In this issue of Clinics in Perinatology, guest editor Dr. Lina Chalak brings her considerable expertise to the topic of Perinatal Asphyxia: Moving the Needle. According to the World Health Organization, birth asphyxia accounts for an estimated 900,000 deaths each year and is one of the primary causes of early neonatal mortality. In this issue, top experts provide current clinical information needed to improve outcomes in newborns, while looking at results from clinical trials, neuroimaging biomarkers, and low-resource settings. Contains 15 relevant, practice-oriented topics including the role of a maternal-placental-fetal triad; treating seizures and improving newborn outcomes; advances in neuroimaging biomarkers and scoring; moving the needle in low-resource settings: is hypothermia a friend or a foe?; ethical and medicolegal perspectives on cooling: where to draw the line?; and more. Provides in-depth clinical reviews on perinatal asphyxia, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.
The Guest Editors have assembled top experts to provide the most current and clinically relevant articles devoted to Birth Asyphyxia. Articles in this issue are devoted to: Neonatal Transition After Birth; Pathophysiology of Birth Asphyxia; Perinatal Asphyxia from the Obstetrical Standpoint: Diagnosis and Interventions; Stillbirths: U.S. and Global Perspectives; Novel Approaches to Resuscitation and the Impact on Birth Asphyxia; Multiorgan Dysfunction and its Management After Birth Asphyxia; Neonatal Encephalopathy and Update on Therapeutic Hypothermia and Other Novel Therapeutics; Biomarkers in Neonatal Encephalopathy; Imaging and Other Diagnostics in Neonatal Encephalopathy; Asphyxia in the Premature Infant; The role of the NeoNeuro Unit for Birth Asphyxia; Long-term Cognitive Outcomes of Birth Asphyxia and the Contribution of Identified Perinatal Asphyxia to Cerebral Palsy; Global Burden, Epidemiologic Trends, and Prevention of Intrapartum Related Deaths in Low-resource Settings; and Neonatal Resuscitation in Low-resource Settings.
In this issue of Clinics in Perinatology, guest editors Drs. David K. Stevenson and Gary M. Shaw, along with research scientist Ron J. Wong, bring their considerable expertise to the topic of Preterm Birth. Preterm birth is the leading cause of death among children, with one million children dying due to preterm birth before the age of five years. This issue is a key resource for perinatologists who seek to predict and improve outcomes for preterm births, providing actionable clinical information in hopes of reaching the United Nations Sustainable Development Goal to end all preventable deaths of newborns and children aged under five years by 2030. Contains 15 practice-oriented topics including genomics of preterm birth; predicting preterm birth using proteomics; predicting preterm birth using the microbiome; predicting preterm birth using the immunome; a new taxonomy of preterm birth; and more. Provides in-depth clinical reviews of preterm birth, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.
In this issue of Clinics in Perinatology, guest editors Drs. Ravi Mangal Patel and Amy Keir bring their considerable expertise to the topic of Neonatal Transfusion Medicine. Transfusions to neonates convey both benefits and risks, and evidence-based data for possible adverse effects, preterm morbidities, mortality, and neuro-developmental problems associated with transfusions is needed to make decisions for proper care. This issue fills the gap of evidence-based knowledge in order to improve outcomes in patients. Contains 9 practice-oriented topics including potential mechanisms mediating harm from platelet transfusions in neonates; plasma transfusion in the neonate; neonatal blood banking practices; transfusion in neonatal ECMO; allogenic cord blood transfusion in infants; and more. Provides in-depth clinical reviews on neonatal transfusion medicine, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.
In consultation with Consulting Editor, Dr. Lucky Jain, Drs. Maximo Vento and Waldemar Carlo have put together a state-of the-art issue of the Clinics in Perinatology devoted to Perinatal Pharmacology. Clinical review articles are specifically devoted to the following: Monitoring and assessment of oxygenation in infants; Oxygen toxicity in neonates; New methods for non-invasive oxygen administration; Targeting oxygen in preterm and term infants starting at birth; Newborn resuscitation in settings without access to supplemental oxygen; Noninvasive versus invasive ventilatory support; Nasal SIMV versus Nasal CPAP before and after invasive ventilatory support; Is high-flow cannula inferior to CPAP for neonates?; Intermittent hypoxia: Importance; Closed-loop control of inspired oxygen in neonates: Compliance with targets; Meta-analysis oxygenation saturation targeting trials: Do infant subgroups matter?; Targets of oxygen saturation to optimize eye outcomes; Achieved oxygenation saturations and outcome in extremely preterm infants; Pulmonary hypertension in preterm infants; and Current recommendations and practice of oxygen therapy in preterm infants. Readers will come away with the latest information on oxygen therapy as they seek to utilize evidence-based recommendations to improve patient outcomes.
