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Seminars in Fetal & Neonatal Medicine

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https://www.readbyqxmd.com/read/28739260/uses-and-misuses-of-albumin-during-resuscitation-and-in-the-neonatal-intensive-care-unit
#1
REVIEW
Wissam Shalish, Francois Olivier, Hany Aly, Guilherme Sant'Anna
Albumin is one of the most abundant proteins in plasma and serves many vital functions. Neonatal concentrations vary greatly with gestational and postnatal age. In critically ill neonates, hypoalbuminemia occurs due to decreased synthesis, increased losses or redistribution of albumin into the extravascular space, and has been associated with increased morbidities and mortality. For that reason, infusion of exogenous albumin as a volume expander has been proposed for various clinical settings including hypotension, delivery room resuscitation, sepsis and postoperative fluid management...
July 21, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28735809/antibiotic-stewardship-in-perinatal-and-neonatal-care
#2
REVIEW
Jayashree Ramasethu, Tetsuya Kawakita
The spread of antibiotic resistance due to the use and misuse of antibiotics around the world is now a major health crisis. Neonates are exposed to antibiotics both before and after birth, often empirically because of risk factors for infection, or for non-specific signs which may or may not indicate sepsis. There is increasing evidence that, apart from antibiotic resistance, the use of antibiotics in pregnancy and in the neonatal period alters the microbiome in the fetus and neonate with an increased risk of immediate and long-term adverse effects...
July 20, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28734732/perinatal-and-neonatal-use-of-sedation-and-analgesia
#3
REVIEW
Christopher McPherson, Terrie Inder
Optimal obstetric and neonatal care requires the provision of adequate analgesia for painful procedures. However, anesthetic and analgesic agents have the potential to adversely impact the developing fetal/neonatal brain. In this setting, clinicians must assess the risks and benefits of pharmacologic anesthesia and analgesia for specific indications in this population. General anesthesia is required for non-obstetric surgery and cesarean section in the absence of neuraxial anesthesia for the health of the mother and fetus...
July 19, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28734731/postnatal-corticosteroids-to-prevent-or-treat-bronchopulmonary-dysplasia-who-might-benefit
#4
REVIEW
Lex W Doyle, Jeanie L Y Cheong
Newborn infants born very preterm are at high risk of developing bronchopulmonary dysplasia, which is associated with not only mortality but also adverse long-term neurological and respiratory outcomes in survivors. Postnatal corticosteroids might reduce the risk of developing bronchopulmonary dysplasia, or reduce its severity. However, it is important to minimize exposure to the potentially harmful effects of corticosteroids, particularly on the developing brain. Systemic corticosteroids started after the first week of life have shown the most benefit in infants at highest risk of developing bronchopulmonary dysplasia, whereas inhaled corticosteroids have little effect in children with established lung disease...
July 19, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28729117/term-respiratory-distress
#5
EDITORIAL
Steven M Donn, Sunil K Sinha
No abstract text is available yet for this article.
July 17, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28724506/the-use-of-non-steroidal-anti-inflammatory-drugs-for-patent-ductus-arteriosus-closure-in-preterm-infants
#6
REVIEW
William E Benitz, Shazia Bhombal
Over the last four decades, non-steroidal anti-inflammatory drugs have been widely used to induce closure of the patent ductus arteriosus (PDA) in preterm infants. Evidence to support this practice is lacking, despite performance of >50 randomized trials. The credibility of those trials may have been compromised by high rates of open treatment in controls, era of study prior to advent of modern practices, or inclusion of insufficient numbers of very immature infants. Meta-analyses show little impact of those factors on main conclusions...
July 17, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28720399/prenatal-and-postnatal-administration-of-prebiotics-and-probiotics
#7
REVIEW
Kristin Sohn, Mark A Underwood
Colonization of the neonatal gut by beneficial bacteria is important for the establishment and maintenance of the mucosal barrier, thus protecting the neonate from enteric pathogens and local and systemic inflammation. The neonatal microbiome is influenced by infant diet, environment, and the maternal microbiome. Dysbiosis in pregnancy increases the risk of pre-eclampsia, diabetes, infection, preterm labor, and later childhood atopy. Dysbiosis of the neonatal gut plays an important role in colic in the term infant, in the disease processes which plague preterm infants, including necrotizing enterocolitis and sepsis, and in the long-term outcomes of neonates...
