MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Clinics in Perinatology' source. Sat, 30 Jan 2010 16:16:56 +0100 http://www.medworm.com/index.php?rid=3039332&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS009551080900102X%2Fabstract%3Frss%3Dyes (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=3039332 Mon, 30 Nov 2009 16:30:10 +0100 3039332 http://www.medworm.com/index.php?rid=3039331&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000700%2Fabstract%3Frss%3Dyes The highest incidence of seizures occurs during the first hours to days after birth. The immature brain is prone to seizures because of reduced inhibition. GABA, which is the primary inhibitory neurotransmitter in the mature brain, is depolarizing and excitatory in the immature brain. Seizures are an ominous sign, indicating either an acquired brain insult or a genetic abnormality. While the primary outcome determinant of neonatal seizures is etiology, whether seizures can result in long-term adverse consequences independently is not clear. While the clinical data is uncertain, there is now a considerable body of evidence indicating that in animals, neonatal seizures can adversely alter the developing brain. Animal data indicates that the sequelae of seizures are strongly age dependent; se... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=3039331 Mon, 30 Nov 2009 16:30:10 +0100 3039331 http://www.medworm.com/index.php?rid=3039330&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000918%2Fabstract%3Frss%3Dyes This article provides an overview of current approaches to the diagnosis and treatment of neonatal seizures, and some of the recent insights about the pathophysiology of neonatal seizures that may provide the foundation for better treatment are identified. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=3039330 Mon, 30 Nov 2009 16:30:10 +0100 3039330 http://www.medworm.com/index.php?rid=3039329&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000694%2Fabstract%3Frss%3Dyes Neonatal brain injury is an important cause of death and disability, with pathways of oxidant stress, inflammation, and excitotoxicity that lead to damage that progresses over a long period of time. Therapies have classically targeted individual pathways during early phases of injury, but more recent therapies such as growth factors may also enhance cell proliferation, differentiation, and migration over time. More recent evidence suggests combined therapy may optimize repair, decreasing cell injury while increasing newly born cells. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=3039329 Mon, 30 Nov 2009 16:30:10 +0100 3039329 http://www.medworm.com/index.php?rid=3039328&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000712%2Fabstract%3Frss%3Dyes Hypoxia-ischemia in the perinatal period is an important cause of cerebral palsy and associated disabilities in children. There has been significant research progress in hypoxic-ischemic encephalopathy over the last 2 decades, and many new molecular mechanisms have been identified. Despite all these advances, therapeutic interventions are still limited. In this article the authors discuss several molecular pathways involved in hypoxia-ischemia, and potential therapeutic targets. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=3039328 Mon, 30 Nov 2009 16:30:10 +0100 3039328 http://www.medworm.com/index.php?rid=3039327&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS009551080900075X%2Fabstract%3Frss%3Dyes This article reviews tissue oximetry and imaging to study the preterm and newborn infant brain by near-infrared spectroscopy. These two technologies are now advanced; nearly 100 reports on their use in newborn infants have been published, and commercial instruments are available. The precision of oximetry, however, is a limitation for its clinical use of assessing cerebral oxygenation. Imaging of brain function needs very well defined protocols for sensory stimulation as well as signal analysis to provide meaningful results. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=3039327 Mon, 30 Nov 2009 16:30:10 +0100 3039327 http://www.medworm.com/index.php?rid=3039326&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000724%2Fabstract%3Frss%3Dyes Recent studies in survivors of extreme prematurity point to an increased prevalence of a previously underrecognized atypical social-behavioral profile strongly suggestive of an autism spectrum disorder. Prospective studies that incorporate early autism screening and autism diagnostic testing are needed to better delineate the sensitivity and specificity of early signs of autism in ex-premature children. Advances in neonatal MRI techniques capable of quantitative structural and functional measurements will also provide important insights into the effects of prematurity itself, and prematurity-related brain injury on the genesis of autism spectrum disorders in this population. Available evidence linking prematurity and autism spectrum disorders is reviewed in this article. (Source: Clinics i... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=3039326 Mon, 30 Nov 2009 16:30:10 +0100 3039326 http://www.medworm.com/index.php?rid=3039325&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000748%2Fabstract%3Frss%3Dyes This article reviews current trends in prevalence, mortality, and morbidity, and the present status of outcome data for cognitive and neurosensory neurodevelopmental dysfunctions in preterm infants. New neuroimaging modalities and analysis tools are contributing to the understanding of neurologic sequelae of preterm birth by providing microstructural evidence of injury sustained by the preterm brain. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=3039325 Mon, 30 Nov 2009 16:30:09 +0100 3039325 http://www.medworm.com/index.php?rid=3039324&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000736%2Fabstract%3Frss%3Dyes The toll-like receptors (TLRs) are a family of microbe-sensing receptors on peripheral immune cells. TLRs have also been discovered to be present in the brain, particularly in circumventricular organs, microglia, and astrocytes. Some TLRs are strongly expressed in the embryonic brain and TLR3 and TLR8 have been implicated in neurogenesis and neurite outgrowth in the developing brain, whereas TLR2 and TLR4 have been shown to regulate adult neurogenesis. TLR2 and TLR4 also play a role in acute ischemic brain injury in the adult, although no neuroprotection was observed following perinatal hypoxic-ischemic injury. These findings suggest that different TLRs have specific roles in the immature and adult brain following brain damage. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=3039324 Mon, 30 Nov 2009 16:30:09 +0100 3039324 http://www.medworm.com/index.php?rid=3039323&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000682%2Fabstract%3Frss%3Dyes This article covers the spectrum of ICH in the preterm infant, including germinal matrix intraventricular hemorrhage, its complications, and associated phenomena, such as the emerging role of cerebellar hemorrhage. The overall aim of this article is to review the current knowledge of the mechanisms, diagnosis, outcome, and management of preterm ICH; to revisit the origins from which they develop; and to discuss future expectations. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=3039323 Mon, 30 Nov 2009 16:30:09 +0100 3039323 http://www.medworm.com/index.php?rid=3039322&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000670%2Fabstract%3Frss%3Dyes This article describes recent advances in the understanding of hemodynamic changes in very low birth weight neonates during postnatal transition, and reviews the complex and developmentally regulated interaction between systemic and cerebral hemodynamics and the effect of this interaction on clinically relevant outcomes. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=3039322 Mon, 30 Nov 2009 16:30:09 +0100 3039322 http://www.medworm.com/index.php?rid=3039321&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS009551080900092X%2Fabstract%3Frss%3Dyes Neonatal neurology began to emerge as a clinical discipline in the 1970s, pioneered by a small cadre of neurologists and neonatologists from around the world. Foremost among these was Joseph Volpe, whose seminal work, “Neurology of the Newborn” galvanized the field. During those early years, the number of presentations on the newborn brain at national academic meetings could be counted on one hand. Over the subsequent 3 decades, however, neonatal neurology has grown into one of the most vibrant subspecialties in newborn medicine, with major meetings now dedicating entire sessions and special interest groups to the newborn brain. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=3039321 Mon, 30 Nov 2009 16:30:09 +0100 3039321 http://www.medworm.com/index.php?rid=3039320&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809001018%2Fabstract%3Frss%3Dyes (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=3039320 Mon, 30 Nov 2009 16:30:09 +0100 3039320 http://www.medworm.com/index.php?rid=3039319&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000931%2Fabstract%3Frss%3Dyes (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=3039319 Mon, 30 Nov 2009 16:30:09 +0100 3039319 http://www.medworm.com/index.php?rid=3039318&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000992%2Fabstract%3Frss%3Dyes (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=3039318 Mon, 30 Nov 2009 16:30:07 +0100 3039318 http://www.medworm.com/index.php?rid=2761352&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000840%2Fabstract%3Frss%3Dyes (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2761352 Mon, 31 Aug 2009 23:00:00 +0100 2761352 http://www.medworm.com/index.php?rid=2761351&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000633%2Fabstract%3Frss%3Dyes SQUID Array for Reproductive Assessment is a unique magnetoencephalography device designed for the noninvasive recording of fetal brain activity. In this article, we provide a general overview of the technology and its potential application to fetal medicine. A large number of studies that have been conducted and published describing this device since it was brought into operation are referenced throughout the article. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2761351 Mon, 31 Aug 2009 23:00:00 +0100 2761351 http://www.medworm.com/index.php?rid=2761350&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000621%2Fabstract%3Frss%3Dyes Fetal magnetic resonance imaging (MRI) may add important diagnostic information to prenatal sonography and has the power to confirm or change decisions at critical points in clinical care. Recent studies have shown MRI to be a critical clinical adjunct in the evaluation of the developing central nervous system (CNS), especially at early gestational ages, and MRI has been used in three significant ways: (1) for the quantification of brain growth and structural abnormalities using biometry, (2) for the qualitative evaluation of CNS microstructure, and (3) for the qualitative assessment of dynamic fetal movements in utero. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2761350 Mon, 31 Aug 2009 23:00:00 +0100 2761350 http://www.medworm.com/index.php?rid=2761349&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS009551080900027X%2Fabstract%3Frss%3Dyes Obstetric care providers and researchers have long relied on analysis of the fetal heart rate tracing for insight into the fetal neurologic status. Although a normal fetal heart rate tracing does provide reassurance of intact neurologic function, an abnormal pattern is a very poor predictor of newborn brain injury. Indeed, if the clinical end point of interest is cerebral palsy, a non-reassuring fetal heart rate tracing has a 99% false positive rate. More recent analyses of fetal heart rate variability and fetal ECG waveforms, however, hold promise for improved diagnostic accuracy. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2761349 Mon, 31 Aug 2009 23:00:00 +0100 2761349 http://www.medworm.com/index.php?rid=2761348&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000517%2Fabstract%3Frss%3Dyes This article examines recent studies that have systematically dissected features of fetal heart rate responses to labor that may help identify developing fetal compromise, such as the slope of the deceleration, overshoot, and variability. Although repeated deep decelerations are never necessarily benign, fetuses with normal placental reserve can fully compensate even for frequent deep but brief decelerations for surprisingly prolonged intervals before developing profound acidosis and hypotension. