Abstract:
:Acute renal failure in the newborn is a common problem and is typically classified as prerenal, intrinsic renal disease including vascular insults, and obstructive uropathy. In the newborn, renal failure may have a prenatal onset in congenital diseases such as renal dysplasia with or without obstructive uropathy and in genetic diseases such as autosomal recessive polycystic kidney disease. Acute renal failure in the newborn is also commonly acquired in the postnatal period because of hypoxic ischemic injury and toxic insults. Nephrotoxic acute renal failure in newborns is usually associated with aminoglycoside antibiotics and nonsteroidal anti-inflammatory medications used to close a patent ductus arteriosis. Alterations in renal function occur in approximately 40% of premature newborns who have received indomethacin and such alterations are usually reversible. Renal artery thrombosis and renal vein thrombosis will result in renal failure if bilateral or if either occurs in a solitary kidney. Cortical necrosis is associated with hypoxic/ischemic insults due to perinatal anoxia, placenta abruption and twin-twin or twin-maternal transfusions with resultant activation of the coagulation cascade. As in older children, hospital acquired acute renal failure is newborns is frequently multifactorial in origin. Although the precise incidence and prevalence of acute renal failure in the newborn is unknown, several studies have shown that acute renal failure is common in the neonatal intensive care unit. Recent interesting studies have demonstrated that some newborns may have genetic risks factors for acute renal failure. Once intrinsic renal failure has become established, management of the metabolic complications of acute renal failure continues to involve appropriate management of fluid balance, electrolyte status, acid-base balance, nutrition and the initiation of renal replacement therapy when appropriate. Renal replacement therapy may be provided by peritoneal dialysis, intermittent hemodialysis, or hemofiltration with or without a dialysis circuit. The preferential use of hemofiltration by pediatric nephrologists is increasing while the use of peritoneal dialysis is decreasing except for neonates and small infants. Peritoneal dialysis has been a major modality of therapy for acute renal failure in the neonate when vascular access may be difficult to maintain. In the newborn, the prognosis and recovery from acute renal failure is highly dependent upon the underlying etiology of the acute renal failure. Factors that are associated with mortality include multiorgan failure, hypotension, need for pressors, hemodynamic instability, and need for mechanical ventilation and dialysis. The mortality and morbidity of newborns with acute renal failure is much worse in neonates with multiorgan failure. Newborns who have suffered substantial loss of nephrons as may occur in cortical necrosis are at risk for late development of renal failure after apparent recovery from the initial insult. Similarly, hypoxic/ischemic and nephrotoxic injury to the developing kidney can result is decreased nephron number. Newborns with acute renal failure need life-long monitoring of their renal function, blood pressure, and urinalysis. Typically, the late development of chronic renal failure will first becomes apparent with the development of hypertension, proteinuria, and eventually an elevated blood urea nitrogen and creatinine.
journal_name
Semin Perinatoljournal_title
Seminars in perinatologyauthors
Andreoli SPdoi
10.1053/j.semperi.2003.11.003keywords:
subject
Has Abstractpub_date
2004-04-01 00:00:00pages
112-23issue
2eissn
0146-0005issn
1558-075Xpii
S0146-0005(03)00127-7journal_volume
28pub_type
杂志文章,评审abstract::The medical literature demonstrates that inadequate hospital protocols or the lack of consistent protocols for diagnosis, management, consultation, and/or referral can lead to confusion and unnecessary variation in patient care. Incongruities in clinical settings have been repeatedly shown to compromise quality of pat...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2015.11.019
更新日期:2016-03-01 00:00:00
abstract::In experienced hands, cranial ultrasonography (cUS) is an excellent tool to detect the most frequently occurring brain abnormalities in preterm and full-term neonates, to study the evolution of lesions, and to follow brain maturation. It enables screening of the brain and serial imaging in high-risk neonates. However,...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2009.10.002
更新日期:2010-02-01 00:00:00
abstract::Effective training has been shown to improve perinatal care and outcome, decrease litigation claims and reduce midwifery sick leave. To be effective, training should be incentivised, in a realistic context, and delivered to inter-professional teams similar to those delivering actual care. Teamwork training is a useful...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2013.02.005
更新日期:2013-06-01 00:00:00
abstract::Pharmacotherapy, or medication-assisted treatment (MAT), is a critical component of a comprehensive treatment plan for the pregnant woman with opioid use disorder (OUD). Methadone and buprenorphine are two types of opioid-agonist therapy which prevent withdrawal symptoms and control opioid cravings. Methadone is a lon...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2019.01.003
更新日期:2019-04-01 00:00:00
