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Seminars in Perinatology

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https://www.readbyqxmd.com/read/29909074/catheter-based-closure-of-the-patent-ductus-arteriosus-in-lower-weight-infants
#1
REVIEW
Leeann R Pavlek, Jonathan L Slaughter, Darren P Berman, Carl H Backes
Risks associated with drug therapy and surgical ligation have led health care providers to consider alternative strategies for patent ductus arteriosus (PDA) closure. Catheter-based PDA closure is the procedure of choice for ductal closure in adults, children, and infants ≥6kg. Given evidence among older counterparts, interest in catheter-based closure of the PDA in lower weight (<6kg) infants is growing. Among these smaller infants, the goals of this review are to: (1) provide an overview of the procedure; (2) review the types of PDA closure devices; (3) review the technical success (feasibility); (4) review the risks (safety profile); (5) discuss the quality of evidence on procedural efficacy; (6) consider areas for future research...
June 13, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29958702/evidence-based-use-of-acetaminophen-for-hemodynamically-significant-ductus-arteriosus-in-preterm-infants
#2
REVIEW
B Jasani, D E Weisz, P J McNamara
While cyclooxygenase inhibitors have been the most common medications used to facilitate earlier closure of patent ductus arteriosus in preterm infants, adverse effects and variable efficacy have highlighted a need for alternative options. Acetaminophen facilitates ductal closure via an alternate pathway of prostaglandin inhibition. Despite treatment with high doses, toxicity is uncommon in preterm infants, possibly due to immature hepatic metabolism. Pooled data from randomized clinical trials of early treatment demonstrate that acetaminophen has similar efficacy as cyclooxygenase inhibitors for PDA closure with a favorable side effect profile and without any apparent increase in adverse neonatal outcomes...
May 24, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29954594/changing-patterns-of-patent-ductus-arteriosus-surgical-ligation-in-the-united-states
#3
REVIEW
Jeff Reese, Theresa A Scott, Stephen W Patrick
Optimal management of patent ductus arteriosus (PDA) is unclear. One treatment, surgical ligation, is associated with adverse outcomes. We reviewed data from the Kids' Inpatient Database (2000-2012) to determine if PDA ligation rates: (1) changed over time, (2) varied geographically, or (3) influenced surgical complication rates. In 2012, 47,900 infants <1500g birth weight were born in the United States, including 2,800 undergoing PDA ligation (5.9%). Ligation was more likely in infants <1000g (85.9% vs...
May 22, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29958703/patent-ductus-arteriosus-its-treatments-and-the-risks-of-pulmonary-morbidity
#4
REVIEW
Ronald I Clyman
A persistent left-to-right shunt through a patent ductus arteriosus (PDA) increases the rate of hydrostatic fluid filtration into the lung's interstitium, impairs pulmonary mechanics, and prolongs the need for mechanical ventilation. In preclinical trials, pharmacologic PDA closure leads to improved alveolarization and minimizes the impaired postnatal alveolar development that is the pathologic hallmark of bronchopulmonary dysplasia (BPD). Although routine prophylactic treatment of a PDA on the day of birth does not appear to offer any more protection against BPD than delaying treatment for 2-3 days, recent evidence from quality improvement trials suggests that early pharmacologic treatment decreases the incidence of BPD compared with a treatment approach that exposes infants to a moderate-to-large PDA shunt for the first 7-10 days after birth...
May 10, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29937096/comparative-physiology-of-the-ductus-arteriosus-among-vertebrates
#5
REVIEW
Edward M Dzialowski
The ductus arteriosus is typically viewed as a mammalian fetal blood vessel providing a right-to-left shunt of right ventricular outflow away from the lungs and to the systemic circuit, that must close at birth. This review provides a wider comparative examination of the ductus arteriosus in lungfish, reptiles, birds, and mammals. The ductus arteriosus evolved with the lung in the ancestors of the lungfish as a connection between the pulmonary arteries and dorsal aorta. During embryonic development, reptiles, birds, and mammals all possess either one or two paired ductus arteriosi that provide a fetal shunt of blood away from the lungs...