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2761348 Mon, 31 Aug 2009 23:00:00 +0100 2761348 http://www.medworm.com/index.php?rid=2761347&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000220%2Fabstract%3Frss%3Dyes Current microbial diagnostics enable rapid and specific identification of the agents causing intrauterine and perinatal infections, and CT and MRI allow precise characterization of the central nervous system effects of these pathogens. Although infections with Toxoplasma gondii, Toxoplasma pallidum, Toxoplasma cruzi, and cytomegalovirus cannot currently be prevented by immunization, postnatal therapy of infected neonates can substantially improve outcome. Therapy with acyclovir should be initiated whenever perinatal herpes simplex virus encephalitis is suspected. Despite these strategies, intrauterine and perinatal infections remain major causes of permanent deafness, vision loss, cerebral palsy, and epilepsy among children throughout the world. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2761347 Mon, 31 Aug 2009 23:00:00 +0100 2761347 http://www.medworm.com/index.php?rid=2761346&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000232%2Fabstract%3Frss%3Dyes This article explores the association of malformations of cerebral development reported in association with inborn errors of metabolism, and speculates on potential mechanisms by which such malformations arise. The detection of cerebral malformations prenatally should lead to a search for both genetic etiologies and inborn errors of metabolism in the fetus. Improving the changes of an early diagnosis provides for timely therapeutic interventions and it is hoped a brighter future for affected children and their families. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2761346 Mon, 31 Aug 2009 23:00:00 +0100 2761346 http://www.medworm.com/index.php?rid=2761345&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000256%2Fabstract%3Frss%3Dyes This article describes the effects of three drugs with similar molecular targets that involve monoaminergic transmitter systems: cocaine, methamphetamine, and selective serotonin re-uptake inhibitors (SSRIs) used to treat maternal depression during pregnancy. We propose a possible common epigenetic mechanism for their potential effects on the developing child. We suggest that exposure to these substances acts as a stressor that affects fetal programming, disrupts fetal placental monoamine transporter expression and alters neuroendocrine and neurotransmitter system development. We also discuss neurobehavioral techniques that may be useful in the early detection of the effects of in utero drug exposure (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2761345 Mon, 31 Aug 2009 23:00:00 +0100 2761345 http://www.medworm.com/index.php?rid=2761344&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000505%2Fabstract%3Frss%3Dyes The outcome of perinatal hypoxiaischemia is highly variable, with only a very broad relationship to the ‘severity’ of oxygen debt as shown by peripheral base deficit and the risk of damage. The present article examines the pathophysiology of asphyxial injury. We dissect the multiple factors that modify the risk of injury, including the depth (‘severity’), duration, and repetition of the insult, the maturity, and condition of the fetus, pre-existing hypoxia, and exposure to pyrexia and infection/inflammation. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2761344 Mon, 31 Aug 2009 23:00:00 +0100 2761344 http://www.medworm.com/index.php?rid=2761343&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000657%2Fabstract%3Frss%3Dyes Even in the presence of normal placental function, cerebral oxygen-substrate supply may be disrupted by disturbances in the fetal circulation caused by anomalous cardiac development. The impact of these cardiac lesions is likely dictated primarily by the volume and oxygen-substrate composition of transverse aortic arch perfusion. Advances in fetal echocardiography, fetal Doppler ultrasound, and advanced fetal magnetic resonance imaging techniques capable of quantitative structural and functional measurements are providing major insights into the in vivo effects of these cardiac lesions on brain growth and development. The progress to date with the application of these techniques is reviewed in this article. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2761343 Mon, 31 Aug 2009 23:00:00 +0100 2761343 http://www.medworm.com/index.php?rid=2761342&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000244%2Fabstract%3Frss%3Dyes Disorders of the placental circulation, including the release of deleterious mediators to the fetus, are important risk factors for central nervous system complications. These disorders result in discrete patterns of placental injury detectable by a thorough placental pathologic examination. Consideration of the location, severity, multiplicity, and timing of these lesions is critical to a full understanding of their significance. Less than 10% of placentas from term infants that later develop cerebral palsy lack any evidence of placental abnormalities potentially related to adverse outcome. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2761342 Mon, 31 Aug 2009 23:00:00 +0100 2761342 http://www.medworm.com/index.php?rid=2761341&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000645%2Fabstract%3Frss%3Dyes The inaccessibility of the human fetal brain to studies of perfusion and metabolism has impeded progress in the understanding of the normal and abnormal systems of oxygen substrate supply and demand. Consequently, current understanding is based on studies in fetal animals or in the premature infant (ex utero fetus), neither of which is ideal. Despite promising developments in fetal magnetic resonance imaging (MRI) and Doppler ultrasound, major advances in fetal neurodiagnostics will be required before rational and truly informed brainoriented care of the fetus becomes feasible. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2761341 Mon, 31 Aug 2009 23:00:00 +0100 2761341 http://www.medworm.com/index.php?rid=2761340&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000268%2Fabstract%3Frss%3Dyes The cerebellum arises from two anatomically and molecularly different proliferative compartments: the cerebellar ventricular zone and the rhombic lip. The protracted development makes the cerebellum vulnerable to a broad spectrum of developmental disorders, of which the more frequent (the Dandy-Walker and related malformations and the pontocerebellar hypoplasias) are discussed in this article. Several genes for congenital malformations of the human cerebellum have recently been identified, including genes causing Joubert syndrome, the Dandy-Walker malformation, and pontocerebellar hypoplasias. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2761340 Mon, 31 Aug 2009 23:00:00 +0100 2761340 http://www.medworm.com/index.php?rid=2761339&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000529%2Fabstract%3Frss%3Dyes This article reviews key recent findings in the field of human cortical development. This development is divided into three major time-dependent phases: neural proliferation of inhibitory and excitatory neurons in spatially distinct regions, migration through multiple cellular boundaries, and maturation through morphologic changes that result in the elaboration of dendrites and axons and that establish the multitude of cellular contacts that underlie neuronal processing. Many of the neurocognitive disorders treated in the clinic can trace their origin to a disorder in one or more of these key steps. Along with this update, work is highlighted that offers a glimpse at the future of therapy for developmental brain disorders that can result from disorders of these cellular events. (Source: Cl... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2761339 Mon, 31 Aug 2009 23:00:00 +0100 2761339 http://www.medworm.com/index.php?rid=2761338&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000669%2Fabstract%3Frss%3Dyes That events in the fetal period may be critical determinants of lifelong neuropsychological function is not a new concept. However, the vast extent and diversity of fetal experiences and the broad spectrum of their postnatal impact are rapidly achieving greater recognition. Two apparently parallel avenues begin at this time to intersect in an enticing way. First, the accelerating field of neurogenetics is vitalizing our understanding of the highly programmed process of brain development and, in cases of brain dysgenesis, its derailment. Second, investigations of internal and external environmental influences are greatly expanding our understanding of their fundamental role in normal and disrupted fetal brain development. The growing body of data from both these avenues of investigation no ... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2761338 Mon, 31 Aug 2009 23:00:00 +0100 2761338 http://www.medworm.com/index.php?rid=2761337&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000839%2Fabstract%3Frss%3Dyes (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2761337 Mon, 31 Aug 2009 23:00:00 +0100 2761337 http://www.medworm.com/index.php?rid=2761336&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000815%2Fabstract%3Frss%3Dyes (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2761336 Mon, 31 Aug 2009 23:00:00 +0100 2761336 http://www.medworm.com/index.php?rid=2515027&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000360%2Fabstract%3Frss%3Dyes (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515027 Sun, 31 May 2009 23:00:00 +0100 2515027 http://www.medworm.com/index.php?rid=2515026&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000074%2Fabstract%3Frss%3Dyes This article offers an outlook on a relatively new dimension in fetal cell-based therapies, namely the engineering of tissues in the laboratory, along with its prospective applications. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515026 Sun, 31 May 2009 23:00:00 +0100 2515026 http://www.medworm.com/index.php?rid=2515025&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000086%2Fabstract%3Frss%3Dyes At the present time, the most likely and eminent application of stem cell therapy to the fetus is in utero hematopoietic stem cell transplantation (IUHCT), and this stem cell type will be discussed as a paradigm for all prenatal stem cell therapy. The authors feel that the most likely initial application of IUHCT will use adult HSC derived from bone marrow (BM) or peripheral blood (PB), and will focus this article on this specific approach. The article also reviews the experimental data that support the capacity of IUHCT to induce donor-specific tolerance. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515025 Sun, 31 May 2009 23:00:00 +0100 2515025 http://www.medworm.com/index.php?rid=2515024&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000177%2Fabstract%3Frss%3Dyes This article focuses on the current status of in utero catheter interventions for CHD with particular interest in therapy for defects characterized by progressive stenosis or atresia of the semilunar valves, the aortic and pulmonary, with development of subsequent ventricular hypoplasia. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515024 Sun, 31 May 2009 23:00:00 +0100 2515024 http://www.medworm.com/index.php?rid=2515023&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000104%2Fabstract%3Frss%3Dyes Fetal intervention for myelomeningocele (MMC) may improve hydrocephalus and hindbrain herniation associated with the Arnold-Chiari II malformation and may reduce the need for ventriculoperitoneal shunting. As of now, there is little evidence that prenatal repair of MMC improves neurologic function. MMC is the first nonlethal disease under consideration and study for fetal surgery. As a result, potential improvements in outcome must be balanced with maternal safety and well-being, in addition to that of the unborn patient. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515023 Sun, 31 May 2009 23:00:00 +0100 2515023 http://www.medworm.com/index.php?rid=2515022&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000165%2Fabstract%3Frss%3Dyes Monochorionic (MC) twin pregnancies may develop significant complications, and twin-to-twin transfusion syndrome (TTTS) has become among the best known to obstetricians and patients alike. A significant percentage of patients referred for suspected TTTS have a different underlying pathologic condition, however, and differentiating the subcategories of MC pathophysiologic conditions may change treatment course and outcome. The key to understanding complicated MC pregnancies lies in the placental angioarchitecture and intertwin vascular communications between the fetuses. