Abstract:
:Our experience in the management of 138 infants with various causes of intestinal obstruction has provided us with important principles of diagnosis and treatments that we adhere to in the course of our practice. 1. The overall mortality of neonates suffering from intestinal obstruction should be fewer than 5 per cent. The high survival rate is accounted for by improved care these patients receive in specialized units. 2. Prematurity did not appear to play a significant factor in the outcome of these infants with intestinal obstruction. Our experience shows that premature infants tolerate operative procedures well, even in those instances in which an associated surgically correctable lesion is simultaneously repaired. 3. The major risk factor in any neonate with intestinal obstruction is the delay in diagnosis and operative intervention, especially in infants diagnosed to have midgut volvulus. The additional second risk factor is the association of chromosome abnormality. 4. Traditional diagnostic studies such as plain films of the abdomen supplemented by either an upper GI or lower GI contrast study for specific indications have been very effective in obtaining an accurate diagnosis of intestinal bowel obstruction. 5. Hirschsprung's disease can be diagnosed in the neonatal period if the index of suspicion for this is high. 6. Special surgical techniques as described should be used whenever indicated to minimize morbidity. 7. The traditional Wangensteen-Rice evaluation of a patient with imperforate anus is accurate, and specialized studies should be deferred for the postoperative period. Collaborative care provided by the neonatologist, pediatric anesthesiologist, and pediatric surgeon for these patients is the key to a favorable outcome.
journal_name
Clin Perinatoljournal_title
Clinics in perinatologyauthors
Reyes HM,Meller JL,Loeff Dsubject
Has Abstractpub_date
1989-03-01 00:00:00pages
85-96issue
1eissn
0095-5108issn
1557-9840journal_volume
16pub_type
杂志文章abstract::Prematurity is the leading cause of perinatal morbidity and mortality in the industrial world, occurring in 4% to 9% of all deliveries, a rate that has remained unchanged during the past decades. Despite the relative minority of obstetric patients affected by this problem, prematurity is responsible for approximately ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1998-09-01 00:00:00
abstract::The treatment of cocaine abuse among pregnant women involves attention not only to the cocaine use, but also to the pregnancy and constellation of medical and social problems substance-abusing women experience. Writing about the needs of women who enter treatment for drug-dependence treatment, Reed has offered suggest...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1993-03-01 00:00:00
abstract::Cytomegalovirus (CMV) is reactivated in the lactating breast in up to 96% of CMV seropositive mothers. There is a relevant entity of postnatally acquired symptomatic CMV infection and disease of preterm infants through raw breast milk (BM). Actual data support negative influence on long-term cognitive development. Con...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2016.11.012
更新日期:2017-03-01 00:00:00
abstract::Moderate preterm, late preterm, and early term deliveries represent a major and growing public health concern. These deliveries are associated with significant financial burden and pose serious risks to mothers and newborns. Women who deliver at moderate and late gestational ages in one pregnancy are at increased risk...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2013.07.001
更新日期:2013-12-01 00:00:00
abstract::The incidence of neonatal abstinence syndrome owing to prenatal opioid exposure has grown rapidly in recent decades and it disproportionately affects rural, non-white, and public insurance-dependent populations. Treatment consists of pharmacologic and nonpharmacologic interventions with wide variability in approaches ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2019.08.012
更新日期:2019-12-01 00:00:00
abstract::Exogenous surfactant therapy has been a significant advance in the management of preterm infants with RDS. It has become established as a standard part of the management of such infants. Both natural and synthetic surfactants lead to clinical improvement and decreased mortality, with natural surfactants having additio...
journal_title:Clinics in perinatology
pub_type: 杂志文章
doi:10.1016/s0095-5108(05)70112-3
更新日期:2001-09-01 00:00:00
abstract::Hemoglobinopathies are frequently occurring disorders for which prenatal diagnosis is possible. Couples in which one parent has microcytic hypochromic red blood cells; is of Southeast Asian, Mediterranean, Middle Eastern, Indian, or African origin; or had one previous child with a known hemoglobinopathy or a previous ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1990-12-01 00:00:00
abstract::Diabetic pregnancies involve complex alterations in maternal-placental and fetal compartments. This article discusses the unique features of diabetic pregnancies as they pertain to the maternal changes that must occur to accommodate the fetus. ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1983-10-01 00:00:00
abstract::Complex biochemical consequences are the result of a series of secondary biochemical changes caused by oxygen depletion. Hypoxia in the fetus and neonate results in decreased GI blood flow, especially to the GI mucosa. Although severe O2 deprivation cannot be entirely compensated for, an increase in tissue O2 extracti...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1986-03-01 00:00:00
abstract::The primary aim of this article is to define good lighting for caregivers(both medical staff and families) working in the hospital neonatal intensive care unit (NICU) and other areas associated with the critical care environment. Defining good lighting requires understanding that lighting is not only important for the...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2004.04.012
更新日期:2004-06-01 00:00:00
abstract::The newborn infant's skin is not a complete barrier to the absorption of externally applied agents, particularly if it is damaged, diseased, or immature. Immaturity is the most important factor that determines percutaneous absorption. Very immature infants in the early neonatal period have a poorly developed epidermis...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1987-12-01 00:00:00
abstract::Preterm birth is a major complication of pregnancy and remains a leading cause of neonatal morbidity and mortality worldwide. Improvements in the authors' understanding of the pathophysiology of preterm labor have led to the development of novel diagnostic tools of use to identify women at greatest risk for preterm bi...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0095-5108(03)00109-x
更新日期:2003-12-01 00:00:00
abstract::The American Academy of Pediatrics supports the feeding of human milk for all infants. Very-low-birth-weight and extremely low-birth-weight infants especially can benefit from the immune and neurodevelopmental effects of human milk. However, human milk alone is nutritionally inadequate for the rapid growth of the very...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2014.02.010
