 76(4): 35-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6473224

Studies

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High-risk pregnancy. Unresolved problems of screening, management, and prognosis. Author(s): Lesinski. Source: Obstetrics and Gynecology. 1975 November; 46(5): 599-603. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1196567

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High-risk pregnancy: graphic representation of the maternal and fetal risks. Author(s): Leon J. Source: American Journal of Obstetrics and Gynecology. 1973 October 15; 117(4): 497504. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4743356

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High-risk pregnancy: hypertensive disorders. Author(s): Coleman S. Source: Home Care Provider. 2001 February; 6(1): 12-3, 17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11174323

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High-risk pregnancy: postpartum rehospitalization. Author(s): Hamilton MS, Brooten D, Youngblut JM. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2002 October-November; 22(7): 566-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12368974

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Hormone assays in diagnosis of high-risk pregnancy. Author(s): White P. Source: Postgraduate Medicine. 1976 June; 59(6): 121-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=934952

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Human choriogonadotropin (hCG): comparisons between determinations of intact hCG, free hCG beta-subunit, and "total" hCG + beta in serum during the first half of high-risk pregnancy. Author(s): Thomas CM, Reijnders FJ, Segers MF, Doesburg WH, Rolland R. Source: Clinical Chemistry. 1990 April; 36(4): 651-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1691055

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Human placental lactogen and the management of high-risk pregnancy. Author(s): Zuckerman JE. Source: Lancet. 1973 January 27; 1(7796): 200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4118810

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Human placental lactogen in high-risk pregnancy. Author(s): Spellacy WN. Source: Clinical Obstetrics and Gynecology. 1973 March; 16(1): 298-312. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4196839

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Human placental lactogen in the monitoring of high-risk pregnancy. Author(s): Chard T. Source: Ric Clin Lab. 1982 January-March; 12(1): 207-20. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6806885

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Identification and evaluation of high-risk pregnancy: the perinatal concept. Author(s): Aubry RH, Pennington JC. Source: Clinical Obstetrics and Gynecology. 1973 March; 16(1): 3-27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4709558

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Identification of high-risk pregnancy by the routine measurement of pregnancyspecific beta 1-glycoprotein. Author(s): Grudzinskas JG, Gordon YB, Menabawey M, Lee JN, Wadsworth J, Chard T. Source: American Journal of Obstetrics and Gynecology. 1983 September 1; 147(1): 10-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6604456

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Identification of the high-risk pregnancy. Author(s): Giles HR. Source: Ariz Med. 1974 November; 31(11): 839-40. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4441302

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Incidence of anti-Toxoplasma antibodies in women with high-risk pregnancy and habitual abortions. Author(s): Galvan Ramirez M de la L, Soto Mancilla JL, Velasco Castrejon O, Perez Medina R. Source: Revista Da Sociedade Brasileira De Medicina Tropical. 1995 October-December; 28(4): 333-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8668832

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Induction of labor in the high-risk pregnancy with PGF 2 alpha. Author(s): O'Sullivan MJ, Stone ML, Gugliucci CL, Shah G, Stephens ML. Source: Obstetrics and Gynecology. 1978 January; 51(1): 77-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=619341

Studies

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Left-handedness and high-risk pregnancy. Author(s): Schwartz M. Source: Neuropsychologia. 1977; 15(2): 341-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=557751

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Letter: High-risk pregnancy. Author(s): Copans SA. Source: Jama : the Journal of the American Medical Association. 1974 December 4; 230(10): 1389. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4479640

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Management of high-risk pregnancy: report of a combined obstetrical and neonatal intensive care unit. Author(s): Effer SB. Source: Can Med Assoc J. 1969 October 4; 101(7): 55-63. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5344991

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Maternal adjustment and infant outcome in medically defined high-risk pregnancy. Author(s): Levy-Shiff R, Lerman M, Har-Even D, Hod M. Source: Developmental Psychology. 2002 January; 38(1): 93-103. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11806705

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Maternal death and high-risk pregnancy: an analysis of 40 maternal deaths in the collaborative project. Author(s): Marmol JG, Vollman RF, Gordon M, Patterson SP, Reid WA. Source: Obstetrics and Gynecology. 1967 December; 30(6): 816-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6061831

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Maternal self-esteem and prenatal attachment in high-risk pregnancy. Author(s): Kemp VH, Page C. Source: Matern Child Nurs J. 1987 Fall; 16(3): 195-206. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3441145

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Maternal serum unconjugated estriol and urine estriol concentrations in normal and high-risk pregnancy. Author(s): Miller CA, Fetter MC, Boguslaski RC, Heiser EW. Source: Obstetrics and Gynecology. 1977 March; 49(3): 287-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=840456

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Maternal steroid sulfatase deficiency--cause of high-risk pregnancy? Author(s): Rizk DE, Johansen KA. Source: American Journal of Obstetrics and Gynecology. 1994 August; 171(2): 566-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8059846

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Monitoring of high-risk pregnancy. Author(s): Svigos J. Source: Australas Nurses J. 1977 May; 6(10): 22-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=587651

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Multiple pregnancy as a high-risk pregnancy. Medical statistical data from the German Democratic Republic. Author(s): Leetz I. Source: Acta Genet Med Gemellol (Roma). 1974; 22 Suppl: 3-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4440421

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Nonspecific decelerations in fetal heart rate during high-risk pregnancy. Author(s): Trimbos JB, Keirse MJ. Source: British Journal of Obstetrics and Gynaecology. 1977 October; 84(10): 732-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=921908

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Nonstress test: evidence-based use in high-risk pregnancy. Author(s): Devoe LD, Jones CR. Source: Clinical Obstetrics and Gynecology. 2002 December; 45(4): 986-92. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12438876

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Oral prostaglandin E2 for labor induction in high-risk pregnancy. Author(s): Cunningham FG, Cox K, Hauth JC, Strong JD, Whalley PJ. Source: American Journal of Obstetrics and Gynecology. 1976 August 1; 125(7): 881-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=941942

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Oxytocin challenge test in high-risk pregnancy. Author(s): Farahani G, Vasudeva K, Petrie R, Fenton AN. Source: Obstetrics and Gynecology. 1976 February; 47(2): 159-68. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1250537

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Parental evaluation of a tour of the neonatal intensive care unit during a high-risk pregnancy. Author(s): Griffin T, Kavanaugh K, Soto CF, White M. Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing : Jognn / Naacog. 1997 January-February; 26(1): 59-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9017548

Studies

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Perinatal mortality and maternal mortality in General Hospital, Ondo, Nigeria use of high-risk pregnancy predictive scoring index. Author(s): Sogbanmu MO. Source: Niger Med J. 1979 April; 9(4): 475-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=539118

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Perinatal mortality and maternal mortality in General Hospital, Ondo, Nigeria. Use of high-risk pregnancy predictive scoring index. Author(s): Sogbanmu MO. Source: Niger Med J. 1979 January; 9(1): 123-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=463324

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Placental grading in the complicated or high-risk pregnancy. Author(s): Clair MR, Rosenberg E, Tempkin D, Andreotti RF, Bowie JD. Source: Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine. 1983 July; 2(7): 297-301. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6864874

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Plasma unconjugated estriol values in high-risk pregnancy. Author(s): Bashore RA, Westlake JR. Source: American Journal of Obstetrics and Gynecology. 1977 June 15; 128(4): 371-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=868934

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Possible acceleration of neurological maturation following high-risk pregnancy. Author(s): Amiel-Tison C. Source: American Journal of Obstetrics and Gynecology. 1980 October 1; 138(3): 303-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7416222

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Practical management of high-risk pregnancy. Author(s): Hume OS. Source: Tex Med. 1975 July; 71(7): 53-61. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1154296