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515022 Sun, 31 May 2009 23:00:00 +0100 2515022 http://www.medworm.com/index.php?rid=2515021&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000050%2Fabstract%3Frss%3Dyes This article presents an overview of what is known about the pathophysiology and the diagnosis of TTTS, the role of echocardiography in TTTS, treatment options available for TTTS, complications of treatment for TTTS, and short- and long-term outcomes of TTTS. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515021 Sun, 31 May 2009 23:00:00 +0100 2515021 http://www.medworm.com/index.php?rid=2515020&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000128%2Fabstract%3Frss%3Dyes The authors present an overview of the prenatal diagnosis, evaluation, contemporary intervention, and antenatal management of lower urinary tract obstruction. They review early experimental models that confirmed the relation between urinary tract obstruction and renal fibrocystic dysplasia and that early in utero relief of the obstruction could prevent irreversible renal injury. Subsequent studies of the electrolyte and protein concentrations in fetal urine from human cases established prognostic threshold values and helped to develop an algorithm to select candidates for antenatal therapy. Although shunting has improved survival, long-term morbidities remain a significant challenge. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515020 Sun, 31 May 2009 23:00:00 +0100 2515020 http://www.medworm.com/index.php?rid=2515019&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000037%2Fabstract%3Frss%3Dyes Prenatal diagnosis provides insight into the in utero evolution of fetal thoracic lesions such as congenital cystic adenomatoid malformation (CCAM), bronchopulmonary sequestration (BPS), congenital lobar emphysema, and mediastinal teratoma. Serial sonographic study of fetuses with thoracic lesions has helped define the natural history of these lesions, determine the pathophysiologic features that affect clinical outcome, and formulate management based on prognosis. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515019 Sun, 31 May 2009 23:00:00 +0100 2515019 http://www.medworm.com/index.php?rid=2515018&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS009551080900013X%2Fabstract%3Frss%3Dyes This article reviews the experimental basis of fetal therapy for CDH and the US clinical experience with tracheal occlusion. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515018 Sun, 31 May 2009 23:00:00 +0100 2515018 http://www.medworm.com/index.php?rid=2515017&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000062%2Fabstract%3Frss%3Dyes Congenital diaphragmatic hernia (CDH) should be diagnosed in the prenatal period and prompt referral to a tertiary referral center for imaging, genetic testing, and multidisciplinary counseling. Individual prediction of prognosis is based on the absence of additional anomalies, lung size, and liver herniation. In severe cases, a prenatal endotracheal balloon procedure is currently being offered at specialized centers. Fetal intervention is now also offered to milder cases within a trial, hypothesizing that this may reduce the occurrence of bronchopulmonary dysplasia in survivors. Postnatal management has been standardized by European high-volume centers for the purpose of this and other trials. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515017 Sun, 31 May 2009 23:00:00 +0100 2515017 http://www.medworm.com/index.php?rid=2515016&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000153%2Fabstract%3Frss%3Dyes In this review, the authors explore the role of noninvasive and invasive fetal interventions in fetal cardiovascular disease guided by observations at fetal echocardiography. They first review fetal cardiac lesions that may be ameliorated by fetal intervention and then review noncardiac fetal pathologic findings for which fetal echocardiography can provide important insight into the pathophysiology and aid in patient selection for and timing of intervention and postintervention surveillance. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515016 Sun, 31 May 2009 23:00:00 +0100 2515016 http://www.medworm.com/index.php?rid=2515015&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000189%2Fabstract%3Frss%3Dyes MRI is being increasingly used to assess for fetal abnormalities. Although significant progress in the field of fetal MRI has occurred during the past 20 years, continued technical advances will likely contribute to significant growth of the field. Moreover, with continued hardware and software improvements, additional MRI sequences will likely become available. Prenatal MRI complements ultrasound because of larger field-of-view, superior soft tissue contrast, easier and more precise volumetric measurement, and greater accuracy in the demonstration of intracranial and spinal abnormalities. While ultrasound remains the primary modality for fetal imaging, these advantages of MRI make it a valuable adjunct to fetal surgery. Because fetal MRI involves many disciplines, the future of fetal MR ... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515015 Sun, 31 May 2009 23:00:00 +0100 2515015 http://www.medworm.com/index.php?rid=2515014&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000116%2Fabstract%3Frss%3Dyes Obstetric ultrasound (US) is an integral part of fetal surgery for open and minimally invasive techniques. With advances in US imaging, the ability to refine diagnosis, predict prognosis, and contribute to fetal treatment continues to grow. Current research in fetal diagnosis and treatment includes identifying the most reliable sonographic features for determining prognosis before and after surgery. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515014 Sun, 31 May 2009 23:00:00 +0100 2515014 http://www.medworm.com/index.php?rid=2515013&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000141%2Fabstract%3Frss%3Dyes The term fetal surgery is used widely for fetal intervention during pregnancy; maternal–fetal surgery may be more appropriate, because all these invasive procedures also affect the mother. Although there is no direct benefit to the mother from these procedures, the risk to her is for a purely altruistic purpose. It is therefore important to understand the potential complications of maternal–fetal surgery, so the physician can provide accurate counseling to the patient. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515013 Sun, 31 May 2009 23:00:00 +0100 2515013 http://www.medworm.com/index.php?rid=2515012&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000049%2Fabstract%3Frss%3Dyes This article provides a comprehensive approach to the ethics of clinical investigation of fetal surgery. Investigators should address the initiation and assessment of clinical trials to determine whether they establish a standard of care and use an appropriate informed consent process to recruit and enroll subjects, consider whether selection criteria should include the abortion preferences of the pregnant woman, and consider whether physicians have an obligation to offer referral to such investigation. This approach is comprehensive because it takes account of the physician's obligations to the fetal patient, the pregnant woman, and future fetal and pregnant patients. The comprehensive approach to the ethics of fetal surgery is applied to the example of in utero surgical management of spi... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515012 Sun, 31 May 2009 23:00:00 +0100 2515012 http://www.medworm.com/index.php?rid=2515011&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000098%2Fabstract%3Frss%3Dyes This article offers a concise overview of the history of fetal surgery, from its tumultuous early days to its current status as an important means for the early treatment of potentially devastating congenital anomalies. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515011 Sun, 31 May 2009 23:00:00 +0100 2515011 http://www.medworm.com/index.php?rid=2515010&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000207%2Fabstract%3Frss%3Dyes This article discusses the indications for and advantages and disadvantages of the commonly used analgesic drugs. Guidance and references for drugs and dosing for specific neonatal procedures are provided. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515010 Sun, 31 May 2009 23:00:00 +0100 2515010 http://www.medworm.com/index.php?rid=2515009&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000219%2Fabstract%3Frss%3Dyes A drug dosage error appeared in the March 2009 issue of Clinics in Perinatology, Volume 36, No. 1, in the article “Drugs of Choice for Sedation and Analgesia in the Neonatal ICU” by R. Whit Hall and Rolla M. Shbarou. In Table 1, the dose for Remifentanil was listed as 1 mg/kg. The correct dosage should be 1 mcg/kg. As a matter of policy, this article has been removed from the March 2009 issue on record. A corrected version of the article is republished in its entirety in the June 2009 issue. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515009 Sun, 31 May 2009 23:00:00 +0100 2515009 http://www.medworm.com/index.php?rid=2515008&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000190%2Fabstract%3Frss%3Dyes Fetal surgery is a multidisciplinary field that relies on the participation and expertise of perinatologists, radiologists, neonatologists, pediatric/fetal surgeons, pediatric cardiologists, social workers, and a variety of other clinicians and support staff. Coordinating input from many different specialists is critical in overcoming the particular challenges of diagnosing and treating maternal–fetal patients. This issue of Clinics in Perinatology devoted to fetal surgery covers the history of the field, maternal considerations, diagnostic considerations, and ethical concerns, as well as specific diseases that may be amenable to fetal intervention. Finally, future possibilities in fetal intervention are discussed. Reflecting the multidisciplinary nature of our field, contributors to thi... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515008 Sun, 31 May 2009 23:00:00 +0100 2515008 http://www.medworm.com/index.php?rid=2515007&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000359%2Fabstract%3Frss%3Dyes (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515007 Sun, 31 May 2009 23:00:00 +0100 2515007 http://www.medworm.com/index.php?rid=2515006&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510809000335%2Fabstract%3Frss%3Dyes (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2515006 Sun, 31 May 2009 23:00:00 +0100 2515006 http://www.medworm.com/index.php?rid=2396976&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808001292%2Fabstract%3Frss%3Dyes (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396976 Sun, 01 Mar 2009 05:00:00 +0100 2396976 http://www.medworm.com/index.php?rid=2396975&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808000900%2Fabstract%3Frss%3Dyes This article provides the reader with an overview of the issues in technology and study design relating to genome-wide association studies and summarizes the current state of association studies in neonatal ICU populations with a brief review of the relevant literature. Future recommendations for genomic association studies in neonatal ICU populations are also provided. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396975 Sun, 01 Mar 2009 05:00:00 +0100 2396975 http://www.medworm.com/index.php?rid=2396974&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808000894%2Fabstract%3Frss%3Dyes Corticosteroids are used to improve lung function in infants who are progressing toward bronchopulmonary dysplasia. Corticosteroids facilitate extubation, but there is conflicting information about adverse effects on the developing brain. An approach to minimizing risk is to use low-dose, short-duration treatments in the highest risk ventilator-dependent patients. Questions remain about which corticosteroid is the safest and how to dose that corticosteroid. