Contributors
LUCKY JAIN, MD, MBA (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 1, 2022 Category: Perinatology & Neonatology Source Type: research
Contents
Lucky Jain (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 1, 2022 Category: Perinatology & Neonatology Source Type: research
Forthcoming Issues
Neurological and Developmental Outcomes of High-Risk Neonates (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - November 1, 2022 Category: Perinatology & Neonatology Source Type: research
In Utero Therapy for Congenital Diaphragmatic Hernia
Congenital diaphragmatic hernia is an anomaly that is often prenatally diagnosed and spans a wide spectrum of disease, with high morbidity and mortality associated with fetuses with severe defects. Congenital diaphragmatic hernia is thus an ideal target for fetal intervention. We review the literature on prenatal diagnosis, describe the history of fetal intervention for congenital diaphragmatic hernia, and discuss fetal endoscopic tracheal occlusion and the Tracheal Occlusion To Accelerate Lung growth trial results. Finally, we present preclinical studies for potential future directions. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - October 12, 2022 Category: Perinatology & Neonatology Authors: Marisa E. Schwab, Hanmin Lee, KuoJen Tsao Source Type: research
Advances and Updates in Fetal and Neonatal Surgery
We are delighted to focus on fetal and neonatal surgery in this issue of Clinics in Perinatology. Tremendous advances in fetal and neonatal treatment have been made in the last 10 years with the recognition that there is a continuum of care from fetal diagnosis and potential therapy through neonatal care. Both fetal surgical care and neonatal surgical care are multidisciplinary fields that rely on the expertise of perinatologists, neonatologists, pediatric surgeons, anesthesiologists, and many other maternal and pediatric specialists. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - October 12, 2022 Category: Perinatology & Neonatology Authors: Hanmin Lee, KuoJen Tsao Tags: Preface Source Type: research
Fetal and Neonatal Surgery: Then and Now
Advances in fetal and neonatal surgery mirror the gains made in the entire field of neonatal-perinatal care. It is hard to believe that the first fetal surgical intervention was performed in 1963 without any ultrasound or other imaging modality when Dr Albert William Liley performed a fetal transfusion for severe erythroblastosis fetalis (Fig. 1).1 The procedure was successful and paved the way for subsequent interventions in this malady that was associated with much morbidity and mortality. Advances in fetal imaging have not only improved our understanding of organ development and embryology but also allowed for entire ...
Source: Clinics in Perinatology - October 12, 2022 Category: Perinatology & Neonatology Authors: Lucky Jain Tags: Foreword Source Type: research
The Rearing of Maternal –Fetal Surgery
Maternal –fetal surgery is fraught with inherent controversy from within the medical community and general public. Despite these challenges, the field of maternal–fetal surgery evolved into an international enterprise. Carefully nurtured by pioneers with foresight and resilience, the field navigated ethi cal dilemmas with rigorous scientific methodology, collaboration, transparency, and accordance. These central pillars are consistent throughout the brief but momentous history of maternal–fetal surgery, serving as the catalyst for its success. The maturation of fetal intervention is an exemplar of technological innov...
Source: Clinics in Perinatology - October 9, 2022 Category: Perinatology & Neonatology Authors: Caressa Chen, Lauren L. Evans, Michael R. Harrison Source Type: research
Fetal Repair of Neural Tube Defects
Myelomeningocele is the most common congenital neurologic defect, and the only nonlethal disease addressed by fetal surgery. A randomized control trial has established amelioration of the Arnold –Chiari II malformation, reduced ventriculoperitoneal shunt rate, and improvement in distal neurologic function in patients that receive in utero repair. Long-term follow-up of these school-age children demonstrates the persistence of these effects. The use of stem cells in fetal repair is being i nvestigated to further improve distal motor function. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - October 9, 2022 Category: Perinatology & Neonatology Authors: Su Yeon Lee, Ramesha Papanna, Diana Farmer, KuoJen Tsao Source Type: research
Molecular and Cellular In Utero Therapy
Significant advances in maternal –fetal medicine and gene sequencing technology have fostered a new frontier of in utero molecular and cellular therapeutics, including gene editing, enzyme replacement therapy, and stem cell transplantation to treat single-gene disorders with limited postnatal treatment strategies. In utero therap ies take advantage of unique developmental properties of the fetus to allow for the correction of monogenic disorders before irreversible disease pathology develops. While early preclinical studies in animal models are encouraging, more studies are needed to further evaluate their safety and eff...
