Abstract:
:Down syndrome (DS) screening has been an integral part of routine prenatal screening for the last three decades. Recent efforts have been directed at developing additional non-invasive prenatal screening techniques that could not only improve sensitivity of prenatal screening, but also be employed in the first trimester to offer earlier diagnostic and interventional opportunities. Nuchal translucency has proven to be an effective and cost-effective screening test that, when combined with serum markers (hCG and pregnancy-associated plasma protein [PAPP-A]) in the first and/or second trimester, broadens the diagnostic possibilities and improves the diagnostic capabilities of current prenatal DS screening methods. Despite the potential benefits, significant operational issues regarding access to and availability of such testing may limit its widespread application and necessitates the maintenance of both non-sonographic and second trimester screening methods. The implementation of first trimester DS testing requires the development and maintenance of nationally standardized quality control systems to ensure the reliability of serum and ultrasound measurements and the accurate assessment of risk. Future efforts to improve prenatal screening should continue to emphasize the need for improved access to all aspects of prenatal care, stress the importance of provider education and the necessity for extensive patient counseling, and reinforce the role of patient education and choice.
journal_name
Semin Perinatoljournal_title
Seminars in perinatologyauthors
Fuchs KM,Peipert JFdoi
10.1053/j.semperi.2005.05.003keywords:
subject
Has Abstractpub_date
2005-08-01 00:00:00pages
267-71issue
4eissn
0146-0005issn
1558-075Xpii
S0146-0005(05)00037-6journal_volume
29pub_type
杂志文章,评审abstract::Many infants with CDH can be managed with conventional mechanical ventilation and pharmacotherapy. However, some infants will require levels of ventilator support that are not compatible with survival. In these circumstances, extracorporeal membrane oxygenation (ECMO) has been used with varying results. The indication...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2005.04.005
更新日期:2005-04-01 00:00:00
abstract::A large body of research indicates that children born very preterm are at increased risk for neurobehavioral impairments; however, research examining outcome for extremely preterm (EP) children is limited. This chapter will review the literature focusing on early development delay, general intellectual functioning, sp...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2007.12.009
更新日期:2008-02-01 00:00:00
abstract::Although a minor constituent by weight, surfactant protein B (SP-B) plays a major role in surfactant function. It is the unique structure of SP-B that promotes permeabilization, cross-linking, mixing, and fusion of phospholipids, facilitating the proper structure and function of pulmonary surfactant as well as contrib...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1053/j.semperi.2008.08.003
更新日期:2008-10-01 00:00:00
abstract::In this article, we have reviewed the most common CNS abnormalities seen in perinatal medicine. The prognosis in ventriculomegaly is most closely related to the presence or absence of associated anomalies. The current treatment for DWM consists of shunting of either the posterior fossa cyst or lateral ventricles. Faci...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1994-08-01 00:00:00
abstract::In mammals, a master circadian clock resides in the suprachiasmatic nuclei of the anterior hypothalamus. The suprachiasmatic nuclei is composed of multiple, single-cell circadian oscillators, which, when synchronized, lead to coordinated circadian outputs that ultimately regulate overt rhythms. Several "clock genes" h...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2000.9122
更新日期:2000-08-01 00:00:00
abstract::The cause for most cases of cerebral palsy is unknown. There are however, risk factors that have been associated with this chronic neuromuscular disease. The objective of this article is to review the maternal and fetal conditions (other than asphyxia and infection) strongly associated with increased rate of cerebral ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2000.7052
更新日期:2000-06-01 00:00:00
abstract::Inhaled nitric oxide (iNO), a selective pulmonary vasodilator, is available for treatment of persistent pulmonary hypertension of the newborn in term and near-term neonates. iNO decreases pulmonary vascular resistance leading to diminished extrapulmonary shunt and also has a microselective effect which improves ventil...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2000.20085
更新日期:2000-12-01 00:00:00
abstract::Maternal obesity, excessive gestational weight gain, and preexisting diabetes are known risk factors for increased maternal and neonatal morbidity. These conditions are more prevalent in certain racial and ethnic minorities. Identification and acknowledgement of racial and ethnic inequalities related to maternal metab...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2017.04.005
更新日期:2017-08-01 00:00:00
abstract::Neonatal hyperinsulinism (HI) is a clinical syndrome of pancreatic beta-cell dysfunction characterized by failure to suppress insulin secretion in the presence of hypoglycemia. Although rare, it is the most common cause for persistent hypoglycemia in the newborn period. Treatment can be extremely difficult, and partia...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sp.2000.6365
更新日期:2000-04-01 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 highly contagious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected every aspect of medical practice and has all but ceased clinical, translational and basic science research. Pregnant women appear to be similarly affected by the virus as non-pregnant adults. As obstetricians, not only do w...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.semperi.2020.151287
更新日期:2020-11-01 00:00:00
abstract::Cytomegalovirus (CMV) infection is the most common perinatal infection and may result in severe injury to the fetus. Forty percent to 50% of infants delivered to mothers with primary CMV will have congenital infections. Of these, 5% to 18% will be overtly symptomatic at birth. The mortality rate in these children is a...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(98)80014-1
更新日期:1998-08-01 00:00:00
abstract::For nearly 30 years the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network has been conducting randomized trials in pregnant women, many of which have changed clinical practice. Since 1986, the MFMU Network has conducted 29 randomized tr...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2016.03.011