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396974 Sun, 01 Mar 2009 05:00:00 +0100 2396974 http://www.medworm.com/index.php?rid=2396973&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS009551080800095X%2Fabstract%3Frss%3Dyes This article examines several of these issues, including the controversies regarding optimal postnatal growth velocity, early aggressive nutritional support, and the transition to enteral nutrition in preterm infants. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396973 Sun, 01 Mar 2009 05:00:00 +0100 2396973 http://www.medworm.com/index.php?rid=2396972&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808000948%2Fabstract%3Frss%3Dyes Gastroesophageal reflux (GER) is common in preterm infants and usually is a physiologic phenomenon with little clinical consequence. GER resulting in clinical signs and symptoms is considered pathologic gastroesophageal reflux disease (GERD). Correlation of clinical signs and symptoms with GER has been poor in most studies. The efficacy of GERD therapy has not been studied systematically in preterm infants. Furthermore, GERD therapy, particularly with prokinetic agents and surgery, carries potential risks that must be considered before initiation of therapy. Alternative diagnoses, pretreatment diagnostic testing, and desired treatment outcomes should be considered before initiating GERD therapy. Cessation of empiric GERD therapy should be considered, particularly if treatment does not resu... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396972 Sun, 01 Mar 2009 05:00:00 +0100 2396972 http://www.medworm.com/index.php?rid=2396971&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808000912%2Fabstract%3Frss%3Dyes Postpartum depression is common in women with infants in the neonatal ICU. Maternal depression can affect infant health and development adversely. A screening program for depression in the neonatal ICU could identify women who have depressive symptoms and facilitate their referral for follow-up services. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396971 Sun, 01 Mar 2009 05:00:00 +0100 2396971 http://www.medworm.com/index.php?rid=2396970&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808000882%2Fabstract%3Frss%3Dyes Ischemic perinatal stroke (IPS) occurs in 1 of 2300 to 5000 live births. It is an under-recognized cause of significant long-term disabilities, including hemiplegic cerebral palsy, epilepsy, cognitive delays, and behavioral impairments. The pathophysiology is complex and multifactorial, involving maternal, fetal, placental, and neonatal factors. Knowledge and interventions are emerging to facilitate early diagnosis and treatment of IPS. Early treatment may translate into improved long-term neurodevelopmental outcomes. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396970 Sun, 01 Mar 2009 05:00:00 +0100 2396970 http://www.medworm.com/index.php?rid=2396969&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808000961%2Fabstract%3Frss%3Dyes Since the late 1980s recombinant human erythropoietin (r-EPO) has been studied as an alternative to packed red blood cell (RBC) transfusion for the treatment of anemia of prematurity in very low birth weight infants. Initial trials and reports focused on r-EPO's ability to prevent or treat anemia of prematurity with the goal of eliminating RBC transfusion but achieved limited success. New concerns about the safety of r-EPO administration have emerged. Past cost–benefit analyses of r-EPO administration versus transfusion for the treatment of anemia of prematurity have been nearly balanced. Autologous transfusion, blood-sparing technologies, changes in RBC transfusion technique and safety, and further elucidation of the risk–benefit ratio of r-EPO therapy may change the cost–benefit an... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396969 Sun, 01 Mar 2009 05:00:00 +0100 2396969 http://www.medworm.com/index.php?rid=2396968&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808000869%2Fabstract%3Frss%3Dyes This article discusses the prognostic factors that predict weaning from parenteral nutrition in SBS. The article also delineates an approach to enteral feeding in SBS. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396968 Sun, 01 Mar 2009 05:00:00 +0100 2396968 http://www.medworm.com/index.php?rid=2396967&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808000936%2Fabstract%3Frss%3Dyes This article focuses on issues that affect decision making regarding the use of home monitors in these two groups of infants and reviews existing data to guide a decision to discontinue monitoring at hospital discharge or to prescribe monitoring in the home. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396967 Sun, 01 Mar 2009 05:00:00 +0100 2396967 http://www.medworm.com/index.php?rid=2396966&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808000833%2Fabstract%3Frss%3Dyes A large proportion of very preterm infants receive treatment for hypotension. The definition of hypotension is unclear, and, currently, there is no evidence that treating it improves outcomes or, indeed, which treatment to choose among the available alternatives. Assessment of circulatory adequacy of the preterm infant requires a careful clinical assessment and may also require ancillary investigations. The most commonly used interventions, fluid boluses and dopamine, are problematic: fluid boluses are statistically associated with worse clinical outcomes and may not even increase blood pressure, whereas dopamine increases blood pressure mostly by causing vasoconstriction and may decrease perfusion. For neither intervention is there any reliable data showing clinical benefit. Prospective t... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396966 Sun, 01 Mar 2009 05:00:00 +0100 2396966 http://www.medworm.com/index.php?rid=2396965&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808000845%2Fabstract%3Frss%3Dyes In the United States, African-American infants have significantly worse outcomes than white infants. In this review, the authors look beyond traditional risk factors and explore the social context of race in this country in an effort to understand African-American women's long-standing pregnancy outcome disadvantage. In the process, new insights are highlighted concerning likely causes for the poor birth outcomes of white infants in this country compared with infants in most other industrialized nations. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396965 Sun, 01 Mar 2009 05:00:00 +0100 2396965 http://www.medworm.com/index.php?rid=2396964&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808000821%2Fabstract%3Frss%3Dyes This article focuses on the potential toxicities, persistent controversies, and unanswered questions regarding the use of this treatment modality in this patient population at high risk for adverse outcomes. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396964 Sun, 01 Mar 2009 05:00:00 +0100 2396964 http://www.medworm.com/index.php?rid=2396963&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808000924%2Fabstract%3Frss%3Dyes This article reviews the predisposing factors and consequences of iron deficiency and iron overload in the preterm infant, discusses the current recommendation for iron supplementation and its appropriateness, and describes potential management strategies that strike a balance between iron deficiency and iron toxicity. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396963 Sun, 01 Mar 2009 05:00:00 +0100 2396963 http://www.medworm.com/index.php?rid=2396962&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808000870%2Fabstract%3Frss%3Dyes This article has been removed at the request of the Guest Editors and Authors. Please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy).Reason: A drug dosage error appeared in the March 2009 issue of Clinics in Perinatology, Volume 36, No. 1, in the article “Drugs of Choice for Sedation and Analgesia in the Neonatal ICU” by R. Whit Hall and Rolla M. Shbarou. In Table 1, the dose for Remifentanil was listed as 1 mg/kg. The correct dosage should be 1 mcg/kg. As a matter of policy, this article has been removed from the March 2009 issue on record. A corrected version of the article is republished in its entirety in the June 2009 issue. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396962 Sun, 01 Mar 2009 05:00:00 +0100 2396962 http://www.medworm.com/index.php?rid=2396961&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808000857%2Fabstract%3Frss%3Dyes Hospital-acquired infections are one of the leading causes of preventable morbidity and mortality in neonatal intensive care units (NICUs). Device-related infections, such as catheter-associated blood stream infections (CABSIs) and ventilator-associated pneumonia (VAP), are the most common nosocomial infections. This review examines the pathogenesis of CABSIs and methods, widely accepted and novel, that can be used to help prevent them. Strategies to prevent fungal infections, which are often associated with the presence of a central venous catheter, are also reviewed. Finally, the dilemmas in the diagnosis and prevention of VAP in the NICU are discussed. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396961 Sun, 01 Mar 2009 05:00:00 +0100 2396961 http://www.medworm.com/index.php?rid=2396960&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808001206%2Fabstract%3Frss%3Dyes The author of the article “Cesarean Delivery and Its Impact on the Anomalous Infant,” which appears in the June 2008 issue of Clinics in Perinatology (Volume 35, Issue 2), would like to amend the paragraph on page 402 under the heading “Hydrops.” The paragraph should read: (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396960 Sun, 01 Mar 2009 05:00:00 +0100 2396960 http://www.medworm.com/index.php?rid=2396959&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS009551080800119X%2Fabstract%3Frss%3Dyes Discussions with colleagues around the world, and even within individual institutions, reveal considerable practice variation. For this issue of Clinics in Perinatology on “controversies,” we chose to focus on these more common concerns facing clinicians caring for neonates. Interestingly, many of these topics have been reviewed in previous issues. Either the initial controversies surrounding each topic remain unresolved or new ones have emerged as knowledge has been obtained. (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396959 Sun, 01 Mar 2009 05:00:00 +0100 2396959 http://www.medworm.com/index.php?rid=2396958&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808001280%2Fabstract%3Frss%3Dyes (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396958 Sun, 01 Mar 2009 05:00:00 +0100 2396958 http://www.medworm.com/index.php?rid=2396957&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.perinatology.theclinics.com%2Farticle%2FPIIS0095510808001267%2Fabstract%3Frss%3Dyes (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2396957 Sun, 01 Mar 2009 05:00:00 +0100 2396957 http://www.medworm.com/index.php?rid=2134203&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161860%26dopt%3DAbstract Authors: Uhing MR, Kliegman R PMID: 19161860 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2134203 Tue, 27 Jan 2009 06:42:45 +0100 2134203 http://www.medworm.com/index.php?rid=2134202&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161869%26dopt%3DAbstract Authors: Von Kohorn I, Ehrenkranz RA Since the late 1980s recombinant human erythropoietin (r-EPO) has been studied as an alternative to packed red blood cell (RBC) transfusion for the treatment of anemia of prematurity in very low birth weight infants. Initial trials and reports focused on r-EPO's ability to prevent or treat anemia of prematurity with the goal of eliminating RBC transfusion but achieved limited success. New concerns about the safety of r-EPO administration have emerged. Past cost-benefit analyses of r-EPO administration versus transfusion for the treatment of anemia of prematurity have been nearly balanced. Autologous transfusion, blood-sparing technologies, changes in RBC transfusion technique and safety, and further elucidation of the risk-benefit ratio of r-EPO the... