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 Perinatoljournal_title
Seminars in perinatologyauthors
Bullard KM,Harrison MRdoi
10.1016/s0146-0005(05)80053-9subject
Has Abstractpub_date
1995-12-01 00:00:00pages
462-73issue
6eissn
0146-0005issn
1558-075Xpii
S0146-0005(05)80053-9journal_volume
19pub_type
杂志文章,评审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::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::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::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::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
更新日期:2009-10-01 00:00:00
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
更新日期:1995-02-01 00:00:00
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
更新日期:2008-04-01 00:00:00
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
更新日期:2019-11-01 00:00:00
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
更新日期:2013-10-01 00:00:00
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
更新日期:2004-04-01 00:00:00
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
更新日期:2016-11-01 00:00:00
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
更新日期:2004-02-01 00:00:00
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
更新日期:2011-12-01 00:00:00
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
更新日期:2012-12-01 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::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::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::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
更新日期:2003-10-01 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::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
更新日期:2017-12-01 00:00:00
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
更新日期:2015-12-01 00:00:00
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
更新日期:2005-10-01 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::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::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
更新日期:2005-02-01 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::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::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::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::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
更新日期:2015-10-01 00:00:00