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Predictive value of antepartum fetal heart rate non-stress test in high-risk pregnancy. Author(s): Lenstrup C, Haase N. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1985; 64(2): 133-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3984690

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Profile of phospholipids in amniotic fluid to assess fetal lung maturity in high-risk pregnancy. Author(s): Mariona FG, Yee H, Espy MJ. Source: Southern Medical Journal. 1983 February; 76(2): 166-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6823591

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Prophylactic use of danaparoid in high-risk pregnancy with heparin-induced thrombocytopaenia-positive skin reaction. Author(s): Myers B, Westby J, Strong J. Source: Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis. 2003 July; 14(5): 485-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12851535

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Psychiatric aspects of high-risk pregnancy. Author(s): Wohlreich MM. Source: The Psychiatric Clinics of North America. 1987 March; 10(1): 53-68. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3575161

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Psychiatric disorders in high-risk pregnancy. Author(s): Powers PS, Johnson T, Knuppel R, Cupoli JM, Achenbach KE. Source: Comprehensive Psychiatry. 1986 March-April; 27(2): 159-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3956196

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Psychologic implications in high-risk pregnancy. Author(s): Penticuff JH. Source: Nurs Clin North Am. 1982 March; 17(1): 69-78. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6919029

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Psychosocial impact of high-risk pregnancy: hospital and home care. Author(s): Heaman M. Source: Clinical Obstetrics and Gynecology. 1998 September; 41(3): 626-39. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9742359

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Psychosocial support during high-risk pregnancy. Author(s): Runkle GP, Ellis DD, Nusbaum MR. Source: The New England Journal of Medicine. 1993 March 25; 328(12): 887; Author Reply 888. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8499021

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Psychosocial support during high-risk pregnancy. Author(s): Madwed MP. Source: The New England Journal of Medicine. 1993 March 25; 328(12): 887-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8441441

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Psychosocial support during high-risk pregnancy. Author(s): Sehn SC. Source: The New England Journal of Medicine. 1993 March 25; 328(12): 887; Author Reply 888. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8441440

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Psychosocial support during high-risk pregnancy. Author(s): Reite M, Boccia M. Source: The New England Journal of Medicine. 1993 March 25; 328(12): 887; Author Reply 888. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8441439

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Risk pregnancy screening: a simple method for non physicians to screen the high-risk pregnancy. Author(s): Sirivongs B, Parisunyakul S. Source: J Med Assoc Thai. 1984 October; 67 Suppl 2: 15-21. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6512454

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Selective delivery in high-risk pregnancy. Author(s): Horger EO 3rd, Keane MW, Miller JM. Source: Southern Medical Journal. 1981 June; 74(6): 688-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7244748

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Serum deoxycytidylate deaminase as an index of high-risk pregnancy. Author(s): Williams GF, Jones DD. Source: British Journal of Obstetrics and Gynaecology. 1982 April; 89(4): 309-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7073998

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Social support during high-risk pregnancy: does it help? Author(s): Hodnett E. Source: Birth (Berkeley, Calif.). 1993 December; 20(4): 218-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8110313

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Spectral analysis as a diagnostic aid in the management of high-risk pregnancy. Author(s): Chess GF, La Bell KS, Milne JK, Calaresu FR. Source: American Journal of Obstetrics and Gynecology. 1975 February 15; 121(4): 471-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1146874

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Staff evaluation of a high-risk pregnancy program. Author(s): Mackey MC, Sobral M. Source: Public Health Nursing (Boston, Mass.). 1997 April; 14(2): 101-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9109320

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Stress and social support in high-risk pregnancy. Author(s): Kemp VH, Hatmaker DD. Source: Research in Nursing & Health. 1989 October; 12(5): 331-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2798954

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Stress factors related to antenatal testing during high-risk pregnancy. Author(s): Hoffman NS. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 1990 June; 10(2): 195-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2358907

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Supporting family functioning during a high-risk pregnancy. Author(s): Stainton MC. Source: Mcn. the American Journal of Maternal Child Nursing. 1994 January-February; 19(1): 24-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8201858

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Surrogate motherhood in the case of high-risk pregnancy. Author(s): Clark ED, Silverman Z. Source: J Halacha Contemporary Society. 1999 September; No. 38: 5-38. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11657892

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Telemedicine: cost-effective management of high-risk pregnancy. Author(s): Morrison J, Bergauer NK, Jacques D, Coleman SK, Stanziano GJ. Source: Manag Care. 2001 November; 10(11): 42-6, 48-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11761593

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The development of an index of high-risk pregnancy. Author(s): Fortney JA, Whitehorne EW. Source: American Journal of Obstetrics and Gynecology. 1982 July 1; 143(5): 501-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7091220

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The evaluation of continuous fetal heart rate monitoring in high-risk pregnancy. Author(s): Haverkamp AD, Thompson HE, McFee JG, Cetrulo C. Source: American Journal of Obstetrics and Gynecology. 1976 June 1; 125(3): 310-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5895

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The experience of high-risk pregnancy. Author(s): McCain GC, Deatrick JA. Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing : Jognn / Naacog. 1994 June; 23(5): 421-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8083783

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The influence of telephonic nursing care coordination on patient satisfaction in a predominantly low-income, high-risk pregnancy population. Author(s): Little M, Saul G, Testa K, Gaziano C. Source: Lippincott's Case Management : Managing the Process of Patient Care. 2002 January-February; 7(1): 15-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11840054

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The management of high-risk pregnancy. Author(s): Pearson JW. Source: Jama : the Journal of the American Medical Association. 1974 September 9; 229(11): 1439-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4408384

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The monitoring of high-risk pregnancy by non-stressed antepartum cardiotocography. Author(s): Kulkarni S, Matadial L. Source: The West Indian Medical Journal. 1985 September; 34(3): 190-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4072183

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The oxytocin challenge test, plasma estriol, and human placental lactogen values in high-risk pregnancy. Author(s): Bashore RA, Staisch KJ, Westlake JR. Source: Trans Pac Coast Obstet Gynecol Soc. 1979; 46: 13-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=542969

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The psychosocial impact of a high-risk pregnancy on the family. Author(s): Kemp VH, Page CK. Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing : Jognn / Naacog. 1986 May-June; 15(3): 232-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3635593

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The use of sonography in the evaluation of the high-risk pregnancy. Author(s): Manning FA. Source: Radiologic Clinics of North America. 1990 January; 28(1): 205-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2404302

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The use of urinary estriol excretion studies in the assessment of the high-risk pregnancy. Author(s): Greene JW Jr, Beargie RA. Source: Pediatric Clinics of North America. 1970 February; 17(1): 43-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5419108

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The value of antenatal cardiotocography in the management of high-risk pregnancy: a randomized controlled trial. Author(s): Brown VA, Sawers RS, Parsons RJ, Duncan SL, Cooke ID. Source: British Journal of Obstetrics and Gynaecology. 1982 September; 89(9): 716-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7052117

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The value of biochemical estimations on amniotic fluid in management of the highrisk pregnancy. Author(s): Merkatz IR, Aladjem S, Little B. Source: Clin Perinatol. 1974 September; 1(2): 301-19. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4620152

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The West Los Angeles Preterm Birth Prevention Project: II. Cost-effectiveness analysis of high-risk pregnancy interventions. Author(s): Ross MG, Sandhu M, Bemis R, Nessim S, Bragonier JR, Hobel C. Source: Obstetrics and Gynecology. 1994 April; 83(4): 506-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8134058

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Two types of umbilical venous pulsations and outcome of high-risk pregnancy. Author(s): Hofstaetter C, Dubiel M, Gudmundsson S. Source: Early Human Development. 2001 March; 61(2): 111-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11223273

