Preterm neonates remain at increased risk for adverse bilirubin-related outcomes, including acute bilirubin encephalopathy relative to term infants. Yet, most vulnerable neonates are likely to benefit from the potent anti-oxidant properties of bilirubin. Evidence-based guidelines for the management of hyperbilirubinemia in preterm infants, however, are lacking. High concentrations of unconjugated bilirubin can cause permanent neurologic damage in infants, evident through magnetic resonance imaging of chronic bilirubin encephalopathy or kernicterus. There is a growing concern that exposures to even moderate concentrations of bilirubin may lead to subtle but permanent neurodevelopmental impairment referred to as bilirubin-induced neurologic dysfunction. Our current use of phototherapy to decrease bilirubin loads and its potential photo-oxidant properties is a biological conundrum that has been questioned in the use of phototherapy for very low birth weight neonates. In this issue of Clinics in Perinatology, we provide updates on the current understanding of the biology, mechanisms of increasing bilirubin load due to hemolysis, decreased bilirubin binding capacity and glucose-6-phosphate dehydrogenase deficiency, as well as clinical strategies to operationalize the thresholds for hyperbilirubinemia interventions in preterm infants.
The impact of cardiovascular disease on an infant extends from the fetal period to well beyond childhood. Perinatalogists and neonatologists can impact maternal and fetal health through wide range of diagnostic modalities and interventional techniques. For our edition focused on cardiovascular health, we sought to encompass the breadth of knowledge that would be the most relevant for the bed side clinician. Our goal was to assemble contents that would allow a clinician to quickly peruse the journal, and then be prepared to make a medical decision. The interaction between cardiology and perinatology/neonatology includes genetics, diagnostics, interventions, counseling, routine stabilization and day to day care. Ultimately, the goal is to establish the foundation for a healthy adult. For this reason, we have even included chapters on topics that are significant on a day to day basis (such as the proper environment for a newborn) and a long term basis (like the overall neurodevelopmental impact of our interventions). Hopefully, whether in the middle of the night as an emergency reference or during the day as a reliable guide, this edition of Clinics in perinatology will be an important bedside tool for anyone that participates in the care of a patient with perinatal heart disease.
Genetic testing and genome sequencing have opened up the possibility to clinicians and families to treat diseases, syndromes, and malformations earlier and provide therapeutic interventions.The guest editors seek to provide a basic overview of the topic for the neonatologist/perinatologist. Articles addres dysmorphology, syndromes in the infant, skeletal dysplasias, limb malformations, craniofacial anomolies, GI/liver disease, disorders of sexual develoment, brain defects, inborn errors of metabolism, and congenital heart disease.
The Year Book of Neonatal and Perinatal Medicine brings you abstracts of the articles that reported the year's breakthrough developments in neonatal and perinatal medicine, carefully selected from more than 500 journals worldwide. Expert commentaries evaluate the clinical importance of each article and discuss its application to your practice. There's no faster or easier way to stay informed! Chapters in this annual cover the most current information on all aspects of neonatal and perinatal medicine from genetics to labor and delivery to issues related to many key bodily systems (heart, respiratory, nervous system, etc.) of newborns. Other topics for 2004 include neurology, gastroenterology and nutrition, medical disorders of pregnancy, fetal evaluation, and neonatal behavior.
Kidney anomalies are the most frequent abnormality detected on prenatal ultrasound. Some are inconsequential and others are life-threatening. All must be addressed by neonatologists. This edition of Pediatric Clinics of Perinatology covers these anomalies. In addition, it addresses a variety of other nephrology and urology issues that neonatologists confront. Some are rare and the chapter may then serve as an important resource. Others are common, and thus will provide updated information on diagnosis and management.
This issue is expected to be in high demand, being extremely valuable to both neonatologists and maternal-fetal medicine physicians. The Guest Editors have put together a very comprehensive issue that looks at the premature infant. Topics include: Moderate Preterm. Late Preterm and Early Term Births: Epidemiology and Trends; Stillbirth Reduction Efforts and Impact on Early Births; Management of Indicated Early Term and Late Preterm Births; Physiological Underpinnings for Clinical Problems in Moderately Preterm, Late Preterm;Brain Maturation in the Second of Half of Pregnancy; Respiratory Disorders in Moderately Preterm, Late Preterm and Early Term Infants; Metabolic and Neurologic Issues in Moderately Preterm, Late Preterm and Early Term Infants; and Quality Initiatives Related to Moderately Preterm, Late Preterm and Early Term Births.
This issue of Clinics in Perinatology will carry the reader through the perinatal period and examine pain management throughout that continuum. Beginning with the genetics of obstetrical pain and opioid use in pregnancy, the discussion moves to the provision of anesthesia to the mother and fetus during fetal surgery – an area of intense concern and interest in many centers. There is an extensive discussion of both pharmacologic and non-pharmacologic management of pain during delivery. A discussion of regional anesthetic techniques is increasingly relevant in light of increasing evidence of adverse neurodevelopmental consequences of fetal exposure to general anesthetics and sedatives. Pain, its implications and management, are extensively covered including discussions of how to assess neonatal pain and how best to provide sedation and non-pharmacologic pain management, systemic pharmacologic, or regional techniques. Of particular interest are the reviews of the potential neurodevelopmental impact of both the treatment and the failure to adequately treat pain in the newborn. This topic is receiving an enormous amount of attention from all those who care for children as well as government and the media.
The Year Book of Neonatal and Perinatal Medicine brings you abstracts of the articles that reported the year's breakthrough developments in neonatal and perinatal medicine, carefully selected from more than 500 journals worldwide. Expert commentaries evaluate the clinical importance of each article and discuss its application to your practice. There's no faster or easier way to stay informed! Chapters in this annual cover the most current information on all aspects of neonatal and perinatal medicine from genetics to labor and delivery to issues related to many key bodily systems (heart, respiratory, nervous system, etc.) of newborns. Other topics for 2004 include neurology, gastroenterology and nutrition, medical disorders of pregnancy, fetal evaluation, and neonatal behavior.