Differences of Sex Development
Differences of sex development (DSD) refer to rare conditions in which an individual ’s sex development is different from typical male or female development. The neonatologist is often the first health care provider to interact with parents of newborns with DSD and must be familiar with the approach to patients with DSD. In this article, we discuss definition of DSD, initial worku p of the patient with DSD, terminology, and controversies in care. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - February 22, 2022 Category: Perinatology & Neonatology Authors: Natalie G. Allen, Kanthi Bangalore Krishna, Peter A. Lee Source Type: research
CME Accreditation Page
(Source: Clinics in Perinatology)
Source: Clinics in Perinatology - February 22, 2022 Category: Perinatology & Neonatology Source Type: research
Current Controversies in Neonatology
CLINICS IN PERINATOLOGY (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - February 22, 2022 Category: Perinatology & Neonatology Authors: ROBERT M. KLIEGMAN, SUSAN S. COHEN Source Type: research
Copyright
ELSEVIER (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - February 22, 2022 Category: Perinatology & Neonatology Source Type: research
Contributors
LUCKY JAIN, MD, MBA (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - February 22, 2022 Category: Perinatology & Neonatology Source Type: research
Contents
Lucky Jain (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - February 22, 2022 Category: Perinatology & Neonatology Source Type: research
Forthcoming Issues
Neonatal and Perinatal Nutrition (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - February 22, 2022 Category: Perinatology & Neonatology Source Type: research
Delirium in the Neonate
Delirium is likely present in the neonatal intensive care unit and has been largely unrecognized. There are several risk factors for delirium including illness severity, neurosedative exposure, and environmental disruptions that put infants at risk for delirium. Regular use of scoring systems should be considered to improve delirium detection. When identified, initial steps in management should include resolving underlying causes and implementation of standard nonpharmacologic measures. Mounting pediatric evidence suggests that the atypical antipsychotics, as well as the α-2 agonists, may be additionally beneficial in tre...
Source: Clinics in Perinatology - January 21, 2022 Category: Perinatology & Neonatology Authors: Samuel J. Adams, Alicia Sprecher Source Type: research
Treatment of Posthemorrhagic Hydrocephalus
The incidence of intraventricular hemorrhage (IVH) has overall declined to 15% to 20% of preterm infants with birth weight less than 1500 g. One of the major complications of severe IVH is posthemorrhagic ventricular dilation (PHVD). Nearly 10% of all infants with IVH and 20% of infants with severe IVH will develop progressive PHVD requiring surgical intervention to prevent parenchymal damage in the developing brain. This review focuses on the controversies regarding posthemorrhagic hydrocephalus interventions with a focus on how to interpret recent data from trials that some have seen as heralding a call toward more aggre...
Source: Clinics in Perinatology - January 21, 2022 Category: Perinatology & Neonatology Authors: Susan Cohen, John Flibotte Source Type: research
Neonatal Hypertension
Neonatal hypertension is uncommon but is becoming increasingly recognized. Normative blood pressure data are limited, as is research regarding the risks, treatment, and long-term outcomes. Therefore, there are no clinical practice guidelines and management is based on clinical judgment and expert opinion. Recognition of neonatal hypertension requires proper blood pressure measurement technique. When hypertension is present there should be a thorough clinical, laboratory, and imaging evaluation to promptly diagnose causes needing medical or surgical management. This review provides a practical overview for the practicing cl...
Source: Clinics in Perinatology - January 21, 2022 Category: Perinatology & Neonatology Authors: Rebecca Hjorten, Joseph T. Flynn Source Type: research
Counseling for Perinatal Outcomes in Women with Congenital Heart Disease
As the adult congenital heart disease population grows, more women are reaching childbearing age. Women with moderate to complex congenital heart disease have an increased risk of morbidity and mortality than the general population. There is increased risk of prematurity and intrauterine growth restriction in infants. Regular preconceptual adult congenital heart disease care, contraception counseling, and multidisciplinary care during a pregnancy can help minimize the risk during pregnancy for both mother and baby. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - January 21, 2022 Category: Perinatology & Neonatology Authors: Jennifer F. Gerardin, Scott Cohen Source Type: research
Withdrawing and Withholding Life-Sustaining Medical Therapies in the Neonatal Intensive Care Unit
In cases whereby the continuation of life-sustaining medical therapies is not in the infant ’s best interest and does not align with the parents’ goals, it is ethically and morally advisable to withhold/withdraw life-sustaining medical therapies. Withdrawing/withholding artificial nutrition hydration is not morally or ethically different from other medical treatments. Determination of what and when to withdraw should occur through shared decision-making considering the parents’ values and the infant’s physiology and comfort. The practice of physician recommendations followed by parental informed nondissent should b...
Source: Clinics in Perinatology - January 21, 2022 Category: Perinatology & Neonatology Authors: Erin L. Rholl, Katie R. Baughman, Steven R. Leuthner Source Type: research
Advances in Understanding the Mechanism of Transitional Neonatal Hypoglycemia and Implications for Management
Our lack of basic knowledge about the basic mechanisms of transitional hypoglycemia and other forms of hypoglycemia in newborns underlies the ongoing controversies over standards for managing these conditions. To address this deficiency, the authors evaluated regulation of insulin secretion in fetal, newborn, and adult rats. The results demonstrate that transitional hypoglycemia in normal neonates and persistent hypoglycemia in high-risk infants both reflect altered beta-cell insulin regulation. These findings provide a new foundation for improving detection and management and preventing hypoglycemic brain injury in normal...
Source: Clinics in Perinatology - January 21, 2022 Category: Perinatology & Neonatology Authors: Diana L. Stanescu, Charles A. Stanley Source Type: research
Beyond the Clinical Trials
Mild therapeutic hypothermia has been extensively studied and validated as an effective and safe treatment for term and near-term infants with moderate and severe hypoxic encephalopathy meeting narrow inclusion criteria. Unanswered questions remain about whether cooling treatment can be optimized to improve outcomes even further, and whether it is reasonable to offer treatment to infants excluded from the foundational studies. Consideration of “off-protocol” cooling practices requires methodical review of available evidence and analysis using both a clinical and a research ethical framework. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - January 21, 2022 Category: Perinatology & Neonatology Authors: Naomi T. Laventhal, John D.E. Barks Source Type: research
Percutaneous Closure of Patent Ductus Arteriosus
Percutaneous-based patent ductus arteriosus closure is technically feasible among infants less than 1.5 kg. However, marked heterogeneity in the type and nature of adverse events obscures current safety profile assessments. Although data on the risks of postdevice closure syndrome remain promising, a lack of comparative trials of surgical ductal ligation and inconsistent surveillance across publishe d studies obscure confidence in present estimates of safety and efficacy. To minimize risk and yield the greatest benefits, clinical studies of patent ductus arteriosus treatment should consider incorporating more robust asse...
Source: Clinics in Perinatology - January 21, 2022 Category: Perinatology & Neonatology Authors: Megan Barcroft, Christopher McKee, Darren P. Berman, Rachel A. Taylor, Brian K. Rivera, Charles V. Smith, Jonathan L. Slaughter, Afif El-Khuffash, Carl H. Backes Source Type: research