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Umbilical artery flow velocity waveforms in high-risk pregnancy. Randomised controlled trial. Author(s): Trudinger BJ, Cook CM, Giles WB, Connelly A, Thompson RS. Source: Lancet. 1987 January 24; 1(8526): 188-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2880017

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Uncertainty and stress in women hospitalized with high-risk pregnancy. Author(s): Clauson MI. Source: Clinical Nursing Research. 1996 August; 5(3): 309-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8850774

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Urinary estriol excretion in high-risk pregnancy. Author(s): Courey NG, Stull RL, Fisher BN, Stull CG, Lundstrom P. Source: Obstetrics and Gynecology. 1969 October; 34(4): 523-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5822678

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Use of Doppler ultrasound in the high-risk pregnancy. Author(s): Trudinger BJ, Ishikawa K. Source: Clin Diagn Ultrasound. 1990; 26: 119-37. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2182086

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Use of urinary estriol determinations in high-risk pregnancy in the community hospital. Author(s): Hoag RW. Source: American Journal of Obstetrics and Gynecology. 1971 May 15; 110(2): 203-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5574624

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Use of urinary estriol determinations in high-risk pregnancy in the community hospital. Author(s): Hoag RW. Source: Trans Pac Coast Obstet Gynecol Soc. 1970; 38: 82-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5522654

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Value of observation of fetal breathing activity in antenatal assessment of high-risk pregnancy. Author(s): Devoe LD, Ruedrich DA, Searle NS. Source: American Journal of Obstetrics and Gynecology. 1989 January; 160(1): 166-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2519510

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What maternal mortality statistics tell us: high-risk pregnancy, a consequence of medical progress. Author(s): Lee RV. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2003 September; 23(5): 532-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12963515

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Women's experience of bed rest in high-risk pregnancy. Author(s): Schroeder CA. Source: Image--The Journal of Nursing Scholarship. 1996 Fall; 28(3): 253-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8854548

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Women's satisfaction with their involvement in health care decisions during a highrisk pregnancy. Author(s): Harrison MJ, Kushner KE, Benzies K, Rempel G, Kimak C. Source: Birth (Berkeley, Calif.). 2003 June; 30(2): 109-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12752168

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CHAPTER 2. ALTERNATIVE MEDICINE AND HIGH-RISK PREGNANCY Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to high-risk pregnancy. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to high-risk pregnancy and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “high-risk pregnancy” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to high-risk pregnancy: •

A randomised double blind placebo controlled trial of fish oil in high risk pregnancy. Author(s): Onwude JL, Lilford RJ, Hjartardottir H, Staines A, Tuffnell D. Source: British Journal of Obstetrics and Gynaecology. 1995 February; 102(2): 95-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7756226

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Antepartum fetal surveillance. Nonstress test, contraction stress test, and biophysical profile. Author(s): Babbitt NE. Source: S D J Med. 1996 November; 49(11): 403-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8973133

•

Antepartum support group for women hospitalized on bed rest. Author(s): Maloni JA, Kutil RM.

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Source: Mcn. the American Journal of Maternal Child Nursing. 2000 July-August; 25(4): 204-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10994310 •

Are we losing the art of midwifery? Author(s): Jacobson AK. Source: Journal of Nurse-Midwifery. 1993 May-June; 38(3): 168-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8331428

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Assessing and identifying the high-risk pregnancy: a holistic approach. Author(s): Sherwen LN, Mele NC. Source: Top Clin Nurs. 1986 April; 8(1): 33-44. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3634540

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Band-aid midwifery. Author(s): Jonquil SG. Source: Midwifery Today Int Midwife. 1998 Spring; (45): 15-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10338600

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Clinical application of Medical Resonance Therapy Music in high-risk pregnancies. Author(s): Sidorenko VN. Source: Integrative Physiological and Behavioral Science : the Official Journal of the Pavlovian Society. 2000 July-September; 35(3): 199-207. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11286372

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Coping and distress in pregnancy: an investigation of medically high risk women. Author(s): Yali AM, Lobel M. Source: Journal of Psychosomatic Obstetrics and Gynaecology. 1999 March; 20(1): 39-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10212886

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Fetal acoustic stimulation for early intrapartum assessment of fetal well-being. Author(s): Chittacharoen A, Chaitum A, Suthutvoravut S, Herabutya Y. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2000 June; 69(3): 275-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10854872

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Fetal biophysical profile and vibratory acoustic stimulation in high-risk pregnancies. Author(s): Petrovic O, Frkovic A, Matejcic N. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1995 July; 50(1): 11-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7556853

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Fetal startle response observed under ultrasonography: a good predictor of a reassuring biophysical profile. Author(s): Sarinoglu C, Dell J, Mercer BM, Sibai BM. Source: Obstetrics and Gynecology. 1996 October; 88(4 Pt 1): 599-602. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8841226

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High-risk pregnancy: preterm labor. Author(s): Coleman S. Source: Home Care Provider. 2001 April; 6(2): 50-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11295682

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Magnesium supplementation in pregnancy. Author(s): Makrides M, Crowther CA. Source: Cochrane Database Syst Rev. 2001; (4): Cd000937. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11687087

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Management of brain metastases in patients with high-risk gestational trophoblastic tumors. Author(s): Newlands ES, Holden L, Seckl MJ, McNeish I, Strickland S, Rustin GJ. Source: J Reprod Med. 2002 June; 47(6): 465-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12092015

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Maternal health, war, and religious tradition: authoritative knowledge in Pujehun District, Sierra Leone. Author(s): Jambai A, MacCormack C. Source: Medical Anthropology Quarterly. 1996 June; 10(2): 270-86. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8744087

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Notes on health care and traditional birth attendants in the region of Yogyakarta, Indonesia. Author(s): Cobb AK. Source: Kans Nurse. 1983 November-December; 58(8): 17-8, 28. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6558256

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Parenting and supportive programs. Author(s): Ladden M, Damato E. Source: Naacogs Clin Issu Perinat Womens Health Nurs. 1992; 3(1): 174-87. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1562443

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Pregnancy following gastric bypass for morbid obesity. Author(s): Wittgrove AC, Jester L, Wittgrove P, Clark GW.

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Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1998 August; 8(4): 461-4; Discussion 465-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9731683 •

Prevention of preeclampsia with calcium supplementation and vitamin D3 in an antenatal protocol. Author(s): Ito M, Koyama H, Ohshige A, Maeda T, Yoshimura T, Okamura H. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1994 November; 47(2): 115-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7843479

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Primary care in Cuba: a public health approach. Author(s): Swanson KA, Swanson JM, Gill AE, Walter C. Source: Health Care for Women International. 1995 July-August; 16(4): 299-308. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7649887

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Randomised clinical trials of fish oil supplementation in high risk pregnancies. Fish Oil Trials In Pregnancy (FOTIP) Team. Author(s): Olsen SF, Secher NJ, Tabor A, Weber T, Walker JJ, Gluud C. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2000 March; 107(3): 382-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10740336

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She's having a baby? Author(s): Silbiger D. Source: Posit Aware. 1997 November-December; 8(6): 34-7, 39. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11364859

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Should assessment of amniotic fluid volume form an integral part of antenatal fetal surveillance of high risk pregnancy? Author(s): Anandakumar C, Biswas A, Arulkumaran S, Wong YC, Malarvishy G, Ratnam SS. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 1993 August; 33(3): 272-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8304891

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The “virtual focus group”: using the Internet to reach pregnant women on home bed rest. Author(s): Adler CL, Zarchin YR.

