Fetal adaptive responses to asphyxia.

Abstract:

:The fetal environment is thus well suited for normal growth and development with oxygen availability exceeding oxidative needs. With impairments in blood gas exchange this excess oxygen acts as a "margin of safety," providing for the maintenance of oxidative metabolism through increases in fractional O2 extraction, although with resultant fetal hypoxemia. Increases in blood O2 capacity and redistribution of cardiac output in response to this hypoxemia further protect fetal oxygenation. Additional adaptive mechanisms involve a decrease in energy-consuming processes, including growth restriction, decreasing fetal movements, and behavioral state alterations. Although protective in so far as essential metabolic functions are maintained, pathologic change may occur as the "oxygen margin of safety" becomes limited or energy-conserving measures give rise to abnormal growth and development.

journal_name

Clin Perinatol

journal_title

Clinics in perinatology

authors

Richardson BS

subject

Has Abstract

pub_date

1989-09-01 00:00:00

pages

595-611

issue

3

eissn

0095-5108

issn

1557-9840

journal_volume

16

pub_type

杂志文章,评审
  • The perinatal paradigm: is it time for a change?

    abstract::Two different care procedures are presented to raise the difficult question of whether we should completely reevaluate our paradigms of care in the perinatal period. In this thorough review, should we continue to use the same framework of beliefs in deciding on the benefits and risks of any care procedure? ...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章

    doi:

    authors: Kennell JH,Klaus MH

    更新日期:1988-12-01 00:00:00

  • Neonatal Stridor: Diagnosis and Management.

    abstract::Stridor, a common presenting sign of respiratory distress in a newborn, has many systemic causes. It may arise from the larynx or the tracheobronchial airway. This article presents the most common pathologic conditions in this anatomic region, with highlights on management. ...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clp.2018.07.015

    authors: Bhatt J,Prager JD

    更新日期:2018-12-01 00:00:00

  • Navigating in the turbulent sea of data: the quality measurement journey.

    abstract::This article provides a roadmap for your quality measurement journey. It begins with a discussion of 3 approaches to measurement (improvement, accountability and research) and challenges readers to be clear about why they are measuring. Key milestones along the quality measurement journey are then presented and a fram...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章

    doi:10.1016/j.clp.2010.01.006

    authors: Lloyd RC

    更新日期:2010-03-01 00:00:00

  • Care at the edge of viability: medical and ethical issues.

    abstract::Decision-making for extremely immature preterm infants at the margins of viability is ethically, professionally, and emotionally complicated. A standard for prenatal consultation should be developed incorporating assessment of parental decision-making preferences and styles, a communication process involving a recipro...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章

    doi:10.1016/j.clp.2011.06.004

    authors: Haward MF,Kirshenbaum NW,Campbell DE

    更新日期:2011-09-01 00:00:00

  • The use of ultrasonography in the labor and delivery suite.

    abstract::Ultrasonography has increasingly become essential in the practice of obstetrics and gynecology. Its antenatal use is well described in the literature and is a continuing subject of study. However, the use of ultrasonography in the labor and delivery suite has not been the subject of many articles. The purpose of this ...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:

    authors: Benito CW,Guzman ER,Vintzileos AM

    更新日期:1996-03-01 00:00:00

  • Neurodevelopmental Outcomes of Preterm Infants Fed Human Milk: A Systematic Review.

    abstract::The neurodevelopmental benefits of breast milk feedings for preterm infants have been controversial. However, the effect on preterm infant neurodevelopment is sustained into childhood. The effects of breast milk feeding during the neonatal period and the duration of breastfeeding display effects on cognition into adol...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clp.2016.11.004

    authors: Lechner BE,Vohr BR

    更新日期:2017-03-01 00:00:00

  • Key nutrients and growth factors for the neonatal gastrointestinal tract.

    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

    authors: Burrin DG,Stoll B

    更新日期:2002-03-01 00:00:00

  • Optical coherence tomography in retinopathy of prematurity: looking beyond the vessels.

    abstract::Retinopathy of Prematurity (ROP) is a leading cause of childhood blindness in the United States. Optical Coherence Tomography (OCT) is a relatively new imaging technology capable of imaging ocular structures in cross section at high resolution. We present an age-customized approach to perform Spectral Domain OCT in ne...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clp.2013.02.007

    authors: Maldonado RS,Toth CA

    更新日期:2013-06-01 00:00:00

  • Treatment of cocaine addiction during pregnancy.

