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Neonatal- Perinatal Medicine

Mary D Brantley, Nicole L Davis, David A Goodman, William M Callaghan, Wanda D Barfield
BACKGROUND: Perinatal services exist today as a dyad of maternal and neonatal care. When perinatal care is fragmented or unavailable, excess morbidity and mortality may occur in pregnant women and newborns. OBJECTIVE: Describe spatial relationships between women of reproductive age, individual perinatal subspecialists (Maternal Fetal Medicine and Neonatology), and obstetric and neonatal critical care facilities in the United States to identify gaps in health care access...
October 20, 2016: American Journal of Obstetrics and Gynecology
Zoran Meštrović, Damir Roje, Marko Vulić, Mirela Zec
BACKGROUND: Optimal gestational weight gain has not yet been clearly defined and remains one of the most controversial issues in modern perinatology. The role of optimal weight gain during pregnancy is critical, as it has a strong effect on perinatal outcomes. PURPOSE: In this study, gestational body mass index (BMI) change, accounting for maternal height, was investigated as a new criterion for gestational weight gain determination, in the context of fetal growth assessment...
October 14, 2016: Archives of Gynecology and Obstetrics
Lynn M Yee, Grecio Sandoval, Jennifer Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, Steve N Caritis, Mona Prasad, Alan T N Tita, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To describe factors associated with delayed pushing and evaluate the relationship between delayed pushing and perinatal outcomes in nulliparous women with singleton term gestations. METHODS: This was a secondary analysis of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Assessment of Perinatal Excellence cohort of 115,502 women and their neonates born in 25 U.S. hospitals from 2008 to 2011. Nulliparous women with singleton, cephalic, nonanomalous term births who achieved 10-cm cervical dilation were included...
October 6, 2016: Obstetrics and Gynecology
Michael van Manen
Antenatal consultation is recognized as a core activity of specialists in neonatal-perinatal medicine. Fundamentally, the intent is for practitioner and parent to meet prior to the birth of a child to contribute to the care of the mother and also the newborn. Antenatal consults may therefore serve a multitude of purposes such as obtaining informed consent, relieving parental anxiety, elaborating medical treatment plans, and supporting parenting practices depending on the various situational and contextual factors underlying the consult...
October 11, 2016: Acta Paediatrica
Mandar S Joshi, Kelsey A Montgomery, Peter J Giannone, John A Bauer, Mina H Hanna
Preterm birth is associated with increased risks of morbidity and mortality along with increased healthcare costs. Advances in medicine have enhanced survival for preterm infants but the overall incidences of major morbidities have changed very little. Abnormal renal development is an important consequence of premature birth. Acute kidney injury (AKI) in the neonatal period is multifactorial and may increase lifetime risk of chronic kidney disease.Traditional biomarkers in newborns suffer from considerable confounders, limiting their use for early identification of AKI...
October 10, 2016: Pediatric Research
C H Backes, E M Bonachea, B K Rivera, M M Reynolds, C E Kovalchin, K M Reber, M K Ball, R Sutsko, S R Guntupalli, C V Smith, J D Mahan, M M Carbajal
OBJECTIVE: To evaluate the preparedness of pediatric residents entering accredited neonatal-perinatal medicine (NPM) fellowships in the United States. STUDY DESIGN: A multi-domain, validated survey was distributed to Program Directors (PDs) of US NPM fellowship programs. The 47-item survey explored 5 domains: professionalism, independent practice, psychomotor ability, clinical evaluation, and academia. A systematic, qualitative analysis on free-text comments was also performed...
September 29, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
R Douglas Wilson, Isabelle De Bie, Christine M Armour, Richard N Brown, Carla Campagnolo, June C Carroll, Nan Okun, Tanya Nelson, Rhonda Zwingerman, Francois Audibert, Jo-Ann Brock, Richard N Brown, Carla Campagnolo, June C Carroll, Isabelle De Bie, Jo-Ann Johnson, Nan Okun, Melanie Pastruck, Karine Vallée-Pouliot, R Douglas Wilson, Rhonda Zwingerman, Christine Armour, David Chitayat, Isabelle De Bie, Sara Fernandez, Raymond Kim, Josee Lavoie, Norma Leonard, Tanya Nelson, Sherry Taylor, Margot Van Allen, Clara Van Karnebeek
OBJECTIVE: This guideline was written to update Canadian maternity care and reproductive healthcare providers on pre- and postconceptional reproductive carrier screening for women or couples who may be at risk of being carriers for autosomal recessive (AR), autosomal dominant (AD), or X-linked (XL) conditions, with risk of transmission to the fetus. Four previous SOGC- Canadian College of Medical Geneticists (CCMG) guidelines are updated and merged into the current document. INTENDED USERS: All maternity care (most responsible health provider [MRHP]) and paediatric providers; maternity nursing; nurse practitioner; provincial maternity care administrator; medical student; and postgraduate resident year 1-7...
