Controversies Will Always Be There: They Need to Be Managed
More than twenty years after the publication of the landmark report To Err Is Human,1 much progress has been made in making health care safe. Institutions across the country have focused on improving quality and patient safety through standardization of practices. In a follow-up publication in 2005, Drs Leape and Berwick2 commented on the progress made after the original report and future expectations. They predicted that the pace of change would accelerate with implementation of electronic medical records, coupled with more widespread adoption of best practices to improve patient safety and outcomes. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - January 20, 2022 Category: Perinatology & Neonatology Authors: Lucky Jain Tags: Foreword Source Type: research

Physiologic Changes during Neonatal Transition and the Influence of Respiratory Support
Very preterm infants have difficulties establishing effective breathing at birth because their lungs are structurally immature, surfactant-deficient, and not supported by a stiff chest wall.1 Indeed, 10% of newborn infants require respiratory support at birth, which is increasing with decreasing gestational age.2 The International Liaison Committee on Resuscitation recommends to provide positive pressure ventilation (PPV) for newborns who are apneic, bradycardic, or demonstrate inadequate respiratory effort immediately after birth. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Authors: Marlies Bruckner, Georg M. Schm ölzer Source Type: research

Synchronized Invasive Mechanical Ventilation
Respiratory care of premature neonates has witnessed substantial advances in the last two  decades and has played a crucial role in decreasing early mortality in this population. This review outlines advances in techniques of synchronization and modes of synchronized invasive mechanical ventilation in neonates. The use of synchronized ventilation in the neonatal population was delayed a s compared to adults, mainly because of technical reasons. Coordinating the infant's respiratory effort and the onset of mechanical ventilation in the neonatal population has requested high sensitivity instruments. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Authors: Ilia Bresesti, Massimo Agosti, Satyan Lakshminrusimha, Gianluca Lista Source Type: research

Volume-Targeted Ventilation
Volume-targeted ventilation (VTV) has been increasingly used in neonatology. In systematic reviews, VTV has been shown to reduce the risk of neonatal morbidities and improve long-term outcomes. It is adaptive ventilation using complex computer algorithms to deliver ventilator inflations with expired tidal volumes close to a target set by clinicians. Significant endotracheal tube leak and patient –ventilator interactions may complicate VTV and make ventilator parameters and waveforms difficult to interpret. In this article, we review the rationale for using VTV and the evidence supporting its use and provide practical...
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Authors: Gusztav Belteki, Colin J. Morley Source Type: research

Weaning from the Ventilator in Bronchopulmonary Dysplasia
For the newborns needing respiratory support at 36  weeks postmenstrual age, regardless of the type of ventilation used, it is critical to take into account the mechanics properties of both airways and lungs affected by severe bronchopulmonary dysplasia (sBPD). Ventilator strategies, settings, and weaning must change dramatically after sBPD is esta blished, but to date there is almost no high-quality evidence base supporting a specific approach to guide the optimal ventilator management and weaning in patients with sBPD. Weaning from invasive mechanical ventilation, management of the immediately postextubation period,...
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Authors: Giovanni Vento, Chiara Tirone, Angela Paladini, Claudia Aurilia, Alessandra Lio, Milena Tana Source Type: research

The Evolving Respiratory Management of Neonates
It is hard to deny the extraordinary influence respiratory ailments and their management have had on the entire discipline of neonatology. The quest to save premature babies and reduce the limit of viability has relied squarely on advances in respiratory management. As we approach the biologic limits at which extrauterine existence appears unlikely, a new quest has begun: achieving handicap-free survival with minimal lung injury. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Authors: Lucky Jain Tags: Foreword Source Type: research

CME Accreditation Page
(Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Source Type: research

Advances in Respiratory Management
CLINICS IN PERINATOLOGY (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Authors: Manuel S ánchez-Luna Source Type: research

Copyright
ELSEVIER (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Source Type: research

Contributors
LUCKY JAIN, MD, MBA (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Source Type: research

Contents
Lucky Jain (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Source Type: research

Forthcoming Issues
Current Controversies in Neonatology (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 11, 2021 Category: Perinatology & Neonatology Source Type: research

COVID-19 Infection in Newborns
Maternal SARS-CoV-2 infection can present with or without symptoms at the time of birth. Symptomatic mothers are likely be associated with preterm births. However population studies, demonstrate a consistent association of SARS-CoV-2 infection and a reduction in preterm birth rate. Newborns with positive SARS-CoV-2 test results appeared to have minimal burden of illness that is directly associated with a viral infection. The reported incidence of positive neonatal SARS-CoV-2 PCR test ranges from 0.56 to 6.9%. Neonatal mortality directly related to SARSCoV-2 is extremely rare. Maternal vaccination in pregnant women leads to...
Source: Clinics in Perinatology - November 8, 2021 Category: Perinatology & Neonatology Authors: Jeffrey M. Perlman, Christine Salvatore Source Type: research