abstract::Traditional birth attendants (TBAs) provided delivery care throughout the world prior to the development of organized systems of medical care. In 2016, an estimated 22% of pregnant women delivered with a TBA, mostly in rural or remote areas that lacked formal health services. Still active in many regions of LMICs, the...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2019.03.013
更新日期:2019-08-01 00:00:00
abstract::The rapid evolution of the COVID-19 pandemic in New York City during the spring of 2020 challenged the Department of Obstetrics and Gynecology at Columbia University Irving Medical Center to rely on its core values to respond effectively. In particular, five core values, "5 C's," were engaged: Communication; Collabora...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1016/j.semperi.2020.151291
更新日期:2020-10-01 00:00:00
abstract::Neonatal hyperbilirubinemia is a normal postnatal phenomenon resulting from a transitional imbalance between the production and elimination of bilirubin in the neonate. Bilirubin has been shown to be not only a potent antioxidant, but also toxic at excessive concentrations. As a result, the biology of bilirubin, its p...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2001.23197
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:To describe inpatient management strategies and considerations for pregnant patients with severe acute respiratory syndrome coronavirus 2 infection. FINDINGS:The novel coronavirus has posed challenges to both obstetric patients and the staff caring for them, due to its variable presentation and current limit...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1016/j.semperi.2020.151280
更新日期:2020-11-01 00:00:00
abstract::Despite major advances in neonatal care, the burden of preterm birth remains high. This is not unexpected since strategies to identify and treat risk factors in early pregnancy have not been very effective in reducing the preterm birth rate. Initial studies suggested a potential benefit for 17-alpha-hydroxyprogesteron...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2016.03.002
更新日期:2016-08-01 00:00:00
abstract::Adverse birth outcomes such as preterm birth, low-birth weight, and infant mortality continue to disproportionately affect black and poor infants in the United States. Improvements in healthcare quality and access have not eliminated these disparities. The objective of this review was to consider societal factors, inc...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2017.07.002
更新日期:2017-10-01 00:00:00
abstract::The intended and unintended effects of epidural labor analgesia are reviewed. Mothers randomized to epidural rather than parenteral opioid analgesia have better pain relief. Fetal oxygenation is not affected by analgesic method; however, neonates whose mothers received intravenous or intramuscular opioids rather than ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2002.32201
更新日期:2002-04-01 00:00:00
abstract::Minimally invasive surgery has been one of the most important surgical advances in the last 15 years. The development of smaller instruments has allowed pediatric surgeons to apply this rapidly evolving technology to neonates. Congenital neonatal deformities including tracheoesophageal fistula, patent ductus arteriosu...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2004.03.008
更新日期:2004-06-01 00:00:00
abstract::For many years, all of the described cases of monoamine neurotransmitter deficiency were associated with hyperphenylalaninemia that was generally detected at neonatal screening. It is now clear that inherited deficiency of monoamines often occurs in the absence of hyperphenylalaninemia and that the normal battery of s...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(99)80051-2
更新日期:1999-04-01 00:00:00
abstract::Medium- and long-term outcomes have been collected and described among survivors of neonatal intensive care units for decades, for a number of purposes: (1) quality control within units, (2) comparisons of outcomes between NICUs, (3) clinical trials (whether an intervention improves outcomes), (4) end-of-life decision...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2016.09.009
更新日期:2016-12-01 00:00:00
abstract::Hydrops fetalis, a condition characterized by abnormal accumulation of fluid and edema in the fetus, is the final common pathway in a number of pathological conditions. The diagnosis of hydrops is based on ultrasonographic findings of generalized edema along with a serous effusion (ascites, pleural effusion, or perica...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(05)80053-9
更新日期:1995-12-01 00:00:00
abstract::Use of immunosuppressants during pregnancy is indicated for anti-rejection therapy in transplantation patients and treatment of autoimmune diseases. Maternal side effects include nephrotoxocity and hepatotoxicity. All immunosuppressant drugs cross the placenta. Immunosuppressant use during the first trimester is not s...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(97)80057-2
更新日期:1997-04-01 00:00:00
abstract::Neonatal herpes simplex virus (HSV) infection is one of the life-threatening infections of newborns. It affects approximately 1,500 to 2,200 infants per year in the United States. Changes in the presentation of neonatal HSV infection over the past two decades include an increase in the frequency of skin, eye, and mout...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(98)80008-6
更新日期:1998-02-01 00:00:00
