Before the horse is out of the barn: fetal surgery for hydrops.

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 pericardial effusion). Polyhydramnios and placentomegaly may also be present. Historically, hydrops fetalis has been described in cases of Rh alloimmunization and severe erythroblastosis (immune hydrops). Hydrops is considered "nonimmune" if there is no evidence of fetal-maternal blood group incompatibility. Over the past few decades, nonimmune hydrops has been recognized more frequently. In a number of series, 80% to 90% of hydropic fetuses were considered nonimmune. Incidence ranges from 1 in 1,500 to 1 in 3,800 births. Etiology is diverse and associated conditions include cardiovascular malformations, chromosomal abnormalities, thoracic lesions, infections, metabolic disorders, fetal anemia and twinning. Overall prognosis is poor, with mortality between 50% and 98%. Advances in obstetric ultrasound and prenatal diagnosis have made it possible to diagnose a number of congenital anomalies early in gestation. In some cases, anatomic anomalies diagnosed in utero progress to nonimmune hydrops and almost certain fetal demise. It is these conditions that can be considered for fetal surgical intervention. This article reviews the pathophysiology and rationale behind surgical correction of two conditions that lead to hydrops: fetal thoracic lesions (congenital cystic adenomatoid malformation, pulmonary sequestration, and fetal pleural effusions) and sacrococcygeal teratoma (SCT).

journal_name

Semin Perinatol

journal_title

Seminars in perinatology

authors

Bullard KM,Harrison MR

doi

10.1016/s0146-0005(05)80053-9

subject

Has Abstract

pub_date

1995-12-01 00:00:00

pages

462-73

issue

6

eissn

0146-0005

issn

1558-075X

pii

S0146-0005(05)80053-9

journal_volume

19

pub_type

杂志文章,评审
  • Minimally invasive surgery in the neonate: review of current evidence.

    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

    authors: Georgeson KE,Robertson DJ

    更新日期:2004-06-01 00:00:00

  • Cold stress and hypoglycemia in the late preterm ("near-term") infant: impact on nursery of admission.

    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

    authors: Laptook A,Jackson GL

    更新日期:2006-02-01 00:00:00

  • After shoulder dystocia: managing the subsequent pregnancy and delivery.

    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

    authors: Gurewitsch ED,Johnson TL,Allen RH

    更新日期:2007-06-01 00:00:00

  • Cesarean section on demand.

    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

    authors: Morrison J,MacKenzie IZ

    更新日期:2003-02-01 00:00:00

  • Prevention of preterm birth based on a short cervix: cerclage.

    abstract::In an attempt to prevent preterm birth, clinicians have recommended cerclage for women with shortened cervical length and other worrisome sonographic cervical features in the mid-trimester, although randomized trials have not supported this practice. Emerging data suggest that preterm birth is a complex and poorly und...

    journal_title:Seminars in perinatology

    pub_type: 杂志文章,评审

    doi:10.1053/j.semperi.2009.06.005

    authors: Mancuso MS,Owen J

    更新日期:2009-10-01 00:00:00

  • Ion channels and the control of myometrial electrical activity.

    abstract::Understanding the role of ion channels in the generation of slow waves and action potentials in the myometrium is critical in designing strategies to regulate uterine contractile activity. The development of the patch clamp technique has allowed the identification of specific types of channels in the myometrium and pr...

    journal_title:Seminars in perinatology

    pub_type: 杂志文章,评审

    doi:10.1016/s0146-0005(95)80045-x

    authors: Sanborn BM

    更新日期:1995-02-01 00:00:00

  • Necrotizing enterocolitis: recent scientific advances in pathophysiology and prevention.

    abstract::Necrotizing enterocolitis (NEC) is a leading cause of morbidity and mortality among infants in the neonatal intensive care unit. Here we review the epidemiology and pathophysiology of NEC, with an emphasis on the latest research findings and potential areas for future research. NEC continues to be one of the most deva...

    journal_title:Seminars in perinatology

    pub_type: 杂志文章,评审

    doi:10.1053/j.semperi.2008.01.004

    authors: Lin PW,Nasr TR,Stoll BJ

    更新日期:2008-04-01 00:00:00

  • The role of long chain polyunsaturated fatty acids in perinatal nutrition.

