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Diagnosis and Management of Pulmonary Hypertension in Infants with Bronchopulmonary Dysplasia
Chronic pulmonary hypertension of infancy (cPHi) is a heterogeneous disease process that contributes to morbidity and mortality in preterm infants. cPHi is most commonly associated with chronic lung disease of prematurity and represents a unique phenotype of bronchopulmonary dysplasia. It is characterized by persistently elevated or newly rising pulmonary vascular resistance and pulmonary artery pressure beyond the first weeks of age. The high-pressure afterload on the right ventricle may or may not be tolerated, depending upon additional cardiovascular shunting and co-morbidities. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - May 25, 2022 Category: Perinatology & Neonatology Authors: Philip T. Levy, Jonathan Levin, Kristen T. Leeman, Mary P. Mullen, Georg Hansmann, Stella Kourembanas Source Type: research

The micropreemie: Advances and challenges in treating the smallest newborn infants
The very tiny infant or micropreemie presents one of the greatest ethical, medical and technological challenges to modern medicine. Not too long ago, in the 1980 ’s, infants (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - May 16, 2022 Category: Perinatology & Neonatology Authors: Satoshi Kusuda, Ju Lee Oei Source Type: research

Practical procedures for the delivery room resuscitation of micropreemies
There are no standardized procedures for the resuscitation of micropreemies but respiratory and circulatory stabilization immediately after birth should be prioritized. Without aggressive support by positive pressure ventilation, establishing effective respiration among micropreemies is not possible. The first step in postnatal stabilization is initiated by positive airway pressure with a bag and mask. Once the heart rate increases above 100 beats/m, intratracheal intubation should be achieved because it is unusual for a micropreemie to breathe spontaneously or by non-invasive respiratory support for a protracted duration....
Source: Seminars in Fetal and Neonatal Medicine - April 29, 2022 Category: Perinatology & Neonatology Authors: Satoshi Kusuda, Hidehiko Nakanishi, Ju Lee Oei Source Type: research

Practical procedures for resuscitations of micropreemies
Although there are no standardized procedures for the resuscitation of micropreemies, respiratory and circulatory stabilization immediately after birth should be prioritized. Without aggressive support by positive pressure ventilation, establishing effective respiration among micropreemies is not possible. The first step of the resuscitation should be initiated by positive airway pressure with a bag and mask. Once the heart rate increases above 100 beats/m, intratracheal intubation should be followed. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 29, 2022 Category: Perinatology & Neonatology Authors: Satoshi Kusuda, Hidehiko Nakanishi, Ju Lee Oei Source Type: research

Personalized support of parents of extremely preterm infants before, during and after birth
This article reviews general concepts and practices that can be learned and applied by clinicians to promote resiliency and help parents cope adaptively. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 22, 2022 Category: Perinatology & Neonatology Authors: Marlyse F. Haward, Thuy Mai Luu, Rebecca Pearce, Annie Janvier Source Type: research

Ethics of care for the micropreemies. Just because we can, should we?
Debates about treatment for the tiniest premature babies focus on three different approaches – universal non-resuscitation, selective resuscitation, and universal resuscitation. Doctors, hospitals, and professional societies differ on which approach is preferable. The debate is evolving as more and more studies show that survival rates for babies born at 22 and 23 weeks of gestation are s teadily improving at centers that offer active treatment to these babies. Still, many centers do not offer such treatment or, if they do, actively discourage it. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 22, 2022 Category: Perinatology & Neonatology Authors: John D. Lantos Source Type: research

Pulmonary Hypertension in Pregnancy and Its Effects on the Fetus
Pulmonary hypertension (PH) is an important and potentially lethal diagnosis for pregnant patients. Although pregnancy is usually contraindicated in this condition and there is no standard algorithm for the treatment of pregnant patients with PH, studies in recent years have shown improvement in maternal outcomes for those with PH. Many factors have likely contributed to the improved outcomes, including earlier treatment by multidisciplinary teams. Pregnant patients with PH require specialized management throughout pregnancy, especially in the early post-partum period. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 21, 2022 Category: Perinatology & Neonatology Authors: Brie Ann Muller, Karim A. Diab Source Type: research

Pulmonary Hypertension and Oxidative Stress: Where is the Link?
Oxidative stress can be associated with hyperoxia and hypoxia and is characterized by an increase in reactive oxygen (ROS) and nitrogen (RNS) species generated by an underlying disease process or by supplemental oxygen that exceeds the neutralization capacity of the organ system. ROS and RNS acting as free radicals can inactive several enzymes and vasodilators in the nitric oxide pathway promoting pulmonary vasoconstriction resulting in persistent pulmonary hypertension of the newborn (PPHN). Studies in animal models of PPHN have shown high ROS/RNS that is further increased by hyperoxic ventilation. (Source: Seminars in Fe...
Source: Seminars in Fetal and Neonatal Medicine - April 19, 2022 Category: Perinatology & Neonatology Authors: Munmun Rawat, Satyan Lakshminrusimha, Maximo Vento Source Type: research