abstract::Transplant recipients are becoming pregnant with increasing frequency, and successful pregnancy outcomes have now been reported for women with all types of solid organ transplants. To prevent rejection of the transplanted organ, these patients are maintained on a life-long immunosuppressive regimen that must also be c...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2007.09.006
更新日期:2007-12-01 00:00:00
abstract::Unpublished results can bias biomedical literature, favoring positive over negative findings, primary over secondary analyses, and can lead to duplicate studies that unnecessarily endanger subjects and waste resources. The Neonatal Research Network's (NRN) publication policies for approving, reviewing, and tracking ab...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1053/j.semperi.2016.05.003
更新日期:2016-10-01 00:00:00
abstract::Pulmonary aspiration of gastric contents is a leading cause of maternal morbidity and mortality for patients during labor. The risk is increased in those women who require obstetric surgery and general anesthesia. Furthermore, gastric aspiration is believed to be largely preventable. Care providers can reduce the risk...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(97)80074-2
更新日期:1997-08-01 00:00:00
abstract::Tumors are a rare but important cause of mortality and morbidity in the neonate. There is a wide spectrum of benign and malignant tumors that can occur, some of which have a unique presentation and behavior in this age group. It is important to recognize that tumors such as stage IVS neuroblastoma, which have a good p...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(97)80026-2
更新日期:1997-02-01 00:00:00
abstract::Over 50 years after its first description, Bronchopulmonary Dysplasia (BPD) remains a devastating pulmonary complication in preterm infants with respiratory failure and develops in 30-50% of infants less than 1000-gram birth weight. It is thought to involve ventilator- and oxygen-induced damage to an immature lung tha...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2018.09.009
更新日期:2018-11-01 00:00:00
abstract::Venous thromboembolism (VTE) is a leading cause of severe maternal morbidity and mortality. While pregnancy alone is a risk factor for VTE, additional population-based risk factors such as obesity are becoming increasingly common, particularly in the developed world. Maternal death from VTE is amenable to prevention a...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2015.11.011
更新日期:2016-03-01 00:00:00
abstract::Preterm births account for a substantial portion of infant mortality, the major difference in mortality between African-American and white births in the United States, and the key reason that US infant mortality exceeds that of other developed nations. Although preterm birth rates are higher in the African-American co...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(05)80039-4
更新日期:1995-08-01 00:00:00
abstract::Nuchal translucency (NT) describes an echo-free area, below the skin, in the posterior nuchal and back region of the fetus and is typically observed in the first and early second trimester of pregnancy. A wide NT has been correlated with chromosomal and congenital abnormalities in the fetus. An accurate NT measurement...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1053/j.semperi.2005.12.004
更新日期:2005-12-01 00:00:00
abstract::Poorly controlled maternal diabetes in pregnancy may delay fetal pulmonary maturation. However, diabetic women with good glycemic control have fetal lung maturation at the same gestational age as nondiabetic women. With modern ultrasound technology, gestational dates can be accurately assessed in the first or early se...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2002.33969
更新日期:2002-06-01 00:00:00
abstract::Clinically silent upper genital tract microbial infections have been strongly associated with spontaneous preterm delivery, especially prior to 32 weeks gestational age. This condition represents a potentially preventable or reversible cause of preterm birth using safe, readily available, and inexpensive antibiotics. ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(03)00006-5
更新日期:2003-06-01 00:00:00
abstract::Up to the immediate past, and perhaps even to the present, a major difference between care of the fetus and of the neonate was the ability to examine directly the physical and biochemical traits of the unborn patient. In a span of time as short as perhaps 10 years it has become progressively possible to institute almo...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:
更新日期:1989-08-01 00:00:00
abstract::Preterm birth occurs in 7% to 12% of all deliveries, but accounts for over 85% of all perinatal morbidity and mortality. Although the ability of obstetric care providers to identify women at risk for preterm delivery has improved, the overall incidence of preterm birth has remained unchanged for the past 30 years. Pre...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2001.26417
更新日期:2001-08-01 00:00:00
abstract::The management of conjoined twins is complex and requires careful preparation. Pre-birth management includes prenatal counseling, which is important due to the overall poor prognosis. In instances of trial of life, the delivery must be tailored to address the anticipated anatomy based on prenatal imaging and anticipat...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2018.07.008
更新日期:2018-10-01 00:00:00