Diagnosis,surveillance, and treatment of the anemic fetus using middle cerebral artery peak systolic velocity measurement

The in utero course of the anemic fetus has improved dramatically, owing to early diagnosis and cordocentesis transfusion. In utero invasive procedures such as amnio- and cordocentesis have become important modalities in the evaluation and treatment of anemic fetuses. However, they carry risks for both the mother and fetus. A valid and sensitive noninvasive means of following the anemic fetus is the evaluation of changes in the middle cerebral artery peak systolic flow velocity (MCA-PSV). This is a sensitive tool for both the evaluation of fetal anemia and response to treatment. Intracerebral vessels respond earliest to the fetal anemic state, and are readily accessible for ultrasound examination. We describe the methodology and evolving clinical applications of MCA-PSV measurement in the fetus, through an overview of the literature describing the development and application of MCA-PSV measurement in fetuses at risk of fetal anemia of various immune and nonimmune etiologies, illustrated by index cases from our center. MCA-PSV measurement is essential in the diagnosis, evaluation, and management of cases of fetal anemia. The use of this modality lessens the need for invasive procedures. The method is readily accessible and should be integrated into the repertoire of all obstetric ultrasound centers. Copyright © 2006 John Wiley & Sons, Ltd.     

Book reviews

Cost Benefit Analysis of Environmental Change

Per‐Olov Johansson

Cambridge, Cambridge University Press, 1993, 232 pp., £13.95

Computerised Environmental Modelling: A Practical Introduction using Excel

J. Hardisty, D. M. Taylor & S. E. Metcalfe

Chichester, Wiley, 1993, 204 pp., £14.95

Keeping Pace with Science and Engineering: Case Studies in Environmental Regulation

Washington DC, US National Academy of Engineering, 1993

World Without End: Economics, Environment and Sustainable Development

D. W. Pearce & J. J. Warford

Oxford University Press, New York, 1993, 440 pp., £35.95     

Factor structure of the transformational leadership model in human service teams

The purpose of this study was to examine the factor structure of the transformational leadership model in human service teams. As the nature of this work environment mandates certain management‐by‐exception practices, patterns of correlations between perceptions of active and passive management‐by‐exception behaviors and transformational, transactional, and laissez‐faire leadership were of interest. 236 leaders and 620 subordinates from 54 mental health teams completed the Multifactor Leadership Questionnaire, form 8Y. Results suggest that active and passive management‐by‐exception factors are independent constructs. Copyright © 2003 John Wiley & Sons, Ltd.