Perinatal Ischemic Stroke
Perinatal ischemic stroke is a common cause of lifelong disability. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 22, 2022 Category: Perinatology & Neonatology Authors: Nicholas V. Stence, David M. Mirsky, Ilana Neuberger Source Type: research
Intrauterine and Perinatal Infections
Imaging plays an important role in evaluating patients with suspected intrauterine and perinatal infections. Advances in fetal imaging including both ultrasound and MRI allow for increasingly more specific diagnosis if the radiologist is familiar with specific imaging features and patterns. Early imaging of neonates with suspected central nervous system infection is valuable to enable prompt treatment and differentiate infection from other conditions which can clinically present similarly. Ultrasound is a useful initial modality to screen for abnormalities however MRI with and without contrast remains the optimal examinati...
Source: Clinics in Perinatology - August 22, 2022 Category: Perinatology & Neonatology Authors: Jennifer A. Vaughn, Luis F. Goncalves, Patricia Cornejo Source Type: research
Imaging of Premature Infants
According to the World Health Organization (WHO), 15 million babies are born preterm each year. Preterm infants are those born at less than 37 weeks, while extremely and very preterm neonates include those born at 22 to less than 32 weeks gestational age. Infants that fail to make it to term are missing a key part in neurodevelopment, as weeks 24 to 40 are a critical period of brain development. Neonatal brain injury is a crucial predic tor for mortality and morbidity in premature and low birth weight ( (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 22, 2022 Category: Perinatology & Neonatology Authors: Abigail Locke, Sangam Kanekar Source Type: research
Congenital Anomalies of the Kidneys and Urinary Tract
Congenital anomalies of the kidneys and urinary tract (CAKUT) are some of the most common abnormalities detected on prenatal imaging assessment. It is estimated that CAKUT comprises 20% to 30% of all major birth defects. More than 200 clinical syndromes currently include CAKUT as a component of the phenotype. This chapter outlines the evaluation and management of the most common forms of CAKUT. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 22, 2022 Category: Perinatology & Neonatology Authors: Deborah Stein, Erin McNamara Source Type: research
Congenital Malformations of Cerebellum
Advances in pre and postnatal neuroimaging techniques, and molecular genetics have increased our understanding of the congenital malformation of the brain. Correct diagnosis of these malformations in regards to embryology, and molecular neurogenetics is of paramount importance to understand the inheritance pattern and risk of recurrence. Lesions detected on prenatal imaging require confirmation either with postnatal ultrasound and/or with MR imaging. With the advent of the faster (rapid) MRI techniques, which can be conducted without sedation, MRI is commonly used in the evaluation of congenital malformation of the brain. ...
Source: Clinics in Perinatology - August 19, 2022 Category: Perinatology & Neonatology Authors: Ali Moosavi, Sangam Kanekar Source Type: research
Advances in Neuroimaging of the Fetus and Newborn
The prenatal and infancy periods are critical to the development of the child. Any insult during these stages of life may lead to a host of congenital malformations. Congenital brain malformations may result from inherited genetic defects, spontaneous mutations within the embryo's genes, or damage to the fetus caused by the mother's exposure to toxins, infection, trauma, or drug use. It is challenging for clinicians to suspect or diagnose these malformations or abnormalities clinically. Non –radiation imaging techniques, such as ultrasound and MRI, play a vital role in diagnosing and characterizing the severity of these ...
Source: Clinics in Perinatology - August 1, 2022 Category: Perinatology & Neonatology Authors: Sangam G. Kanekar, Sarah Sarvis Milla Tags: Preface Source Type: research
Neonatal and Preterm Infant Growth Assessment
The needs to assess preterm infant growth clinically differ from the needs to summarize growth for research. Clinically, growth assessments are used to understand individuals ’ growth relative to their individual genetic potential, morbidity status and nutrition care. Growth quantification for research purposes is used to quantify growth of groups using meaningful metrics. Historically, neonatology has lacked consistency in the use of growth metrics, over-used irreleva nt categories and over-diagnosed growth failure. Understanding the numerous preterm infant expected growth patterns can help identify concerning growth. (...
Source: Clinics in Perinatology - June 1, 2022 Category: Perinatology & Neonatology Authors: Tanis R. Fenton, Susan Dai, Vikki Lalari, Belal Alshaikh Source Type: research
Parenteral Nutrition
Prematurity and other complications at birth are nutritional emergencies. Parenteral nutrition is a bridge to enteral nutrition for a few days or months, and sometimes the sole source of nutrition for life. Parenteral nutrition regimens are constructed to provide adequate and balanced energy, macronutrients, and micronutrients to support growth and prevent deficiencies. Neonatal parenteral nutrition regimens are complicated by periodic shortages of essential products, compatibility challenges, and contaminants. Newborns benefit from serial growth assessments, monitoring of biochemical status, nutrition-focused physical exa...