May 10, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29910032/transcriptional-profiling-of-the-ductus-arteriosus-comparison-of-rodent-microarrays-and-human-rna-sequencing
#6
REVIEW
Michael T Yarboro, Matthew D Durbin, Jennifer L Herington, Elaine L Shelton, Tao Zhang, Cris G Ebby, Jason Z Stoller, Ronald I Clyman, Jeff Reese
DA closure is crucial for the transition from fetal to neonatal life. This closure is supported by changes to the DA's signaling and structural properties that distinguish it from neighboring vessels. Examining transcriptional differences between these vessels is key to identifying genes or pathways responsible for DA closure. Several microarray studies have explored the DA transcriptome in animal models but varied experimental designs have led to conflicting results. Thorough transcriptomic analysis of the human DA has yet to be performed...
May 10, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29907397/association-between-prophylactic-indomethacin-and-death-or-bronchopulmonary-dysplasia-a-systematic-review-and-meta-analysis-of-observational-studies
#7
REVIEW
Erik A Jensen, Elizabeth E Foglia, Barbara Schmidt
The use of prophylactic indomethacin in very preterm infants is controversial. The last randomized controlled trial (RCT) to study this therapy enrolled infants over 20 years ago. More recently, observational studies have investigated the association between exposure to prophylactic indomethacin and neonatal morbidities and mortality. We performed a systematic review and meta-analysis of these studies for the outcomes of death and bronchopulmonary dysplasia (BPD). Two observational studies involving a total of 11,289 very preterm infants were suitable for meta-analysis...
May 10, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29891126/towards-a-greater-understanding-of-the-ductus-arteriosus
#8
EDITORIAL
Jeff Reese
No abstract text is available yet for this article.
May 10, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29880312/novel-drug-targets-for-ductus-arteriosus-manipulation-looking-beyond-prostaglandins
#9
REVIEW
Elaine L Shelton, Gautam K Singh, Colin G Nichols
Forty years ago, non-steroidal anti-inflammatory drugs were first reported to decrease systemic prostaglandin levels and promote ductus arteriosus (DA) closure. And yet, prolonged patency of the DA (PDA) remains a significant clinical problem, complicated by imperfect therapies and wide variations in treatment strategy. There are few pharmacology-based tools available for treating PDA (indomethacin, ibuprofen, and acetaminophen), or for maintaining DA patency (PGE1 ) as is needed to facilitate corrective surgery for ductus-dependent congenital heart defects...
May 10, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29627075/congenital-syphilis
#10
REVIEW
Joshua M Cooper, Pablo J Sánchez
Congenital syphilis remains a major public health problem worldwide, and its incidence is increasing in the United States. This review highlights the ongoing problem of this preventable infection, and discusses vertical transmission and clinical manifestations while providing a practical algorithm for the evaluation and management of infants born to mothers with reactive serologic tests for syphilis. Every case of congenital syphilis must be seen as a failure of our public health system to provide optimal prenatal care to pregnant women, as congenital syphilis can be prevented by early and repeated prenatal serologic screening of mothers and penicillin treatment of infected women, their sexual partners, and their newborn infants...
April 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29544668/neonatal-herpes-simplex-virus-infections
#11
REVIEW
Swetha G Pinninti, David W Kimberlin
Neonatal herpes simplex virus (HSV) is an uncommon but devastating infection in the newborn, associated with significant morbidity and mortality. The use of PCR for identification of infected infants and acyclovir for treatment has significantly improved the prognosis for affected infants. The subsequent use of suppressive therapy with oral acyclovir following completion of parenteral treatment of acute disease has further enhanced the long-term prognosis for these infants. This review article will discuss the epidemiology, risk factors and routes of acquisition, clinical presentation, and evaluation of an infant suspected to have the infection, and treatment of proven neonatal HSV disease...
April 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29526384/introduction
#12
EDITORIAL
Shannon A Ross
No abstract text is available yet for this article.
April 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29526383/update-on-the-management-of-hepatitis-b-and-c-infections-in-the-neonatal-period
#13
REVIEW
Claudia M Espinosa, Ravi Jhaveri
Hepatitis B virus and hepatitis C virus have received a significant amount of attention in recent years, and both viruses share a significant amount of similarities with one another beyond just that they both primarily target the liver. In recent years, cases of both infections have been fueled by a nationwide epidemic of injection drug use. Most relevant to this audience, they are both transmitted from mother to child. The increased cases in young adults combined with mother to child transmission translate into more exposed infants that will need to be managed and followed...