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Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing : Jognn / Naacog. 2002 July-August; 31(4): 418-27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12146931 •

The effect of antenatal steroid administration on the fetal response to vibroacoustic stimulation. Author(s): Rotmensch S, Celentano C, Liberati M, Sadan O, Glezerman M. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1999 November; 78(10): 847-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10577612

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The effect of zinc supplementation on pregnancy outcome. Author(s): Goldenberg RL, Tamura T, Neggers Y, Copper RL, Johnston KE, DuBard MB, Hauth JC. Source: Jama : the Journal of the American Medical Association. 1995 August 9; 274(6): 463-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7629954

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The utero-placental circulation, eugenics and the prevention and treatment of high risk pregnancies. Author(s): Wu XR, Li Y, Yang DS, Han BJ, Si YZ, Shan ZZ, Ma TY, Wen LZ, Sun YP, Huang YP, et al. Source: J Tongji Med Univ. 1994; 14(1): 1-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7877185

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Vibroacoustic stimulation for risk assessment. Author(s): Smith CV. Source: Clin Perinatol. 1994 December; 21(4): 797-808. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7882644

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMDHealth: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 3. BOOKS ON HIGH-RISK PREGNANCY Overview This chapter provides bibliographic book references relating to high-risk pregnancy. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on high-risk pregnancy include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “high-risk pregnancy” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on high-risk pregnancy: •

Medicaid managed care and reproductive health care for women: Ob-Gyns workings with states to shape health policy Source: Washington, DC: Committee on Health Care for Underserved Women, American College of Obstetricians and Gynecologists. 2002. 68 pp. Contact: Available from American College of Obstetricians and Gynecologists, 409 12th Street, S.W, Washington, DC 20024-2188. Telephone: (202) 638-5577 or (202) 863-2518 Reference Desk / e-mail: [email protected] / Web site: http://www.acog.org. Contact for cost information. Summary: This book is about reproductive and health care services available to women through Medicaid managed care. Topics include a brief overview of Medicaid and Medicaid managed care; enrollment issues for women of childbearing age, including recent legislation impacting low income groups; gynecologic and obstetric care; family

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planning services and access issues; provider issues; adolescent reproductive health services; obstetric case management; and high-risk pregnancy. Reference and a glossary are provided. Four appendices provide information on select provisions of the Balanced Budget Act pertaining to enrollment; a proposal for universal access to maternity care called U.S. MaternaCare; an educational bulletin from the American College of Obstetricians and Gynecologists (ACOG) focusing on psychosocial risk factors: perinatal screening and intervention; and sample patient history intake and medical forms. [Funded in part by the Maternal and Child Health Bureau]. •

Trying Again: A Guide to Pregnancy After Miscarriage, Stillbirth, and Infant Loss Source: Lanham, MD: Taylor Trade Publishing/Rowman and Littlefield Publishing Group. 2000. 321 p. Contact: Available from Taylor Trade Publishing/Rowman and Littlefield Publishing Group, 4720 Boston Way, Lanham, MD 20706. (301) 459-3366, (800) 462-6420 (orders and customer service), (800) 338-4550 (Fax), [email protected] (E-mail), http://www.rlpgbooks.com (Web Site). $16.95. ISBN 0-87833-182-4. Summary: This book is intended to give women and their partners the information and reassurance they need to withstand the physical and emotional difficulties of a high-risk subsequent pregnancy. The book focuses on the kinds of issues that are of primary concern to couples who are embarking on pregnancy after miscarriage, stillbirth, or infant death. The following topics are covered: risk factors for and causes of ectopic pregnancy, molar pregnancy, miscarriage, recurrent miscarriage, and stillbirth; tests that can determine the causes of miscarriage, recurrent miscarriage, and stillbirth; the 10 leading causes of infant death; emotional and physical factors involved in a couple's decision to attempt another pregnancy; preparing for another pregnancy, including having a preconception health checkup; how one's reproductive history will affect the next pregnancy; determining whether a couple is a good candidate for genetic counseling; what couples can do to increase their odds of conceiving quickly; how couples can tell if they have a fertility problem; the challenges of coping with infertility after pregnancy loss or infant death; the emotions a couple may experience when the pregnancy test comes back positive; components of a healthy lifestyle and what pregnant women can do to ensure the healthiest possible baby; the pros and cons of prenatal testing; coping with the unique physical and emotional challenges of a highrisk pregnancy; chronic conditions in the mother that can put the pregnancy at risk; problems that can occur during a multiple pregnancy; preparing for the birth by taking prenatal classes, writing a birth plan, and hiring a doula; pain relief options during labor; the signs of labor and the three stages of labor; what to expect during a cesarean delivery; and how to survive the emotional highs and lows that can occur after birth. The more than 100 parents who were interviewed for this book answered a series of questionnaires that focused on every aspect of pregnancy after a loss: how they decided it was time to start trying to conceive again, how they maintained their sanity when they didn't conceive as quickly as they wanted, whether they stayed with the same physician or midwife they had worked with in the past, whether they went through prenatal testing, how they coped with their fear that something also would happen to this baby, and what they did to prepare themselves for the upcoming birth. Appendixes contain a table of infant deaths and infant mortality rates for the year 1997, a directory of relevant organizations in the United States and Canada, and a directory of internet resources. Numerous references.

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Pregnancy After a Loss: A Guide to Pregnancy After a Miscarriage, Stillbirth, or Infant Death Source: New York, NY: Berkley Books/Penguin Putnam, Inc. 1999. 391 p. Contact: Available from Berkley Books/Penguin Putnam, Inc., 375 Hudson Street, New York, NY 10014. (800) 788-6262 (orders), (800) 631-8571 (customer service hotline), (800) 227-9604 (Fax), [email protected] (E-mail), http://www.penguinputnam.com (Web Site). $14.95. ISBN 0-425-17047-0. Summary: This book, written by a woman who lost her son, Patrick, to an umbilical cord problem on her due date, is designed to give hope and practical information to other women who have suffered a pregnancy loss. The author interviewed nearly 100 women while writing this book, all of whom made it through pregnancy after a loss and now have one or more healthy babies. The book focuses on the feelings that are unique to women who have suffered a pregnancy loss, and provides advice on reducing anxiety. Medical aspects of pregnancy loss are described in simple, straightforward language. Chapter 1 takes readers down the road that a bereaved mother would travel to find out why her baby died. This chapter covers the followup visit with the obstetrician, which is when the parents discuss the autopsy and any genetic testing that was done on the baby. If these do not provide an answer, the doctor may suggest that the mother be tested for autoimmune disorders, uterine abnormalities, genetic disorders, viral and bacterial infections, and hormone imbalances. Other common reasons for pregnancy loss are described (i.e., neural tube defects, placental problems, umbilical cord problems, incompetent cervix, and maternal illness) as are common reasons for early infant death: congenital problems, streptococcus infection, and sudden infant death syndrome. Chapter 2 discusses the subject of getting ready to get pregnant again, both physically and emotionally. This chapter covers the advantages and disadvantages of getting pregnant right away, factors that will affect one's decision to get pregnant, when partners disagree on the timing of another pregnancy, and where to find support and guidance during the decision-making process. Even if a woman has waited 6 months or a year to get pregnant again, there are certain things she should do to prepare for the pregnancy. Mothers to be should get a thorough physical exam; get into shape; take folic acid; keep track of her periods; and avoid drugs, alcohol, and cigarettes. This chapter also covers the pros and cons of choosing a new doctor or staying with the old one, questions one should ask each doctor under consideration, the stress of not getting pregnant right away, infertility problems and treatment, and when the pregnancy is a surprise. Chapter 4 focuses on the first trimester of a new pregnancy, including concerns over telling others about the pregnancy, suggestions for alleviating the anxiety, what to expect during the prenatal visits, tests one can have done at this time, and the signs of an impending miscarriage. Chapter 5 focuses on the second trimester, including concerns about answering awkward questions, the gender of the baby, delivering too early, exercising, and sexual intercourse. Feelings that may be common during this trimester are panic over the baby's movements, reluctance to bond with the baby, anxiety about surpassing the anniversary of the previous baby's death, superstitions about the pregnancy, and fear. Prenatal tests that can be offered at this time and symptoms that are not normal during the second trimester also are covered. Chapter 6 examines the concerns mothers are likely to have during the third trimester regarding early delivery, setting up the nursery, baby shower offers, choosing a name, and excessive weight gain. Feelings that may be common during this time include obsession over the baby's movements, constant worry, and being annoyed by unsolicited advice. Tips for alleviating the anxiety include taking a prepared childbirth class, writing a birth plan, getting a doula, calling the doctor frequently, insisting on frequent prenatal visits,

