Abstract:
:Because of the high frequency, serious sequelae, and complex and costly management, neonatal jaundice is a good candidate for preventive treatment. In this respect the clinical problem of neonatal jaundice has many similarities with the problem of hemorrhagic disease of the newborn. Both conditions are transient peculiarities of newborn metabolism. Most neonates exhibit the biochemical abnormality, but a small minority is placed in jeopardy of life or suffers serious sequelae. In both conditions a loose relationship exists between the degree of biochemical abnormality and the clinical manifestations that are poorly predicted by monitoring the abnormalities. The administration of vitamin K at birth corrected the biochemical abnormalities and eliminated clinical hemorrhagic disease. The simplicity, efficacy, and safety of vitamin K prevention of hemorrhagic disease of the newborn is the prototype in the search for the solution to the problem of neonatal jaundice. For most neonates, antenatal phenobarbital comes close to this prototype in terms of efficacy and simplicity. The combination of antenatal and postnatal therapy seems suitable for use in preterm labor in combination with tocolysis. This recommendation is conditional on the demonstration of safety by long-term follow-up. The competitive inhibition of HO by synthetic metalloporphyrins offers an even simpler solution, but the level of efficacy achieved with the doses and compounds used so far are not comparable with that of phenobarbital. For the time being, phenobarbital is recommended for population groups with high risk of severe neonatal jaundice, or scarcity of resources for the management of neonatal jaundice with phototherapy and exchange transfusion.
journal_name
Clin Perinatoljournal_title
Clinics in perinatologyauthors
Valaes TN,Harvey-Wilkes Ksubject
Has Abstractpub_date
1990-06-01 00:00:00pages
245-73issue
2eissn
0095-5108issn
1557-9840journal_volume
17pub_type
杂志文章,评审abstract::Billions of dollars are spent yearly in perinatal medicine on studies designed to improve outcomes for mothers and their neonates. However, implementing research findings is challenging and imperfect. Strategies for implementation must be multifaceted and comprehensive. These implementation challenges extend to, and a...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2018.01.003
更新日期:2018-06-01 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 LBW infant with congenital heart defects is likely to be at a higher risk for postoperative death and complications than their normal-sized counterparts because of the effects of prematurity and other organ system dysfunction. Current experience, however, does not suggest that waiting to obtain an arbitrary weight...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0095-5108(05)70078-6
更新日期:2001-03-01 00:00:00
abstract::Correct fluid and electrolyte concentrations are essential to reduce mortality in critically ill infants. The authors list considerations in calculating the necessary maintenance volumes and emphasize the importance of continuous monitoring of data and a review and retabulation every eight hours, because requirements ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1979-03-01 00:00:00
abstract::Nonstress testing appears to be an effective means of identifying fetal condition. Its most definitive benefit is the identification of the "normal" fetus, which often permits a path of nonintervention. A significant benefit of the nonstress test approach is its simplicity and portability which, in a practical sense, ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1982-06-01 00:00:00
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:
更新日期:1990-06-01 00:00:00
abstract::This article summarizes new information on the natural history of maternal varicella and maternal parvovirus B19. Controversies in the therapy of respiratory syncytial virus are presented. Prophylactic and therapeutic immunotherapy of neonatal enteroviral disease are reviewed. ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1997-03-01 00:00:00
abstract::Oxygen therapy is an essential part of neonatal care. Targeting oxygen saturations and preventing hypoxemia and hyperoxemia is difficult, particularly in preterm infants. The mode of oxygen delivery directly affects the stability of oxygen saturations, hypoxemia, and hyperoxemia. This stability has important clinical ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2019.05.012
更新日期:2019-09-01 00:00:00
abstract::The placenta not only "records" and reflects the intrauterine environment, it also provides valuable information on the cause and timing of many adverse events and conditions. The placenta may be useful in several ways. It may be the cause of injury due to an inherent abnormality, it may "malfunction" because of disea...
journal_title:Clinics in perinatology
pub_type: 杂志文章
doi:10.1016/j.clp.2007.03.013
更新日期:2007-09-01 00:00:00
abstract::Staphylococci are common pathogens in the neonatal period. Increased survival of premature infants leads to prolonged hospital stay with associated risk factors for developing invasive staphylococcal disease. Challenges of diagnosing coagulase-negative staphylococcal infections result in conflicting definitions and in...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2014.10.013
更新日期:2015-03-01 00:00:00
abstract::Pulmonary hypertension in the newborn infant has many potential causes, and multiple etiologies are common. In this article, the author outlines the basic principles in pathophysiology, classification, and etiology that should be well understood by those who care for neonates with disease processes in which pulmonary ...
journal_title:Clinics in perinatology
pub_type: 杂志文章
doi:
更新日期:1984-10-01 00:00:00
abstract::Preterm births remain a major cause of neonatal morbidity and mortality despite our efforts over the past several decades. Our improved understanding of the complex mechanisms surrounding preterm labor, however, has resulted in the development of numerous biologic and clinical predictors of spontaneous preterm births....