    abstract::The importance of omega-3 long chain polyunsaturated fatty acids in the perinatal period has been the focus of research for several decades. Infants born preterm miss out on the last trimester in utero transfer of omega-3 fatty acids and consequently have lower blood levels than infants born at term. Preterm infant fo...

    journal_title:Seminars in perinatology

    pub_type: 杂志文章,评审

    doi:10.1053/j.semperi.2019.06.004

    authors: Collins CT,Gibson RA,McPhee AJ,Makrides M

    更新日期:2019-11-01 00:00:00

  • Morbidly adherent placenta.

    abstract::Morbidly adherent placenta, which describes placenta accreta, increta, and percreta, implies an abnormal implantation of the placenta into the uterine wall. The incidence of placenta accreta has increased significantly over the past several decades, with the main risk factors include prior cesarean section and placent...

    journal_title:Seminars in perinatology

    pub_type: 杂志文章,评审

    doi:10.1053/j.semperi.2013.06.014

    authors: Abuhamad A

    更新日期:2013-10-01 00:00:00

  • Acute renal failure in the newborn.

    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 i...

    journal_title:Seminars in perinatology

    pub_type: 杂志文章,评审

    doi:10.1053/j.semperi.2003.11.003

    authors: Andreoli SP

    更新日期:2004-04-01 00:00:00

  • Simulation for neonatal extracorporeal membrane oxygenation teams.

    abstract::Extracorporeal membrane oxygenation (ECMO) is a highly technical and complex method of life support. Patient and circuit emergencies on ECMO are rare, but in these cases, prompt and correct actions to address the crisis are needed to prevent morbidity and mortality. ECMO simulation programs have gained popularity in r...

    journal_title:Seminars in perinatology

    pub_type: 杂志文章,评审

    doi:10.1053/j.semperi.2016.08.002

    authors: Johnston L,Oldenburg G

    更新日期:2016-11-01 00:00:00

  • Customized fetal growth standards: rationale and clinical application.

    abstract::Accurate assessment of fetal growth status requires the definition of an optimal standard, which represents the growth potential of the baby. Against this standard, individually 'customized' percentiles can be calculated. They improve the distinction between normal and abnormal, and help in our understanding and diagn...

    journal_title:Seminars in perinatology

    pub_type: 杂志文章

    doi:10.1053/j.semperi.2003.12.002

    authors: Gardosi J

    更新日期:2004-02-01 00:00:00

  • Antepartum obstetrical complications associated with obesity.

    abstract::Obesity is a major risk factor for many obstetrical complications, including pre-eclampsia, gestational diabetes, indicated preterm birth, macrosomia, and stillbirth. Clinicians should be aware of the unique obstetrical management considerations related to obesity, including recommendations for alterations in prenatal...

    journal_title:Seminars in perinatology

    pub_type: 杂志文章

    doi:10.1053/j.semperi.2011.05.015

    authors: Thornburg LL

    更新日期:2011-12-01 00:00:00

  • Treatment and prophylaxis of invasive candidiasis.

    abstract::Invasive candidiasis (IC) is a leading cause of morbidity and mortality in preterm infants. Even if successfully treated, IC can cause significant neurodevelopmental impairment. Preterm infants are at increased risk for hematogenous Candida meningoencephalitis owing to increased permeability of the blood-brain barrier...

    journal_title:Seminars in perinatology

    pub_type: 杂志文章,评审

    doi:10.1053/j.semperi.2012.06.003

    authors: Tripathi N,Watt K,Benjamin DK Jr

    更新日期:2012-12-01 00:00:00

  • Got daddy issues? Fathers impact on perinatal outcomes.

    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

    authors: Brumberg HL,Shah SI

    更新日期:2020-06-01 00:00:00

  • What we have learned about the design of randomized trials in pregnancy.

    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

    authors: Thom EA,Rice MM,Saade GR,Reddy UM,Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal–Fetal Medicine Units Network.

    更新日期:2016-08-01 00:00:00

  • Substrate metabolism in the developing heart.

    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

    authors: Ascuitto RJ,Ross-Ascuitto NT

    更新日期:1996-12-01 00:00:00

  • Antifungal pharmacotherapy for neonatal candidiasis.

    abstract::Candida is a leading cause of late onset infection (> 3 days of age) in the premature infant. Therefore, decisions about the diagnosis and management of infections caused by Candida are commonplace in the neonatal intensive care unit. Despite this fact, there are few comparative trials about treatment of neonatal Cand...

    journal_title:Seminars in perinatology

    pub_type: 杂志文章,评审

    doi:10.1016/s0146-0005(03)00060-0

    authors: Bliss JM,Wellington M,Gigliotti F

    更新日期:2003-10-01 00:00:00

  • Obstetrical venous thromboembolism: Epidemiology and strategies for prophylaxis.