Nasal Continuous Positive Airway Pressure and High-Flow Nasal Cannula Today
This study reviews the mechanisms of action and physiologic effects of nasal continuous positive airway pressure (nCPAP) and high-flow nasal cannula (HFNC) in preterm infants with respiratory distress syndrome, discusses the main characteristics of available devices and patients ’ interfaces, reports on risk of failure and possible adverse effects, and summarizes clinical evidence regarding effectiveness for preventing mechanical ventilation as primary respiratory support or after extubation in the neonatal intensive care unit. nCPAP is preferred to HFNC as primary mode o f noninvasive respiratory support in preterm ...
Source: Clinics in Perinatology - October 2, 2021 Category: Perinatology & Neonatology Authors: Carlo Dani Source Type: research

Nasal Intermittent Positive Pressure Ventilation for Neonatal Respiratory Distress Syndrome
Nasal or noninvaisve intermittent positive pressure ventilation (NIPPV) refers to well-established noninvasive respiratory support strategies combining a continuous distending pressure with intermittent pressure increases. Uncertainty remains regarding the benefits provided by the various devices and techniques used to generate NIPPV. Our included meta-analyses of trials comparing NIPPV with continuous positive airway pressure (CPAP) in preterm infants demonstrate that both primary and postextubation NIPPV are superior to CPAP to prevent respiratory failure leading to additional ventilatory support. This short-term benefit...
Source: Clinics in Perinatology - October 2, 2021 Category: Perinatology & Neonatology Authors: Christoph M. R üegger, Louise S. Owen, Peter G. Davis Source Type: research

Synchronized Nasal Intermittent Positive Pressure Ventilation
Avoiding MV is a critical goal in neonatal respiratory care. Different modes of noninvasive respiratory support beyond nasal CPAP, such as nasal intermittent positive pressure ventilation (NIPPV) and synchronized NIPPV (SNIPPV), may further reduce intubation rates. SNIPPV offers consistent benefits over nonsynchronized techniques such as a more efficient positive pressure transmission to the lung, an effective increase in transpulmonary pressure during ventilation, and a better stabilization of the chest wall during inspiration. This review discusses mechanisms of action, benefits and limitations of synchronized noninvasiv...
Source: Clinics in Perinatology - October 2, 2021 Category: Perinatology & Neonatology Authors: Corrado Moretti, Camilla Gizzi Source Type: research

Nasal High-Frequency Ventilation
Noninvasive high-frequency oscillatory (NHFOV) and percussive (NHFPV) ventilation represent 2 nonconventional techniques that may be useful in selected neonatal patients. We offer here a comprehensive review of physiology, mechanics, and biology for both techniques. As NHFOV is the technique with the wider experience, we also provided a meta-analysis of available clinical trials, suggested ventilatory parameters boundaries, and proposed a physiology-based clinical protocol to use NHFOV. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - October 2, 2021 Category: Perinatology & Neonatology Authors: Daniele De Luca, Roberta Centorrino Source Type: research

Neurally Adjusted Ventilatory Assist in Newborns
This article provides an updated review of the physiology and the scientific literature pertaining to the use of NAVA in children (neonatal and pediatric age groups). Both the invasive NAVA and NIV-NAVA publications since 2016 are summarized, as well as the use of Edi monitoring. Overall, the use of NAVA and Edi monitoring is feasible and safe. Compared with conventional ventilation, NAVA improves patient-ventilator interaction, provides lower peak inspiratory pressure, and lowers oxygen requirements. Evidence from several studies suggests improved comfort, less sedation req uirements, less apnea, and some trends toward re...
Source: Clinics in Perinatology - October 2, 2021 Category: Perinatology & Neonatology Authors: Jennifer Beck, Christer Sinderby Source Type: research

New Modes of Respiratory Support for the Premature Infant: Automated Control of Inspired Oxygen Concentration
Most extremely premature infants have respiratory instability that can manifest as frequent episodes of intermittent hypoxemia. Although caregivers target clinically recommended ranges of arterial oxygen saturation (oxygen saturation as measured by pulse oximetry [Spo2]), consistent maintenance of these ranges is not always achieved. Excessive administration of supplemental oxygen combined with limited staff resources increases exposure to extreme Spo2 levels. In this population, exposure to hyperoxemia and prolonged episodes of intermittent hypoxemia have been associated with damage to the eye and lung and impaired neurod...
Source: Clinics in Perinatology - October 2, 2021 Category: Perinatology & Neonatology Authors: Nelson Claure, Eduardo Bancalari Source Type: research

