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Seminars in Perinatology

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https://www.readbyqxmd.com/read/29627075/congenital-syphilis
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/29336832/anticoagulation-in-neonatal-ecmo
#12
REVIEW
Aditi Kamdar, Natalie Rintoul, Leslie Raffini
Despite advances made in technology and neonatal intensive care, the rate of hemorrhagic and thrombotic complications remains unacceptably high in patients undergoing extracorporeal membrane oxygenation (ECMO) and these complications negatively impact morbidity and mortality. Management of anticoagulation in neonates who have a developing hemostatic system is vastly different from adults and poses unique challenges. Variation in practice among ECMO centers regarding anticoagulation monitoring and titration reflects the lack of high-quality evidence...
March 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29331209/ethical-and-end-of-life-considerations-for-neonates-requiring-ecmo-support
#13
REVIEW
Roxanne Kirsch, David Munson
ECMO has proven to be a life-saving intervention for a variety of disease entities with a high rate of survival in the neonatal population. However, ECMO requires clinical teams to engage in many ethical considerations. Even with ongoing improvements in technology and expertise, some patients will not survive a course of ECMO. An unsuccessful course of ECMO can be difficult to accept and cause a great deal of angst. These questions can result in real conflict both within the care team, and between the care team and the family...
March 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29307472/special-equipment-considerations-for-neonatal-ecmo
#14
REVIEW
James Connelly, Thane Blinman
Extracorporeal membrane oxygenation (ECMO) for neonates is applied routinely at major children's hospitals around the world. While the practice seems routine, the peculiar physiology of the small human imposes particular constraints on selection of equipment, performance of the circuit, and risks to the child. The physiology of small patients and physics of circuit elements leave many areas opaque and far from optimal, but still allow assembly of a set of useful heuristics for good practice. Here, we examine individual mechanical components of the ECMO circuit with attention to selection, pitfalls, and peculiarities of each when applied to the neonate...
March 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29305227/current-trends-in-neonatal-ecmo
#15
REVIEW
Burhan Mahmood, Debra Newton, Eugenia K Pallotto
Extracorporeal membrane oxygenation (ECMO) is a life-saving therapy for patients with respiratory and cardiac failure refractory to maximal medical management. The extracorporeal life support organization registry is the largest available resource for describing the population and outcomes of patients treated with this therapy. The use of ECMO for neonatal patients is decreasing in proportion to the total annual ECMO runs most likely due to advancements in medical management. Although the overall survival for neonatal ECMO has decreased, this is likely a reflection of the increasingly complex neonatal patients treated with this therapy...
March 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29305226/extracorporeal-membrane-oxygenation-in-congenital-heart-disease
#16
REVIEW
Kiona Y Allen, Catherine K Allan, Lillian Su, Mary E McBride
This review article will discuss the indications for and outcomes of neonates with congenital heart disease who receive extracorporeal membrane oxygenation (ECMO) support. Most commonly, ECMO is used as a perioperative bridge to recovery or temporary support for those after cardiac arrest or near arrest in patients with congenital or acquired heart disease. What had historically been considered a contraindication to ECMO, is evolving and more of the sickest and most complicated babies are cared for on ECMO...
March 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29291939/introduction-update-on-neonatal-extracorporeal-membrane-oxygenation
#17
EDITORIAL
Lindsay C Johnston, Natalie E Rintoul, Anne M Ades
No abstract text is available yet for this article.
March 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29463391/maternal-sepsis
#18
REVIEW
Arthur Jason Vaught
Sepsis is a leading cause of maternal morbidity and mortality in developed and developing nations. Obstetric practitioners should be familiar with guidelines that promote the safe and expeditious recovery of those affected. This article will provide the reader with rational steps to aid in the recovery of such a patient.
February 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29463390/managing-congenital-heart-disease-in-the-obstetric-patient
#19
REVIEW
Heidi M Connolly
OBJECTIVE: Cardiovascular disease is the major cause of pregnancy-related maternal mortality in the United States, and congenital heart disease (CHD) is the most common form of structural heart disease affecting women of childbearing age. Most females born with CHD will reach childbearing age and consider pregnancy. Adult CHD and maternal-fetal medicine (MFM) specialists managing women with CHD should provide preconception counseling, cardiovascular risk assessment prior to pregnancy that estimates maternal and fetal risk, management during pregnancy, and in the peripartum period and also know the potential complications and special circumstances that may occur in the post-partum period...
February 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29463389/trauma-in-pregnancy
#20
REVIEW
Christopher Kevin Huls, Corey Detlefs
Trauma is the leading non-obstetric cause of death during pregnancy and approximately 6-8% of all pregnancies are complicated by injury, both accidental and intentional. The initial evaluation and management of the injured pregnant patient often requires a multidisciplinary, collaborative team to provide the optimal outcome for both mother and fetus. It is important to recognize that even minor mechanisms of injury may result in poor outcomes for both fetus and mother. Injured pregnant patients meeting admission criteria experience a progressive increase in the number of complications as well as the number of patients that require delivery...
February 2018: Seminars in Perinatology
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