Seminars in Perinatology
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3.30
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2,277
Papers 2,439
1 page of 244 pages (2,439 results)
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#1Marlyse F. Haward (Albert Einstein College of Medicine)H-Index: 10
#2Antoine Payot (UdeM: Université de Montréal)H-Index: 13
Last. Annie Janvier (UdeM: Université de Montréal)H-Index: 31
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Abstract null null Communication with parents is an essential component of neonatal care. For extremely preterm infants born at less than 25 weeks, this process is complicated by the substantial risk of mortality or major morbidity. For some babies with specific prognostic factors, the majority die. Although many of these deaths occur after admission to the intensive care unit, position statements have focused on communication during the prenatal consultation. This review takes a more comprehens...
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#1Trisha M Prentice (Royal Children's Hospital)H-Index: 6
#2Lynn Gillam (University of Melbourne)H-Index: 27
Last. Annie Janvier (UdeM: Université de Montréal)H-Index: 31
view all 4 authors...
Abstract null null Advances in perinatal care bring with them ethical challenges and difficult questions. When should we provide life-sustaining interventions, and who should decide? Particularly at the edges of viability, some clinicians may feel required to provide a level of care that they believe is not in the patient's interests, resulting in moral distress. null This article will discuss the complex nature of moral distress arising during the care of extremely preterm babies. It will descr...
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Abstract null null Introduction null At extremely low gestational ages, preterm infants are markedly physiologically immature, thus their responses to common clinical interventions may differ from more mature preterm babies. This study was performed to describe the evidence base which is available to make care decisions for such infants. null null null Methods null A literature search of recent large neonatal randomized controlled trials (RCTs) was performed to determine the representation of in...
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#1Satoshi Kusuda (Kyorin University)H-Index: 16
#2Shinya Hirano (Boston Children's Hospital)H-Index: 8
Last. Tomohiko Nakamura (Boston Children's Hospital)H-Index: 19
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Abstract null null Treatment for extremely preterm infants born at less than 25 weeks of gestation in Japan was initiated mainly due to the amendment of the Maternal Health Act lowering the upper limit of abortion from 24 weeks to 22 weeks in 1990. Five years after the amendment, the Japanese national government started a nationwide project to improve the perinatal care system. Once selected perinatal centers reported improvements in survival rates, more centers have adopted aggressive treatment...
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#1Bryan P. Finn (UCC: University College Cork)
#2Neidin Bussmann (UCC: University College Cork)
Last. Eugene M. Dempsey (UCC: University College Cork)H-Index: 43
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Abstract null null As survival rates continue to improve for infants born at less than 25 weeks gestation, delineating normal cardiovascular physiology from pathophysiology becomes much more challenging. With a paucity of ‘normative’ data for such infants, an over-reliance on studies at older gestations can result in a ‘best guess’ approach. Here we offer a pragmatic approach to these diagnostic challenges from a cardiovascular viewpoint. An appreciation of the unique physiology, from the immatu...
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#1Johan Ågren (Boston Children's Hospital)H-Index: 11
Abstract null null The care of infants born at the lowest extreme of gestation requires dedication, skill, and experience. Most centers apply a selective approach where intensive care at these gestational ages is being offered to a varying proportion of infants depending on the views and experiences of the medical community, the individual physician, and the parents. Consequently, the outcomes differ dramatically with survival rates at 22-23 weeks ranging from 0 to greater than 50%. This paper p...
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#1Johan Ågren (Uppsala University)H-Index: 11
#2Jeffrey L. Segar (MCW: Medical College of Wisconsin)H-Index: 29
Last. Edward F. Bell (UI: University of Iowa)H-Index: 60
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Emerging data regarding the encouraging outcomes of extremely preterm infants from centers taking active approaches to the care of these infants have prompted dialogue regarding optimal medical management. Among the multitude of decisions providers make in caring for extremely premature infants is the prescribing of parenteral fluids. Surprisingly, there are limited data to guide evidenced-based approaches to fluid and electrolyte management in this population. Immaturity of renal function and s...
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#1John M. DagleH-Index: 28
#2Matthew A. RysavyH-Index: 10
Last. Jeffrey L. Segar (MCW: Medical College of Wisconsin)H-Index: 29
view all 25 authors...
Abstract null null The approach to clinical care of infants born at 22 weeks’ gestation must be consistent and well-designed if optimal results are to be expected. Publications from several international centers have demonstrated that, although there may be variance in aspects of care in this vulnerable population, treatment should be neither random nor inconsistent. In designing a standardized approach, careful attention should be paid to the unique anatomy, physiology, and biochemistry of this...
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#1Yara El Helou (UIC: University of Illinois at Chicago)H-Index: 1
#2Irina A. Buhimschi (UIC: University of Illinois at Chicago)H-Index: 58
Last. Catalin S. Buhimschi (UIC: University of Illinois at Chicago)H-Index: 59
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ABSTRACT null null In the setting of threatened extreme preterm birth, balancing maternal and fetal risks and benefits in order to choose the best available treatment options is of utmost importance. Inconsistency in treatment practices for infants born between 22 and 24 weeks of gestatotional age may account for inter-hospital variation in survival rates with and without impairment. Most importantly, non-biased and accurate information must be presented to the family as soon as extremely preter...
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#1Richard Sindelar (Uppsala University)H-Index: 9
#2Hidehiko Nakanishi (Kitasato University)H-Index: 1
Last. Jonathan M. Klein (UI: University of Iowa)H-Index: 18
view all 5 authors...
Abstract null null Survival of preterm newborn infants have increased steadily since the introduction of surfactant treatment and antenatal steroids. In the absence of randomized controlled trials on ventilatory strategies in extremely preterm infants, we present ventilatory strategies applied during the initial phase and the continued ventilatory care as applied in three centers with proactive prenatal and postnatal management and well documented good outcomes in terms of mortality and morbidit...
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