Abstract：
:A number of ethical considerations arise with regard to screening for, detecting, and managing fetal anomalies. Some of these considerations involve the need to give attention to emotional distress the pregnant woman might be experiencing. The ethical principle of beneficence gives rise to a duty of the obstetrician to provide emotional support when needed in relation to screening, confirmatory testing, giving bad news, making abortion decisions, making management decisions after viability, and dealing with the grieving process. Other issues involve ethical decision-making, such as deciding what recommendations to make concerning management of fetal anomalies after viability. The ethical principle of autonomy creates a duty of the obstetrician to help the pregnant woman make informed management decisions based on her values and goals. A recommendation for a particular approach to management is sometimes ethically justifiable on the basis of an analysis of the risks and benefits to the mother and fetus. Legal considerations are relevant because they create requirements or prohibitions that must be taken into account in ethical decision-making. The discussion in this article does not exhaust the range of issues that arise. For example, sometimes a delivery procedure is considered that is traumatic to the fetus, such as cephalocentesis for vaginal delivery of a fetus with hydrocephaly. The reader is referred to other sources for a discussion of the ethics of delivery procedures that might injure or kill the fetus. Other issues involve deciding when there is a duty to offer new prenatal genetic tests, routinely or for high-risk couples, and whether to carry out maternal requests for prenatal tests for late-onset diseases and susceptibilities to diseases. These issues have been discussed elsewhere.
journal_name
Clin Perinatoljournal_title
Clinics in perinatologyauthors
Strong Cdoi
10.1016/s0095-5108(02)00083-0subject
Has Abstractpub_date
2003-03-01 00:00:00pages
113-26issue
1eissn
0095-5108issn
1557-9840pii
S0095-5108(02)00083-0journal_volume
30pub_type
杂志文章abstract：:Neutropenia is a relatively common problem in the NICU, recognized in as many as 8% of patients at some time during their hospital stay. In most instances, neutropenia among NICU patients is of short duration and has little influence on outcome. In other cases it is prolonged and severe, and constitutes a serious anti...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/s0095-5108(05)70040-3
更新日期：2000-09-01 00:00:00
abstract：:Fetal and neonatal infections can occur at different times during pregnancy, from conception to birth. Infections that take place near the time of conception often destroy the zygote or embryo and only rarely leave definitive evidence. The mother can transmit the infection to her fetus through several routes, but the ...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：
更新日期：1988-06-01 00:00:00
abstract：:We emphasize again that the prevalence of maternal infections may vary in different populations, and others might arrive at different estimates about the percentage of infants colonized and, concerning those infants colonized, about the percentage with adverse outcomes. Additionally, many women are colonized or infect...
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：:Although therapies in addition to whole-body cooling are being developed to treat the neonate at risk for hypoxic-ischemic encephalopathy, we have no quickly measured serum inflammatory or neuronal biomarkers to acutely and accurately identify brain injury or to follow the efficacy of therapy. This review covers infla...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/j.clp.2016.04.008
更新日期：2016-09-01 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：:Glomerular disorders in infancy can include nephrotic and nephritic syndromes. Congenital nephrotic syndrome (CNS) is most commonly caused by single gene mutations in kidney proteins, but may also be due to congenital infections or passive transfer of maternal antibodies that target kidney proteins. Prenatal findings ...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/j.clp.2014.05.009
更新日期：2014-09-01 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：: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：:There is a distinct lack of age-appropriate cardiotonic drugs, and adult derived formulations continue to be administered, without evidence-based knowledge on their dosing, safety, efficacy, and long-term effects. Dopamine remains the most commonly studied and prescribed cardiotonic drug in the neonatal intensive care...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/j.clp.2019.02.010
更新日期：2019-06-01 00:00:00
abstract：:A scheme of regionalization is proposed in which a regional perinatal system within a defined geographic area permits access of the high risk mother-fetus and infant to the appropriate level of technology for improved perinatal outcome. ...