Preterm birth interrupts the normal developmental progression of most organs, particularly when birth occurs at the lowest level of viability. An immediate task is to successfully transition to a post-natal life without a placental circulation. To do this demands careful management of the cardiorespiratory systems. To best help the fragile preterm infant at this demanding time, care-givers must remember two most pressing goals. These are first to maintain adequacy of gas exchange and delivery, while simultaneously minimizing any secondary injury to the fragile preterm lung. However, after these immediate priorities in the delivery room, the longer term effects of an immature lung development and its associated problems come to the forefront. These problems include the inflammation of perinatal infection, oxygen, and invasive mechanical ventilation. Both the immaturity itself, and secondary lung injury and its inflammation - collectively will often lead to the condition termed bronchopulmonary dysplasia (BPD). Although many of these infants may eventually be discharged to home without a need for oxygen supplementation or pulmonary medications, the long-term impact of interrupted lung development and secondary lung injury remain serious concerns. It is now well recognized that mechanical ventilation is pivotal to developing secondary lung injury and BPD. Consequently, a great deal of time and effort has been put into the development and application of non-invasive ventilator (NIV) approaches to supporting respiratory function in neonates. Since the landmark publication by Gregory and colleagues in 1967, nasal continuous positive airway pressure (nCPAP) has been the most commonly applied approach to NIV. This approach has been supported by the recent generation of randomized controlled trials. However, cumulatively these trials have shown only a small reduction in rates of BPD. Outside of the trial data, despite the wider application of nCPAP, rates of BPD remain relatively unchanged over recent years. This has led to investigations of other NIV approaches including nasal ventilation and high flow nasal cannula therapy. Not only have available modes increased, but so have the interfaces through which these modes may be applied. In the issue of Clinic in Perinatology, readers will find an up-to-date review of non-invasive approaches to supporting preterm respiratory function. This draws on the expertise of leading investigators in the field. This issue reviews the physiologic mechanisms by which the various approaches to NIV may support respiratory function; the evidence base supporting different NIV approaches; and adjunctive aspects of NIV therapy including their use during neonatal transport and the application of other supportive therapies such as inhaled NO.
This textbook addresses the themes that are at the forefront of neonatal clinical care and research, based on natural divisions in care during pregnancy, and postnatally by gestational age at birth. The book offers a unique approach, in that it proposes discussion of important general principles underpinning neonatal care that are not addressed in most general neonatology textbooks, such as ethical issues, counselling, effective training methods, quality and safety, among other subjects. These are fundamental aspects and challenges that need to be appreciated by senior clinicians. A chapter authored by parents describing their perspectives of neonatal intensive care is unique and will be highly educational, with the potential to influence the way in which individuals view and deliver neonatal care. The authors discuss common and important conditions, to promote adoption of sound evidenced based practice where this is available. However, where evidence is limited, as is the case in many areas of neonatal practice, the authors aim to encourage critical thinking and evidence appraisal, which are necessary skills for busy clinicians wishing to filter evidence to guide delivery of care. This text is suitable for senior trainees wishing to pursue a career in neonatal medicine, early career neonatologists and paediatricians with an interest in neonatology. It is also of interest to established neonatologists wishing to update their neonatal knowledge. The content is based on the RCPCH Level 3 curriculum, and addresses important topical and/or controversial aspects of neonatal care.
The second edition of this quick reference handbook for obstetricians and gynecologists and primary care physicians is designed to complement the parent textbook Clinical Obstetrics: The Fetus & Mother The third edition of Clinical Obstetrics: The Fetus & Mother is unique in that it gives in-depth attention to the two patients – fetus and mother, with special coverage of each patient. Clinical Obstetrics thoroughly reviews the biology, pathology, and clinical management of disorders affecting both the fetus and the mother. Clinical Obstetrics: The Fetus & Mother - Handbook provides the practising physician with succinct, clinically focused information in an easily retrievable format that facilitates diagnosis, evaluation, and treatment. When you need fast answers to specific questions, you can turn with confidence to this streamlined, updated reference.
The Pocket Book is for use by doctors nurses and other health workers who are responsible for the care of young children at the first level referral hospitals. This second edition is based on evidence from several WHO updated and published clinical guidelines. It is for use in both inpatient and outpatient care in small hospitals with basic laboratory facilities and essential medicines. In some settings these guidelines can be used in any facilities where sick children are admitted for inpatient care. The Pocket Book is one of a series of documents and tools that support the Integrated Managem.