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2134202 Tue, 27 Jan 2009 06:41:57 +0100 2134202 http://www.medworm.com/index.php?rid=2130798&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161860%26dopt%3DAbstract Authors: Uhing MR, Kliegman R PMID: 19161860 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2130798 Sun, 25 Jan 2009 05:34:34 +0100 2130798 http://www.medworm.com/index.php?rid=2130797&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161861%26dopt%3DAbstract Authors: Garland JS, Uhing MR Hospital-acquired infections are one of the leading causes of preventable morbidity and mortality in neonatal intensive care units (NICUs). Device-related infections, such as catheter-associated blood stream infections (CABSIs) and ventilator-associated pneumonia (VAP), are the most common nosocomial infections. This review examines the pathogenesis of CABSIs and methods, widely accepted and novel, that can be used to help prevent them. Strategies to prevent fungal infections, which are often associated with the presence of a central venous catheter, are also reviewed. Finally, the dilemmas in the diagnosis and prevention of VAP in the NICU are discussed. PMID: 19161861 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2130797 Sun, 25 Jan 2009 05:34:30 +0100 2130797 http://www.medworm.com/index.php?rid=2130796&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161862%26dopt%3DAbstract This article discusses the indications for and advantages and disadvantages of the commonly used analgesic drugs. Guidance and references for drugs and dosing for specific neonatal procedures are provided. PMID: 19161862 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2130796 Sun, 25 Jan 2009 05:34:27 +0100 2130796 http://www.medworm.com/index.php?rid=2130795&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161863%26dopt%3DAbstract This article reviews the predisposing factors and consequences of iron deficiency and iron overload in the preterm infant, discusses the current recommendation for iron supplementation and its appropriateness, and describes potential management strategies that strike a balance between iron deficiency and iron toxicity. PMID: 19161863 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2130795 Sun, 25 Jan 2009 05:34:24 +0100 2130795 http://www.medworm.com/index.php?rid=2130794&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161864%26dopt%3DAbstract This article focuses on the potential toxicities, persistent controversies, and unanswered questions regarding the use of this treatment modality in this patient population at high risk for adverse outcomes. PMID: 19161864 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2130794 Sun, 25 Jan 2009 05:34:20 +0100 2130794 http://www.medworm.com/index.php?rid=2130793&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161865%26dopt%3DAbstract Authors: Collins JW, David RJ In the United States, African-American infants have significantly worse outcomes than white infants. In this review, the authors look beyond traditional risk factors and explore the social context of race in this country in an effort to understand African-American women's long-standing pregnancy outcome disadvantage. In the process, new insights are highlighted concerning likely causes for the poor birth outcomes of white infants in this country compared with infants in most other industrialized nations. PMID: 19161865 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2130793 Sun, 25 Jan 2009 05:34:16 +0100 2130793 http://www.medworm.com/index.php?rid=2130792&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161866%26dopt%3DAbstract Authors: Dempsey EM, Barrington KJ A large proportion of very preterm infants receive treatment for hypotension. The definition of hypotension is unclear, and, currently, there is no evidence that treating it improves outcomes or, indeed, which treatment to choose among the available alternatives. Assessment of circulatory adequacy of the preterm infant requires a careful clinical assessment and may also require ancillary investigations. The most commonly used interventions, fluid boluses and dopamine, are problematic: fluid boluses are statistically associated with worse clinical outcomes and may not even increase blood pressure, whereas dopamine increases blood pressure mostly by causing vasoconstriction and may decrease perfusion. For neither intervention is there any reliable data ... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2130792 Sun, 25 Jan 2009 05:34:12 +0100 2130792 http://www.medworm.com/index.php?rid=2130791&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161867%26dopt%3DAbstract This article focuses on issues that affect decision making regarding the use of home monitors in these two groups of infants and reviews existing data to guide a decision to discontinue monitoring at hospital discharge or to prescribe monitoring in the home. PMID: 19161867 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2130791 Sun, 25 Jan 2009 05:34:09 +0100 2130791 http://www.medworm.com/index.php?rid=2130790&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161868%26dopt%3DAbstract This article discusses the prognostic factors that predict weaning from parenteral nutrition in SBS. The article also delineates an approach to enteral feeding in SBS. PMID: 19161868 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2130790 Sun, 25 Jan 2009 05:34:05 +0100 2130790 http://www.medworm.com/index.php?rid=2130789&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161869%26dopt%3DAbstract Authors: Von Kohorn I, Ehrenkranz RA Since the late 1980s recombinant human erythropoietin (r-EPO) has been studied as an alternative to packed red blood cell (RBC) transfusion for the treatment of anemia of prematurity in very low birth weight infants. Initial trials and reports focused on r-EPO's ability to prevent or treat anemia of prematurity with the goal of eliminating RBC transfusion but achieved limited success. New concerns about the safety of r-EPO administration have emerged. Past cost-benefit analyses of r-EPO administration versus transfusion for the treatment of anemia of prematurity have been nearly balanced. Autologous transfusion, blood-sparing technologies, changes in RBC transfusion technique and safety, and further elucidation of the risk-benefit ratio of r-EPO the... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2130789 Sun, 25 Jan 2009 05:34:01 +0100 2130789 http://www.medworm.com/index.php?rid=2130788&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161870%26dopt%3DAbstract Authors: Barnette AR, Inder TE Ischemic perinatal stroke (IPS) occurs in 1 of 2300 to 5000 live births. It is an under-recognized cause of significant long-term disabilities, including hemiplegic cerebral palsy, epilepsy, cognitive delays, and behavioral impairments. The pathophysiology is complex and multifactorial, involving maternal, fetal, placental, and neonatal factors. Knowledge and interventions are emerging to facilitate early diagnosis and treatment of IPS. Early treatment may translate into improved long-term neurodevelopmental outcomes. PMID: 19161870 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2130788 Sun, 25 Jan 2009 05:33:56 +0100 2130788 http://www.medworm.com/index.php?rid=2130787&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161871%26dopt%3DAbstract Authors: Mounts KO Postpartum depression is common in women with infants in the neonatal ICU. Maternal depression can affect infant health and development adversely. A screening program for depression in the neonatal ICU could identify women who have depressive symptoms and facilitate their referral for follow-up services. PMID: 19161871 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2130787 Sun, 25 Jan 2009 05:33:53 +0100 2130787 http://www.medworm.com/index.php?rid=2130786&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161872%26dopt%3DAbstract Authors: Tipnis NA, Tipnis SM Gastroesophageal reflux (GER) is common in preterm infants and usually is a physiologic phenomenon with little clinical consequence. GER resulting in clinical signs and symptoms is considered pathologic gastroesophageal reflux disease (GERD). Correlation of clinical signs and symptoms with GER has been poor in most studies. The efficacy of GERD therapy has not been studied systematically in preterm infants. Furthermore, GERD therapy, particularly with prokinetic agents and surgery, carries potential risks that must be considered before initiation of therapy. Alternative diagnoses, pretreatment diagnostic testing, and desired treatment outcomes should be considered before initiating GERD therapy. Cessation of empiric GERD therapy should be considered, parti... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2130786 Sun, 25 Jan 2009 05:33:45 +0100 2130786 http://www.medworm.com/index.php?rid=2130785&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161873%26dopt%3DAbstract This article examines several of these issues, including the controversies regarding optimal postnatal growth velocity, early aggressive nutritional support, and the transition to enteral nutrition in preterm infants. PMID: 19161873 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2130785 Sun, 25 Jan 2009 05:33:41 +0100 2130785 http://www.medworm.com/index.php?rid=2130784&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161874%26dopt%3DAbstract Authors: Jobe AH Corticosteroids are used to improve lung function in infants who are progressing toward bronchopulmonary dysplasia. Corticosteroids facilitate extubation, but there is conflicting information about adverse effects on the developing brain. An approach to minimizing risk is to use low-dose, short-duration treatments in the highest risk ventilator-dependent patients. Questions remain about which corticosteroid is the safest and how to dose that corticosteroid. PMID: 19161874 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2130784 Sun, 25 Jan 2009 05:33:37 +0100 2130784 http://www.medworm.com/index.php?rid=2130783&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19161875%26dopt%3DAbstract This article provides the reader with an overview of the issues in technology and study design relating to genome-wide association studies and summarizes the current state of association studies in neonatal ICU populations with a brief review of the relevant literature. Future recommendations for genomic association studies in neonatal ICU populations are also provided. PMID: 19161875 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=2130783 Sun, 25 Jan 2009 05:33:33 +0100 2130783 http://www.medworm.com/index.php?rid=1989449&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026330%26dopt%3DAbstract Authors: Spitzer AR, White RD PMID: 19026330 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1989449 Thu, 27 Nov 2008 08:21:24 +0100 1989449 http://www.medworm.com/index.php?rid=1989448&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026331%26dopt%3DAbstract This article reviews current understanding of cerebral perfusion, in the sick premature infant in particular, and discusses challenges that lie ahead. PMID: 19026331 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1989448 Thu, 27 Nov 2008 08:21:20 +0100 1989448 http://www.medworm.com/index.php?rid=1989447&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026332%26dopt%3DAbstract This article reviews evidence that infection outside of the brain can damage the brain, and discusses specific cytokines and pathomechanisms that probably mediate the putative effect of remote infection on the developing brain. Events associated with increased circulating inflammatory cytokines, chemokines, and immune cells are described. Finally, studies of genetic variation in susceptibility to cytokine-related brain damage are reviewed. PMID: 19026332 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1989447 Thu, 27 Nov 2008 08:21:17 +0100 1989447 http://www.medworm.com/index.php?rid=1989446&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026333%26dopt%3DAbstract Authors: Toet MC, van Rooij LG, de Vries LS Amplitude-integrated electroencephalography (aEEG) plays an important role in integrated care of the full-term infant with neonatal encephalopathy. The three main features that are provided with aEEG are the background pattern on admission and the rate of recovery seen during the first 24 to 48 hours after birth, the presence of most electrographic discharges, and the effect of antiepileptic drugs. PMID: 19026333 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1989446 Thu, 27 Nov 2008 08:21:14 +0100 1989446 http://www.medworm.com/index.php?rid=1989445&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026334%26dopt%3DAbstract Authors: Lawrence RK, Inder TE Encephalopathy from hypoxic-ischemic injury is a major cause of morbidity and mortality in term infants. MRI is the gold standard in evaluating the nature and extent of injury. Although imaging this population is challenging, important information can be obtained safely. Patterns of injury and the likely mechanisms that cause them