    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:

    authors: Farkas KJ,Parran TV Jr

    更新日期:1993-03-01 00:00:00

  • Imitators of severe pre-eclampsia/eclampsia.

    abstract::Several microangiopathic disorders that are encountered during pregnancy provide physicians with a formidable diagnostic challenge. Severe pre-eclampsia with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome and many other obstetric and medical or surgical conditions produce similar clinical presen...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clp.2004.06.007

    authors: Sibai BM

    更新日期:2004-12-01 00:00:00

  • Epidemiology of moderate preterm, late preterm and early term delivery.

    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

    authors: Ananth CV,Friedman AM,Gyamfi-Bannerman C

    更新日期:2013-12-01 00:00:00

  • Hemodynamics of preeclampsia.

    abstract::A review of the English literature reveals considerable disagreement regarding the cardiovascular hemodynamics of preeclampsia as measured by both noninvasive and invasive techniques. In the untreated patient, most of the data suggest the presence of low CO, low PCWP, and elevated SVR as compared to normotensive pregn...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:

    authors: Sibai BM,Mabie WC

    更新日期:1991-12-01 00:00:00

  • Obstetrics: basic equipment needs.

    abstract::The enunciation of equipment requirements has been attempted as needs appear today. Detailed and technical specifications for some of this equipment must be understood prior to major acquisitions. An awareness of current trends in clinical research can often be obtained from appropriate consultants which should forest...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章

    doi:

    authors: Paul RH

    更新日期:1976-09-01 00:00:00

  • Interventional cardiac procedures in neonates and infants: state of the art.

    abstract::The currently available interventional cardiac procedures in neonates and infants are at various stages of development. We currently dilate neonates and infants with critical valvular pulmonary and aortic stenosis and postoperative aortic obstruction. We do not routinely dilate native coarctation of the aorta because ...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:

    authors: Zeevi B,Perry SB,Keane JF,Mandell VS,Lock JE

    更新日期:1988-09-01 00:00:00

  • Omenn Syndrome Identified by Newborn Screening.

    abstract::Severe combined immunodeficiency (SCID) encompasses a group of genetic defects. T cell development is universally affected and has alteration of B and/or NK cells. We present the case of a 5-day-old boy with combined heterozygous frame shift (c.256_257del, p.(Lys86Valfs*33)) and missense (c.1186C>T, p.(Arg396Cys)) var...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clp.2019.09.004

    authors: Tallar M,Routes J

    更新日期:2020-03-01 00:00:00

  • Clinical uses, collection, and banking of human milk.

    abstract::The Mothers' Milk Bank (MMB) of San Jose, CA, has provided banked human milk to clinicians and researchers since its founding in 1974. This article briefly acknowledges the many and varied reasons for the use of human milk. Its primary focus however, is to review the protocol followed by the MMB for collection, bankin...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章

    doi:

    authors: Asquith MT,Pedrotti PW,Stevenson DK,Sunshine P

    更新日期:1987-03-01 00:00:00

  • Endocrine and metabolic homeostasis in diabetic pregnancy.

    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:

    authors: Hollingsworth DR

    更新日期:1983-10-01 00:00:00

  • Metabolic changes in gestational diabetes.

    abstract::Normal pregnancy produces profound metabolic alterations that occur, in large part, by the conclusion of the first trimester. Although necessary to support the metabolic needs of the conceptus, the metabolic and cardiovascular changes of pregnancy are well established weeks before the metabolic needs of the fetus and ...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:

    authors: Carpenter MW

    更新日期:1993-09-01 00:00:00

  • Pharmacologic neuroprotective strategies in neonatal brain injury.

    abstract::This article explains the mechanisms underlying choices of pharmacotherapy for hypoxic-ischemic insults of both preterm and term babies. Some preclinical data are strong enough that clinical trials are now underway. Challenges remain in deciding the best combination therapies for each age and insult. ...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clp.2013.09.004

    authors: Juul SE,Ferriero DM

    更新日期:2014-03-01 00:00:00

  • How bilirubin gets into the brain.

    abstract::The last decades of bilirubin research seem to have clarified the basic mechanisms by which bilirubin enters the brain. Clinical studies have so far failed to show any value of the presently known risk factors in predicting bilirubin toxicity in the newborn infant, however. This indicates that bilirubin entry into the...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:

    authors: Bratlid D

    更新日期:1990-06-01 00:00:00

  • Feeding practices and necrotizing enterocolitis.