更新日期:2016-08-01 00:00:00
abstract::Nitric oxide (NO) is intimately involved in vascular homeostasis through its antiplatelet, antiproliferative, and vasodilating actions. Because of these beneficial properties, methods of harnessing NO for the prevention of vascular injury responses, such as intimal hyperplasia, are being explored. One such method invo...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(00)80056-7
更新日期:2000-02-01 00:00:00
abstract::The studies described above collectively suggest that, whenever there is a decrease in fluid balance in the fetus, both fetal urine flow and tracheal secretion into the amniotic space are decreased. Conversely, when fetal hydration is increased, both urine and tracheal flows into the amniotic fluid may be increased. T...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1986-04-01 00:00:00
abstract::This review evaluates and compares, by using the best available medical evidence, the risks and benefits of postnatal steroid use in very low birth weight infants. Systemic postnatal steroids are effective at reducing the risk of chronic lung disease in ventilated very low birth weight infants; they appear to be most ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2001.29034
更新日期:2001-12-01 00:00:00
abstract::Concern over the influence of pregnancy-related alterations in hydration has prompted questions regarding the accuracy of using standard methods of determining body composition. We sought to investigate whether differences exist between body composition determined at 30 weeks and 39 weeks of gestation and postpartum, ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(96)80027-9
更新日期:1996-08-01 00:00:00
abstract::Laboratory tests are critical in the detection and timely treatment of infection. Two categories of tests are commonly used in neonatal sepsis management: those that identify the pathogen and those that detect host response to a potential pathogen. Decision-making around antibiotic choice is related to the performance...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1016/j.semperi.2020.151328
更新日期:2020-12-01 00:00:00
abstract::This review documents and assesses recent trends in sudden infant death syndrome. We review medical literature, Internet resources, and national governmental data. A striking reduction in SIDS incidence of more than 50% has been observed in various countries after interventions, particularly during the early 1990s, to...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2002.34774
更新日期:2002-08-01 00:00:00
abstract::The product label required by the FDA for every drug approved for marketing in the US is a legal document that originates with the company that wants to market the drug, but it must be approved by the FDA. Despite the recognized limitations of registries, the FDA's new labeling rule, effective from July 1, 2015, has g...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1053/j.semperi.2015.08.004
更新日期:2015-11-01 00:00:00
abstract::Multiple gestation carries a significant risk of perinatal complications and mortality. Often twin neonates are delivered small and early with a perinatal mortality rate five to seven times that of singleton neonates. Increased morbidity and mortality is due to an increased incidence of antepartum complications, monoz...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1986-01-01 00:00:00
abstract::Neuroblastoma is the most common malignant neoplasm occurring in the neonate and arguably the most variable in its presentation. This review examines differences in the tumor's clinical course in the context of known biologic determinants of behavior. Tumors that would go undetected except for prenatal ultrasonography...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(99)80035-4
更新日期:1999-08-01 00:00:00
abstract::Doppler ultrasonography was introduced into clinical obstetric practice over 20 years ago. It is also accepted that a variety of common obstetrical complications such as preeclampsia and intrauterine growth restriction have their origin in abnormal development of the placental vasculature and this could be reflected i...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2001.22892
更新日期:2001-02-01 00:00:00
abstract:PURPOSE:The purpose of this analysis was to determine the impact on specific forms of neonatal morbidity and mortality by allowing women to opt for delivery by elective cesarean section at 39 weeks of gestation (EGA). According to the National Vital Statistics Reports, over 70% of deliveries in the U.S. annually are at...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2006.07.009
更新日期:2006-10-01 00:00:00
abstract::The outcome literature on low birthweight (LBW) premature children indicates that they are at risk for a variety of neurodevelopmental impairments throughout childhood. To prevent such disabilities, numerous interventions have been initiated with LBW children. Nineteen intervention programs designed for LBW preterms t...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(05)80049-7
更新日期:1995-08-01 00:00:00
abstract::Inhalation of nitric oxide (NO) is an experimental treatment for severe pulmonary hypertension. Being rapidly metabolized by hemoglobin, inhaled NO causes selective vasodilation in the pulmonary vascular bed. In addition to the vascular smooth muscle, other pulmonary structures are exposed to inhaled NO, resulting in ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(96)80046-2
更新日期:1996-06-01 00:00:00
abstract::With 50-90% of pregnant women experiencing nausea and vomiting of pregnancy (NVP), the burden of illness can become quite significant if symptoms are under-treated and/or under-diagnosed, thus allowing for progression of the disease. The majority of these women will necessitate at least one visit with a provider to sp...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2014.08.014
更新日期:2014-12-01 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::Perinatal health outcomes in the United States continue to worsen, with the greatest burden of inequity falling on Black birthing communities. Despite transdisciplinary literature citing structural racism as a root cause of inequity, interventions continue to be mostly physician-centered models of perinatal and reprod...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.semperi.2020.151267
更新日期:2020-08-01 00:00:00
abstract::We have hypothesized that an alteration in the production of endothelium-dependent factors by sex hormones is a potential unifying mechanism for both the decreased arterial contractility and the redistribution of cardiac output characteristic of normal pregnancy. Thus, the effect of pregnancy/ estradiol on any one vas...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(97)80003-1
更新日期:1997-10-01 00:00:00