Neonatal/Perinatal Medicine Topic Homepage

Medical Videos

An Introduction to Twin-Twin Transfusion Syndrome and Possible Treatments
An Introduction to Twin-Twin Transfusion Syndrome and Possible Treatments
An Introduction to Diagnosing Gastroschisis or Omphalocele
An Introduction to Diagnosing Gastroschisis or Omphalocele

Recent Drug Updates

Medical Journal Abstracts on Neonatal/Perinatal Medicine

Neonatal medical exposures and characteristics of low birth weight hepatoblastoma cases: A report from the Children's Oncology Group

Thu 07 Aug 2014 -  Pediatric Blood & Cancer

Background: Hepatoblastoma is a malignancy of young children. Low birth weight is associated with significantly increased risk of hepatoblastoma and neonatal medical exposures are hypothesized as ...

Fetal Sex–Based Differences in Maternal Hormones, Angiogenic Factors, and Immune Mediators During Pregnancy and the Postpartum Period

Mon 04 Aug 2014 -  American Journal of Reproductive Immunology

Problem:Several pregnancy complications have disparities based on the sex of the fetus. It is unknown whether the sex of the fetus differentially alters the maternal immune milieu, potentially ...

Clinical Guidelines

Antibiotics for early-onset neonatal infection: Antibiotics for the prevention and treatment of early-onset neonatal infection

Aug 2012

Early-onset neonatal bacterial infection (infection with onset within 72 hours of birth) is a..

... significant cause of mortality and morbidity in newborn babies. Parent organisations and the scientific literature report that there can be unnecessary delays in recognising and treating sick babies. In addition, concern about the possibility of early-onset neonatal infection is common. This concern is an important influence on the care given to pregnant women and newborn babies. There is wide variation in how the risk of early-onset neonatal infection is managed in healthy babies.

Neonatal jaundice

May 2010

This guideline provides guidance regarding the recognition, assessment and treatment of neonatal..

... jaundice. The advice is based on evidence where this is available and on consensus-based practice where it is not.

Online CME

Clinical review - Prader-Willi syndrome

This article discusses the genetic inheritance of PW syndrome, the neonatal features and adult complications of the syndrome.

Antenatal and newborn screening - in association with the UK National Screening Committee

After completing this module, you should: understand the principles of screening and how they are applied in practice, know what NHS antenatal and newborn screening programmes are available, know where...

Antenatal care for healthy pregnant women

After completing this module you should know: what lifestyle advice is recommended, how to manage common symptoms, what examinations to carry out, what screening to perform, what clinical conditions and...

Clinical Trials

Remifentanil for General Anesthesia in the Context of Immaturity (REAGI)

06-01-2014

One of the problems during general anesthesia (GA) for caesarean section is the place of opioid agents. Indeed, the literature does not provide so far a clear answer regarding the use of opioids prior to extraction of the newborn. Indeed, if the opioid administration at induction is beneficial for the mother (better..

... control of autonomic responses to noxious stimuli), the impact on the newborn can be unfavorable in terms of adaptation to extrauterine life . This is especially true if the birth takes place in a context of prematurity and / or acute fetal distress.

The pharmacokinetics of remifentanil make it the only opioid which is consistent with a rapid sequence induction. Its short period of action avoids the manual ventilation of patients before intubation, while providing a peak of action concomitant to the nociceptive stimulation. Patients at high risk of aspiration, including pregnant women, may benefit from this type of morphine at induction. In addition, the fact that remifentanil seems to be associated with relative fetal safety in obstetrical or neonatal context legitimized the development of protocols to study maternal-fetal consequences of the use of remifentanil at induction of AG for emergency caesarean section.

While cesarean section under general anesthesia mainly concern premature newborns in France, no work has focused on the use of remifentanil for caesarean section in a context of preterm without preeclampsia.

The main hypothesis of this study is to evaluate the safety of the use of remifentanil in terms of adaptation to extrauterine life in children born prematurely by caesarean section under general anesthesia outside the context of preeclampsia.

To do this, we will compare two groups of children, one consisting of children born by cesarean section under general anesthesia with maternal remifentanil infusion, the other made up of children born by cesarean section under general anesthesia without maternal infusion of remifentanil. This study is prospective, single-center, randomized, double-blinded.

The primary endpoint is formed by the value of the Apgar score less than 7 at 5 minutes, calculated in the delivery room by the team supporting the child (midwives and pediatricians).

The secondary endpoints are formed by maternal hemodynamic parameters (SBP, DBP, MAP, HR), the rate of complications during induction (difficult intubation, aspiration), the onset of respiratory distress requiring ventilation mask in the newborn, the rate of intubation in neonates, and the rate of use of adjuvant anesthetic agents

Safety and Efficacy of Propranolol Eye Drops in Treating Retinopathy of Premature (DROP-PROP)

10-12-2013

The aim of the present study is to evaluate the safety and efficacy of propranolol eye drops in preterm newborns with a precocious stage of retinopathy of prematurity (ROP). Preterm newborns (gestational age 23-32 weeks) with a stage 2 ROP (zone II without plus) will receive propranolol eye drops treatment until..

... retinal vascularization will be completed. Propranolol concentrations will be measured on dried blood spots during the first 3 days of treatment and at the steady state. Cardiovascular and respiratory parameters will be continuously monitored. Blood samplings checking metabolic, renal and liver functions will be performed periodically, as well as cardiac function, in order to verify the treatment safety. Serial ophthalmological evaluations will be planned to monitor the efficacy of the treatment, the ROP progression and the possible complications.
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