    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

    authors: Friedman AM,Ananth CV

    更新日期:2016-03-01 00:00:00

  • New techniques in evaluation of the cervix.

    abstract::The process of parturition is poorly understood, but the cervix clearly plays a key role. Because of this, recent research efforts have been directed at objective quantification of cervical remodeling. Investigation has focused on two basic areas: (1) quantification of tissue deformability and (2) presence, orientatio...

    journal_title:Seminars in perinatology

    pub_type: 杂志文章,评审

    doi:10.1053/j.semperi.2017.08.006

    authors: Feltovich H,Carlson L

    更新日期:2017-12-01 00:00:00

  • Rapid whole genome sequencing and precision neonatology.

    abstract::Traditionally, genetic testing has been too slow or perceived to be impractical to initial management of the critically ill neonate. Technological advances have led to the ability to sequence and interpret the entire genome of a neonate in as little as 26 h. As the cost and speed of testing decreases, the utility of w...

    journal_title:Seminars in perinatology

    pub_type: 杂志文章,评审

    doi:10.1053/j.semperi.2015.09.009

    authors: Petrikin JE,Willig LK,Smith LD,Kingsmore SF

    更新日期:2015-12-01 00:00:00

  • Prenatal diagnosis and multiple pregnancy.

    abstract::The incidence of twins, triplets, and high-order multiples has increased dramatically in the last two decades secondary to greater reliance on fertility treatments and to delayed childbearing. Offspring of a multiple gestation are at increased risk for both chromosomal and structural abnormalities. Prenatal diagnosis ...

    journal_title:Seminars in perinatology

    pub_type: 杂志文章,评审

    doi:10.1053/j.semperi.2005.08.005

    authors: Cleary-Goldman J,D'Alton ME,Berkowitz RL

    更新日期:2005-10-01 00:00:00

  • Neurodevelopmental outcome of extremely low-birth-weight infants randomly assigned to restrictive or liberal hemoglobin thresholds for blood transfusion.

    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

    authors: Whyte RK

    更新日期:2012-08-01 00:00:00

  • Reflections on future directions of perinatal medicine.

    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:

    authors: Manning FA

    更新日期:1989-08-01 00:00:00

  • ECMO and congenital heart disease.

    abstract::Although initially designed for respiratory failure, venoarterial extracorporeal membrane oxygenation (VA ECMO) has become a mainstay of therapy in the treatment of patients with congenital heart disease, providing preoperative and postoperative support for infants with temporary impairment of myocardial function. Pos...

    journal_title:Seminars in perinatology

    pub_type: 杂志文章,评审

    doi:10.1053/j.semperi.2004.02.001

    authors: Hines MH

    更新日期:2005-02-01 00:00:00

  • Conducting research during the COVID-19 pandemic.

    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

    authors: Mourad M,Bousleiman S,Wapner R,Gyamfi-Bannerman C

    更新日期:2020-11-01 00:00:00

  • Neonatal herpes simplex virus infections.

    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

    authors: Jacobs RF

    更新日期:1998-02-01 00:00:00

  • An update on the post-NICU discharge management of bronchopulmonary dysplasia.

    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

    authors: Bhandari A,Panitch H

    更新日期:2018-11-01 00:00:00

  • Role of microbiological tests and biomarkers in antibiotic stewardship.

    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

    authors: Rub DM,Dhudasia MB,Healy T,Mukhopadhyay S

    更新日期:2020-12-01 00:00:00

  • Induction of labor in women with a prior cesarean delivery.

    abstract::Given the historically high rates of cesarean delivery in the United States, obstetrical providers must often consider an induction of labor for women with a history of prior cesarean delivery versus repeat cesarean delivery. Clinical evaluation of this scenario involves weighing the benefits of a successful trial of ...

    journal_title:Seminars in perinatology

    pub_type: 杂志文章,评审

    doi:10.1053/j.semperi.2015.07.011

    authors: Hoffman MK,Hunter Grant G

    更新日期:2015-10-01 00:00:00