are reviewed. Conventional images combined with additional techniques provide clues to cause, timing, and long-term prognosis. As altering acute neurologic damage with interventions in the acute period becomes a reality, MRI will play a crucial role in delineating which infants have the most to gain and act as a biomarker to gauge response. PMID: 19026334 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1989445 Thu, 27 Nov 2008 08:21:11 +0100 1989445 http://www.medworm.com/index.php?rid=1989444&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026335%26dopt%3DAbstract This article reviews the current uses of proteomics-based newborn evaluation and evaluates how this rapidly evolving area of medicine may be used to assess the fetus and the neonate in the near future. PMID: 19026335 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1989444 Thu, 27 Nov 2008 08:21:06 +0100 1989444 http://www.medworm.com/index.php?rid=1989443&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026336%26dopt%3DAbstract Authors: Sahni R, Sanocka UM We are entering an era in which hypothermia will be used in combination with other novel neuroprotective interventions. The targeting of multiple sites in the cascade leading to brain injury may prove to be a more effective treatment strategy after hypoxic-ischemic encephalopathy in newborn infants than hypothermia alone. PMID: 19026336 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1989443 Thu, 27 Nov 2008 08:21:03 +0100 1989443 http://www.medworm.com/index.php?rid=1989442&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026337%26dopt%3DAbstract Authors: Gunn AJ, Bennet L There is strong evidence that prolonged, moderate cerebral hypothermia initiated within a few hours after severe hypoxia-ischemia and continued until resolution of the acute phase of delayed cell death can reduce neuronal loss and improve behavioral recovery in term infants and adults after cardiac arrest. This review examines the evidence that mild to moderate hypothermia is protective after hypoxia-ischemia in models of preterm brain injury and evaluates the potential risks. Induced hypothermia likely has potential to significantly reduce disability. Cautious, systematic trials are essential before hypothermia can be used in these vulnerable infants. PMID: 19026337 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1989442 Thu, 27 Nov 2008 08:20:59 +0100 1989442 http://www.medworm.com/index.php?rid=1989441&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026338%26dopt%3DAbstract This article suggests clinical management and shows examples of potential adverse effects of clinical hypothermia. The practical cooling recommendations suggested herein are therefore likely to develop and change over time as more experience is gained. PMID: 19026338 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1989441 Thu, 27 Nov 2008 08:20:55 +0100 1989441 http://www.medworm.com/index.php?rid=1989440&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026339%26dopt%3DAbstract This article assumes that clinicians are sufficiently convinced by the available evidence of safety and efficacy to proceed to the implementation step and offers guidelines for starting a neonatal cooling program. PMID: 19026339 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1989440 Thu, 27 Nov 2008 08:20:52 +0100 1989440 http://www.medworm.com/index.php?rid=1989439&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026340%26dopt%3DAbstract Authors: McCrea HJ, Ment LR Intraventricular hemorrhage (IVH) occurs in 20% to 25% of very low birthweight preterm neonates and may be associated with significant sequelae. Infants who have IVH are at risk for posthemorrhagic hydrocephalus and periventricular leukomalacia; as many as 75% of those who have parenchymal involvement of hemorrhage suffer significant neurodevelopmental disability. Because of the prevalence of IVH and the medical and societal impact of this disease, many postnatal pharmacologic prevention strategies have been explored. Randomized clinical prevention trials should provide long-term neurodevelopmental follow-up to assess the impact of preterm birth, injury, and pharmacologic intervention on the developing brain. PMID: 19026340 [PubMed - in process] (Source:... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1989439 Thu, 27 Nov 2008 08:20:48 +0100 1989439 http://www.medworm.com/index.php?rid=1989438&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026341%26dopt%3DAbstract Authors: Marks JD, Schreiber MD Although inhaled nitric oxide-mediated decreases in chronic lung disease and severe intraventricular hemorrhage/periventricular leukomalacia undoubtedly contribute to improved neurodevelopmental outcomes, inhaled nitric oxide has an independent neuroprotective effect. Although these data are encouraging, additional studies are required before recommending the routine use of inhaled nitric oxide for neuroprotection in preterm infants. PMID: 19026341 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1989438 Thu, 27 Nov 2008 08:20:45 +0100 1989438 http://www.medworm.com/index.php?rid=1989437&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026342%26dopt%3DAbstract Authors: Clancy RR Neonatal hypoxic-ischemic encephalopathy, prematurity, sepsis-meningitis, and serious forms of complex congenital heart disease requiring infant heart surgery are just a few examples of disorders that share high mortality and morbidity rates. Newborn heart surgery represents a period of planned and deliberate ischemia-reperfusion injury, which is obliged to occur to cure or palliate complex forms of congenital heart disease. Advances in cardiothoracic surgical and anesthetic techniques, including cardiopulmonary bypass and deep hypothermic circulatory arrest, have substantially decreased mortality, expanding the horizon to address functional neurologic and cardiac outcomes in long-term survivors. Interest in the functional status of survivors now stretches beyond the... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1989437 Thu, 27 Nov 2008 08:20:40 +0100 1989437 http://www.medworm.com/index.php?rid=1938016&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952014%26dopt%3DAbstract Authors: Jain L, Wapner RJ PMID: 18952014 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1938016 Mon, 01 Sep 2008 04:00:00 +0100 1938016 http://www.medworm.com/index.php?rid=1914060&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952014%26dopt%3DAbstract Authors: Jain L, Wapner RJ PMID: 18952014 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1914060 Mon, 01 Sep 2008 04:00:00 +0100 1914060 http://www.medworm.com/index.php?rid=1914059&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952015%26dopt%3DAbstract Authors: Weiner S, Monge J, Mann A Human biologic evolution involves a compromise between the physical adaptations for bipedalism with effects on birthing success and the much later increases in encephalization of our species. Much of what comes to define life history parameters like gestation length, and brain and birth weight in our species is best understood from this evolutionary perspective. Human populations have been dealing with the obstetric dilemma for many hundreds of thousands of years and modern biomedicine, using techniques like cesarean sections, has alleviated, but not eliminated, birthing as a "scar" of human evolution. If women begin to demand access to universal cesarean delivery, what will the outcome be for the future of human evolution? We can only speculate on th... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1914059 Mon, 01 Sep 2008 04:00:00 +0100 1914059 http://www.medworm.com/index.php?rid=1914058&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952016%26dopt%3DAbstract Authors: Mancuso MS, Rouse DJ Cesarean delivery is indicated at any stage in the labor process in the presence of nonreassuring fetal status or when conservative measures fail in the setting of abnormal labor. In the absence of maternal or fetal indications for expedited delivery, cesarean delivery is not indicated for latent phase disorders. When to intervene for protracted labor is arguable, but slow rates of labor progress are consistent with safe vaginal delivery. Cesarean delivery in the second stage should be avoided for at least 4 hours if there is progressive fetal descent. PMID: 18952016 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1914058 Mon, 01 Sep 2008 04:00:00 +0100 1914058 http://www.medworm.com/index.php?rid=1914057&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952017%26dopt%3DAbstract Authors: Landon MB By2004, only 9.2% of women in the United States with prior cesareans underwent a term of labor (TOL), although nearly two thirds of these women are actually candidates for a TOL. In this article, the author notes that the principal risk associated with vaginal birth after cesarean delivery (VBAC)-TOL is uterine rupture, which can lead to perinatal death, fetal hypoxic brain injury, and hysterectomy. Risk factors for uterine rupture include number of prior cesareans, prior vaginal delivery, interdelivery interval, and uterine closure technique. The author concludes by noting that a pregnant woman with prior cesarean delivery is at risk for maternal and perinatal complications, whether undergoing TOL or choosing elective repeat operation. Complications of both procedur... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1914057 Mon, 01 Sep 2008 04:00:00 +0100 1914057 http://www.medworm.com/index.php?rid=1914056&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952018%26dopt%3DAbstract Authors: Lee YM, D'Alton ME Mothers should be counseled that the most concerning risks related to maternal request cesarean delivery are neonatal respiratory morbidity and those that may affect the mother's future reproductive health, including life-threatening conditions, such as placenta accreta. The literature suggests that overall risks of maternal complications with cesarean delivery on maternal request are slightly lower than a trial of vaginal delivery and are primarily driven by the avoidance of unplanned or emergent cesarean deliveries and their associated increased rate of complications. When addressing risks and benefits with patients, there are three areas of importance. First, the risks for neonatal respiratory morbidity and abnormal placentation with future pregnancies sh... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1914056 Mon, 01 Sep 2008 04:00:00 +0100 1914056 http://www.medworm.com/index.php?rid=1914055&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952019%26dopt%3DAbstract This article reviews the potential mechanisms by which uterine scarring may lead to abnormal trophoblast invasion, the association of cesarean section with placenta accreta and scar pregnancies, current management, and suggestions for future research to reduce the incidence of these potentially devastating complications of pregnancy. PMID: 18952019 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1914055 Mon, 01 Sep 2008 04:00:00 +0100 1914055 http://www.medworm.com/index.php?rid=1914054&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952020%26dopt%3DAbstract Authors: Bonanno C, Gaddipati S Postpartum hemorrhage is an obstetric emergency that represents a major cause of maternal morbidity and mortality. With the recent rise in the cesarean delivery rate, prompt recognition and proper management at the time of cesarean delivery are becoming increasingly important for providers of obstetrics. Preparedness for hemorrhage can be achieved by recognition of prior risk factors and implementation of specific hemorrhage protocols. Medical and surgical therapies are available to treat obstetric hemorrhage after cesarean delivery. PMID: 18952020 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1914054 Mon, 01 Sep 2008 04:00:00 +0100 1914054 http://www.medworm.com/index.php?rid=1914053&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952021%26dopt%3DAbstract Authors: Miller R, Depp R Despite advances in obstetric and neonatal care, the last several decades have not witnessed an improvement in the prediction or prevention of term cerebral palsy. Obstetric interventions such as electronic fetal heart rate monitoring and cesarean delivery, although biologically plausible as intervention strategies, do not improve perinatal outcomes in clinical practice. In reaction to mounting medicolegal pressure, obstetricians continue to increase the number of cesarean deliveries they perform as a form of defensive medicine, despite evidence that this practice is not associated with improved perinatal outcomes. The current standard for expeditious delivery in a case of potential fetal compromise is described by the "30-minute rule." However, obstetricians'... