...BACKGROUND The research paper addresses the diagnosis of aneuploidy during the first trimester using Nuchal Translucency. The study was done in the fetal medicine unit in Chris Hani Baragwanath Hospital in South Africa. It included a total of 428 patients who were screened between July 2003 and July 2005. Those patients were chosen using a set of criteria that the Fetal Medicine Foundation (FMF) has established. The patients had a mean age of 30 years. Of all the patients, 59 were screened positive and the remaining 356 were screened negative. 24 of those that screened positive had Chorionic Villus Sampling (CVS) performed. CVS is an invasive prenatal test that takes a sample of the chorionic villi to asses for chromosomal defects4. Therefore,...
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...generally defined as the implantation of the placenta over or near the internal os of the cervix. There are four types of placenta previa; total, low-lying, partial, and marginal. The higher incidence of low-lying placenta and placenta previa is sonographically diagnosed in the second trimester and ranges from 6% to 46%. This rate, however, decreases to as low as 0.5 % at delivery (11). Despite advances in blood transfusion techniques and surgical procedures, abnormal placentation still remains a difficult challenge for obstetricians. Intrapartum maternal hemorrhage and the need for emergency cesarean section or hysterectomy related to abnormal placentation are main causes of maternal-fetal morbidity and mortality. The overall incidence of placenta previa at delivery is reported as 0.5 % in most studies (3, 5) and the risk factors for placenta previa include advanced maternal age (above 35 years), parity, smoking, and, most importantly, prior cesarean delivery. Placenta previa with prior cesarean delivery increases risk up to 1% - 4%. As the number of previous cesarean deliveries increases, the incidence of placenta previa and abnormal placentation shows a linear increase (3). Vaginal ultrasound is the most accurate method for localizing and diagnosing placenta previa, because it can provide a better resolution in the lower margin of the placenta (4, 6, 11). There is a little increase in congenital anomalies associated with placenta previa when compared to normal pregnancies, but...
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...the sound wave for imaging the embryo or fetus in pregnant woman as well as imaging the ovaries and the uterus of the female. There are many congenital abnormalities that may occur during the pregnancy, some might happen in the first, second or the third trimester. In this study I'm going to talk about the Ventricular Septal Defect it's mainly occur when the heart develops within the first 8 weeks in the first trimester. Gynecology Ultrasound Examination There are two types of ultrasound examination used in...
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...Case Study on Moral Status Andrea Jenison (Wilson) HLT310V-O102 Grand Canyon University According to Webster’s Dictionary, moral obligation is “an obligation arising out of considerations of right and wrong” (Webster’s Dictionary, n.d.). What is considered a moral obligation to one person may be completely different to another person. This paper will outline the theories used by Jessica, Marco, Dr. Wilson, and Aunt Maria in the Fetal Abnormality Case Study, and explain how those theories influenced their recommendations for action. In the Fetal Abnormality Case Study, Jessica finds out that her fetus has abnormalities. Jessica seems to lean towards the theory of having moral obligations towards all living things. She states that she believes all life is sacred, which follows a Christian worldview. Aunt Maria also seems to follow this theory, as she pleads with Jessica to follow through with the pregnancy and allow what “God intends” to take place. Both Jessica and Aunt Maria seems to follow the Christian worldview, and agree with Genesis 9:8-10 “I now establish my covenant with you and all you descendants. This covenant also extends to every living creature in the world—the birds, the domesticated animals, and every wild animal on the earth—as many as emerged with you from the ark” (Bible Gateway, 2012). It is believed by this author that their recommendations for action are due to their belief that all life is sacred. Dr. Wilson seems to agree more with science and rationality...
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...macrosystem (Bukatko, 2008). Bronfenbrenner’s theory stresses the need to understand how children develop in everyday life. The development issue I chose to discuss is Fetal Alcohol Syndrome (FAS) and how the surroundings and everyday life affects the development. There are different characteristics that accompany FAS in the different stages of a child's life. "At birth, infants with intrauterine exposure to alcohol frequently have low birth rate; pre-term delivery; a small head circumference; and the characteristic facial features of the eyes, nose, and mouth" (Phelps, 1995, p. 204). Some of the facial abnormalities that are common of children with FAS are: microcephaly, small eye openings, broad nasal bridge, flattened mid-faces, thin upper lip, skin folds at the corners of the eyes, indistinct groove on the upper lip, and an abnormal smallness of the lower jaw (Wekselman, Spiering, Hetteberg, Kenner, & Flandermeyer, 1995; Phelps, 1995). These infants also display developmental delays, psychomotor retardation, and cognitive deficits. As a child with FAS progresses into preschool physical, cognitive and behavioral abnormalities are more noticeable. These children are not the average weight and height compared to the children at the same age level. A cognitive manifestation is another problem with children who have FAS. "Studies have found that preschoolers with FAS generally score in the mentally...