April 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29526382/neonatal-nonpolio-enterovirus-and-parechovirus-infections
#14
REVIEW
Nada Harik, Roberta L DeBiasi
Nonpolio enteroviruses and parechoviruses are frequent causes of neonatal infection. Clinical manifestations of infection range from asymptomatic infection to mild infection without sequelae to septic shock with muiltiorgan failure. Neonates with clinically apparent infection typically have mothers and/or other contacts with recent symptoms consistent with a viral illness. Severe neonatal infection with nonpolio enterovirus or parechovirus cannot be differentiated clinically from serious bacterial infection...
April 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29523447/adverse-outcomes-of-pregnancy-associated-zika-virus-infection
#15
REVIEW
William J Britt
The spread of Zika virus to the Americas was accompanied by surge in the number of infants with CNS abnormalities leading to a declaration of a health emergency by the WHO. This was accompanied by significant responses from governmental health agencies in the United States and Europe that resulted in significant new information described in the natural history of this perinatal infection in a very short period of time. Although much has been learned about Zika virus infection during pregnancy, limitations of current diagnostics and the challenges for accurate serologic diagnosis of acute Zika virus infection has restricted our understanding of the natural history of this perinatal infection to infants born to women with clinical disease during pregnancy and to Zika exposed infants with obvious clinical stigmata of disease...
April 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29503048/congenital-cytomegalovirus-infection
#16
REVIEW
Karen B Fowler, Suresh B Boppana
Each year, thousands of children are born with or develop permanent disabilities such as hearing loss, vision loss, motor and cognitive deficits from congenital CMV infection (cCMV). However, awareness of cCMV and its associated sequelae is very low in pregnant women and healthcare providers. Both targeted and universal approaches to screen newborns for CMV infection are now achievable due to recent scientific advances including the development of a rapid, high-throughput method for detecting CMV in saliva, the efficacy of antiviral treatment in symptomatic infants, and the demonstration of cost effectiveness of CMV screening...
April 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29397959/neuromonitoring-in-the-neonatal-ecmo-patient
#17
REVIEW
Nan Lin, John Flibotte, Daniel J Licht
Utilization of extraocorporeal membrane oxygenation (ECMO) has become increasingly widespread as a bridging therapy for neonates with severe, reversible respiratory or cardiac diseases. While significant risks remain, due to advances in medical and surgical management, overall mortality has decreased. However, short and long-term neurological morbidity has remained high. Therefore, increasing attention has been focused on multimodal neuromonitoring to track and optimally, minimize or prevent intracranial injury...
March 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29338874/extracorporeal-membrane-oxygenation-in-infants-with-congenital-diaphragmatic-hernia
#18
REVIEW
Theresa R Grover, Natalie E Rintoul, Holly L Hedrick
Congenital diaphragmatic hernia (CDH) is a severe congenital anomaly which impairs normal pulmonary development leading to acute and chronic respiratory failure, pulmonary hypoplasia, pulmonary hypertension, and mortality. CDH is the most common non-cardiac indication for neonatal ECMO. Prenatal and postnatal predictors of CDH severity aid in patient selection. Centers vary in preferred mode of ECMO and timing of CDH repair. Survivors of severe CDH with ECMO are at risk for long-term sequelae including neurodevelopmental delays...
March 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29336834/an-overview-of-medical-ecmo-for-neonates
#19
REVIEW
Kathryn Fletcher, Rachel Chapman, Sarah Keene
Extracorporeal membrane oxygenation (ECMO), a life-saving therapy for respiratory and cardiac failure, was first used in neonates in the 1970s. The indications and criteria for ECMO have changed over the years, but it continues to be an important option for those who have failed other medical therapies. Since the Extracorporeal Life Support Organization (ELSO) Registry was established in 1989, more than 29,900 neonates have been placed on ECMO for respiratory failure, with 84% surviving their ECMO course, and 73% surviving to discharge or transfer...
March 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29336833/education-for-ecmo-providers-using-education-science-to-bridge-the-gap-between-clinical-and-educational-expertise
#20
REVIEW
Lindsay Johnston, Susan B Williams, Anne Ades
A well-organized educational curriculum for the training of both novice and experienced ECMO providers is critical for the continued function of an institutional ECMO program. ELSO provides guidance for the education for ECMO specialists, physicians and staff, which incorporates "traditional" instructor-centered educational methods, such as didactic lectures and technical skill training. Novel research suggests utilization of strategies that align with principles of adult learning to promote active learner involvement and reflection on how the material can be applied to understand existing and new constructs may be more effective...
March 2018: Seminars in Perinatology
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