High-frequency Ventilation
High-frequency ventilation (HFV) is an alternative to conventional mechanical ventilation, with theoretic benefits of less risk of ventilator lung injury and more effectivity in washout CO2. Previous clinical studies have not demonstrated advantages of HFV in preterm infants compared with conventional ventilation, so rescue HFV has been used when severe respiratory insufficiency needs aggressive ventilator settings in immature infants. Today it is possible to measure, set directly, and fix tidal volume, which can protect the immature lung from large volumes and fluctuations of the tidal volume. This strategy can be used in...
Source: Clinics in Perinatology - October 2, 2021 Category: Perinatology & Neonatology Authors: Manuel S ánchez-Luna, Noelia González-Pacheco, Martín Santos-González, Francisco Tendillo-Cortijo Source Type: research

Mechanical Ventilation During Chronic Lung Disease
For infants with the most severe forms of chronic lung disease, regardless of etiology, chronic mechanical ventilation can provide stability, reduce acute respiratory events, and alleviate increased work of breathing. This approach prioritizes the baby ’s growth and development during early life. Once breathing comfortably, these infants can tolerate developmental therapies with the goal of achieving the best neurocognitive outcomes possible. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - October 2, 2021 Category: Perinatology & Neonatology Authors: Christopher D. Baker Source Type: research

Lung Protection During Mechanical Ventilation in the Premature Infant
Mechanical ventilation can be life-saving for the premature infant, but is often injurious to immature and underdeveloped lungs. Lung injury is caused by atelectrauma, oxygen toxicity, and volutrauma. Lung protection must include appropriate lung recruitment starting in the delivery suite and throughout mechanical ventilation. Strategies include open lung ventilation, positive end-expiratory pressure, and volume-targeted ventilation. Respiratory function monitoring, such as capnography and ventilator graphics, provides clinicians with continuous real-time information and an adjunct to optimize lung-protective ventilatory s...
Source: Clinics in Perinatology - October 2, 2021 Category: Perinatology & Neonatology Authors: Emma E. Williams, Anne Greenough Source Type: research

A New Era in the Respiratory Support of the Sick and Immature Neonate
We are living today in a new era in respiratory support of the sick and immature neonate. From the knowledge that ventilator-induced lung injury can be prevented or reduced due to a better understanding of the respiratory physiology, therapies, and more friendly medical devices, a “new respiratory distress syndrome (RDS) of the prematurity” is the leading respiratory problem and represents, instead of the old hyaline membrane disease, a new disease due to the multiple mechanisms involved in the respiratory insufficiency of the immaturity. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - October 2, 2021 Category: Perinatology & Neonatology Authors: Manuel S ánchez-Luna Tags: Preface Source Type: research

The Term Newborn
Term newborn infants without significant medical problems usually transition from fetal to newborn life without medical assistance. Infants requiring therapy often need care in a neonatal intensive care unit as opposed to a well-baby unit. Infants with unclear physiologic status or disease that may require therapies in the immediate newborn period may benefit from a period of observation with close monitoring before admission to a well-baby unit. Whenever possible, providing care for a newborn infant in an area that provides care for the newborn and mother together in the same room facilitates adaptation to normal breastfe...
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Authors: Tina A. Leone, Wanda J. Abreu Source Type: research

Cord Management of the Term Newborn
This article provides arguments for delaying cord clamping for a minimum of 3 minutes. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Authors: Ola Andersson, Judith S. Mercer Source Type: research

The Term Newborn
The changing epidemiology of early-onset neonatal sepsis among term infants has required reappraisal of approaches to management of newborn infants at potential risk. As this is now a rare disease, new strategies for reduction in diagnostic testing and empirical treatment have been developed. Adoption and refinement of these strategies should be a priority for all facilities where babies are born. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Authors: Karen M. Puopolo, Sagori Mukhopadhay, Adam Frymoyer, William E. Benitz Source Type: research

The Term Newborn
This article focuses on the evaluation and management of infants with common congenital infections such as cytomegalovirus, and infections that warrant early diagnosis and treatment to prevent serious complications, such as toxoplasmosis, human immunodeficiency virus, and syphilis. Zika virus and Chagas disease remain uncommon. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Authors: Amaran Moodley, Kurlen S.E. Payton Source Type: research