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1914053 Mon, 01 Sep 2008 04:00:00 +0100 1914053 http://www.medworm.com/index.php?rid=1914052&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952022%26dopt%3DAbstract Authors: Kakkilaya V, Pramanik AK, Ibrahim H, Hussein S Delay in cord clamping up to 30 to 40 seconds is feasible and should be practiced in preterm and term infants born by cesarean section. In term infants, this maneuver may decrease iron deficiency anemia at 6 months of age. Premature infants may have a higher blood volume and hematocrit initially requiring fewer transfusions. They also have a decreased incidence of intraventricular hemorrhage. The effect of compounding factors, such as maternal blood pressure, uterine contraction, medications, bleeding, and their effects on the infant's immediate and long-term outcome are unclear. PMID: 18952022 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1914052 Mon, 01 Sep 2008 04:00:00 +0100 1914052 http://www.medworm.com/index.php?rid=1914051&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952023%26dopt%3DAbstract Authors: Wylie BJ, Mirza FG Two trends are apparent regarding cesarean delivery in the developing world. In the least developed countries, access to the procedure remains limited at levels much less than 5% of all births. This limited access is linked with increases in maternal and neonatal mortality. Safety concerns are equally valid when more than half of women in certain socioeconomic strata are having surgical delivery, as is evident in the more advanced developing economies of Latin America and China. The optimal minimum and maximum cesarean delivery rates continue to be a matter of debate and may never be resolved; however, these two extremes of cesarean delivery use evident in the developing world deserve critical examination. PMID: 18952023 [PubMed - as supplied by publishe... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1914051 Mon, 01 Sep 2008 04:00:00 +0100 1914051 http://www.medworm.com/index.php?rid=1914050&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952024%26dopt%3DAbstract This article reviews the rates of pelvic floor dysfunction following vaginal delivery and cesarean section as cited in short-term and long-term follow-up studies. PMID: 18952024 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1914050 Mon, 01 Sep 2008 04:00:00 +0100 1914050 http://www.medworm.com/index.php?rid=1914049&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952025%26dopt%3DAbstract This article reviews the relevant economic issues surrounding elective cesarean section and cesarean section at maternal request, summarizes the methodological quality and results of current literature on the topic, and presents recommendations for further study. PMID: 18952025 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1914049 Mon, 01 Sep 2008 04:00:00 +0100 1914049 http://www.medworm.com/index.php?rid=1708035&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18456069%26dopt%3DAbstract Authors: Jain L, Wapner R PMID: 18456069 [PubMed - indexed for MEDLINE] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1708035 Sun, 01 Jun 2008 04:00:00 +0100 1708035 http://www.medworm.com/index.php?rid=1422377&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18456069%26dopt%3DAbstract Authors: Jain L, Wapner R PMID: 18456069 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1422377 Tue, 06 May 2008 19:43:02 +0100 1422377 http://www.medworm.com/index.php?rid=1422376&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18456070%26dopt%3DAbstract Authors: Macdorman MF, Menacker F, Declercq E The percentage of United States cesarean births increased from 20.7% in 1996 to 31.1% in 2006. Cesarean rates increased for women of all ages, race/ethnic groups, and gestational ages and in all states. Both primary and repeat cesareans have increased. Increases in primary cesareans in cases of "no indicated risk" have been more rapid than in the overall population and seem the result of changes in obstetric practice rather than changes in the medical risk profile or increases in "maternal request." Several studies note an increased risk for neonatal and maternal mortality for medically elective cesareans compared with vaginal births. PMID: 18456070 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1422376 Tue, 06 May 2008 19:42:57 +0100 1422376 http://www.medworm.com/index.php?rid=1422375&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18456071%26dopt%3DAbstract Authors: Bettegowda VR, Dias T, Davidoff MJ, Damus K, Callaghan WM, Petrini JR The increasing trend of delivering at earlier gestational ages has raised concerns of the impact on maternal and infant health. The delicate balance of the risks and benefits associated with continuing a pregnancy versus delivering early remains challenging. Among singleton live births in the United States, the proportion of preterm births increased from 9.7% to 10.7% between 1996 and 2004. The increase in singleton preterm births occurred primarily among those delivered by cesarean section, with the largest percentage increase in late preterm births. For all maternal racial/ethnic groups, singleton cesarean section rates increased for each gestational age group. Singleton cesarean section rates for non-Hisp... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1422375 Tue, 06 May 2008 19:42:51 +0100 1422375 http://www.medworm.com/index.php?rid=1422374&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18456072%26dopt%3DAbstract Authors: Engle WA, Kominiarek MA Delivery of infants who are physiologically mature and capable of successful transition to the extrauterine environment is an important priority for obstetric practitioner. A corollary of this goal is to avoid iatrogenic complications of prematurity and maternal complications from delivery. The purpose of this review is to describe the consequences of birth before physiologic maturity in late preterm and term infants, to identify factors contributing to the decline in gestational age of deliveries in the United States, and to describe strategies to reduce premature delivery of late preterm and early term infants. PMID: 18456072 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1422374 Tue, 06 May 2008 19:42:47 +0100 1422374 http://www.medworm.com/index.php?rid=1422373&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18456073%26dopt%3DAbstract Authors: Fuchs K, Gyamfi C In this article, the authors review the standard management of several maternal and fetal complications of pregnancy and examine the effect these practices may have on the late preterm birth rate. Given the increasing rate of late preterm birth and the increased recognition of the morbidity and mortality associated with delivery between 34 and 37 weeks, standard obstetric practices and practice patterns leading to late preterm birth should be critically evaluated. The possibility of expectant management of some pregnancy complications in the late preterm period should be investigated. Furthermore, prospective research is warranted to investigate the role of antenatal corticosteroids beyond 34 weeks. PMID: 18456073 [PubMed - in process] (Source: Clinics in... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1422373 Tue, 06 May 2008 19:42:43 +0100 1422373 http://www.medworm.com/index.php?rid=1422372&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18456074%26dopt%3DAbstract This article explores the effects of elective cesarean delivery (ECD) at term on neonatal morbidity and mortality. Available data have limitations, and do not provide conclusive evidence regarding the safety of planned ECD versus planned vaginal delivery. Some data suggest an association between ECD and increased neonatal respiratory morbidity and lacerations, and possibly decreased central and peripheral nervous system injury. Potentially increased risks of neonatal mortality with ECD at term may be counterbalanced by risks for fetal demise in ongoing pregnancies. Patients and physicians considering ECD should review competing risks and benefits; further research is needed to inform these discussions. PMID: 18456074 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1422372 Tue, 06 May 2008 19:42:41 +0100 1422372 http://www.medworm.com/index.php?rid=1422371&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18456075%26dopt%3DAbstract This article discusses the respiratory morbidity associated with elective cesarean section, the physiologic mechanisms underlying fetal lung fluid absorption, and potential strategies for facilitating neonatal transition when infants are delivered by elective cesarean section before the onset of spontaneous labor. PMID: 18456075 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1422371 Tue, 06 May 2008 19:42:38 +0100 1422371 http://www.medworm.com/index.php?rid=1422370&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18456076%26dopt%3DAbstract Authors: Hamrick SE Although cesarean deliveries frequently are performed for anomalous fetal conditions, available data do not always support a fetal benefit from this delivery management. The literature on cesarean delivery for anomalous infants reports insufficient information on comorbid neonatal conditions, so these complications are unknown in this population of newborns. In a minority of cases, a cesarean delivery is reasonable to prevent dystocia or optimize outcome. Areas for future investigation include prospective, randomized, controlled trials of prelabor cesarean compared with vaginal deliveries for myelomeningocele and anterior abdominal wall defects. The rarity of other lesions likely precludes randomized controlled trials. PMID: 18456076 [PubMed - in process] (Sourc... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1422370 Tue, 06 May 2008 19:42:35 +0100 1422370 http://www.medworm.com/index.php?rid=1422369&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18456077%26dopt%3DAbstract This article outlines those infections known to be transmitted perinatally through the infected birth canal and details the current recommendations for cesarean delivery. Pregnant women with active genital herpes lesions or with known herpes simplex virus infection and a prodromal illness consistent with recurrence at the time of presentation in labor should undergo cesarean delivery. Pregnant women who are HIV infected and have detectable viremia (>1000 copies/mL) should be counseled regarding the potential benefits of cesarean delivery as an adjunct to antiretroviral therapy. Hepatitis C virus (HCV) can be transmitted intrapartum, but prevention of HCV transmission by cesarean delivery has not been proved effective and is not generally indicated. A limited number of other infectious a... