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Specialty: Perinatology & Neonatology

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Total 102 results found since Jan 2013.

Highlights from the literature
Morphine and the baby brain Morphine gets used a lot in neonatal care, especially as we now understand the need to give appropriate analgesia and sedation to babies receiving intensive care. Yet there has always been a nagging concern that though we do the right thing in early life, we may be creating difficulties for these babies in later childhood. We should take some reassurance about this from a paper by Steinhorn (J Pediatr 2015;166:1200–7) in which 230 babies, all under 30 weeks at birth and a quarter of whom received morphine, were followed up at 2 and 7 years. At 2 years the morphine exposed babies demonstrat...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - June 19, 2015 Category: Perinatology & Neonatology Tags: Clinical trials (epidemiology), Epidemiologic studies, Cerebral palsy, Epilepsy and seizures, Pain (neurology), Stroke, Child health, Neonatal and paediatric intensive care, Neonatal health, Pain (palliative care) Hyperion Source Type: research

Undiagnosed Heterotopic Pregnancy, Maternal Hemorrhagic Shock, and Ischemic Stroke in the Intrauterine Fetus
Abstract Heterotopic pregnancy occurs rarely following natural conception; however, intrauterine embryo transfer following IVF is a known risk factor for its occurrence. A 29‐year‐old woman presented with acute abdomen at 14w5d gestation following IVF‐ET treatment. A ruptured heterotopic gestation in the left fallopian tube was identified at laparoscopy and treated by salpingectomy. Subsequently, at 21‐week gestation, routine sonogram demonstrated bilateral ventriculomegaly in the intrauterine fetus. Fetal MRI was highly suggestive of ischemic brain injury, most likely attributable to the maternal hypovolemic shock...
Source: Prenatal Diagnosis - June 1, 2015 Category: Perinatology & Neonatology Authors: Mohammad Ezzati, Alireza A. Shamshirsaz, Sina Haeri Tags: Research Letter Source Type: research

Maternal allopurinol administration during suspected fetal hypoxia: a novel neuroprotective intervention? A multicentre randomised placebo controlled trial
Conclusions Maternal treatment with allopurinol during fetal hypoxia did not significantly lower neuronal damage markers in cord blood. Post hoc analysis revealed a potential beneficial treatment effect in girls. Trial registration number NCT00189007, Dutch Trial Register NTR1383.
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - April 17, 2015 Category: Perinatology & Neonatology Authors: Kaandorp, J. J., Benders, M. J. N. L., Schuit, E., Rademaker, C. M. A., Oudijk, M. A., Porath, M. M., Oetomo, S. B., Wouters, M. G. A. J., van Elburg, R. M., Franssen, M. T. M., Bos, A. F., de Haan, T. R., Boon, J., de Boer, I. P., Rijnders, R. J. P., Jac Tags: Clinical trials (epidemiology), Stroke Original articles Source Type: research

Quality of life in adulthood after resection of a sacrococcygeal teratoma in childhood: a Dutch multicentre study
Conclusions The long-term QoL of patients treated for SCT during childhood does not differ from that of the general population. Moreover, patients do not show impairment in social, physical or emotional functioning in adulthood.
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - April 17, 2015 Category: Perinatology & Neonatology Authors: Kremer, M. E. B., Dirix, M., Koeneman, M. M., van Baren, R., Heij, H. A., Wijnen, M. H. W. A., Wijnen, R. M. H., van der Zee, D. C., van Heurn, L. W. E. Tags: Oncology, Health policy, Stroke, Health service research Original articles Source Type: research

MRI for neurodevelopmental prognostication in the high-risk term infant
MRI performed in the neonatal period has become a tool widely used by clinicians and researchers to evaluate the developing brain. MRI can provide detailed anatomical resolution, enabling identification of brain injuries due to various perinatal insults. This review will focus on the link between neonatal MRI findings and later neurodevelopmental outcomes in high-risk term infants. In particular, the role of conventional and advanced MR imaging in prognosticating outcomes in neonates with hypoxic–ischemic encephalopathy, ischemic perinatal stroke, need for extracorporeal membrane oxygenation life support, congenital hear...
Source: Seminars in Perinatology - February 21, 2015 Category: Perinatology & Neonatology Authors: An N. Massaro Source Type: research