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eliminating unnecessary stress, and practicing relaxation techniques. The nature of prenatal visits during the third trimester, tests that are usually done at this time, monitoring the baby's kicks, and danger signals in late pregnancy also are discussed. Chapter 7 deals with the truly high-risk pregnancy. Common reasons for high-risk status are a history of preterm labor or delivery, incompetent cervix, impending multiple birth, history of placental problems, history of two or more miscarriages, genetic problems, chronic medical conditions, and pregnancy after age 35. Bed rest is a commonly prescribed treatment in high-risk pregnancies. This chapter provides suggestions for surviving extended bed rest as well as a chart of activities to help mothers and their OB/GYNs mutually define what she can and can't do. Other topics that are discussed include hospitalization, the impact of that and bed rest on family and career, selective reduction in cases of multiples, feelings that are common among mothers during bed rest, and tips for relieving the anxiety. The signs and treatment of preterm labor also are discussed. Chapter 8 deals with labor and delivery, including fetal monitoring during labor, bonding with the baby, feelings commonly reported after birth, what to expect if your baby goes to the NICU, and tips for relieving anxiety. Chapter 9 talks about the consequences of pregnancy loss on parenting the subsequent child. It is common for parents to feel anxious and overprotective, but their loss also may make them exceptional parents. There is often continued sadness and introspection and a totally changed outlook on life. This chapter also reviews some of the private and public ways in which parents have chosen to remember their infants who died. Chapter 10 looks at pregnancy after a loss from a father's perspective, including feelings that are common to fathers who are expecting again and ways in which the mother can ease her spouse's anxiety. A list of resources includes support organizations for pregnancy and infant loss, high-risk pregnancy, subsequent pregnancy, infertility, and pregnancy/childbirth; publishers of relevant books; and internet resources.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “high-risk pregnancy” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “high-risk pregnancy” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “high-risk pregnancy” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Management of high-risk pregnancy and intensive care of the neonate; ISBN: 0801604141; http://www.amazon.com/exec/obidos/ASIN/0801604141/icongroupinterna

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Management of high-risk pregnancy and intensive care of the neonate by S. Gorham Babson; ISBN: 0801604133; http://www.amazon.com/exec/obidos/ASIN/0801604133/icongroupinterna

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Practical Guide to High-Risk Pregnancy and Delivery by Fernando, M.D. Arias; ISBN: 080160057X; http://www.amazon.com/exec/obidos/ASIN/080160057X/icongroupinterna

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The Peace of God : A Mother's Journal of God's Grace for Her and Her Family During a High-Risk Pregnancy and the Premature Birth of their Daughter by Sara J. Groenheide; ISBN: 0970523807; http://www.amazon.com/exec/obidos/ASIN/0970523807/icongroupinterna

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CHAPTER 4. PERIODICALS AND NEWS ON HIGH-RISK PREGNANCY Overview In this chapter, we suggest a number of news sources and present various periodicals that cover high-risk pregnancy.

News Services and Press Releases One of the simplest ways of tracking press releases on high-risk pregnancy is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “high-risk pregnancy” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to high-risk pregnancy. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “high-risk pregnancy” (or synonyms). The following was recently listed in this archive for high-risk pregnancy: •

Antibiotic treatment of bacterial vaginosis in high-risk pregnancy reduces preterm delivery Source: Reuters Industry Breifing Date: April 18, 2003

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “high-risk pregnancy” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “high-risk pregnancy” (or synonyms). If you know the name of a company that is relevant to high-risk pregnancy, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “high-risk pregnancy” (or synonyms).

Periodicals and News

37

Academic Periodicals covering High-Risk Pregnancy Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to high-risk pregnancy. In addition to these sources, you can search for articles covering high-risk pregnancy that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

39

APPENDICES

41

APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute4: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

4

These publications are typically written by one or more of the various NIH Institutes.

42

High-Risk Pregnancy

•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

Physician Resources

43

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.5 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:6 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

5 Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 6 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The NLM Gateway7

The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.8 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “high-risk pregnancy” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 1785 169 987 20 25 2986

HSTAT9 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.10 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.11 Simply search by “high-risk pregnancy” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x. The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 9 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 10 The HSTAT URL is http://hstat.nlm.nih.gov/. 11 Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 7 8

Physician Resources

45

Coffee Break: Tutorials for Biologists12 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.13 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.14 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 14 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process. 12

13

47

APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on high-risk pregnancy can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internetbased services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to high-risk pregnancy. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to high-risk pregnancy. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “high-risk pregnancy”:

48

•

High-Risk Pregnancy

Guides on high-risk pregnancy High Risk Pregnancy http://www.nlm.nih.gov/medlineplus/highriskpregnancy.html

•

Other guides Diabetes and Pregnancy http://www.nlm.nih.gov/medlineplus/diabetesandpregnancy.html Preeclampsia http://www.nlm.nih.gov/medlineplus/preeclampsia.html Prenatal Care http://www.nlm.nih.gov/medlineplus/prenatalcare.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to high-risk pregnancy. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

Patient Resources

•

49

WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to high-risk pregnancy. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with high-risk pregnancy. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about high-risk pregnancy. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “high-risk pregnancy” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “high-risk pregnancy”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “high-risk pregnancy” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.

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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “high-risk pregnancy” (or a synonym) into the search box, and click “Submit Query.”

51

APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.15

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

15

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)16: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

16

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries

53

•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries

55

•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

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New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

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Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

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On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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HIGH-RISK PREGNANCY DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abortion: 1. The premature expulsion from the uterus of the products of conception - of the embryo, or of a nonviable fetus. The four classic symptoms, usually present in each type of abortion, are uterine contractions, uterine haemorrhage, softening and dilatation of the cervix, and presentation or expulsion of all or part of the products of conception. 2. Premature stoppage of a natural or a pathological process. [EU] Acoustic: Having to do with sound or hearing. [NIH] Acuity: Clarity or clearness, especially of the vision. [EU] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaline Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.1. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Ambulatory Care: Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility. [NIH]

Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amnion: The extraembryonic membrane which contains the embryo and amniotic fluid. [NIH]

Amniotic Fluid: Amniotic cavity fluid which is produced by the amnion and fetal lungs and kidneys. [NIH]

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Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Arteries: The vessels carrying blood away from the heart. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Audiometry: The testing of the acuity of the sense of hearing to determine the thresholds of the lowest intensity levels at which an individual can hear a set of tones. The frequencies between 125 and 8000 Hz are used to test air conduction thresholds, and the frequencies between 250 and 4000 Hz are used to test bone conduction thresholds. [NIH] Autopsy: Postmortem examination of the body. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Infections: Infections by bacteria, general or unspecified. [NIH] Bacteriuria: The presence of bacteria in the urine with or without consequent urinary tract infection. Since bacteriuria is a clinical entity, the term does not preclude the use of urine/microbiology for technical discussions on the isolation and segregation of bacteria in the urine. [NIH] Bed Rest: Confinement of an individual to bed for therapeutic or experimental reasons. [NIH] Beta-Thalassemia: A disorder characterized by reduced synthesis of the beta chains of hemoglobin. There is retardation of hemoglobin A synthesis in the heterozygous form

