Intrauterine Growth Restriction: Aetiology and Management will be the first book to focus exclusively on this extremely important and common complication of pregnancy. There have been many recent developments in our understanding of the aetiology and pathogenesis of the condition as well as in screening, monitoring and therapy. This book is unique in that it covers both the aetiology and pathogenesis as well as clinical management and also includes sections on definitions and potential future advances. Every aspect is covered by an international expert which will provide the reader with a valuable insight into this condition.

Covers all aspects of intrauterine growth restriction including both etiology and pathogenesis and clinical management

1. Definitions of Intrauterine Growth Restriction.- Approaches to the Recognition and Measurement of IUGR.- References.- Section 1 Aetiology and Pathognesis.- 2. Genes, Chromosomes and IUGR.- Chromosome Abnormalities.- Confined Placental Mosaicism and Uniparental Disomy.- Syndromes.- Conclusions.- References.- 3. Perinatal Viral Infections as a Cause of Intrauterine Growth Restriction.- Properties of Viruses and their Replication.- Cytomegalovirus.- Rubella.- Varicella-Zoster Virus Infection.- Human Immunodeficiency Virus.- Conclusion.- References.- 4. Therapeutic Drugs, Recreational Drugs and Lifestyle Factors.- Therapeutic Drugs.- Recreational Drugs.- Lifestyle Factors.- Conclusion.- References.- 5. Studies of Fetal Growth in Animals.- Determinants of Fetal Growth.- Experimental Measurement of Fetal Growth Rate.- Animal Models for Studying Fetal Growth.- Duration and Severity of Insult.- References.- 6. The Uteroplacental Circulation: Extravillous Trophoblast.- Cell Adhesion Molecules and the Extracellular Matrix.- Adhesion Molecules in Trophoblast Invasion.- In Vivo Studies Suggest CTB Invasion is Associated with Switching of Integrin Repertoires.- In Vitro Studies also Suggest that CTB Invasion is Associated with Switching of Integrin Repertoires.- Invading CTB Expresses Endothelial CAMs.- CTB Invasion, CAMs and Pre-eclampsia.- Oxygen Tension, CTB Proliferation and Adhesion Molecules.- Proteinases, Inhibitors and Activators.- Growth Factors, their Receptors and Proto-oncogenes.- Nitric Oxide.- Gap Junctions and Connexins.- Human Chorionic Gonadotrophin.- Activins and Inhibins.- The Major Histocompatibility Complex.- Blood Group Antigens.- Proliferative EVT.- Routes of Trophoblast Differentiation.- Conclusions.- References.- 7. Villous Development and the Pathogenesis of IUGR.- Development of Placental Villi.- Villous Maldevelopment in IUGR.- Summary.- References.- 8. Growth Factor Regulators of Placental Angiogenesis.- Vasculogenesis.- Branching Angiogenesis.- Non-branching Angiogenesis.- Angiogenic Growth Factors and their Receptors.- Effects of Oxygen on Placental Development.- Conclusions.- References.- 9. Placental Transfer and Intrauterine Growth Restriction.- Basic Concepts of Placental Transfer.- Fetal Asphyxia.- Placental Oxygen Transfer and Hypoxaemia in IUGR.- Carbon Dioxide Transfer and Hypercapnia in IUGR.- Placental Proton Transfer and Acidosis in IUGR.- Placental Glucose Transfer and Hypoglycaemia in IUGR.- Placental Amino Acid Transfer and Hypoaminoacidaemia in IUGR.- Drug Abuse, Placental Transfer and IUGR.- Conclusions.- References.- 10. Placental Pathology.- The Small for Gestational Age Infant.- Placental Size.- Gross Abnormalities.- Histological Abnormalities.- Maternal Perfusion.- Fetal Perfusion.- Cytogenetic Abnormalities.- Conclusions.- References.- Section 2 Clinical Management.- 11. Ultrasound Assessment.