August 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
G Sorin, B Tosello
Anemia of prematurity remains a common complication despite recent advances in perinatal and neonatal medicine. The delayed cord clamping (at least 30seconds as recommended) has several benefits: increased hemoglobin and hematocrit levels at birth, improved initial hemodynamic, decreased incidence of transfusions and intraventricular hemorrhages. When the birth transition is difficult, wait 30seconds before clamping can be impossible. So as not to interfere with the neonatal resuscitation, the "milking" has been proposed as an alternative method to the delayed cord clamping...
September 13, 2016: Gynécologie, Obstétrique & Fertilité
Kwesi B Mensah, Charles Ansah
UNLABELLED: Epidemiological studies show clearly that Caesarean birth, perinatal or neonatal irrational antibiotic use is strongly associated with increased risk of obesity and diabetes in later life. Irrational use of antibiotics is a great global public health concern especially in developing economies like Ghana due to poor regulation on medicines. Unfortunately, this concern has been reduced to the fear of development of resistant organisms and the destruction of the world's limited range of antibiotics therapy at the expense of other insidious risks including the development of metabolic and atopic diseases...
June 2016: Ghana Medical Journal
James R Kiger, David J Annibale
CONTEXT: The problems associated with generating a collaborative ranked preference list represent a common source of dilemma in academic medicine and medical education. Such issues present during the process of choosing among applicants to medical schools, during the selection of postgraduate trainees, and in the course of performance assessments and the prioritising of financial expenditures. Currently, most institutions use pseudo-quantitative methods, such as the averaging of scores awarded on an arbitrary scale...
October 2016: Medical Education
Lynn M Yee, William A Grobman
OBJECTIVE: To investigate the relationship between fetal presentation at the time of admission for preterm premature rupture of membranes (PROM) and perinatal outcomes, including gestational latency, among women in a large and well-characterized population with preterm PROM at less than 32 weeks of gestation. METHODS: This was a secondary analysis of data from women randomized to receive magnesium sulfate compared with placebo in the previously reported Maternal-Fetal Medicine Units Network Beneficial Effects of Antenatal Magnesium Sulfate (1997-2004) trial...
October 2016: Obstetrics and Gynecology
Donatella Bagagiolo, Alessia Didio, Marco Sbarbaro, Claudio Giuseppe Priolo, Tiziana Borro, Daniele Farina
Osteopathic medicine is a form of complementary and alternative medicine. Osteopathic practitioners treat patients of all ages: according to the Osteopathic International Alliance's 2012 survey, about one-third of all treated patients are aged between 31 and 50 years and nearly a quarter (23.4%) are pediatric patients, with 8.7% of them being younger than 2 years. In 2013 a systematic review evaluated the effectiveness of osteopathic manipulative treatment (OMT) in pediatric patients with different underlying disorders, but due to the paucity and low methodological quality of the primary studies the results were inconclusive...
September 2016: American Journal of Perinatology
Avroy A Fanaroff
No abstract text is available yet for this article.
September 2016: American Journal of Perinatology
Abolfazl Khoshdel, Hajar Noormohammadi, Soleiman Kheiri, Roya Reisi, Seyed Mohammad-Kazem Nourbakhsh, Gholam Reza Panahandeh, Esfandiar Heidarian
OBJECTIVES: Perinatal asphyxia (PA) is very significant in perinatal medicine due to the involvement of the central nervous system. This study was conducted to investigate the biochemical, clinical, and paraclinical changes associated with phenobarbital administration in neonates with PA. METHODS: In this prospective, case-control study, 30 neonates with PA in two groups of 15 each (case and control) were investigated. The case group received 20 mg/kg intravenous phenobarbital within six hours of birth, and the control group did not receive phenobarbital...