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(thalassemia minor), which is asymptomatic, while in the homozygous form (thalassemia major, Cooley's anemia, Mediterranean anemia, erythroblastic anemia), which can result in severe complications and even death, hemoglobin A synthesis is absent. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Bone Conduction: Sound transmission through the bones of the skull to the inner ear. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Brain metastases: Cancer that has spread from the original (primary) tumor to the brain. [NIH]

Breast Feeding: The nursing of an infant at the mother's breast. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Carcinogenic: Producing carcinoma. [EU] Cardiac: Having to do with the heart. [NIH] Cardiotocography: Monitoring of fetal heart frequency before birth in order to assess impending prematurity in relation to the pattern or intensity of antepartum uterine contraction. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Arteries: The arteries supplying the cerebral cortex. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH]

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Checkup: A general physical examination. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Choriocarcinoma: A malignant tumor of trophoblastic epithelium characterized by secretion of large amounts of chorionic gonadotropin. It usually originates from chorionic products of conception (i.e., hydatidiform mole, normal pregnancy, or following abortion), but can originate in a teratoma of the testis, mediastinum, or pineal gland. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and

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theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contraceptive: An agent that diminishes the likelihood of or prevents conception. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Curative: Tending to overcome disease and promote recovery. [EU] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cystine: A covalently linked dimeric nonessential amino acid formed by the oxidation of cysteine. Two molecules of cysteine are joined together by a disulfide bridge to form cystine. [NIH]

Diagnostic procedure: A method used to identify a disease. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Eclampsia: Onset of convulsions or coma in a previously diagnosed pre-eclamptic patient. [NIH]

Ectopic Pregnancy: The pregnancy occurring elsewhere than in the cavity of the uterus. [NIH]

Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Ego: The conscious portion of the personality structure which serves to mediate between the demands of the primitive instinctual drives, (the id), of internalized parental and social prohibitions or the conscience, (the superego), and of reality. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH]

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Embryo Transfer: Removal of a mammalian embryo from one environment and replacement in the same or a new environment. The embryo is usually in the pre-nidation phase, i.e., a blastocyst. The process includes embryo or blastocyst transplantation or transfer after in vitro fertilization and transfer of the inner cell mass of the blastocyst. It is not used for transfer of differentiated embryonic tissue, e.g., germ layer cells. [NIH] Embryology: The study of the development of an organism during the embryonic and fetal stages of life. [NIH] Encephalocele: Cerebral tissue herniation through a congenital or acquired defect in the skull. The majority of congenital encephaloceles occur in the occipital or frontal regions. Clinical features include a protuberant mass that may be pulsatile. The quantity and location of protruding neural tissue determines the type and degree of neurologic deficit. Visual defects, psychomotor developmental delay, and persistent motor deficits frequently occur. [NIH]

Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estriol: (16 alpha,17 beta)-Estra-1,3,5(10)-triene-3,16,17-triol. A metabolite of estradiol and usually the predominant estrogenic metabolite in urine. During pregnancy, large amounts of estriol are produced by the placenta. It has also been obtained from plant sources. The 16 beta-isomer has also been isolated from the urine of pregnant women. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fathers: Male parents, human or animal. [NIH] Fertilization in Vitro: Fertilization of an egg outside the body when the egg is normally fertilized in the body. [NIH] Fetal Development: Morphologic and physiologic growth and development of the mammalian embryo or fetus. [NIH] Fetal Heart: The heart of the fetus of any viviparous animal. It refers to the heart in the postembryonic period and is differentiated from the embryonic heart (heart/embryology) only on the basis of time. [NIH] Fetal Monitoring: Physiologic or biochemical monitoring of the fetus. It is usually done during labor and may be performed in conjunction with the monitoring of uterine activity. It may also be performed prenatally as when the mother is undergoing surgery. [NIH] Fetal Movement: Motion of the fetus perceived by the mother and felt by palpation of the abdomen. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system.

Dictionary 65

It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Bypass: Surgical procedure in which the stomach is transected high on the body. The resulting proximal remnant is joined to a loop of the jejunum in an end-to-side anastomosis. This procedure is used frequently in the treatment of morbid obesity. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Genetic Counseling: Advising families of the risks involved pertaining to birth defects, in order that they may make an informed decision on current or future pregnancies. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Gestational trophoblastic disease: A rare cancer in women of child-bearing age in which cancer cells grow in the tissues that are formed in the uterus after conception. Also called gestational trophoblastic tumor, gestational trophoblastic neoplasia, molar pregnancy, or choriocarcinoma. [NIH] Gestational trophoblastic neoplasia: A rare cancer in women of child-bearing age in which cancer cells grow in the tissues that are formed in the uterus after conception. Also called gestational trophoblastic disease, gestational trophoblastic tumor, molar pregnancy, or choriocarcinoma. [NIH] Gestational trophoblastic tumor: A rare cancer in women of child-bearing age in which cancer cells grow in the tissues that are formed in the uterus after conception. Also called gestational trophoblastic disease, gestational trophoblastic neoplasia, molar pregnancy, or choriocarcinoma. [NIH] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]

Glycerophospholipids: Derivatives of phosphatidic acid in which the hydrophobic regions are composed of two fatty acids and a polar alcohol is joined to the C-3 position of glycerol through a phosphodiester bond. They are named according to their polar head groups, such as phosphatidylcholine and phosphatidylethanolamine. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gonadal: Pertaining to a gonad. [EU]

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Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Grading: A system for classifying cancer cells in terms of how abnormal they appear when examined under a microscope. The objective of a grading system is to provide information about the probable growth rate of the tumor and its tendency to spread. The systems used to grade tumors vary with each type of cancer. Grading plays a role in treatment decisions. [NIH]

Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Handedness: Preference for using right or left hand. [NIH] Health Services: Services for the diagnosis and treatment of disease and the maintenance of health. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH]

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Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [NIH]

Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intracellular: Inside a cell. [NIH] Introspection: Examination by a person of his own feelings, thoughts, and mental state. [NIH]

Jejunum: That portion of the small intestine which extends from the duodenum to the ileum; called also intestinum jejunum. [EU] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Lactation: The period of the secretion of milk. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Maternal Mortality: Maternal deaths resulting from complications of pregnancy and childbirth in a given population. [NIH] Meconium: The thick green-to-black mucilaginous material found in the intestines of a fullterm fetus. It consists of secretions of the intestinal glands, bile pigments, fatty acids, amniotic fluid, and intrauterine debris. It constitutes the first stools passed by a newborn. [NIH]

MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [EU] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Lipids: Lipids, predominantly phospholipids, cholesterol and small amounts of