Application and potential of artificial intelligence in neonatal medicine
Neonatal care is becoming increasingly complex with large amounts of rich, routinely recorded physiological, diagnostic and outcome data. Artificial intelligence (AI) has the potential to harness this vast quantity and range of information and become a powerful tool to support clinical decision making, personalised care, precise prognostics, and enhance patient safety. Current AI approaches in neonatal medicine include tools for disease prediction and risk stratification, neurological diagnostic support and novel image recognition technologies. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 18, 2022 Category: Perinatology & Neonatology Authors: T ’ng Chang Kwok, Caroline Henry, Sina Saffaran, Marisse Meeus, Declan Bates, David Van Laere, Geraldine Boylan, James P. Boardman, Don Sharkey Source Type: research

Perinatal Care for the Extremely Preterm Infant
Being born preterm (prior to 37 weeks of completed gestation) is the leading cause of childhood death up to five years of age, and is responsible for the demise of around one million preterm infants each year. Rates of prematurity, which range from approximately 5 to 18% of births, are increasing in most countries. Babies born extremely preterm (less than 28 weeks ’ gestation) and in particular, in the periviable (200/7 – 256/7 weeks) period, are at the highest risk of death, or the development of long-term disabilities. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 14, 2022 Category: Perinatology & Neonatology Authors: Haruo USUDA, Sean CARTER, Tsukasa TAKAHASHI, John P. NEWNHAM, Erin L. FEE, Alan H. JOBE, Matthew W. KEMP Source Type: research

Infection Prevention for Extremely Low Birth Weight Infants in the NICU
Extremely preterm infants are particularly vulnerable to systemic infections secondary to their immature immune defenses, prolonged hospitalizations, delays in enteral feeding, early antibiotic exposure, and need for life-sustaining invasive interventions. There have been several evidence-based practices for infection prevention in this population, such as human milk feedings, utilization of “bundle checklists” and decolonization of pathogenic organisms. Other practices, such as the use of probiotics, human milk-derived fortifiers, and antifungal prophylaxis are more controversial and require further investigation rega...
Source: Seminars in Fetal and Neonatal Medicine - April 13, 2022 Category: Perinatology & Neonatology Authors: Noa Fleiss, Samiksha Tarun, Richard A. Polin Source Type: research

An economic analysis of the cost of survival of micro preemies: A systematic review
This study aimed to systematically review the current literature on the economic costs of micro preemie as well as evidence on the cost-effectiveness of interventions to improve outcomes for micro preemie babies with a birth weight of ≤ 500g. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 8, 2022 Category: Perinatology & Neonatology Authors: Evelyn Lee, Deborah Schofield, Chris Owens, Ju-Lee Oei Source Type: research

Using Real-World Data in Pediatric Clinical Trials: Lessons Learned and Future Applications in Studies of Persistent Pulmonary Hypertension of the Newborn
Persistent pulmonary hypertension of the newborn (PPHN) is a complication of term birth, characterized by persistent hypoxemia secondary to failure of normal postnatal reduction in pulmonary vascular resistance, with potential for short- and long-term morbidity and mortality. The primary pharmacologic goal for this condition is reduction of the neonate ’s elevated pulmonary vascular resistance with inhaled nitric oxide, the only approved treatment option. Various adjunctive, unapproved therapeutics have been trialed with mixed results, likely related to challenges with recruiting the full, intended patient population int...
Source: Seminars in Fetal and Neonatal Medicine - April 7, 2022 Category: Perinatology & Neonatology Authors: Thomas F. Miller, Andreas Kaiser, Thomas Schmelter, Joerg Lippert, Jonathan M. Davis Source Type: research

The Tiniest Babies Registry: A registry of survivors born weighing less than 400  grams
The Tiniest Babies Registry was launched in the year 2000 as a web-based registry for patients who survived to discharge after being born with birth weights below 400  grams. The registry began with 15 patients and by January 2022 had grown to 291, ranging in birth weight from 212 to 399 grams and in gestational age from 21 to 34 weeks. Three patients were born in the 1930s, and no others were born until 1985. The greatest number in a single year was 21 in 2010 . The infants were born in 16 countries, but 166 of 291 (57%) were born in the U.S. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 4, 2022 Category: Perinatology & Neonatology Authors: Edward F. Bell Source Type: research

The Tiniest Babies Registry: a registry of survivors born weighing less than 400 grams
The Tiniest Babies Registry was launched in 2000 as a web-based registry for patients who survived to discharge after being born with birth weights below 400 grams. The registry began with 15 patients and by January 2022 had grown to 291, ranging in birth weight from 212 to 399 grams and in gestational age from 21 to 34 weeks. Three patients were born in the 1930s, and no others were registered ? until 1985. The greatest number registered in a single year was 21 in 2010. The infants were born in 16 countries, but 166 of 291 (57%) were born in the U.S. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 4, 2022 Category: Perinatology & Neonatology Authors: Edward F. Bell Source Type: research