    abstract::Necrotizing enterocolitis (NEC) is a multifactorial disorder that primarily affects premature infants. Human milk compared with formula reduces the incidence of NEC. Feeding practices do not increase the incidence of NEC in preterm infants. There is no evidence supporting continuous versus intermittent tube feedings i...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clp.2012.12.001

    authors: Ramani M,Ambalavanan N

    更新日期:2013-03-01 00:00:00

  • Umbilical artery Doppler in the assessment of fetal growth restriction.

    abstract::Antepartum fetal surveillance with Doppler ultrasound of umbilical artery has shown significant diagnostic efficacy in identifying fetal compromise in pregnancies complicated with fetal growth restriction (FGR). Its effectiveness in decreasing perinatal mortality has been shown by randomized clinical trials (Level I e...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clp.2010.12.004

    authors: Maulik D,Mundy D,Heitmann E,Maulik D

    更新日期:2011-03-01 00:00:00

  • The use of ultrasound in fetal surgery.

    abstract::Obstetric ultrasound (US) is an integral part of fetal surgery for open and minimally invasive techniques. With advances in US imaging, the ability to refine diagnosis, predict prognosis, and contribute to fetal treatment continues to grow. Current research in fetal diagnosis and treatment includes identifying the mos...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clp.2009.03.009

    authors: Hopkins LM,Feldstein VA

    更新日期:2009-06-01 00:00:00

  • Congenital lobar emphysema.

    abstract::Congenital lobar emphysema is an uncommon but potentially life-threatening cause of respiratory distress in the newborn. The clinical picture and radiologic findings are diagnostic. Lobectomy in the distressed neonate is curative. In infants with onset of symptoms between one and four months of age surgery may not be ...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章

    doi:

    authors: Buckner DM

    更新日期:1978-03-01 00:00:00

  • Nasal Intermittent Positive Pressure Ventilation for Preterm Neonates: Synchronized or Not?

    abstract::Although continuous positive airway pressure (CPAP) is an effective strategy to prevent invasive ventilation, failure rates are high and many babies require endotracheal intubation. Prolonged exposure to mechanical ventilation is linked with bronchopulmonary dysplasia and other morbidities. Different techniques of nas...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clp.2016.07.013

    authors: Waitz M,Mense L,Kirpalani H,Lemyre B

    更新日期:2016-12-01 00:00:00

  • Lighting for caregivers in the neonatal intensive care unit.

    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

    authors: Rea M

    更新日期:2004-06-01 00:00:00

  • Gastrointestinal Endoscopy in the Neonate.

    abstract::Gastrointestinal endoscopy permits direct observation of the alimentary tract, acquisition of mucosal tissue for histopathologic examination, and other diagnostic and therapeutic maneuvers. Endoscopes of appropriate size for many neonates and an expanding array of compatible tools and accessories have broadened what i...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clp.2020.02.012

    authors: Mezoff EA,Williams KC,Erdman SH

    更新日期:2020-06-01 00:00:00

  • Electrolyte disorders associated with respiratory distress syndrome and bronchopulmonary dysplasia.

    abstract::In understanding the various electrolyte disorders associated with respiratory failure, one has to appreciate how the otherwise healthy premature infant maintains extracellular fluid homeostasis. The same physiologic processes that regulate body fluids are affected to varying degrees in the infant with respiratory fai...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:

    authors: Brem AS

    更新日期:1992-03-01 00:00:00

  • Mechanisms of hemostasis at cesarean delivery.

    abstract::Postpartum hemorrhage is an obstetric emergency that represents a major cause of maternal morbidity and mortality. With the recent rise in the cesarean delivery rate, prompt recognition and proper management at the time of cesarean delivery are becoming increasingly important for providers of obstetrics. Preparedness ...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clp.2008.07.007

    authors: Bonanno C,Gaddipati S

    更新日期:2008-09-01 00:00:00

  • Advances in prenatal diagnosis and treatment of congenital diaphragmatic hernia.

    abstract::Congenital diaphragmatic hernia (CDH) is a common birth anomaly. Absence or presence of liver herniation and determination of lung-to-head ratio are the most accurate predictors of prognosis for fetuses with CDH. Though open fetal CDH repair has been abandoned, fetal endoscopic balloon tracheal occlusion promotes lung...

    journal_title:Clinics in perinatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clp.2012.04.005

    authors: Shue EH,Miniati D,Lee H

    更新日期:2012-06-01 00:00:00