July 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28720398/perinatal-and-neonatal-use-of-paracetamol-for-pain-relief
#8
REVIEW
Karel Allegaert, John N van den Anker
Paracetamol (acetaminophen) is the most widely used drug to treat pain or fever in pregnant women or neonates, but its pharmacokinetics (PK) and pharmacodynamics (PD) warrant a focused analysis. During pregnancy, there is an important increase in paracetamol clearance. Consequently, it is reasonable to anticipate that the analgesic effect of paracetamol will decrease faster, whereas higher doses may result in even higher oxidative toxic metabolites. Therefore, most peripartal PD data relate to multimodal analgesia strategies...
July 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28709949/pulmonary-hypoplasia
#9
REVIEW
C Michael Cotten
To survive the transition to extrauterine life, newborn infants must have lungs that provide an adequate surface area and volume to allow for gas exchange. The dynamic activities of fetal breathing movements and accumulation of lung luminal fluid are key to fetal lung development throughout the various phases of lung development and growth, first by branching morphogenesis, and later by septation. Because effective gas exchange is essential to survival, pulmonary hypoplasia is among the leading findings on autopsies of children dying in the newborn period...
July 11, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28709948/mechanical-ventilation-strategies
#10
REVIEW
Martin Keszler
Although only a small proportion of full term and late preterm infants require invasive respiratory support, they are not immune from ventilator-associated lung injury. The process of lung damage from mechanical ventilation is multifactorial and cannot be linked to any single variable. Atelectrauma and volutrauma have been identified as the most important and potentially preventable elements of lung injury. Respiratory support strategies for full term and late preterm infants have not been as thoroughly studied as those for preterm infants; consequently, a strong evidence base on which to make recommendations is lacking...
July 11, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28669541/carrier-screening-for-single-gene-disorders
#11
REVIEW
Nancy C Rose, Myra Wick
Screening for genetic disorders began in 1963 with the initiation of newborn screening for phenylketonuria. Advances in molecular technology have made both newborn screening for newborns affected with serious disorders, and carrier screening of individuals at risk for offspring with genetic disorders, more complex and more widely available. Carrier screening today can be performed secondary to family history-based screening, ethnic-based screening, and expanded carrier screening (ECS). ECS is panel-based screening, which analyzes carrier status for hundreds of genetic disorders irrespective of patient race or ethnicity...
June 29, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28619624/fetal-stem-cell-and-gene-therapy
#12
REVIEW
Russell Witt, Tippi C MacKenzie, William H Peranteau
Advances in our understanding of stem cells, gene editing, prenatal imaging and fetal interventions have opened up new opportunities for the treatment of congenital diseases either through in-utero stem cell transplantation or in-utero gene therapy. Improvements in ultrasound-guided access to the fetal vasculature have also enhanced the safety and efficacy of cell delivery. The fetal environment offers accessible stem cell niches, localized cell populations with large proliferative potential, and an immune system that is able to acquire donor-specific tolerance...
June 12, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28551277/an-extrauterine-environment-for-neonatal-development-extending-fetal-physiology-beyond-the-womb
#13
REVIEW
Emily A Partridge, Marcus G Davey, Matthew A Hornick, Alan W Flake
Extreme prematurity is a major cause of neonatal mortality and morbidity, and remains an unsolved clinical challenge. The development of an artificial womb, an extrauterine system recreating the intrauterine environment, would support ongoing growth and organ maturation of the extreme preterm fetus and would have the potential to substantially improve survival and reduce morbidity. Previous efforts toward the development of such a system have demonstrated the ability to maintain the isolated fetus for short periods of support, but have failed to achieve the long-term stability required for clinical application...
May 24, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28551276/responsible-surgical-innovation-and-research-in-maternal-fetal-surgery
#14
REVIEW
Ryan M Antiel, Alan W Flake
The field of maternal-fetal intervention is rapidly evolving with new technologies and innovations. This raises complex ethical and medico-legal challenges related to what constitutes innovative treatment versus human experimentation, with or without the umbrella of "medical research." There exists a gray zone between these black and white classifications, but there are also clear guidelines that should be responsibly negotiated when making the essential transition between an innovative treatment and a validated therapy...
