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By Peter Gruenwald (auth.), Uwe Stave (eds.)

ISBN-10: 1468423169

ISBN-13: 9781468423167

ISBN-10: 1468423185

ISBN-13: 9781468423181

Living Nature, now not uninteresting paintings Shall plan my methods and rule my center -Cardinal Newman Nature and artwork 1868 one of many ineluctable effects of progress in any box of technological know-how is that matters of inquiry as soon as tested are likely to supply start to subsubjects and that the subsubjects as soon as demonstrated will in time endure extra mitotic department. now not such a lot of years in the past, difficulties surrounding the ietus and newly born toddler lay in a realm virtually to be defined as a "no-man's land." Obstetricians thoroughly gave significant attention to knowing and studying approximately methods and problems inquisitive about maternal healthiness and defense. The welfare of the baby was once considered as of secondary value. Pediatricians on their half hesitated to invade the nursery, a sanctum considered as belonging to the area of the accoucheur. And the pathologist, enveloped within the mysteries of lifestyles and demise within the grownup, came upon scant tim~ for the neonate and the placenta.

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An extensive absorbing surface is achieved within limited space by a branching system of chorionic villi capped by microvilli. The terminal villi progressively fill with thin-walled capillaries. This remarkable intimacy between the maternal and fetal circulations permits the efficient exchange of materials. By this mechanism, the maternal blood composition, which is maintained within narrow limits by fmely developed homeostatic controls, becomes a major factor in maintaining constancy of fetal blood composition.

One of these mechanisms. CHAPTER 2 • THE PLACENTA: AN OVERVIEW Mother Fetus Placenta Cholesterol Cholestrol DHA-SO", 23 Dehydroepiandrosterone sulfate (DHA-SO",) Estrone (E, ) --+-- DHA-SO", Estradiol (E 2 ) c: o 16 Q-hydroxydehydroepiandrosterone (16 Q OH -DHA-SO",) Sulfate '':- ':::>Cl" 'c o 16 Q OH -DHA-SO", u {E3 Fig. 2. Steroid hormone metabolism in the fetomaternal unit, Reproduced from Dancis. Used by permission of B. , Philadelphia. J. It should be stressed that the immunologic without circulating antibodies if they were not reaction of the mother is not eliminated.

At the same time, the neonate leaves a liquid-phase, constant-temperature environment and enters the gas-phase environment with quickly varying temperatures. In addition, the lung function for breathing air and the digestive processes must be established. These events are topped by the need for a neurohumoral regulatory system that never before was similarly flooded with stimuli of all kinds and never had to direct its regulatory efforts toward a new and different homeostasis. (22) The crucial point is that the newborn has been developmentally prepared for birth and for the existence in the extrauterine environment.

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Perinatal Physiology by Peter Gruenwald (auth.), Uwe Stave (eds.)

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