Pharmacologic approaches to the prevention and treatment of neonatal hyperbilirubinemia.

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 Perinatol

journal_title

Clinics in perinatology

authors

Valaes TN,Harvey-Wilkes K

subject

Has Abstract

pub_date

1990-06-01 00:00:00

pages

245-73

issue

2

eissn

0095-5108

issn

1557-9840

journal_volume

17

pub_type

杂志文章,评审
  • Quality Improvement in Perinatal Medicine and Translation of Preterm Birth Research Findings into Clinical Care.

    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

    authors: Manuck TA,Fry RC,McFarlin BL

    更新日期:2018-06-01 00:00:00

  • Biochemical predictors of preterm labor: fetal fibronectin and salivary estriol.

    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

    authors: Ramsey PS,Andrews WW

    更新日期:2003-12-01 00:00:00

  • Cardiac surgery in the low-birth weight neonate. New approaches.

    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

    authors: Wernovsky G,Rubenstein SD,Spray TL

    更新日期:2001-03-01 00:00:00

  • Fluid and electrolyte balance in very low birth weight infants.

    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:

    authors: Bell EF,Oh W

    更新日期:1979-03-01 00:00:00

  • The evaluation of antepartum fetal well-being using the nonstress test.

    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:

    authors: Paul RH

    更新日期:1982-06-01 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

  • Other viral agents of perinatal importance. Varicella, parvovirus, respiratory syncytial virus, and enterovirus.

    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:

    authors: Keyserling HL

    更新日期:1997-03-01 00:00:00

  • New Methods for Noninvasive Oxygen Administration.

    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

    authors: Travers CP,Carlo WA

    更新日期:2019-09-01 00:00:00

  • The placenta as witness.

    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

    authors: Baergen RN

    更新日期:2007-09-01 00:00:00

  • Staphylococcal infections in infants: updates and current challenges.

    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

    authors: Blanchard AC,Quach C,Autmizguine J

    更新日期:2015-03-01 00:00:00

  • Neonatal pulmonary hypertension: pathophysiology, classification, and etiology.

    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:

    authors: Gersony WM

    更新日期:1984-10-01 00:00:00

  • Current concepts on the pathogenesis and markers of preterm births.

    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

    authors: Lu GC,Goldenberg RL

    更新日期:2000-06-01 00:00:00

  • Posterior nuchal cystic hygroma.

    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:

    authors: Edwards MJ,Graham JM Jr

    更新日期:1990-09-01 00:00:00

  • Continuous Positive Airway Pressure: To Bubble or Not to Bubble?

    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

    authors: Gupta S,Donn SM

    更新日期:2016-12-01 00:00:00

  • Periviable Birth and the Shifting Limit of Viability.

    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

    authors: Mercer BM

    更新日期:2017-06-01 00:00:00

  • Insulin resistance and preeclampsia.

    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:

    authors: Berkowitz KM

    更新日期:1998-12-01 00:00:00

  • Nutritional and biochemical properties of human milk, Part I: General aspects, proteins, and carbohydrates.

    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:

    authors: Kunz C,Rodriguez-Palmero M,Koletzko B,Jensen R

    更新日期:1999-06-01 00:00:00

  • Perinatal asphyxia: clinical aspects.

    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:

    authors: Hill A,Volpe JJ

    更新日期:1989-06-01 00:00:00

  • Craniofacial and neck anomalies.

    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

    authors: Dar P,Gross SJ

    更新日期:2000-12-01 00:00:00

  • The dreaded desaturating baby: a difficult problem in clinical management.

    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

    authors: Spitzer AR

    更新日期:2007-03-01 00:00:00

  • Digitalis, digitalis antibodies, digitalis-like immunoreactive substances, and sodium homeostasis: a review.

    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:

    authors: Hastreiter AR,John EG,van der Horst RL

    更新日期:1988-09-01 00:00:00

  • The diagnosis, management, and postnatal prevention of intraventricular hemorrhage in the preterm neonate.

    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

    authors: McCrea HJ,Ment LR

    更新日期:2008-12-01 00:00:00

  • Neonatal Cushing Syndrome: A Rare but Potentially Devastating Disease.

    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

    authors: Tatsi C,Stratakis CA

    更新日期:2018-03-01 00:00:00

  • Hypoglycemic injury to the immature brain.

    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

    authors: Yager JY

    更新日期:2002-12-01 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

  • Multiple gestation: the role of multifetal pregnancy reduction and selective termination.

    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:

    authors: Evans MI,Littmann L,King M,Fletcher JC

    更新日期:1992-06-01 00:00:00

  • Anesthesia Neurotoxicity in the Developing Brain: Basic Studies Relevant for Neonatal or Perinatal Medicine.

    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

    authors: Clausen NG,Hansen TG,Disma N

    更新日期:2019-12-01 00:00:00

  • Oxygen Saturation Targeting and Bronchopulmonary Dysplasia.

    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

    authors: Darlow BA,Morley CJ

    更新日期:2015-12-01 00:00:00

  • Beta-sympathomimetic agents: use in perinatal obstetrics.

    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:

    authors: Nuwayhid B,Rajabi M

    更新日期:1987-12-01 00:00:00

  • Training of personnel-pediatrics.

    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:

    authors: Coen RW

    更新日期:1976-09-01 00:00:00