- The Normal Length of Pregnancy.- Assessment of Gestational Age: LMP, Ultrasound, or Conception?.- Commonly Used Ultrasound Measurements.- Precision of Ultrasound Measurements.- Appropriate Reference Ranges.- Assessment of Fetal Size.- Assessment of Fetal Growth.- Predicting the Small Infant by Biometry.- Predicting Adverse Outcome by Biometry.- Screening for Malformations.- Placental Morphology.- Amniotic Fluid.- Doppler Ultrasound Velocimetry of the Fetal Circulation.- Screening by Uterine Artery Velocimetry.- Conclusions.- References.- 12. Biochemical Markers of Fetoplacental Growth Restriction.- Alpha Fetoprotein.- Human Chorionic Gonadotrophin.- AFP, hCG and Other Risk Factors.- Other Biochemical Markers of Fetoplacental Growth Restriction.- Conclusions.- Acknowledgements.- References.- 13. Diagnosis and Management of IUGR.- Differential Diagnosis of SGA.- Is the Fetus Potentially Viable?.- Viable Early Onset "Placental IUGR".- Late Gestation "Placental IUGR" (> 35 weeks).- When is an Attempt at Vaginal Birth Futile?.- What to Do at Delivery.- Postnatal Role of the Obstetrician.- References.- 14. Management of Late Gestation IUGR: Induction or Caesarean Section?.- Outcome of Labour in the SGA Fetus.- Antepartum Tests and Outcome of Labour.- Induction of Labour.- Caesarean Section.- Conclusions.- References.- 15. Coexistent Maternal Disease and Intrauterine Growth Restriction.- The Association of Pre-eclampsia with Intrauterine Growth Restriction.- The Association Between Maternal Thrombophilias and Intrauterine Growth Restriction.- Conclusions.- References.- 16. Prevention and Treatment of IUGR.- Antenatal Care.- Antenatal Treatment.- Conclusions.- References.- 17. Management of Antepartum Fetal Death.- Obstetric Management.- Investigations.- After Delivery and Follow-up.- References.- 18. Paediatric Implications - Neonatal Complications.- Immediate Condition at Birth and Resuscitation.- Mortality.- Specific Neonatal Conditions.- The SGA Term Infant Without Risk Factors.- Metabolic Adaptation.- Necrotising Enterocolitis.- Respiratory Distress Syndrome.- Neurological Effects of Fetal Growth Restriction.- Other Problems Encountered in Preterm Infants.- Growth over the First Year.- Conclusions.- References.- 19. Paediatric Implications of IUGR with Special Reference to Cerebral Palsy.- Criteria for the Inference of IUGR.- Potential Confounders in Studies of the Association Between Paediatric Outcomes and Measures of Growth.- Studies Investigating Associations Between Paediatric Outcomes and IUGR.- Conclusions.- References.- 20. Long Term Implications for Adult Health.- The Concept of Programming During Early Development.- Fetal Growth and Adult Cardiovascular Disease.- Metabolic and Endocrine Disease.- Mechanisms Linking Fetal Programming with Adult Disease.- Effects at Different Stages of Development.- Influences Underlying Fetal Programming.- The Future.- References.- Section 3 Future Advances.- 21. Molecular Regulation of Placental Development.- Stages of Placental Development in Mice and Men.- Potential Origins of IUGR During Placental Development.- Molecular Control of Placental Development.- Finding the Molecular Targets in the IUGR Placenta.- Conclusions.- References.- 22. Towards Evidence-based Management.- The Evidence.- Effective Treatment.- Clinical Trials.- Trials of Therapy for Fetal Growth Restriction.- The GRIT Study.- Applying the Evidence to Individual Patients.- Appendix: Useful Addresses for Reviewers.- References.- 23. The Internet and Medicinev.- Medical Informatics and the Modern Physician.- The Internet.- History of the Internet.- Anatomy of the Internet.- Websites.- References.