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1422369 Tue, 06 May 2008 19:42:32 +0100 1422369 http://www.medworm.com/index.php?rid=1422368&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18456078%26dopt%3DAbstract Authors: Malloy MH, Doshi S Births of extremely preterm infants, less than 26 weeks' gestation, by cesarean section have increased significantly in the United States over the past decade. The justification for this increase is not well supported in the literature. This review examines recent analyses that suggest there may be some survival advantage for infants less than 26 weeks delivered by cesarean section. The appropriateness of intervening with cesarean sections for these very immature infants, however, remains uncertain. PMID: 18456078 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1422368 Tue, 06 May 2008 19:42:29 +0100 1422368 http://www.medworm.com/index.php?rid=1422367&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18456079%26dopt%3DAbstract Authors: Adams-Chapman I Prevention of neurologic injury to the fetus through skilled and attentive care during the peripartum period is designed to identify signs of fetal distress so that appropriate obstetric interventions can occur. The impact of mode of delivery on neurologic outcome varies depending on the clinical indication for cesarean delivery and the associated maternal and fetal conditions. This review summarizes current knowledge of the impact of mode of delivery on long-term neurologic outcome. PMID: 18456079 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1422367 Tue, 06 May 2008 19:42:26 +0100 1422367 http://www.medworm.com/index.php?rid=1422366&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18456080%26dopt%3DAbstract This article reviews the current ethical debate of maternal choice and autonomy in elective cesarean delivery. PMID: 18456080 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1422366 Tue, 06 May 2008 19:42:23 +0100 1422366 http://www.medworm.com/index.php?rid=1241317&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18280872%26dopt%3DAbstract Authors: Hermansen MC PMID: 18280872 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1241317 Tue, 19 Feb 2008 20:31:50 +0100 1241317 http://www.medworm.com/index.php?rid=1241316&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18280873%26dopt%3DAbstract This article explains the process of iatrogenicity and separates the iatrogenic problems that are preventable from those that are currently unpreventable. PMID: 18280873 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1241316 Tue, 19 Feb 2008 20:31:48 +0100 1241316 http://www.medworm.com/index.php?rid=1241315&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18280874%26dopt%3DAbstract This article highlights the common and some of the very serious complications that may occur following neuraxial analgesia for labor and delivery, including headache, backache, infection, hypotension, and hematoma. Total spinal and failed block also are discussed, as are complications unique to epidural anesthesia, such as the intravascular injection of large volumes of local anesthetic (causing seizure or cardiac arrest) and accidental dural puncture. PMID: 18280874 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1241315 Tue, 19 Feb 2008 20:31:46 +0100 1241315 http://www.medworm.com/index.php?rid=1241314&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18280875%26dopt%3DAbstract Authors: Ananth CV, Vintzileos AM Preterm birth complicates over 500,000 births annually, affecting 12.5% of pregnancies in the United States. Much of the temporal increase in preterm birth (<37 weeks) over the past decade is largely driven by a concurrent temporal increase in medically indicated preterm birth. Maternal and fetal indications that prompt an intervention at preterm gestational ages include preeclampsia, intrauterine growth restriction, and placental abruption-conditions that constitute "ischemic placental disease." Ischemic placental disease is implicated in over one of every two indicated preterm births compared with less than one in five births at term. Comprehensive evaluation of risk factors, with careful consideration of heterogeneity in the syndrome of medically... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1241314 Tue, 19 Feb 2008 20:31:44 +0100 1241314 http://www.medworm.com/index.php?rid=1241313&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18280876%26dopt%3DAbstract Authors: Doumouchtsis SK, Arulkumaran S Instrumental vaginal delivery involves the use of the vacuum extractor or obstetric forceps to facilitate delivery of the fetus. It is associated with substantial risk of head injury, including hemorrhage, fractures, and, rarely, brain damage or fetal death. This review article describes the different types, etiology, pathophysiology, risk factors, and clinical features of head trauma after instrumental birth, along with their management and prevention strategies. PMID: 18280876 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1241313 Tue, 19 Feb 2008 20:31:42 +0100 1241313 http://www.medworm.com/index.php?rid=1241312&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18280877%26dopt%3DAbstract This article reviews the data regarding these antepartum and intrapartum predictors for uterine rupture. The author hopes that the information presented in this article will help clinicians assess an individual's risk for uterine rupture. PMID: 18280877 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1241312 Tue, 19 Feb 2008 20:31:40 +0100 1241312 http://www.medworm.com/index.php?rid=1241311&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18280878%26dopt%3DAbstract Authors: Kfuri TA, Morlock L, Hicks RW, Shore AD The findings highlighted in this article suggest that obstetricians and perinatologists face several challenges for safe medication use during pregnancy. Furthermore, evidence of in-hospital medication errors from obstetric services has been provided by national medication error data voluntarily submitted from many hospitals. The data provide fresh insight into the nature of medication errors in obstetrics, especially regarding the medication use process, the most common types of errors reported, the most commonly reported products overall, as well as those that resulted in patient harm. Providers and staff working within health care organizations should be well aware that a substantial number of patients experience medication errors whi... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1241311 Tue, 19 Feb 2008 20:31:38 +0100 1241311 http://www.medworm.com/index.php?rid=1241310&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18280879%26dopt%3DAbstract This article compares and discusses iatrogenic medication errors in the NICU that are related to computer entry and computerized physician order entry systems. The authors also propose a possible approach for evaluating technology that is intended to prevent iatrogenic mediation errors in the NICU. PMID: 18280879 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1241310 Tue, 19 Feb 2008 20:31:36 +0100 1241310 http://www.medworm.com/index.php?rid=1241309&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18280880%26dopt%3DAbstract This article reviews the prevalence and types of medication errors affecting the care of the neonate and summarizes approaches that have been used to reduce these errors. Safety initiatives applicable to minimizing medication errors also are discussed. PMID: 18280880 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1241309 Tue, 19 Feb 2008 20:31:34 +0100 1241309 http://www.medworm.com/index.php?rid=1241308&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18280881%26dopt%3DAbstract Authors: Lai TT, Bearer CF Premature infants in the neonatal intensive care unit (NICU) face many illnesses and complications. Another potential source of iatrogenic disease is the NICU environment. Research in this area, however, is limited. PMID: 18280881 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1241308 Tue, 19 Feb 2008 20:31:32 +0100 1241308 http://www.medworm.com/index.php?rid=1241307&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18280882%26dopt%3DAbstract This article reviews the physiology of thermoregulation, hypothermia, and hyperthermia. The differential diagnosis of hypothermia and hyperthermia is discussed. The benefits of hypothermia following hypoxic-ischemic injury are discussed; however, both hypothermia and hyperthermia, in the extreme, are potentially harmful to the newborn. Recommendations for the prevention of these problems are discussed, as well as available treatments. PMID: 18280882 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1241307 Tue, 19 Feb 2008 20:31:30 +0100 1241307 http://www.medworm.com/index.php?rid=1241306&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18280883%26dopt%3DAbstract This article reviews complications of venous and arterial catheters in the neonatal ICU and discusses treatment approaches and methods to prevent such complications, based on current evidence. PMID: 18280883 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1241306 Tue, 19 Feb 2008 20:31:27 +0100 1241306 http://www.medworm.com/index.php?rid=1241305&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18280884%26dopt%3DAbstract Authors: Carey AJ, Saiman L, Polin RA Nosocomial infections are an important cause of morbidity and mortality in the preterm neonate. Extrinsic and intrinsic risk factors make the preterm neonate particularly susceptible to infection. This review focuses on two major pathogens that cause nosocomial infection, Candida and methicillin-resistant Staphylococcus aureus. The difficult diagnosis of meningitis in the neonate also is discussed. PMID: 18280884 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1241305 Tue, 19 Feb 2008 20:31:25 +0100 1241305 http://www.medworm.com/index.php?rid=1241304&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18280885%26dopt%3DAbstract This article reviews the current scientific knowledge related to the etiology and pathogenesis of NEC and discusses some possible preventive measures. PMID: 18280885 [PubMed - as supplied by publisher] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1241304 Tue, 19 Feb 2008 20:31:23 +0100 1241304 http://www.medworm.com/index.php?rid=1241303&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18280886%26dopt%3DAbstract Authors: Miller JD, Carlo WA Mechanical ventilation is necessary and life saving in many neonates. Most complications are inherent to this intervention and cannot be confused with iatrogenic errors in judgment or care practices by clinicians. Clinical data suggest that complications such as volutrauma and air leak syndromes can negatively affect long-term pulmonary and non-pulmonary outcomes. Careful attention to many aspects of neonatal care, such as delivery room resuscitation, ventilatory support, and routine care practices, is needed to decrease pulmonary complications of mechanical ventilation. Clinical research is needed to improve mechanical ventilator strategies to reduce pulmonary complications and improve long-term outcomes. PMID: 18280886 [PubMed - as supplied by publish... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1241303 Tue, 19 Feb 2008 20:31:21 +0100 1241303 http://www.medworm.com/index.php?rid=1081347&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18063101%26dopt%3DAbstract Authors: Rayburn WF PMID: 18063101 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1081347 Sat, 01 Dec 2007 05:00:00 +0100 1081347 http://www.medworm.com/index.php?rid=1081346&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18063102%26dopt%3DAbstract Authors: Nathanielsz PW, Poston L, Taylor PD The developed and developing worlds are experiencing an epidemic of obesity and associated predisposition to diabetes. This epidemic places a major drain on health care resources. It is now clear that maternal obesity and gestational diabetes have major adverse effects on the developing fetus that lead to increased neonatal morbidity and mortality, as discussed elsewhere in this issue. Obesity in pregnancy and gestational diabetes represent a special problem, not only as a result of their immediate adverse effects on maternal health and pregnancy outcome, but also because of growing evidence for their persistent and deleterious effects on the developing child. PMID: 18063102 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1081346 Sat, 01 Dec 2007 05:00:00 +0100 1081346 http://www.medworm.com/index.php?rid=1081345&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18063103%26dopt%3DAbstract This article focuses on the clinical evaluation and management of women who have thrombophilia-related placental vascular complications, including fetal loss, pre-eclampsia, intrauterine fetal growth restriction, and placental abruption. All are major causes of maternal and fetal adverse outcomes. PMID: 18063103 [PubMed - in process] (Source: Clinics in Perinatology) Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1081345 Sat, 01 Dec 2007 05:00:00 +0100 1081345 http://www.medworm.com/index.php?rid=1081344&cid=s_33214_69_f&fid=33214&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18063104%26dopt%3DAbstract Authors: Neale DM, Cootauco AC, Burrow G Twenty-seven million Americans are affected with thyroid disease, yet over half of this population remains undiagnosed. Thyroid disease often manifests itself during the reproductive period of a woman's life and is the second most common endocrinopathy that affects women of childbearing age. The physiologic changes of pregnancy can mimic thyroid disease or cause a true remission or exacerbation of underlying disease. In addition, thyroid hormones are key players in fetal brain development. Maternal, fetal and neonatal thyroid are discussed here. Moreover, this article serves as a review of the more common thyroid diseases that are encountered during pregnancy and the postnatal period, their treatments, and their potential effects on pregnancy. ... Clinics in Perinatology journals http://www.medworm.com/rss/comments.php?id=1081344 Sat, 01 Dec 2007 05:00:00 +0100 1081344