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Part Ⅰ DISTURBANCES OF PRE-NATAL LIFE 1
1．ENVIRONMENTAL AND HEREDITARY INFLUENCES 3
External environment 3
Internal environment 4
Heredity 9
2．CONGENITAL ABNORMALITIES 14
Incidence 15
Abnormalities with an established hereditary basis 18
Deformities due to physical intra-uterine moulding strains 19
The controversy on environment versus heredity 19
The contribution of chromosomal abnormality and of gene mutation 28
Conclusion 29
3．THE FOETAL CIRCULATION，THE PLACENTA AND THE FOETAL MEMBRANES 34
The foetal vascular system 34
The foetal part of the placenta 42
The maternal part of the placenta 55
The placenta as a whole—senescent and pathological changes 59
Placental efficiency and reserve 71
The amnion and the chorion 74
Abnormalities of the umbilical cord 77
4．FOETAL NUTRITION AND GROWTH 83
The sharing of available nutrient between mother and foetus 83
Assessment of intra-uterine nutrition 87
Validity for man of animal observations 90
Some results of maternal nutritional deficiency 91
Placental transfer and foetal nutrition 95
Conclusion 96
5．PREMATURITY AND POSTMATURITY AND LARGE BABIES 99
Assessment of the maturity of the infant 99
Handicaps imposed by premature birth 106
Immaturity and retrolental fibroplasia 111
The incidence of prematurity 112
Aetiology 112
The fate of the premature infant 113
Postmaturity 119
Large babies 122
6．STILLBIRTHS AND FOETAL DEATHS 129
Abortion，stillbirth and foetal death 129
Methods of classification and comparison of results 131
Factors influencing the general incidence of stillbirth 139
The pathological study of stillborn infants 141
7．MULTIPLE BIRTHS 145
Like and unlike twins 145
The placenta and foetal membranes in twins 147
Asymmetry，double monsters and teratomas 150
Incidence of multiple births and influence of environment and heredity 158
Triplets，quadruplets and quintuplets 159
The hazards of plural births 159
8．CONGENITAL TUMOURS 163
Hamartomas，heterotopia and simple tumours 163
Embryomas and teratomas 168
Malignant tumours 169
Congenital leukaemia 171
Transfer of malignant disease from the mother 172
Congenital tumours and carcinogenesis 172
Part Ⅱ ADAPTATION TO EXTRA-UTERINE EXISTENCE 177
9．ADAPTATION OF THE NORMAL FOETUS TO EXTRA-UTERINE RESPIRATION 179
Preparations for the initiation of extra-uterine respiration 179
Changes in the circulatory system associated with extra-uterine respiration 189
The initiation of extra-uterine respiration 190
The maintenance of extra-uterine respiration 194
The anatomical basis of imperfect pulmonary respiration 195
Pre-natal or extrinsic anoxia and adaptation to extra-uterine respiration 198
10．LESIONS WITHIN THE INFANT INFLUENCING ADAPTATION TO EXTRA-UTERINE RESPIRATION 211
Lesions involving the air passages and lungs 211
Disturbances involving the heart and blood vessels 219
Disturbances involving the central nervous system 236
11．THE BLOOD CONSTITUENTS AND ADAPTATION TO EXTRA-UTERINE LIFE 250
Disturbances involving the red blood cells and their formative tissue 250
The metabolism of the bile pigments 260
Thrombosis and embolism 264
Bleeding disturbances 269
12．ADAPTATION TO EXTRA-UTERINE ALIMENTATION 278
Disturbances of the movement of the intestinal contents 278
Disturbances of digestion 303
Absorption from the intestine 316
13．THE ESTABLISHMENT OF POST-NATAL METABOLISM 324
Metabolism of specific substances 325
Energy metabolism and body temperature 342
The role of the endocrine glands 344
Toxic agents and post-natal metabolism 356
14．POST-NATAL EXCRETION AND ITS CONTRIBUTION TO THE INTERNAL ENVIRONMENT 364
Biochemical factors influencing excretion 364
Excretory disturbances primarily of renal origin 366
The urinary passages and disturbances of excretion 374
15．CONDITIONS INTERFERING WITH NORMAL POST-NATAL DEVELOPMENT AND GROWTH 380
Lesions anatomically limited to the central nervous system 380
Lesions of the nervous system associated with defects of adjacent structures 389
Lesions of the skeleton and supporting tissues 399
Lesions of the integument 410
Lesions of the eye 413
Abnormalities of sex differentiation 414
Disturbances affecting multiple tissues and organs 415
Part Ⅲ INFECTIONS IN FOETAL AND NEONATAL LIFE 423
16．DEFENCE MECHANISMS IN THE FOETUS AND NEWBORN INFANT 425
The integrity and protection of exposed surfaces 425
Humoral substances and infections 427
Cellular reactions in infection 434
17．MICROBES OF THE INTRA-UTERINE AND POST-NATAL ENVIRONMENT 440
Microbic environment before the membranes rupture 440
Microbic environment after the rupture of the membranes 442
Acquisition of the post-natal flora 444
18．PATHOLOGY OF ACUTE INFECTIONS ACQUIRED IN UTERO 451
Protozoal and bacterial infections with unruptured membranes 451
Virus infections with unruptured membranes 455
Infections with membranes ruptured：Syndrome of infection of the amnion 457
19．THE PATHOLOGY OF ACUTE INFECTIONS ACQUIRED AFTER BIRTH 469
Predominant involvement of the respiratory system 471
Predominant involvement of the alimentary canal 479
Predominant involvement of the nervous system 487
Wound and skin infections 490
Infection of the urinary system 494
Septicaemia and blood disseminated sepsis 494
Disseminated virus infections 498
20．CHRONIC AND GENERALIZED SPECIFIC INFECTIONS IN FOETUS AND NEONATE 505
Syphilis 505
Tuberculosis 512
Toxoplasmosis 513
Torulosis，coccidioidomycosis and histoplasmosis 516
INDEX 521