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0095-5108(05)70021-x
更新日期:2000-06-01 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::Continuous positive airway pressure (CPAP) systems can be broadly grouped into continuous flow or variable flow devices. Bubble CPAP (bCPAP) is a continuous flow device and has physiologic properties that could facilitate gas exchange. Its efficacy has been reported to be similar to variable flow CPAP systems when use...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2016.07.003
更新日期:2016-12-01 00:00:00
abstract::Periviable birth carries a high risk of fetal and newborn death, and the potential for life-long complications in survivors. The family at risk for periviable birth should receive objective, accurate, and up to date information regarding fetal, newborn, and maternal risks and outcomes with delivery or with continued p...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2017.02.002
更新日期:2017-06-01 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::Human milk provided by healthy and well-nourished mothers is believed to cover the infant's nutrient requirements during the first half year of life. It is composed of a mixture of nutritive components as well as other bioactive factors with relevant physiologic effects in the neonate infant. Human milk composition ha...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1999-06-01 00:00:00
abstract::This article reviews the significance of hypoxic-ischemic encephalopathy and the associated patterns of cerebral injury in the context of the most probable timing of the insult and prognosis. The evolution of the clinical features of significant hypoxic-ischemic encephalopathy, and the diagnostic value of imaging and ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1989-06-01 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::There are various causes for frequent desaturations in infants. Frequent hypoxemia is a significant change in clinical status and must be investigated carefully for possible etiology. When common extra-airway causes for desaturation are ruled out, one should attempt to distinguish between central apnea and obstructive...
journal_title:Clinics in perinatology
pub_type: 历史文章,杂志文章,评审
doi:10.1016/j.clp.2006.12.013
更新日期:2007-03-01 00:00:00
abstract::Most pharmacokinetic and biologic attributes of digitalis are age dependent. They are determined in great measure by the chemical structure of the specific cardiac glycoside being used. These effects differ in the intact normal circulation and in heart failure because of the altered autonomic nervous system and hormon...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1988-09-01 00:00:00
abstract::Intraventricular hemorrhage (IVH) occurs in 20% to 25% of very low birthweight preterm neonates and may be associated with significant sequelae. Infants who have IVH are at risk for posthemorrhagic hydrocephalus and periventricular leukomalacia; as many as 75% of those who have parenchymal involvement of hemorrhage su...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2008.07.014
更新日期:2008-12-01 00:00:00
abstract::Neonatal Cushing syndrome (CS) is most commonly caused by exogenous administration of glucocorticoids and rarely by endogenous hypercortisolemia. CS owing to adrenal lesions is the most common cause of endogenous CS in neonates and infants, and adrenocortical tumors (ACTs) represent most cases. Many ACTs develop in th...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2017.10.002
更新日期:2018-03-01 00:00:00
abstract::Despite the fact that hypoglycemia is an extremely common disorder of the newborn, consensus has been difficult to reach regarding definition, diagnosis, outcome, and treatment. With improved neuroradiologic techniques, such as MRI and PET scanning becoming increasingly available, studies to determine the correlation ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0095-5108(02)00054-4
更新日期:2002-12-01 00:00:00
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:
更新日期:1987-03-01 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::Diagnostic and invasive procedures in premature infants may require general anesthesia. General anesthetics interfere with the development of the immature animal brain. Accelerated apoptosis, disturbed synaptogenesis, and cytoarchitecture are among the mechanisms suspected to underlie this phenomenon. The implications...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2019.08.002
更新日期:2019-12-01 00:00:00
abstract::Oxygen saturation targeting is widely used in neonatal intensive care, but the optimal target range in very preterm infants has been uncertain and is the subject of recent debate and research. This review briefly discusses the technology of oxygen monitoring and the role of oxygen toxicity in preterm infants. The back...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2015.08.008
更新日期:2015-12-01 00:00:00
abstract::Beta-sympathomimetic agents are used extensively in obstetrics to inhibit premature labor. Knowledge of the pharmacology, mode of action on smooth muscle, and cardiovascular and metabolic side effects of these agents is essential for the obstetrician and perinatologist. This review article draws extensively on recent ...
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::The educational programs that have been developed in newborn special care facilities have two purposes: first, they teach personnel the manual skills that are necessary to manage the sick newborn infant; second, they provide personnel with a better understanding of neonatal pathophysiology so that they can begin to re...
journal_title:Clinics in perinatology
pub_type: 杂志文章
doi:
更新日期:1976-09-01 00:00:00