Source: Clinics in Perinatology - June 1, 2022 Category: Perinatology & Neonatology Authors: Sharon Groh-Wargo, Stephanie Merlino Barr Source Type: research
Evidence-Based Approaches to Successful Oral Feeding in Infants with Feeding Difficulties
Infants in the neonatal intensive care unit (NICU) frequently have feeding difficulties with the root cause remaining elusive to identify. Evaluation of the provider/parent/infant feeding process may provide objective clues to sources of feeding difficulty. Specialized testing may be necessary to determine if the infant ’s swallowing skills are dysfunctional, immature, or maldeveloped, and to determine the risk of feeding failure or chronic tube feeding. Current evidence-based diagnostic and management approaches resulting in successful oral feeding in the NICU infant are discussed. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - June 1, 2022 Category: Perinatology & Neonatology Authors: Kathryn A. Hasenstab, Sudarshan R. Jadcherla Source Type: research
Maternal Nutrition and Fetal/Infant Development
Nutrition in pregnant mothers has long been known to be an important determinant of fetal/maternal outcomes. In general, the typical American diet shows opportunities for improvement. The intake of fruits, vegetables, whole grains, and fiber may be below recommended levels, but the relative proportion of sodium, fats, and carbohydrates seems high. In this review, we present current evidence on how the fetal/neonatal outcomes may be altered by maternal nutrition at the time of conception, fetal nutrition in utero, contribution of maternal dietary factors in fetal outcomes, weight gain during pregnancy, diabetes during pregn...
Source: Clinics in Perinatology - June 1, 2022 Category: Perinatology & Neonatology Authors: Sangeeta Jain, Akhil Maheshwari, Sunil K. Jain Source Type: research
Human Milk Lipids Induce Important Metabolic and Epigenetic Changes in Neonates
Lipids are a major source of energy during the fetal/neonatal period. Most are received from the mother, transplacentally during the intrauterine period or via maternal milk after birth. However, in addition to the known nutritional roles, lipids are now known to bind a variety of cellular receptors to regulate specific patterns in metabolism and gene expression. The expression of these receptors is regulated by various genetic and environmental stimuli, and ligation can activate positive-feedback loops in the expression and the activity of downstream signaling pathways. The authors summarize the role of lipid ligands, cog...
Source: Clinics in Perinatology - June 1, 2022 Category: Perinatology & Neonatology Authors: Keyur Donda, Akhil Maheshwari Source Type: research
Enteral Nutrition
This article focuses on human milk, its composition and bioactive factors, and how it affects the gut –brain axis through the microbiome. We examine how differences between mother's own milk and pasteurized donor human milk affect the premature infant. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - June 1, 2022 Category: Perinatology & Neonatology Authors: Jaclyn B. Wiggins, Rachael Trotman, Patti H. Perks, Jonathan R. Swanson Source Type: research
Long-Term Impact of Early Nutritional Management
Extremely preterm infants are born at a time of critical brain development. After 24 weeks’ gestation, total and regional brain volumes increase 1.5- to nearly 4-fold through term age, respectively.1,2 Concurrently, there is important maturation of the cortical gray matter, rapid development of white matter cell types, and growth of cortical connections.3,4 In preterm infants, b rain maturation is impaired in comparison with infants born at term, demonstrating the vulnerability of these cell types at this critical stage of development. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - June 1, 2022 Category: Perinatology & Neonatology Authors: Catherine O. Buck, Angela M. Montgomery Source Type: research
Maternal, Fetal, and Neonatal Nutrition Has Lifelong Implications
Nutrition during the late perinatal and neonatal period is an important “environmental” modifier of long-term metabolic, growth, and developmental outcomes.1-5 Preclinical and human clinical studies show that fetal undernutrition can occur due to maternal undernutrition, altered placental growth, or impaired uteroplacental vascular perfusion.6,7 In animal models, ma ternal undernutrition can cause perinatal/neonatal metabolic derangements; cause anatomical/functional changes in the liver, pancreas, and the intestine; predispose to neurobehavioral changes, possible loss of cognitive potential; and even introduce risk fa...
Source: Clinics in Perinatology - June 1, 2022 Category: Perinatology & Neonatology Authors: Akhil Maheshwari, Jonathan R. Swanson Tags: Preface Source Type: research
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(Source: Clinics in Perinatology)
Source: Clinics in Perinatology - June 1, 2022 Category: Perinatology & Neonatology Source Type: research
