By M. Charles. Bridgewater College.
As an offset levitra soft 20mg cheap, the physician 142 Schneider defendant can claim economic and noneconomic benefits such as love and happiness provided to the parents cheap levitra soft 20 mg without prescription. Wrongful life litigation typi- cally arises from negligent preconception care or from early preg- nancy genetic counseling. On the one hand, the obstetrician has responsibility for both the mother and the fetus. However, the mother has the right and authority of ascribing patient status to her unborn under the doctrine of autonomy. Assuming a competent parent, the physician may only take those actions for the baby consented to by the mother/parent. All aspects of informed refusal should be thoroughly documented in the medical record, particularly the potential risks imparted to the unborn by the decision of the parent. It is best to avoid making the mother feel accused of potentially harm- ing her baby. The majority of malpractice claims in gynecology arise from the issues surrounding reproductive function. Both medical and surgical management of pelvic diseases may impair fertility and reproduction. When assisted reproduction is at issue, the learned Ob/Gyn specialist defers and refers to experts in the subspecialty of reproductive biology and endocrinology. For those physicians specializing in infertility, the majority of suits evolve from failure to meet implied outcome expec- tations. The patient has the right to receive informed consent, which includes outcome statistics comparing potential results from other infertility centers available to the patient. The more common Ob/Gyn clinical issues leading to litigation include those inherent in all specialties, such as the following: • Failure to provide informed consent. There are a number of issues specific to obstetrics and gynecology that are frequently the subject of litigation. Antibiotic prophylaxis is recommended to prevent vaginal cuff infection in all hysterectomies (3) and to prevent group B streptococcus (GBS) sepsis in the newborn (4,5).
Objective 7 Define embryo and describe the major events Extraembryonic Membranes of the embryonic period of development purchase levitra soft 20mg on line. At the same time that the internal organs of the embryo are Objective 8 List the embryonic needs that must be met to being formed levitra soft 20 mg lowest price, a complex system of extraembryonic membranes avoid a spontaneous abortion. The extraembryonic membranes are the amnion, yolk sac, allantois, and chorion. These membranes Objective 9 Describe the structure and function of each of are responsible for the protection, respiration, excretion, and the extraembryonic membranes. At parturition, Objective 10 Describe the development and functions of the placenta, umbilical cord, and extraembryonic membranes the placenta and the umbilical cord. During the embryonic period—from the beginning of the third week to the end of the eighth week—the developing organism is Amnion correctly called an embryo. It loosely envelops the embryo, forming an cord, and extraembryonic membranes. The term conceptus refers amniotic sac that is filled with amniotic fluid (fig. In to the embryo, or to the fetus later on, and all of the extraembry- later fetal development, the amnion expands to come in contact onic structures—the products of conception. The development of the amnion is initiated early in the embryonic period, at which time its margin is at- Embryology is the study of the sequential changes in an or- ganism as the various tissues, organs, and systems develop. As Chick embryos are frequently studied because of the easy access the amniotic sac enlarges during the late embryonic period (at through the shell and their rapid development. Mice and pig embryos about 8 weeks), the amnion gradually sheaths the developing are also extensively studied as mammalian models. Genetic manipu- lation, induction of drugs, exposure to disease, radioactive tagging or umbilical cord with an epithelial covering (fig. During the preembryonic period of cell division and differ- • It cushions and protects by absorbing jolts that the mother entiation, the developing structure is self-sustaining. These needs include (1) formation of a vascular association • It helps eliminate metabolic wastes. Developmental © The McGraw−Hill Anatomy, Sixth Edition Development Anatomy, Postnatal Companies, 2001 Growth, and Inheritance Chapter 22 Developmental Anatomy, Postnatal Growth, and Inheritance 763 Amniotic fluid Embryonic disc Amnion Allantois Implanted embryo Yolk sac Body of uterus Chorion (a) Amnion (b) Connecting (a) stalk Villi of chorion Umbilical cord Placenta frondosum Yolk sac Chorion Allantois frondosum (c) Creek Chorion Amnion FIGURE 22.