The BRACELET study: implications for the design of randomised controlled trials in neonatal and paediatric intensive care
Research is essential to improving care and outcomes, but presents challenges when infants and children are the patients. Over the last few years, several thousand infants and children receiving intensive care have joined randomised controlled trials (RCT) in the UK, the majority of those conducted under the auspices of the National Institute for Health Research (NIHR) portfolio. Globally, tens of thousands of children and infants take part in RCTs. When those children survive, many continue to partake in studies with involvement over several years and potentially into adulthood. That is essential; in no other branch of me...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - February 18, 2015 Category: Perinatology & Neonatology Authors: Embleton, N. D., Rankin, J. Tags: Clinical trials (epidemiology), Stroke, Pregnancy, Reproductive medicine, Child health, Neonatal and paediatric intensive care, Neonatal health, Neonatal intensive care, Paediatric intensive care Editorials Source Type: research

Lactate, rather than ketones, may provide alternative cerebral fuel in hypoglycaemic newborns
Conclusions Hypoglycaemic babies within the first 48 h after birth are unlikely to receive neuroprotection from ketones. However, lactate may provide an alternative cerebral fuel for many. Lactate, rather than ketones, may provide alternative cerebral fuel in hypoglycaemic newborns. Trial registration number ACTRN12608000623392.
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - February 18, 2015 Category: Perinatology & Neonatology Authors: Harris, D. L., Weston, P. J., Harding, J. E. Tags: Stroke, Childhood nutrition, Reproductive medicine, Child health, Infant nutrition (including breastfeeding), Diabetes, Metabolic disorders Short research reports Source Type: research

A Pilot Randomized Controlled Trial of Early versus Routine Caffeine in Extremely Premature Infants
Conclusion This pilot study demonstrated the feasibility of conducting such a trial in extremely preterm neonates. We found that early caffeine administration was associated with improved hemodynamics. Larger studies are needed to determine whether early caffeine reduces intubation, intraventricular hemorrhage, and related long-term outcomes.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents  |  Abstract  |  Full text
Source: American Journal of Perinatology - January 21, 2015 Category: Perinatology & Neonatology Authors: Katheria, Anup C.Sauberan, Jason B.Akotia, DevangRich, WadeDurham, JaysonFiner, Neil N. Tags: Original Article Source Type: research

Intrapartum magnesium sulfate and need for intensive delivery room resuscitation
Conclusions Intrapartum MgSO4 for fetal neuroprotection was not associated with an increased need for intensive delivery room resuscitation in this cohort of preterm infants.
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - December 14, 2014 Category: Perinatology & Neonatology Authors: Weisz, D. E., Shivananda, S., Asztalos, E., Yee, W., Synnes, A., Lee, S. K., Shah, P. S., on behalf of the Canadian Neonatal Network Tags: Epidemiologic studies, Drugs: CNS (not psychiatric), Stroke, Child health, Infant health, Neonatal and paediatric intensive care, Neonatal health, Mechanical ventilation, Resuscitation Original articles Source Type: research

The challenges of interventional trials in fetal therapy
Fetal therapy is an advancing specialty but the assessment of effectiveness for many therapies has been limited to observational data1 2 with randomised controlled trials (RCTs) employed with varying success.3 4 More recently systematic reviews have been used to assess the quality and summarise the outcomes of this evidence.5 6 Our experiences from one such trial (the PLUTO study4) highlight the difficulties of such research. Congenital lower urinary tract obstruction (LUTO) may be identified using prenatal ultrasound and is associated with high mortality and morbidity (perinatal and childhood), due to pulmonary hypoplasia...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - October 15, 2014 Category: Perinatology & Neonatology Authors: Morris, R. K., Daniels, J., Deeks, J., Field, D., Kilby, M. D. Tags: Obstetrics and gynaecology, Urology, Oesophagus, Clinical trials (epidemiology), Epidemiologic studies, Stroke, Pregnancy, Reproductive medicine, Child health, Radiology, Clinical diagnostic tests, Radiology (diagnostics) Leading articles Source Type: research