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...alcohol in the fetus bloodstream. At five weeks the fetus begins to form the brain, which then starts to grow rapidly, this is a crucial time for mothers to nourish their bodies with many proteins and keep away from dangerous toxins. One of the most probable results of drinking while pregnant is the Fetal Alcohol Syndrome (FAS). The Fetal Alcohol Syndrome has been linked to low I.Q. in children. Over the years there has been many studies to determine if a child’s I.Q. if affected by Fetal Alcohol Syndrome. Jones and Smith first introduced Fetal Alcohol Syndrome in the United States in 1973, Jones and Smith described FAS as a “distinctive set of facial anomalies in children whose mothers drank heavily during pregnancy, accompanied by prenatal and/or postnatal growth retardation and cognitive/behavioral problems” (Burden). Children who suffer from FAS commonly have face abnormalities, which may or may not include: flat mid-face, short nose, low nasal bridge, thin lips, short palpable fissures, indistinct philtrum, epicanthal folds, minor ear abnormalities, and micrognathia. These kids also tend to have a much more smaller head than the average child. Fetal Alcohol Syndrome has also been linked to I.Q deficiency. Doctors cannot diagnose a child with AFS without being certain that a child has a cognitive deficit. “in order to be diagnosed...
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...Case Study: Fetal Abnormality Briante Bankston Grand Canyon University: HLT-302 Professor Waddell May 23, 2013 Moral Case Study: Fetal Abnormality All throughout life we go through and sometimes have to face and deal with the most challenging and unexpected circumstances. Thankfully, we have the ability to take a moment and think wisely about our choices. Because that is ultimately what life is about making decisions. In the Case Study: Fetal Abnormality Jessica and Marco are faced with some unfortunate news from Dr.Wilson, that the fetus Jessica was carrying was not likely to develop any arms and had a quarter of a chance of having Down syndrome. They were faced with a couple of options to deal with the situation accordingly which was either to keep, abort, or give the baby up for adoption. However, each of the individuals involved gave their recommendation for action based on the different moral status theories. When it comes to Aunt Maria, I would associate two theories with her, which is the moral agency and the relationship theory. For one she is involving God in the equation as being a factor in the decision making process for both Jessica and Marco in regards to aborting the fetus. Immediately when she mentioned God and the fact that He intended the pregnancy to happen, me being a Christian, I know that He makes no mistakes and for Jessica and Marco to go along with the abortion it would be seen as sinful. “ Thou shalt not kill”. (Exodus...
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...WHAT IS FETAL ALCOHOL SYNDROME? Fetal Alcohol Syndrome (FAS) is a birth defect caused by heavy alcohol consumption (usually in a binge pattern) during pregnancy. It is characterised by growth retardation, facial and neural abnormalities as well as malformations of other organ systems. Maternal risk for giving birth to a child with FAS is known to vary substantially by population and that the risk also varies between individuals. Alcohol and its primary metabolite, acetaldehyde, are known tissue toxins which may interfere directly with cellular growth and metabolism. When a pregnant woman consumes alcohol, it is carried to all her organs and tissues including the placenta. The placenta functions to protect the fetus and provides nourishment from the mother to the fetus. Alcohol is able to cross the placental membrane and is then transported directly to all developing tissues of the fetus. These adverse effects of alcohol on the developing fetus are characterised by an array of disorders, termed Fetal Alcohol Spectrum Disorders (FASD). They include structural anomalies as well as behavioural and neuro-cognitive disabilities. Children at the severe end of the spectrum are defined as having the fetal alcohol syndrome (FAS). HOW MANY CHILDREN ARE AFFECTED BY FAS? FAS is the most common preventable cause of mental retardation worldwide, even more so than Down’s syndrome. In South Africa, FAS related research has been limited to a few at-risk...
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...by pregnant women to determine the sex of babies. Methods: * Maternal Blood Sample to analyze the small amount of fetal DNA that can be found within, it provides the earliest post-implantation test. * Chorionic Villus Sampling (CVS) and Amniocentesis are two rather invasive testing procedures. These may, in principle, be formed as early as the 8th and 9th week of pregnancy. The difficulty of these tests and the risk of damage to the fetus, potentially resulting in miscarriage or congenital abnormalities (especially when done early during the pregnancy), make them quite rare during the first trimester. Amniocentesis (also referred to as amniotic fluid test or AFT) is a medical procedure used in prenatal diagnosis of chromosomal abnormalities and fetal infections, in which a small amount of amniotic fluid, which contains fetal tissues, is sampled from the amnion or amniotic sac surrounding a developing fetus, and the fetal DNA is examined for genetic abnormalities. This process can be used for prenatal sex discernment and hence this procedure has legal restrictions in some countries. * Obstetric Ultrasonography, either transvaginally or transabdominally, can check for the sagittal sign as a marker of fetal sex. It can be performed between 65 and 69 days from fertilization (week 12 of gestational age), where it gives a result in 90% of cases. Applications: Potential applications of prenatal sex discernment include: * A complement to specific gene testing...
