Neonatal/Perinatal Medicine Topic Homepage

Medical Videos

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

Recent Drug Updates

Medical Journal Abstracts on Neonatal/Perinatal Medicine

Neurologic disease with pregnancy and considerations for the obstetric anesthesiologist

Thu 28 Aug 2014 -  Seminars in Perinatology

Women with neurologic conditions present a challenge during pregnancy and in the peripartum period. Given the low prevalence of these diseases during pregnancy, most management decisions are guided ...

Additional value of fetal magnetic resonance imaging in the prenatal diagnosis of central nervous system anomalies: a systematic review of the literature

Thu 21 Aug 2014 -  Ultrasound in Obstetrics & Gynecology

Objectives: To analyze literature on the additional value of fetal magnetic resonance imaging (MRI) in assessing central nervous system (CNS) anomalies suspected by ultrasound. Methods: A ...

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

Levetiracetam Treatment of Neonatal Seizures: Safety and Efficacy Phase II Study (LEVNEONAT1)

27-08-2014

LEVNEONAT is a multicentre French clinical trials with the aim to develop new treatment strategies for the treatment of neonatal seizures using Levetiracetam. The purpose of this study is to determine the correct dosing, safety and efficacy for..

... intravenous levetiracetam as first line treatment in term new born babies with seizures. This new anticonvulsivant drug is a promising treatment for seizures in newborns.

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

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