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glycolipids found in membranes including cellular and intracellular membranes. These lipids may be arranged in bilayers in the membranes with integral proteins between the layers and peripheral proteins attached to the outside. Membrane lipids are required for active transport, several enzymatic activities and membrane formation. [NIH] Menarche: The establishment or beginning of the menstrual function. [EU] Menopause: Permanent cessation of menstruation. [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Health: The state wherein the person is well adjusted. [NIH] Mesenteric: Pertaining to the mesentery : a membranous fold attaching various organs to the body wall. [EU] Mesentery: A layer of the peritoneum which attaches the abdominal viscera to the abdominal wall and conveys their blood vessels and nerves. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Middle Cerebral Artery: The largest and most complex of the cerebral arteries. Branches of the middle cerebral artery supply the insular region, motor and premotor areas, and large regions of the association cortex. [NIH] Midwifery: The practice of assisting women in childbirth. [NIH] Miscarriage: Spontaneous expulsion of the products of pregnancy before the middle of the second trimester. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Molar pregnancy: A rare cancer in women of child-bearing age in which cancer cells grow in the tissues that are formed in the uterus after conception. Also called gestational trophoblastic disease, gestational trophoblastic neoplasia, gestational trophoblastic tumor, or choriocarcinoma. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Mucilaginous: Pertaining to or secreting mucus. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neural tube defects: These defects include problems stemming from fetal development of

Dictionary 69

the spinal cord, spine, brain, and skull, and include birth defects such as spina bifida, anencephaly, and encephalocele. Neural tube defects occur early in pregnancy at about 4 to 6 weeks, usually before a woman knows she is pregnant. Many babies with neural tube defects have difficulty walking and with bladder and bowel control. [NIH] Nursing Care: Care given to patients by nursing service personnel. [NIH] Obsession: A recurrent, persistent thought, image, or impulse that is unwanted and distressing (ego-dystonic) and comes involuntarily to mind despite attempts to ignore or suppress it. Common obsessions involve thoughts of violence, contamination, and selfdoubt. [EU] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxytocin: A nonapeptide posterior pituitary hormone that causes uterine contractions and stimulates lactation. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palpation: Application of fingers with light pressure to the surface of the body to determine consistence of parts beneath in physical diagnosis; includes palpation for determining the outlines of organs. [NIH] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial. [NIH] Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH]

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Plasma cells: A type of white blood cell that produces antibodies. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Preeclampsia: A toxaemia of late pregnancy characterized by hypertension, edema, and proteinuria, when convulsions and coma are associated, it is called eclampsia. [EU] Pregnancy Outcome: Results of conception and ensuing pregnancy, including live birth, stillbirth, spontaneous abortion, induced abortion. The outcome may follow natural or artificial insemination or any of the various reproduction techniques, such as embryo transfer or fertilization in vitro. [NIH] Pregnancy-Specific beta 1-Glycoprotein: A glycoprotein with the electrophoretic mobility of a beta-1 globulin. It is produced by the placental trophoblast and secreted into the maternal bloodstream during pregnancy. It can be detected 18 days after ovulation and its concentration in plasma rises steadily until, at the end of gestation, it reaches 200 mg/ml. It has been proposed as a measure of placental function for fertility control and is a candidate for an early pregnancy test. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH]

Dictionary 71

Reassurance: A procedure in psychotherapy that seeks to give the client confidence in a favorable outcome. It makes use of suggestion, of the prestige of the therapist. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Relaxation Techniques: The use of muscular relaxation techniques in treatment. [NIH] Reproduction Techniques: Methods pertaining to the generation of new individuals. [NIH] Reproductive History: An important aggregate factor in epidemiological studies of women's health. The concept usually includes the number and timing of pregnancies and their outcomes, the incidence of breast feeding, and may include age of menarche and menopause, regularity of menstruation, fertility, gynecological or obstetric problems, or contraceptive usage. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spina bifida: A defect in development of the vertebral column in which there is a central deficiency of the vertebral lamina. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spontaneous Abortion: The non-induced birth of an embryo or of fetus prior to the stage of viability at about 20 weeks of gestation. [NIH]

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Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stillbirth: The birth of a dead fetus or baby. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Streptococcus: A genus of gram-positive, coccoid bacteria whose organisms occur in pairs or chains. No endospores are produced. Many species exist as commensals or parasites on man or animals with some being highly pathogenic. A few species are saprophytes and occur in the natural environment. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Superstitions: A belief or practice which lacks adequate basis for proof; an embodiment of fear of the unknown, magic, and ignorance. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Systemic: Affecting the entire body. [NIH] Thalassemia: A group of hereditary hemolytic anemias in which there is decreased synthesis of one or more hemoglobin polypeptide chains. There are several genetic types with clinical pictures ranging from barely detectable hematologic abnormality to severe and fatal anemia. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Toxaemia: 1. The condition resulting from the spread of bacterial products (toxins) by the bloodstream. 2. A condition resulting from metabolic disturbances, e.g. toxaemia of pregnancy. [EU] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH]

Dictionary 73

Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Trophoblast: The outer layer of cells of the blastocyst which works its way into the endometrium during ovum implantation and grows rapidly, later combining with mesoderm. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Umbilical Arteries: Either of a pair of arteries originating from the internal iliac artery and passing through the umbilical cord to carry blood from the fetus to the placenta. [NIH] Umbilical Cord: The flexible structure, giving passage to the umbilical arteries and vein, which connects the embryo or fetus to the placenta. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterine Contraction: Contraction of the uterine muscle. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vaginosis: A condition caused by the overgrowth of anaerobic bacteria (e. g., Gardnerella vaginalis), resulting in vaginal irritation and discharge. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used

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together with artificial substrates and/or conditions. [NIH] War: Hostile conflict between organized groups of people. [NIH]

75

INDEX A Abortion, 59, 62, 70 Acoustic, 24, 59 Acuity, 59, 60 Adjustment, 13, 59 Adverse Effect, 59, 71 Algorithms, 59, 61 Alkaline, 7, 59, 61 Alkaline Phosphatase, 7, 59 Alternative medicine, 36, 59 Ambulatory Care, 6, 59 Amino acid, 59, 60, 63, 65, 70 Amino Acid Sequence, 59, 60 Amnion, 59 Amniotic Fluid, 8, 16, 20, 26, 59, 67 Anaerobic, 60, 73 Anaesthesia, 60, 66 Anastomosis, 60, 65 Anemia, 60, 61, 65, 72 Antibodies, 12, 60, 70 Antibody, 60, 62, 67 Antigen, 60, 62, 67 Anxiety, 31, 60, 69 Arteries, 60, 61, 63, 68, 73 Artery, 10, 20, 60, 63, 68, 73 Assay, 8, 60 Asymptomatic, 6, 60, 61 Audiometry, 4, 60 Autopsy, 31, 60 B Bacteria, 60, 66, 68, 72, 73 Bacterial Infections, 31, 60 Bacteriuria, 6, 60 Bed Rest, 22, 23, 26, 32, 60 Beta-Thalassemia, 10, 60 Bile, 61, 67, 72 Bile Pigments, 61, 67 Biochemical, 7, 20, 61, 64 Biotechnology, 3, 36, 43, 61 Bladder, 61, 69, 73 Blood Coagulation, 16, 61 Bone Conduction, 60, 61 Bowel, 61, 69 Brain metastases, 25, 61 Breast Feeding, 61, 71 C Calcium, 26, 61, 62 Carcinogenic, 61, 72