Human Milk for the Term Newborn
Human milk provides optimal nutrition for term newborns, but the prevalence of its use is below target, and risks have been identified. Infants of black mothers as well as term newborns admitted to the neonatal intensive care unit are at risk for not receiving human milk. To improve human milk intake, multiple individual-level interventions have been shown to be effective, but some popular system-level interventions are ineffective or harmful. Expressed milk and donor milk may be less beneficial than direct breastfeeding. Nuanced public policies can help support lactation while promoting individual choice and equity. (Sour...
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Authors: Isabelle Von Kohorn, Valerie Flaherman Source Type: research

Hyperbilirubinemia in the Term Infant
This article attempts to highlight contemporary issues relating to term neonatal hyperbilirubinemia and to focus attention on controversial issues and concepts with the potential to effect change in clinical approach. On the one hand, the focus is bilirubin neurotoxicity, which is now known to encompass a wide, diverse spectrum of features. The various aspects of this spectrum are outlined and defined. On the other hand, bilirubin also possesses antioxidant properties. As such, mild hyperbilirubinemia is suggested as actually offering the neonate some protective advantage. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Authors: Cathy Hammerman, Michael Kaplan Source Type: research

The Term Newborn
Prenatal genetic screening, including evaluation for inherited genetic disorders, aneuploidy risk assessment, and sonographic assessment, combined with a thorough newborn examination and standard newborn screening, including blood, hearing, and congenital heart disease screening, can reveal conditions requiring further evaluation after delivery. Abnormal prenatal or newborn screening results should prompt additional diagnostic testing guided by maternal fetal medicine, perinatal genetics, or pediatric specialists. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Authors: Kathryn A. Johnson, Valerian Catanzarite Source Type: research

Perinatal Cardiovascular Physiology and Recognition of Critical Congenital Heart Defects
This article reviews diagnosis and management of CHD in the delivery room and before surgery in the NICU. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Authors: Yogen Singh, Satyan Lakshminrusimha Source Type: research

Pathophysiology and Management of Persistent Pulmonary Hypertension of the Newborn
Persistent pulmonary hypertension of the newborn (PPHN) is a disorder of circulatory transition resulting in high pulmonary vascular resistance with extrapulmonary right-to-left shunts causing hypoxemia. There has been substantial gain in understanding of pathophysiology of PPHN over the past 2  decades, and biochemical pathways responsible for abnormal vasoconstriction of pulmonary vasculature are now better understood. Easy availability of bedside echocardiography helps in establishing early definitive diagnosis, understanding the pathophysiology and hemodynamic abnormalities, monitorin g the disease process, and re...
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Authors: Yogen Singh, Satyan Lakshminrusimha Source Type: research

Sudden Unexpected Infant Death
Sudden unexpected infant death is a leading cause of death in infancy. Both safe sleep practices and breastfeeding can help decrease the risk, although the current practice of educating parents about the recommendations has not resulted in universal adherence. Prenatal counseling provides opportunities to discuss recommendations as well as troubleshoot common barriers to breastfeeding and safe infant sleep with goals to gradually change attitudes, address social norms, and prepare new parents. A conversational, motivational approach to discussions about the importance of safe sleep and continued breastfeeding, with explana...
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Authors: Ann Kellams, Lori Feldman-Winter Source Type: research

The Term Newborn
This article reviews specific adverse perinatal outcomes associated with the use of a variety of substances and provides guidance on exposure with continued breastfeeding. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Authors: Courtney Townsel, Torri D. Metz, Maya Bunik Source Type: research

The Term Newborn
The care of late preterm and term newborns delivered in hospital settings in the United States is largely standardized with many routine interventions and screenings that are evidence-based and serve to protect newborn ’s and the public’s health. Refusals of various aspects of routine newborn care are uncommon but can be challenging for clinicians who care for newborns to navigate for many reasons. In this article, we describe the spectrum of refusal. We review suggested approaches that clinicians can take sta rting with increasing their own awareness of what specific components of newborn care are refused and ...
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Authors: Michelle Leff, Jaspreet Loyal Source Type: research

The Term Newborn
This review provides an update on neonatal hypoglycemia in the term infant, including discussion of glucose metabolism, definitions of hypoglycemia, identification of infants commonly at risk, and the screening, treatment, and potential neurologic outcomes of postnatal hypoglycemia. Neonatal hypoglycemia is a common metabolic condition that continues to plague clinicians because there is no clear relationship between low glucose concentrations or their duration that determines adverse neurologic outcomes. However, severely low, prolonged, recurrent low glucose concentrations in infants who also have marked symptoms such as...
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Authors: Eustratia M. Hubbard, William W. Hay Source Type: research

