Fetology - Diagnosis and management of the fetal patient

di Bianchi - AAVV • 2010 • dettagli prodotto

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DESCRIZIONE

Forty years ago it made sense to link obstetrics with gynecology because both dealt exclusively with the care of women, pregnant or not. In the 1960s, research began to focus on the hitherto unexplored world of the developing fetus, and the technological explosion of the mid-1970s made it possible for the first time to visualize the fetus throughout gestation and to monitor its development. Direct and indirect tests of fetal well-being were subsequently developed and led to fetal therapy; the first report of intraperitoneal fetal red-cell transfusion for Rh isoimmunization appeared in 1963. Simultaneously, advances in knowledge about genetics and related technology raised the possibility of genetic evaluation of the fetus. The first report of successful karyotyping of amniocytes appeared in 1966, followed by the first report of genetic amniocentesis in 1970. By the mid-1970s, the fetus had become a full-fledged patient, and obstetrics had become a complicated specialty -- so much so that in 1974 the first board-certification examination was given in the subspecialty of maternal-fetal medicine, in recognition of the tremendous body of knowledge in this area. Obstetricians now care for two patients, the pregnant woman and her fetus, and are expected to diagnose abnormalities accurately and to provide therapy appropriate to both