September 2016: Oman Medical Journal
Masayuki Ochiai, Yuki Matsushita, Hirosuke Inoue, Takeshi Kusuda, Dongchon Kang, Kiyoshi Ichihara, Naoki Nakashima, Kenji Ihara, Shouichi Ohga, Toshiro Hara
Preterm low-birth-weight infants remain difficult to manage based on adequate laboratory tests. The aim of this study was to establish blood reference intervals (RIs) in those newborns who were admitted to and survived in the neonatal intensive care unit (NICU). A multicenter prospective study was conducted among all infants admitted to 11 affiliated NICUs from 2010 to 2013. The clinical information and laboratory data were registered in a network database designed for this study. The RIs for 26 items were derived using the parametric method after applying the latent abnormal values exclusion method...
2016: PloS One
J Nguyen, R Amirnovin, R Ramanathan, S Noori
OBJECTIVE: The current state of point-of-care ultrasonography (POCUS) use and education in neonatal-perinatal medicine (NPM) and pediatric critical care medicine (PCCM) is unknown. Our aim was to quantify POCUS use, training and perceptions regarding education and barriers among the United States NPM and PCCM fellowship programs. STUDY DESIGN: A 14-question survey was emailed to the fellowship directors of all the United States NPM and PCCM fellowship programs. RESULTS: The response rate was 55% (52/95) and 59% (39/66) for NPM and PCCM programs, respectively...
August 11, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Vincenzo Zanardo, Alessandro Mazza, Matteo Parotto, Giovanni Scambia, Gianluca Straface
BACKGROUND: Despite the current obesity epidemic, maternal underweight remains a common occurrence with potential adverse perinatal outcomes. METHODS: We aimed to investigate the relationship between weight gain during pregnancy, and fetal growth in underweight women with low and late fertility. Women body mass index (BMI), defined according to the World Health Organization's definition, gestational weight gain (GWG), defined by the Institute of Medicine and National Research Council and neonatal birth weight were prospectively collected at maternity ward of Policlinico Abano Terme (Italy) in 793 consecutive at term, uncomplicated deliveries...
2016: Italian Journal of Pediatrics
Julie M Buser, Jody R Lori
Objectives Decreasing neonatal morbidity and mortality remains a challenge in low resource settings. Maternity waiting homes (MWHs) may offer a way to better provide perinatal obstetric care and improve newborn outcomes. The purpose of this scoping review is to examine the impact of MWHs on newborn outcomes and to inform the development of targeted interventions and services to decrease neonatal mortality. Methods A literature search of four databases in the fields of nursing, medicine and global health was conducted yielding a total of 11 articles included for the review...
July 30, 2016: Maternal and Child Health Journal
D Wei, C Osman, D Dukhovny, J Romley, M Hall, S Chin, T Ho, P S Friedlich, A Lakshmanan
OBJECTIVE: The objectives of this study were (1) to describe the prevalence and correlates of cost consciousness among physician providers in neonatology and (2) to describe knowledge of cost of common medications, laboratory/imaging evaluations, hospitalization costs and reimbursements. STUDY DESIGN: A 54-item survey was administered to members of the Section on Neonatal-Perinatal Medicine of the American Academy of Pediatrics. RESULTS: Of the 602 participants, 37% reported cost consciousness in decision making...
July 28, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Joanna Kieliszczyk, Wojciech Baranowski, Wojciech Kosiak
UNLABELLED: Appropriate hydration is a very important prognostic factor for the patient's health. Ultrasonographic assessment of hydration status is rarely used in pediatric medicine and it is not used at all in neonates due to the fact that no reference values have been established for this age group. The aim of the paper was to establish reference values for neonates. MATERIAL AND METHODS: The study included 50 neonates from two hospitals in the Lower Silesia region of Poland; 25 of them were healthy patients (full-term newborns with no perinatal complications) and 25 were sick patients (newborns with heart defects such as ostium secundum atrial septal defect, ventricular septal defect, permanent foramen ovale and patent ductus arteriosus as well as newborns with neonatal jaundice or pneumonia that occurred during the first days of life)...
June 2016: Journal of Ultrasonography
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