The Term Newborn
Neonatal encephalopathy due to perinatal hypoxia-ischemia (hypoxic-ischemic encephalopathy [HIE]) occurs at a rate of 1 to 3 per 1000 live births. Therapeutic hypothermia is the standard of care and the only currently available therapy to reduce the risk of death or disability in newborns with moderate to severe HIE. Hypothermia therapy needs to be initiated within 6  hours after birth in order to provide the best chance for neuroprotection. All pediatricians and delivery room attendants should be trained to recognize encephalopathy and understand the eligibility criteria for treatment. The modified Sarnat examination...
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Authors: Sonia Lomeli Bonifacio, Shandee Hutson Source Type: research

The Term Infant
Reproduction, pregnancy, and lactation are all processes that are mandatory for the survival of our species. Evolution has put an enormous amount of energy into the survival of the newborn; and they are, as a rule, robust little beings. However, the transition of the infant at the time of delivery is one of the most amazing and complex physiologic transitions that humans undergo. How the infant manages that transition is key to their survival. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Authors: Anup C. Katheria, Lisa Marie Stellwagen Tags: Preface Source Type: research

Newborn Care is a Team Sport
The birth of a healthy newborn is truly a miracle! Increasingly, well-informed parents are looking for a perfect outcome of a pregnancy and delivery that is much anticipated and planned. This puts an added burden on a team that is often operating with imperfect information and a general lack of evidence-based guidelines. Practitioners struggle with various aspects of delivery: optimal time (gestational age), mode (vaginal, cesarean), site (home, hospital), management of labor (induction, augmentation), and so on. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Authors: Lucky Jain Tags: Foreword Source Type: research

Care for the Term Newborn
CLINICS IN PERINATOLOGY (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Authors: Anup C. Katheria, Lisa Marie Stellwagen Source Type: research

Copyright
ELSEVIER (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Source Type: research

Contributors
LUCKY JAIN, MD, MBA (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Source Type: research

Contents
Lucky Jain (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Source Type: research

Forthcoming Issues
Advances in Respiratory Management (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Source Type: research

CME Accreditation Page
(Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 1, 2021 Category: Perinatology & Neonatology Source Type: research

Association of Infection in Neonates and Long-Term Neurodevelopmental Outcome
This article describes the current epidemiology of neonatal sepsis, the pathogenesis of brain injury with sepsis, and the reported long-term neurodevelopment outcomes among survivors. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - May 22, 2021 Category: Perinatology & Neonatology Authors: Elizabeth Sewell, Jessica Roberts, Sagori Mukhopadhyay Source Type: research

Necrotizing Enterocolitis
This article discusses risk factors for NEC, how dysbiosis in preterm infants plays a role in the pathogenesis of NEC, and how probiotic and antibiotic therapy may be used to prevent and/or treat NEC and its sequelae. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - May 22, 2021 Category: Perinatology & Neonatology Authors: Jennifer Duchon, Maria E. Barbian, Patricia W. Denning Source Type: research

Neonatal Herpes Simplex Virus Disease
This article defines neonatal herpes simplex virus (HSV) disease and describes the progress over the past 40  years that has revolutionized the management of HSV disease in neonates to improve their outcomes. These advancements include the introduction of acyclovir in the 1980s, polymerase chain reaction (PCR) for the detection of HSV DNA in the 1990s, and recommendations on managing infants born to mothe rs with active genital lesions. Despite these advancements, however, there remain high morbidity and mortality in affected neonates, with need for continued improvement. Areas of high interest include vaccine develop...
Source: Clinics in Perinatology - May 22, 2021 Category: Perinatology & Neonatology Authors: Nicole L. Samies, Scott H. James, David W. Kimberlin Source Type: research

HIV in Neonates and Infants
This article provides insights on the current state of perinatal HIV, recent advances, and future needs. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - May 22, 2021 Category: Perinatology & Neonatology Authors: Andres F. Camacho-Gonzalez, Paul Palumbo Source Type: research

Syphilis in Neonates and Infants
Syphilis in neonates and infants remains a significant public health problem because it is a major cause of fetal and neonatal morbidity and mortality globally. Despite decades of experience with syphilis in adults and infants, maternal and congenital syphilis are increasing substantially in the United States. The vertical transmission, clinical manifestations, diagnosis, evaluation, treatment, and follow-up are reviewed to guide the health care professional in understanding the optimal management of this preventable disease. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - May 22, 2021 Category: Perinatology & Neonatology Authors: Alexandra K. Medoro, Pablo J. S ánchez Source Type: research