Source: Clinics in Perinatology - October 9, 2022 Category: Perinatology & Neonatology Authors: Cara L. Berkowitz, Valerie L. Luks, Marcelina Puc, William H. Peranteau Source Type: research
Abdominal Wall Defects
The 2 most common congenital abdominal wall defects are gastroschisis and omphalocele. Gastroschisis is a defect in the abdominal wall with exposed abdominal contents. Mortality rates are low but lengths of stay are often prolonged by bowel dysmotility and other intestinal abnormalities in complicated cases. Omphalocele is a defect through the umbilical cord with herniated abdominal contents covered by a sac. It is associated with other genetic abnormalities and other anomalies that can lead to significant morbidity and mortality. Prenatal diagnosis in both conditions allows for improved prenatal consultation and coordinat...
Source: Clinics in Perinatology - October 9, 2022 Category: Perinatology & Neonatology Authors: Alyssa R. Mowrer, Daniel A. DeUgarte, Amy J. Wagner Source Type: research
Review of Necrotizing Enterocolitis and Spontaneous Intestinal Perforation Clinical Presentation, Treatment, and Outcomes
The Necrotizing Enterocolitis Surgery Trial (NEST) highlights the importance of distinguishing necrotizing enterocolitis (NEC) from spontaneous intestinal perforation (SIP) when developing surgical treatment plans. Further research is needed to increase the accuracy of this distinction, but even with our current abilities to do this initial laparotomy appears to be optimal for infants with presumed NEC. The preferred initial operation for those with SIP is more equivocal. Rates of NEC are likely decreasing slowly, whereas those with SIP are not. New imaging modalities, especially ultrasound, are becoming more useful but re...
Source: Clinics in Perinatology - October 9, 2022 Category: Perinatology & Neonatology Authors: Laura A. Rausch, David N. Hanna, Anuradha Patel, Martin L. Blakely Source Type: research
Advances in the Treatment of Neonatal Biliary Disease
This article discusses current standard of care in neonatal biliary disease, particularly management of biliary atresia and choledochal cysts. It highlights surgical considerations, guidelines for adjuvant therapies, and promising therapeutic options that are under investigation. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - October 9, 2022 Category: Perinatology & Neonatology Authors: Sarah Mohamedaly, Amar Nijagal Source Type: research
Fetal Therapy for Renal Anhydramnios
The most severe forms of congenital anomalies of the kidney and urinary tract present in fetal life with early pregnancy renal anhydramnios and are considered lethal due to pulmonary hypoplasia without fetal therapy. Due to the high rate of additional structural anomalies, genetic abnormalities, and associated syndromes, detailed anatomic survey and genetic testing are imperative when stratifying which pregnancies are appropriate for fetal intervention. Restoring amniotic fluid around the fetus is the principal goal of prenatal treatment. The ongoing multi-center Renal Anhydramnios Fetal Therapy (RAFT) trial is assessing t...
Source: Clinics in Perinatology - October 9, 2022 Category: Perinatology & Neonatology Authors: Jena L. Miller, Ahmet A. Baschat, Meredith A. Atkinson Source Type: research
Advances in the Management of the Neonate Born with an Anorectal Malformation
Anorectal malformations occur in 1 in 3000 to 5000 children, and present with a marked variety in type and severity. Most of the malformations are diagnosed in the early neonatal period, as an antenatal diagnosis remains relatively elusive. Following diagnosis, an accurate assessment and focused management is crucial to reduce the potential for morbidity and mortality. This review focuses on the investigation and management of newborns with anorectal malformations, and the introduction of novel assessment tools for the more complex malformation types. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - October 9, 2022 Category: Perinatology & Neonatology Authors: Sebastian K. King, Marc A. Levitt Source Type: research
Surgical Management of Congenital Diaphragmatic Hernia
Congenital diaphragmatic hernia (CDH) is a challenging surgical disease that requires complex preoperative, perioperative, and postoperative care. Survival depends on successful reduction and repair of the defect, and numerous complex decisions must be made regarding timing and preparation for surgery. This review describes the challenges and controversies inherent to surgical CDH care and provides recommendations for management based on the most recent evidence. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - October 9, 2022 Category: Perinatology & Neonatology Authors: Matthew T. Harting, Tim Jancelewicz Source Type: research