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...Fetal examination of hydrocephalus Abstract: Introduction (500) Prenatal detection and diagnosis of hydrocephalus In this chapter, the discussion will mainly focus on answering three questions; how is fetal hydrocephalus diagnosed? Or in other words, what methods are used?, What is the rationale for using them? What are the clinical implications to detecting fetal hydrocephalus? Ultrasonography (US) Introduction The earliest recorded implementation of ultrasonography in identifying fetal anatomy was in 1958 when Donald et al. published his paper ‘The investigation of abdominal masses by pulsed ultrasound’ in The Lancet, containing the first published ultrasound image of the fetal head (Figure 6.1.1) and various other gynecological...
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...proposed legislation to assist controlling the alcohol intake of women. (“Liquor Surprise for Pregnant Women,” 2012) But is this enough to meaningfully diminish the consumption of alcohol by pregnant women in South Africa? Within this context the following questions will be addressed: What is Foetal Alcohol Syndrome? How is FAS characterised? How is a baby affected by Foetal Alcohol Syndrome? How does alcohol affect the brain? What kind of role has the South African context played in FAS? Definition of Foetal Alcohol Syndrome (FAS) The South African National Council on Alcoholism (SANCA) defines FAS as a term used to describe children who have growth deficiencies, mental retardation, and physical and central nervous system abnormalities as a result of their mothers’ alcohol consumption during pregnancy (Foetal Alcohol Syndrome, n.d.). FAS affected...
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.... Felicia Asenso Grand Canyon University: HLT-302 June 1, 2015 This is a case study analysis concerning the issue of a fetus with abnormalities. The four people in this study are Jessica and husband Marco, Dr. Wilson and Aunt Maria. The couple have been told that their unborn baby is developing abnormally. Dr. Wilson have discussed with them that abortion in this case is scientifically and medically sound. In this situation all present has a moral and belief system that would influence their action by the realization of the fetal abnormality. Based on the reading from the case study, it is apparent that Jessica and Aunt Maria have chosen to take a Christian ethical approach in the circumstances. Aunt Maria is pleading with Jessica to let the pregnancy take its course and to sue her maternal place to protect her unborn baby. She prays to God which also symbolism her faith. Jessica intends to keep her baby referring to the fact that all life is sacred, in Psalms 139:14 (English Standard Version) the verse refers to the fact that man is fearfully and wonderfully made in the image of God. Marco on the other hand is worried about what the impact of a disable child will have in their life but all the same very supportive of his wife and intends to go with whatever decision she makes. My personal theory is the Christian approach in this case. I agree with a paragraph that Christians have our belief in the notion that every person is created individually by...
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...GENETIC COUNSELING IN NURSING AND ETHICS Hyang Ko Azusa Pacific University Abstract The current development of genetic information and technique leaves us assignments. It is included ethical issues, roles of nurses, and the responsibilities in healthcare professionals. In order to understand nurses’ role and responsibilities and to provide genetic counseling, two research article with text books were reviewed. There were conflicts within ethical principles and nurses’ obligation. Each principle is important but one principle is superior to others when healthcare professionals make a decision in a certain context. It is necessary that genetic counseling is provided to patients and their family when healthcare professionals deal with genetic information. The two research articles empathized that experienced nurses are excellent candidates in genetic counseling within healthcare professionals by being educated, trained about genetic information. Genetic Counseling in Nursing and Ethics Definitions of Genetics and Genetic Counseling Officially, the terms of Genetics and genetic counseling is defined by Wekipidia as below: Genetics, a discipline of biology, is the science of genes, heredity, and variation in living organisms (http://en.wikipedia.org/wiki/Genetics). Genetic counseling is the process by which patients or relatives, at risk of an inherited disorder, are advised of the consequences and nature of the disorder, the probability of developing or transmitting...
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...computer to assess movement time is another test for Parkinson's disease. To examine the electrophysiological characteristics of tremor and preclinical nigral dysfunction characteristic of Parkinson's EMG (electromyography recordings) can be used. Finally, a symptomatic screening is often utilized and consists of nine symptom related questions, as well as disease specific and drug specific questions. This provides an indirect functional measure of the nigrostriatal dopamine system. Increasing age strongly increases the risk of Parkinson's disease. Male gender and possibly Caucasian ancestry are associated with more modest increases in risk. The reported prevalence of Parkinson's disease varies widely in international community-based studies; ranging from 31 to 328 per 100,000 people. Whether these differences represent actual differences in the...
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...cell diseases. Approval Details: This drug is manufactured by Novartis Pharmaceutical Cooperation (Oncology Department). The New Drug Application was submitted under section 505b of Federal Food, Drug and Cosmetic Act on May 30th, 2014. FDA approved the product under accelerated approval regulations 21 CFR314.510 and requested further clinical trials and well controlled studies to explain the clinical benefit of this drug. FDA also requested to submit the post marketing requirements under section 505 (o) and the promotional material. Dosage and Administration: Initial dose is 14 mg/kg for transfusion iron overdose and...
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