Abstract：
:Medical liability coverage has become increasingly expensive and scarce since 2001, especially for obstetrics and other high-risk specialties. Physicians, whose own fees are constrained, see this as a crisis needing tort reform to cap payouts. Plaintiffs' lawyers fight caps; they blame insurance trends and call for stronger regulation of insurers and physicians. Doctors' arguments are somewhat better than lawyers' about insurance developments, but the huge tort reform battle wholly ignores the biggest problems--the medical system has too many preventable medical injuries, and the legal system fails to prevent them. It is time to try out better approaches, three of which are discussed in this paper.
journal_name
Clin Perinatoljournal_title
Clinics in perinatologyauthors
Bovbjerg RRdoi
10.1016/j.clp.2004.11.003subject
Has Abstractpub_date
2005-03-01 00:00:00pages
203-33, viii-ixissue
1eissn
0095-5108issn
1557-9840pii
S0095-5108(04)00130-7journal_volume
32pub_type
杂志文章,评审abstract：:Many aspects of the forward propulsion of enteral nutrients are not fully mature in the preterm and term neonate. Because the regulation of motor activity in the gastrointestinal tract is complex and multifaceted, many levels of regulation of this activity are immature in the preterm infant; however, as neonatologists...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：
更新日期：1996-06-01 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：:History has always been a series of pendulum swings, and there is perhaps no better example in obstetrics than that of vaginal birth after cesarean. Vaginal birth after cesarean (VBAC) rates rose steadily in the early 1990s. However, VBAC rates have declined dramatically over recent years, while the cesarean delivery ...
journal_title：Clinics in perinatology
pub_type： 杂志文章
doi：10.1016/j.clp.2011.03.005
更新日期：2011-06-01 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：:HFV is a mode of therapy that allows gas exchange with pressure fluctuations much lower than that required for conventional ventilation, and may consequently decrease the incidence of barotrauma and chronic lung disease. At present the National Institute of Health is sponsoring the first large controlled trial to test...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：
更新日期：1987-09-01 00:00:00
abstract：:The role of infection in the pathogenesis of preterm labor and delivery, and the specific mechanisms through which this association is demonstrated are presented. Cellular and biochemical changes that initiate parturition in the setting of infection are discussed, particularly prostaglandins and cytokines. ...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：
更新日期：1995-06-01 00:00:00
abstract：:The authors believe that the literature provides sufficient evidence that antenatal corticosteroid administration is beneficial and safe even in conditions of ruptured membranes. The evidence by now is remarkably robust and one can be reasonably confident regarding the benefits of antenatal corticosteroids in the sett...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/s0095-5108(03)00078-2
更新日期：2001-12-01 00:00:00
abstract：:Infants in the Neonatal Oxygenation Prospective Meta-analysis trials were randomized to SpO2 targets of 85% to 89% or 91% to 95%. Group allocation was masked. Different outcomes are likely partially attributable to differences in achieved SpO2. Infants randomized to the lower range had higher than intended readings. S...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/j.clp.2019.05.011
更新日期：2019-09-01 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：: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：: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
更新日期：2011-03-01 00:00:00
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, al...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：
更新日期：1989-09-01 00:00:00
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：
更新日期：1996-03-01 00:00:00
abstract：:Ischemic perinatal stroke (IPS) occurs in 1 of 2300 to 5000 live births. It is an under-recognized cause of significant long-term disabilities, including hemiplegic cerebral palsy, epilepsy, cognitive delays, and behavioral impairments. The pathophysiology is complex and multifactorial, involving maternal, fetal, plac...
journal_title：Clinics in perinatology
pub_type： 杂志文章
doi：10.1016/j.clp.2008.09.008
更新日期：2009-03-01 00:00:00
abstract：:MPR and ST are important options for patients who have multifetal pregnancies. Both procedures have been shown to be technically safe and result in acceptable pregnancy loss rates and GAs at delivery. An important caveat is that these findings are observed in centers that have vast experience performing this type of p...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/s0095-5108(03)00055-1
更新日期：2003-09-01 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：:It is now recognized that pregnancy is associated with significant changes in maternal thyroid function that are largely mediated by the placenta. The author summarizes the understanding of these changes during pregnancy and follows with a discussion of fetal thyroid system ontogenesis. ...
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：: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
更新日期：2014-03-01 00:00:00
abstract：:Numerous articles have chronicled the problems that stem from patients' lack of compliance with health care recommendations, yet there has not been a systematic approach to the development of a strategy for increasing the effectiveness of health education programs. In this article, making use of anticipatory guidance,...
journal_title：Clinics in perinatology
pub_type： 杂志文章
doi：
更新日期：1985-06-01 00:00:00
abstract：:This chapter describes the utility of event-related potential recordings in the assessment of auditory and visual system integrity in the newborn infant. A battery of electrophysiologic tests is described that permits the evaluation of sequential levels of processing within these sensory system. ...
journal_title：Clinics in perinatology
pub_type： 杂志文章
doi：
更新日期：1985-02-01 00:00:00
abstract：:The epitome of FAS and ARBD has been documented substantially in the medical literature. There appears to be little question that alcohol is a teratogen. The precise nature for the mechanism of causing congenital defects, whether it be direct or indirect, is still unknown. There is no unequivocal information that can ...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：
更新日期：1991-03-01 00:00:00
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
更新日期：2016-12-01 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：:Visual evoked potentials (VEPs) are easily recorded in the neonatal intensive care setting using light-emitting diode goggles as the flash stimulus. They are sensitive measures of CNS integrity and are altered or abolished by hypoxia. Prognosis in newborns with birth asphyxia or hypoxia is difficult to predict; howeve...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：
更新日期：1993-06-01 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 lifespan risk of seizures is highest in the neonatal period. Current therapies have limited efficacy. Although the treatment of neonatal seizures has not changed significantly in the last several decades, there has been substantial progress in understanding developmental mechanisms that influence seizure generatio...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/j.clp.2009.08.001
更新日期：2009-12-01 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：:Congenital hemiplegia is the most common form of cerebral palsy in children born at term, and stroke is the number one cause. Neonatal ischemic stroke includes perinatal arterial ischemic stroke, presumed pre- or perinatal stroke, and cerebral sinovenous thrombosis, all of which have emerged as important contributors ...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/j.clp.2006.03.008
更新日期：2006-06-01 00:00:00
abstract：:Dysphagia and aspiration are commonly encountered problems in the neonatal population. It is often multifactorial in nature and management should be tailored to the individual patient. Multiple causes should be considered, including anatomic abnormalities, neurologic/developmental delay, cardiopulmonary disease/infect...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/j.clp.2018.07.005
更新日期：2018-12-01 00:00:00
abstract：:The nature of perinatal education has been transformed, reflecting the changes in health care and health care consumers. Because of short maternity stays, the venue of most perinatal education, especially postpartum education, has moved from hospitals to other areas, including the home. In light of conflicting finding...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：
更新日期：1998-06-01 00:00:00
