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 anticipated physiology. A multidisciplinary team is essential to anticipate and address the ergonomic challenges and medical issues related to organ fusion, cross-circulation and associated anomalies. There are several suggested modifications to the current Neonatal Resuscitation Program algorithm including modifications to initial assessment, airway management, administration of chest compressions, obtaining emergency access, and medication dosing. Simulation is essential to address challenges, practice Neonatal Resuscitation Program modifications, delineate clear roles during delivery and practice communication. This paper offers a discussion of unique issues associated with delivery of conjoined twins and recommendations on how to approach these challenges based on our experience and available literature.
journal_name
Semin Perinatoljournal_title
Seminars in perinatologyauthors
C Sager E,Thomas A,C Sundgren Ndoi
10.1053/j.semperi.2018.07.008subject
Has Abstractpub_date
2018-10-01 00:00:00pages
321-328issue
6eissn
0146-0005issn
1558-075Xpii
S0146-0005(18)30047-8journal_volume
42pub_type
杂志文章,评审abstract::The safety of cesarean section has improved dramatically over the past 50 years. During the past 20 years a greater awareness of and discussion about the symptomatic morbidity that can result for women following vaginal delivery has occurred and women's expectations for the outcome of pregnancy for them and their babi...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2003.50002
更新日期:2003-02-01 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::Bronchopulmonary dysplasia (BPD) is a chronic lung disease which develops as a result of neonatal/perinatal lung injury. It is the commonest cause of chronic lung disease in infancy and the most frequent morbidity associated with prematurity. The incidence of BPD has continued to rise despite many advances in neonatal...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2018.09.011
更新日期:2018-11-01 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::Preeclampsia, intrauterine growth restriction (IUGR), and placental abruption are obstetrical conditions that constitute the syndrome of ischemic placental disease or IPD, the leading cause of indicated preterm birth and an important cause of neonatal morbidity and mortality. While the phenotypic manifestations vary s...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2014.03.002
更新日期:2014-04-01 00:00:00
abstract::Surviving extremely low-birth-weight infants are at risk of severe neurodevelopmental disability. Transfusion with packed red cells is almost universal in the care of these infants, but the hemoglobin threshold at which these transfusions should be given is unclear. Different clinical trials of restrictive (low hemogl...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2012.04.010
更新日期:2012-08-01 00:00:00
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 trimest...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2005.05.003
更新日期:2005-08-01 00:00:00
abstract::Late preterm infants (34-37 weeks postmenstrual age at birth) are intermediate between less mature preterm infants and infants born at 38 weeks or more in regard to autonomic brain stem maturation. Ventilatory responses to CO(2) in preterm infants born at 33 to 36 week are significantly higher than in infants born at ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2006.02.005
更新日期:2006-04-01 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::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::Newborn screening describes various tests that can occur during the first few hours or days of a newborn's life and have the potential for preventing severe health problems, including death. Newborn screening has evolved from a simple blood or urine screening test to a more comprehensive and complex screening system c...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2015.03.002
更新日期:2015-04-01 00:00:00
abstract::The neurodevelopmental outcome of very low birth weight infants experiencing early-onset intraventricular hemorrhage (IVH) occurring within the first 6 postnatal hours was compared with that of their peers without early-onset IVH at 3 years corrected age. The 440 surviving preterm infants (birth weight 600 to 1,250 g)...