Cardiac, 61, 68, 72 Cardiotocography, 19, 20, 61 Cell, 60, 61, 62, 64, 66, 67, 68, 69, 70, 71 Cell membrane, 61, 69 Cerebral, 61, 63, 64, 68 Cerebral Arteries, 61, 68 Cervix, 31, 59, 61 Checkup, 30, 62 Cholesterol, 61, 62, 67, 72 Choriocarcinoma, 62, 65, 68 Chronic, 30, 32, 62, 67, 72 Clinical trial, 3, 26, 43, 62, 70 Cloning, 61, 62 Complement, 62 Complementary and alternative medicine, 23, 28, 62 Complementary medicine, 23, 62 Computational Biology, 43, 62 Conception, 59, 62, 63, 64, 65, 68, 70, 72 Conduction, 60, 63 Contamination, 63, 69 Contraceptive, 63, 71 Contraindications, ii, 63 Convulsions, 63, 70 Coordination, 19, 63 Coronary, 63, 68 Coronary Thrombosis, 63, 68 Cortex, 61, 63, 64, 68, 70 Curative, 63, 72 Cysteine, 63 Cystine, 7, 63 D Diagnostic procedure, 36, 63 Direct, iii, 63, 71 Drug Interactions, 63 E Eclampsia, 63, 70 Ectopic Pregnancy, 30, 63 Edema, 63, 70 Ego, 63, 69 Elective, 17, 63 Embryo, 59, 63, 64, 66, 70, 71, 73 Embryo Transfer, 64, 70 Embryology, 64 Encephalocele, 64, 69 Environmental Health, 42, 44, 64 Enzymatic, 59, 61, 62, 64, 68 Enzyme, 59, 64, 73

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Epidemiological, 64, 71 Estradiol, 64 Estriol, 13, 15, 19, 20, 21, 64 F Family Planning, 30, 43, 64 Fathers, 9, 32, 64 Fertilization in Vitro, 64, 70 Fetal Development, 64, 68 Fetal Heart, 8, 14, 15, 19, 61, 64 Fetal Monitoring, 32, 64 Fetal Movement, 9, 64 Fetus, 59, 64, 67, 69, 70, 71, 72, 73 Folate, 64, 65 Fold, 64, 68 Folic Acid, 31, 64 G Gastric, 25, 65 Gastric Bypass, 25, 65 Gastrin, 65, 66 Gene, 61, 65, 71 Genetic Counseling, 30, 65 Genetic testing, 31, 65 Gestation, 65, 69, 70, 71 Gestational, 10, 25, 65, 68 Gestational trophoblastic disease, 65, 68 Gestational trophoblastic neoplasia, 65, 68 Gestational trophoblastic tumor, 25, 65, 68 Glucuronic Acid, 65, 66 Glutamic Acid, 64, 65 Glycerol, 65, 69 Glycerophospholipids, 65, 69 Glycoprotein, 65, 70 Gonadal, 65, 72 Governing Board, 66, 70 Grade, 66 Grading, 15, 66 Gram-positive, 66, 72 Grasses, 65, 66 H Habitual, 12, 66 Handedness, 13, 66 Health Services, 30, 66 Hemoglobin, 60, 66, 72 Heparin, 16, 66 Hormone, 11, 31, 64, 65, 66, 69, 70 Hypertension, 66, 70 I In vivo, 66 Induction, 12, 14, 66 Infarction, 63, 66, 68 Infection, 31, 67, 72 Infertility, 30, 31, 67

Intensive Care, 13, 14, 32, 67 Intestinal, 67 Intestines, 67 Intracellular, 67, 68 Introspection, 32, 67 J Jejunum, 65, 67 K Kb, 42, 67 L Lactation, 67, 69 Liver, 61, 65, 66, 67 Localized, 67 Loop, 65, 67 Lymphatic, 67 Lymphoid, 60, 67 M Maternal Mortality, 15, 21, 67 Meconium, 10, 67 MEDLINE, 43, 67 Megaloblastic, 65, 67 Membrane, 59, 61, 62, 67, 69 Membrane Lipids, 67, 69 Menarche, 68, 71 Menopause, 68, 71 Menstruation, 68, 71 Mental, iv, 3, 42, 44, 67, 68, 70 Mental Health, iv, 3, 42, 44, 68, 70 Mesenteric, 10, 68 Mesentery, 68 Metabolite, 64, 68 MI, 21, 32, 57, 68 Microbiology, 60, 68 Middle Cerebral Artery, 9, 68 Midwifery, 8, 24, 68 Miscarriage, 30, 31, 68 Mobility, 68, 70 Molar pregnancy, 30, 65, 68 Molecular, 43, 45, 60, 61, 63, 66, 68 Mucilaginous, 67, 68 Myocardium, 68 N Necrosis, 66, 68 Neonatal, 5, 9, 10, 13, 14, 19, 27, 68 Nerve, 68 Neural, 31, 64, 68 Neural tube defects, 31, 68 Nursing Care, 19, 69 O Obsession, 31, 69 Ovulation, 69, 70 Oxidation, 63, 69

77

Oxytocin, 14, 19, 69 P Palliative, 69, 72 Palpation, 64, 69 Panic, 31, 69 Patient Satisfaction, 19, 69 Perinatal, 9, 10, 11, 12, 15, 18, 30, 69 Pharmacologic, 69, 72 Phospholipids, 16, 67, 69 Phosphorus, 61, 69 Physical Examination, 62, 69 Placenta, 64, 69, 70, 73 Plasma, 15, 19, 60, 61, 66, 69, 70 Plasma cells, 60, 70 Pneumonia, 63, 70 Posterior, 69, 70 Practice Guidelines, 44, 70 Preeclampsia, 26, 48, 70 Pregnancy Outcome, 27, 70 Pregnancy-Specific beta 1-Glycoprotein, 12, 70 Prenatal, 13, 30, 31, 48, 63, 70 Progesterone, 70, 72 Protein S, 61, 70 Proteins, 59, 60, 61, 62, 68, 69, 70, 71, 73 Proteinuria, 70 Protocol, 4, 26, 70 Psychotherapy, 70, 71 Public Health, 18, 26, 44, 70 Public Policy, 43, 70 R Randomized, 8, 20, 70 Reassurance, 30, 71 Refer, 1, 62, 71 Relaxation Techniques, 32, 71 Reproduction Techniques, 70, 71 Reproductive History, 30, 71 Risk factor, 30, 71 S Saponins, 71, 72 Screening, 10, 11, 17, 30, 62, 71 Segregation, 60, 71 Serum, 7, 11, 13, 17, 62, 71 Side effect, 59, 71, 72 Skull, 61, 64, 69, 71 Small intestine, 66, 67, 71 Social Support, 18, 71 Specialist, 49, 71 Species, 71, 72 Spina bifida, 69, 71

Spinal cord, 62, 69, 71 Spontaneous Abortion, 70, 71 Sterility, 67, 72 Steroid, 14, 27, 71, 72 Stillbirth, 30, 31, 70, 72 Stomach, 65, 66, 67, 71, 72 Streptococcus, 31, 72 Stress, 15, 18, 21, 23, 31, 72 Subacute, 67, 72 Subclinical, 67, 72 Superstitions, 31, 72 Supplementation, 25, 26, 27, 72 Support group, 23, 72 Symptomatic, 72 Systemic, 67, 72 T Thalassemia, 61, 72 Therapeutics, 72 Tissue, 7, 60, 63, 64, 67, 68, 71, 72 Toxaemia, 70, 72 Toxic, iv, 66, 72 Toxicity, 63, 72 Toxicology, 44, 72 Toxins, 60, 65, 67, 72, 73 Transfection, 61, 73 Trophoblast, 70, 73 U Ultrasonography, 25, 73 Umbilical Arteries, 73 Umbilical Cord, 31, 73 Urethra, 73 Urinary, 20, 21, 60, 73 Urinary tract, 60, 73 Urinary tract infection, 60, 73 Urine, 13, 60, 61, 64, 70, 73 Uterine Contraction, 59, 61, 69, 73 Uterus, 59, 61, 63, 65, 68, 70, 73 V Vagina, 61, 68, 73 Vaginal, 73 Vaginosis, 35, 73 Vascular, 66, 67, 69, 73 Vein, 7, 73 Venous, 20, 70, 73 Veterinary Medicine, 43, 73 Viral, 31, 73 Virus, 73 Vitro, 64, 66, 73 W War, 25, 74

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79

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