journal_title：Clinics in perinatology
pub_type： 杂志文章
doi：
更新日期：1976-09-01 00:00:00
abstract：:Liquid breathing has been in medical literature for nearly 80 years and has been proposed as a means of improving gas exchange in critically ill infants since the 1970s. Extensive laboratory experience with perfluorochemical liquid ventilation has lead to clinical trials in infants, children, and adults. This article ...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：
更新日期：1998-03-01 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：:Congenital heart defects (CHDs) are structural abnormalities of the heart and great vessels that are present from birth. The presence or absence of extracardiac anomalies has historically been used to identify patients with possible monogenic, chromosomal, or teratogenic CHD causes. These distinctions remain clinicall...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/j.clp.2015.02.009
更新日期：2015-06-01 00:00:00
abstract：:The Healthy People 2000 objectives for breastfeeding were to move the breastfeeding initiation rate to 75% from 54% and the breastfeeding continuation rate to 50% at age 6 months from the 1988 baseline of 21%. The 1996 data indicated that the goal will not be met either for initiation or duration in spite of governmen...
journal_title：Clinics in perinatology
pub_type： 杂志文章
doi：
更新日期：1999-06-01 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：:Neonatal sepsis continues to take a devastating toll globally. Although adequate to protect against invasive infection in most newborns, the distinct function of neonatal innate host defense coupled with impairments in adaptive immune responses increases the likelihood of acquiring infection early in life, with subseq...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/j.clp.2010.04.001
更新日期：2010-06-01 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：:Gastroesophageal reflux (GER) is considered physiologic and is a normal process; whereas, when aerodigestive consequences are associated, it is often interpreted as GER disease (GERD). However, the distinction between them remains a challenge in infants in the NICU. Reflux-type of symptoms are heterogeneous, and often...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/j.clp.2020.02.004
更新日期：2020-06-01 00:00:00
abstract：:This article discusses the historical background, epidemiology, and pathophysiology of meconium-stained amniotic fluid and provides current concepts in delivery room management of meconium-stained neonate including the current Neonatal Resuscitation Program guidelines. ...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/j.clp.2012.09.004
更新日期：2012-12-01 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：: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
更新日期：2010-03-01 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：: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：:Current methods of intrapartum surveillance have made little impact on fetal mortality and morbidity while leading to increased caesarean section rates. Near-infrared spectroscopy is a powerful new technique that can continuously measure changes in fetal cerebral oxygenation and hemodynamics during labor. Data are pre...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：
更新日期：1997-09-01 00:00:00
abstract：:Cesarean delivery as a result of maternal request is increasingly popular, leading to important ethical questions. One of the challenging issues is balancing respect for the autonomy of a pregnant woman with concerns of beneficence and nonmaleficence for her and the fetus. The perceived benefit of cesarean section is ...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/j.clp.2008.03.011
更新日期：2008-06-01 00:00:00
abstract：:Emphasis has been placed on engaging parents in processes of shared decision making for delivery room management decisions of critically ill neonates whose outcomes are uncertain and unpredictable. The goal of antenatal consultation should rather be to adapt to parental needs and empower them through a personalized de...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/j.clp.2017.01.006
更新日期：2017-06-01 00:00:00
abstract：:Each year, approximately 2.7 million babies die during the neonatal period; more than 90% of these deaths occur in developing countries, largely from preventable causes. The known, evidence-based, simple, low-cost interventions that may improve neonatal survival often have low or unknown baseline coverage rates. Gaps ...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/j.clp.2017.05.002
更新日期：2017-09-01 00:00:00
abstract：:Obstetric care providers and researchers have long relied on analysis of the fetal heart rate tracing for insight into the fetal neurologic status. Although a normal fetal heart rate tracing does provide reassurance of intact neurologic function, an abnormal pattern is a very poor predictor of newborn brain injury. In...
journal_title：Clinics in perinatology
pub_type： 杂志文章,评审
doi：10.1016/j.clp.2009.06.006
更新日期：2009-09-01 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：: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