May 24, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28532678/selective-intrauterine-growth-restriction-in-monochorionic-diamniotic-twin-pregnancies
#15
REVIEW
Mar Bennasar, Elisenda Eixarch, Josep Maria Martinez, Eduard Gratacós
Selective intrauterine growth restriction (sIUGR) affects 10-15% of all monochorionic pregnancies. Early severe forms are associated with intrauterine demise or neurological adverse outcome for both twins. The characteristics of umbilical artery (UA) Doppler in the IUGR fetus determine three clinical types: (I) normal UA Doppler and associated with good prognosis; (II) persistently absent/reverse UA end-diastolic flow and associated with early deterioration of the IUGR twin and very preterm delivery; (III) intermittently absent/reverse end-diastolic flow in the UA, and associated with unexpected fetal demise or neurological injury in one or both twins...
May 19, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28522033/placenta-directed-gene-therapy-for-fetal-growth-restriction
#16
REVIEW
Tara Krishnan, Anna L David
Fetal growth restriction (FGR) is a serious pregnancy complication affecting ∼8% of all pregnancies. There is no treatment to increase fetal growth in the uterus. Gene therapy presents a promising treatment strategy for FGR, with the use of adenoviral vectors encoding for proteins such as vascular endothelial growth factor (VEGF) and insulin-like growth factor demonstrating improvements in fetal growth, placental function, and neonatal outcome in preclinical studies. Safety assessments suggest no adverse risk to the mother or fetus for VEGF maternal gene therapy; a clinical trial is in development...
May 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28457816/interventions-to-prevent-stillbirth
#17
REVIEW
Jessica M Page, Robert M Silver
Stillbirth is one of the most distressing complications of pregnancy and still occurs far too frequently. The rate of stillbirth has been decreasing worldwide but room for improvement remains even in high-income countries. Risk factors for stillbirth have been identified in an effort to detect those women at increased risk. However, risk factors are non-specific and do not identify most stillbirths. Strategies employed to screen the general population such as assessment of fetal activity, fetal growth screening and biomarkers have also been used to identify increased risk for stillbirth...
June 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28325580/perinatal-death-investigations-what-is-current-practice
#18
REVIEW
J W Nijkamp, N J Sebire, K Bouman, F J Korteweg, J J H M Erwich, S J Gordijn
Perinatal death (PD) is a devastating obstetric complication. Determination of cause of death helps in understanding why and how it occurs, and it is an indispensable aid to parents wanting to understand why their baby died and to determine the recurrence risk and management in subsequent pregnancy. Consequently, a perinatal death requires adequate diagnostic investigation. An important first step in the analysis of PD is to identify the case circumstances, including relevant details regarding maternal history, obstetric history and current pregnancy (complications are evaluated and recorded)...
June 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28285990/classification-of-causes-and-associated-conditions-for-stillbirths-and-neonatal-deaths
#19
REVIEW
Vicki Flenady, Aleena M Wojcieszek, David Ellwood, Susannah Hopkins Leisher, Jan Jaap H M Erwich, Elizabeth S Draper, Elizabeth M McClure, Hanna E Reinebrant, Jeremy Oats, Lesley McCowan, Alison L Kent, Glenn Gardener, Adrienne Gordon, David Tudehope, Dimitrios Siassakos, Claire Storey, Jane Zuccollo, Jane E Dahlstrom, Katherine J Gold, Sanne Gordijn, Karin Pettersson, Vicki Masson, Robert Pattinson, Jason Gardosi, T Yee Khong, J Frederik Frøen, Robert M Silver
Accurate and consistent classification of causes and associated conditions for perinatal deaths is essential to inform strategies to reduce the five million which occur globally each year. With the majority of deaths occurring in low- and middle-income countries (LMICs), their needs must be prioritised. The aim of this paper is to review the classification of perinatal death, the contemporary classification systems including the World Health Organization's International Classification of Diseases - Perinatal Mortality (ICD-PM), and next steps...
June 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28279640/care-following-stillbirth-in-high-resource-settings-latest-evidence-guidelines-and-best-practice-points
#20
REVIEW
Danya Bakhbakhi, Christy Burden, Claire Storey, Dimitrios Siassakos
Third-trimester stillbirth affects approximately 2.6 million women worldwide each year. Although most stillbirths (98%) occur in low- and middle-income countries, most of the research on the impact of stillbirth and bereavement care has come from high-income countries. The impact of stillbirth ranges from stigma to disenfranchised grief, broken relationships, clinical depression, chronic pain, substance use, increased use of health services, employment difficulties, and debt. Appropriate bereavement care following a stillbirth is essential to minimise the negative socio-economic impact on parents and their families...
June 2017: Seminars in Fetal & Neonatal Medicine
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