更新日期:2014-06-01 00:00:00
abstract::We have learned from prenatal diagnosis that there is a wide spectrum of clinical severity for fetuses that have a lung mass. Accurate prognostic information is necessary for providing appropriate management and parental counseling. If an associated life-threatening anomaly is present or if the mother is ill with the ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0095-5108(03)00047-2
更新日期:2003-09-01 00:00:00
abstract::In summary, the in utero diagnosis of nonimmune hydrops is associated with a grave prognosis. Antenatal evaluation will determine the cause in many cases, allowing appropriate decisions to be made regarding the management of the pregnancy. To date, no specific in utero therapy exists for most causes of nonimmune hydro...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1989-12-01 00:00:00
abstract::Pharmacotherapy for gastroesophageal reflux (GER) in neonates, aimed at interfering with this physiologic process and potentially reducing the negative sequelae that providers often attribute to GER, consists primarily of drugs that increase the viscosity of feeds, reduce stomach acidity, or improve gut motility. Medi...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2011.12.015
更新日期:2012-03-01 00:00:00
abstract::Despite advances in neonatal medicine, the mortality rate for congenital diaphragmatic hernia remains high. The results of work in animal models suggest that this anomaly may be amenable to in utero surgical correction. In this article, the natural history of congenital diaphragmatic hernia in humans is reviewed, and ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1996-09-01 00:00:00
abstract::The development of the flow-directed pulmonary artery catheter in the early 1970s moved invasive monitoring from the laboratory to the patient's bedside. Its current use in obstetrics is directed toward definition of certain pathophysiologic states unique to pregnancy and toward diagnosis and management of critically ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1986-12-01 00:00:00
abstract::Outcomes of neonatal intensive care unit (NICU) graduates have been categorized by rates of neurodevelopmental impairment at 2 years old. Although useful as metrics for research, these early childhood assessments may underestimate or overestimate later functional capabilities. Often overlooked are less severe but more...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2018.05.008
更新日期:2018-09-01 00:00:00
abstract::The evaluation of the craniofacial region is a multistep process. First, sonographic skill and expertise are required to ascertain these often subtle abnormalities. Next, precise measurements must be obtained in appropriate and reproducible planes. Finally, a thorough search for other related fetal anomalies is essent...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0095-5108(05)70054-3
更新日期:2000-12-01 00:00:00
abstract::Neonatal stress responses have been investigated only in recent years. Term neonates mount substantial hormonal and metabolic responses, which are distinct from those of adult patients. These responses can be altered significantly by the effects of prematurity, the effects of graded surgical stress, and the anesthetic...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1990-03-01 00:00:00
abstract::With the increased use of fertility agents and the transfer of multiple embryos, multifetal gestations have increased in number. As the number of fetuses increases, the probability of premature birth and delivery does. The role of multifetal pregnancy reduction and selective termination is reviewed. ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-01 00:00:00
abstract::Advances in fetal echocardiography are providing highly accurate diagnoses of congenital heart disease prior to delivery, making it possible to plan the delivery-room management of these newborns. Knowledge of the expected transitional circulation occurring with birth and the pathophysiologic implications of congenita...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2005.09.014
更新日期:2005-12-01 00:00:00
abstract::It is clear that prostaglandins and related compounds are important in the physiology and pathophysiology of the perinatal pulmonary circulation. This article focuses on what is known about prostaglandin-related compounds (PRC) in the pulmonary circulation of the developing and newly born mammal. Also included is a di...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1984-10-01 00:00:00
abstract::When cystic hygroma is detected antenatally, the prognosis is usually poor, and intrauterine or neonatal death are common. This seems especially true for Turner syndrome (the largest etiologic group associated with cystic hygroma) and the lethal multiple pterygium syndromes. However, some fetuses with Turner syndrome,...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1990-09-01 00:00:00
abstract::The nutritional support of gastrointestinal growth and function is an important consideration in the clinical care of neonatal infants. In most health infants, the provision of either breast milk or formula seems to support normal intestinal mucosal growth, but the most significant advantages of breast milk may be for...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0095-5108(03)00065-4
更新日期:2002-03-01 00:00:00
abstract::Insulin resistance appears to be a causative mechanism for the development of essential hypertension. Insulin resistance syndrome consists of a cluster of abnormalities that aggravate preexisting tendencies to develop hypertension, resulting in a cascade of physiologic alterations and ultimately leading to increased r...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1998-12-01 00:00:00
abstract::Late preterm neonates have unique susceptibilities to infection. The closed setting of the neonatal ICU (NICU) and the immunologic immaturity of premature infants set the state for the development of nosocomial infections. This article discusses infections that might be seen in this population and gives options for di...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2006.09.005
更新日期:2006-12-01 00:00:00
abstract::Congenital lung lesions (CLLs) comprise a heterogeneous group of developmental and histologic entities often diagnosed on screening prenatal ultrasound. Most fetuses with CLL are asymptomatic at birth; however, the risk of malignancy and infection drives the decision to prophylactically resect these lesions. The autho...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2017.08.003
更新日期:2017-12-01 00:00:00
abstract::The phenomenal developments in molecular genetics and technological refinements which have occurred over the past decade are revolutionizing the area of prenatal genetics. State-of-the-art care commences with comprehensive preconceptional counseling. Prenatal diagnosis is now feasible from the moment of conception onw...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1994-12-01 00:00:00