journal_title:Seminars in perinatology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0146-0005(99)80065-2
更新日期:1999-06-01 00:00:00
abstract::This article reviews the central role of nutrition in advancing the maternal, newborn, and child health agenda with a focus on evidence for effective interventions generated using randomized controlled trials in low- and middle-income countries (LMIC). The 1000 days spanning from conception to 2 years of life are a cr...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2015.06.009
更新日期:2015-08-01 00:00:00
abstract::This article presents an overview of current topics related to the genetics of hearing loss. The review focuses on the approach toward a child with a sensorineural hearing loss of unknown etiology and the incorporation of genetic testing into the workup. Nongenetic causes of hearing loss are reviewed, as they are impo...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2004.12.002
更新日期:2005-06-01 00:00:00
abstract::The developing heart undergoes a remarkable metabolic transformation as it adjusts to the higher-oxygen, extrauterine environment. During gestation, glycolysis and lactate oxidation constitute the major sources of adenosine triphosphate (ATP) for the fetal heart. After birth, however, there is a rapid shift from carbo...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(96)80068-1
更新日期:1996-12-01 00:00:00
abstract::Prostaglandins are currently used to maintain patency of the ductus arteriosus and to elicit uterine contractions. Prostaglandin synthesis inhibitors are used to promote closure of the ductus and their administration in pregnant animals has produced fetal pulmonary hypertension. Exposure of the human fetus to inhibito...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1987-01-01 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 American Heart Association (AHA) categorizes pulmonary embolism (PE) into three main categories based on the presence or absence of hemodynamic changes and evidence of right ventricular dysfunction. The AHA characterizes massive PE as occurring in the setting of persistent hypotension, profound bradycardia, or pul...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2019.03.005
更新日期:2019-06-01 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
abstract::In this review the factors present in human amniotic fluid that may function to inhibit bacterial growth have been examined. It appears that several potential antibacterial systems are present. Lysozyme and B-lysin may significantly contribute to the killing of gram-positive bacteria. Whether or not the remaining anti...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1977-01-01 00:00:00
abstract::Retinopathy of Prematurity (ROP) is a preventable neovascular retinal disease with a lifetime impact on vision and ocular morbidities. Retinal vessel immaturity and oxygen therapy, influenced or modulated by several risk factors including oxidative stress, intermittent hypoxia and desaturations, inflammation, infectio...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2019.05.009
更新日期:2019-10-01 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::STDs can be one of the most common antepartum complications in high-risk gravidas. Screening for gonorrhea, syphilis, HPV, and possibly hepatitis B and chlamydial infection, should be considered in most, if not all, pregnant women. Familiarity with the common clinical presentations and treatment of bacterial STDs will...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1990-04-01 00:00:00
abstract::Mothers' genetics as well as their environment, behaviors, and social determinants of health are all important factors influencing short and long term childhood outcomes. There is an emerging body of literature investigating the extent to which fathers also contribute to their offspring's future health. We review fath...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1016/j.semperi.2020.151238
更新日期:2020-06-01 00:00:00
abstract::Among risk factors for shoulder dystocia, a prior history of delivery complicated by shoulder dystocia is the single greatest risk factor for shoulder dystocia occurrence, with odds ratios 7 to 10 times that of the general population. Recurrence rates have been reported to be as high as 16%. Whereas prevention of shou...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2007.03.009
更新日期:2007-06-01 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::Late preterm infants (34-37 weeks gestation) pose unique challenges to physicians and nurses involved in their care after birth. They may be cared for in different units within hospitals after birth, including Neonatal Intensive Care Units, Newborn Nurseries, or rooming in with the mother. As a result of their gestati...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1053/j.semperi.2006.01.014
更新日期:2006-02-01 00:00:00
abstract::Ultrasound remains the modality of choice in imaging the fetus due to its availability, safety, and low cost. With advances in technology, however, magnetic resonance imaging (MRI) has become an important adjuvant in the evaluation of the fetus. MRI is not limited by fetal lie, oligohydramnios, overlying bone, or obes...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2013.06.005
更新日期:2013-10-01 00:00:00
abstract::Infants meeting retinopathy of prematurity (ROP) screening guidelines based on birth weight and gestational age undergo serial examinations by ophthalmologists for detection and treatment. However, less than 10% require treatment, and less than half develop ROP. Slow postnatal weight gain is highly predictive of ROP, ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2019.05.008
更新日期:2019-10-01 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