Non-Invasive Cardiac Output Monitoring in Preterm Infants Undergoing Patent Ductus Arteriosus Ligation: A Comparison with Echocardiography.
Conclusion: Continuous LVO measurement using NICOM was feasible and demonstrated a consistent systematic bias compared with echocardiography in unstable extremely preterm infants without a PDA ligation. NICOM may be used as a trending tool for continuous monitoring in this population, but wide limits of agreement and increasing bias over time suggest it is not interchangeable with echocardiography. © 2014 S. Karger AG, Basel. PMID: 25278031 [PubMed - as supplied by publisher]
Source: Neonatology - October 1, 2014 Category: Perinatology & Neonatology Authors: Weisz DE, Jain A, Ting J, McNamara PJ, El-Khuffash A Tags: Neonatology Source Type: research

Passive Leg Raising during Pregnancy
Conclusions PLR did not result in cardiac output recruitment in a cohort of healthy pregnant women during the third trimester.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents  |  Abstract  |  Full text
Source: American Journal of Perinatology - September 21, 2014 Category: Perinatology & Neonatology Authors: Marques, Nicole RibeiroMartinello, CarolineKramer, George C.Costantine, Maged M.Vadhera, Rakesh B.Saade, George R.Hankins, Gary D.Pacheco, Luis D. Tags: Original Article Source Type: research

Rapid target allopurinol concentrations in the hypoxic fetus after maternal administration during labour
Conclusions A dose of 500 mg intravenous allopurinol rapidly crosses the placenta and provides target concentrations in 95% of the fetuses at the moment of delivery, which makes it potentially useful as a neuroprotective agent in perinatology with very little side effects. Trial registration The study is registered in the Dutch Trial Register (NTR1383) and the Clinical Trials protocol registration system (NCT00189007).
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - February 13, 2014 Category: Perinatology & Neonatology Authors: Kaandorp, J. J., van den Broek, M. P. H., Benders, M. J. N. L., Oudijk, M. A., Porath, M. M., Bambang Oetomo, S., Wouters, M. G. A. J., van Elburg, R., Franssen, M. T. M., Bos, A. F., Mol, B. W. J., Visser, G. H. A., van Bel, F., Rademaker, C. M. A., Derk Tags: Stroke, Medicines regulation Original articles Source Type: research

Neonatal Seizures: Advances in Mechanisms and Management
Seizures occur in approximately 1 to 5 per 1000 live births and are among the most common neurologic conditions managed by a neonatal neurocritical care service. There are several, age-specific factors that are particular to the developing brain, which influence excitability and seizure generation, response to medications, and impact of seizures on brain structure and function. Neonatal seizures are often associated with serious underlying brain injury such as hypoxia-ischemia, stroke, or hemorrhage. Conventional, prolonged, continuous video electroencephalogram is the gold standard for detecting seizures, whereas amplitud...
Source: Clinics in Perinatology - December 16, 2013 Category: Perinatology & Neonatology Authors: Hannah C. Glass Source Type: research

Antenatal screening for Down Syndrome and other chromosomal abnormalities: increasingly complex issues
The rapid changes in prenatal screening and diagnostic techniques bring new challenges. Alberry et al1 discuss the ‘unintended consequences’ of recent national guidance for anomaly screening and invasive testing from the point of view of a regional fetal medicine unit. Developments in Trisomy 21 (Down Syndrome) screening have sought to increase sensitivity and specificity of screening tests. From the point of view of the individual woman, this means that if she chooses to participate in screening, she will have a high chance of detection of Down Syndrome, and a low chance that a subsequent invasive diagnostic t...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - December 13, 2013 Category: Perinatology & Neonatology Authors: Dolk, H., Wellesley, D. Tags: Drugs: CNS (not psychiatric), Stroke, Pregnancy, Child health, Sexual health, Clinical diagnostic tests, Screening (epidemiology), Ethics of reproduction, Screening (public health) Editorials Source Type: research