BOOK
Fanaroff and Martin's Neonatal-Perinatal Medicine E-Book
Richard J. Martin | Avroy A. Fanaroff | Michele C. Walsh
(2014)
Additional Information
Book Details
Abstract
Tackle your toughest challenges and improve the quality of life and long-term outcomes of your patients with authoritative guidance from Fanaroff and Martins Neonatal-Perinatal Medicine. Drs. Richard J. Martin, Avroy A. Fanaroff, and Michele C. Walsh and a contributing team of leading experts in the field deliver a multi-disciplinary approach to the management and evidence-based treatment of problems in the mother, fetus and neonate. New chapters, expanded and updated coverage, increased worldwide perspectives, and many new contributors keep you current on the late preterm infant, the fetal origins of adult disease, neonatal anemia, genetic disorders, and more.
"...a valuable reference book and a pleasure to read." Reviewed by BACCH Newsletter, Mar 2015
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- Obtain more global perspectives and best practices with contributions from international leaders in the field of neonatal-perinatal medicine.
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- Stay at the forefront of your field thanks to new and completely revised chapters covering topics such as: Principles and Practice l Immune and Non-immune Hydrops Fetalis l Amniotic Fluid Volume l Enhancing Safe Prescribing in the Neonatal Intensive Care Unit l Role of Imaging in Neurodevelopmental Outcomes of High-Risk Neonates l Patent Ductus Arteriosus l Gastroesophageal Reflux and Gastroesophageal Reflux Diseases in the Neonate.
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Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| e9780323295376v1.pdf | 1 | ||
| Front cover | 1 | ||
| Endsheet 2_Vol.1 | 2 | ||
| Fanaroff and Martin’s Neonatal-Perinatal Medicine | 3 | ||
| Copyright page | 4 | ||
| Dedication | 5 | ||
| Contributors | 7 | ||
| Preface | 19 | ||
| Table of Contents | 21 | ||
| 1 The Field of Neonatal-Perinatal Medicine | 27 | ||
| 1 Growth Of Neonatal-Perinatal Medicine: | 28 | ||
| Perinatal Pioneers | 28 | ||
| The High-Risk Fetus and Perinatal Obstetrics | 28 | ||
| Midwives and Perinatal Care | 31 | ||
| Neonatal Resuscitation: Tales of Heroism and Desperation | 31 | ||
| Apgar and the Language of Asphyxia | 31 | ||
| Foundling Asylums and Infant Care | 32 | ||
| Saving Infants to Man the Army | 32 | ||
| An Ingenious Contrivance, the Couveuse, and Premature Baby Stations | 33 | ||
| Incubators, Baby Shows, and Origins of Neonatal Intensive Care Units | 33 | ||
| Supportive Care and Oxygen Therapy | 34 | ||
| Ventilatory Care: “Extended Resuscitation” | 35 | ||
| Supportive Care: Intravenous Fluid and Blood Transfusions | 36 | ||
| Tools and Supplies for Neonatal Intensive Care Units | 36 | ||
| Pediatric Surgery: Not For Rabbits Anymore | 37 | ||
| Global Neonatal Care | 37 | ||
| Medical Errors and “Patient Safety” as a New Discipline | 38 | ||
| Controlled Clinical Trials, Evidence-Based Medicine, and Research Networks | 38 | ||
| Future of Neonatal Research, Education, and Databases in the Internet Era | 38 | ||
| Some Famous High-Risk Infants | 39 | ||
| Acknowledgment | 40 | ||
| References | 40 | ||
| 2 Epidemiology for Neonatologists | 42 | ||
| Births | 42 | ||
| Maternal Mortality | 42 | ||
| Infant Mortality | 42 | ||
| Reversing the Low Birth Weight Explosion | 43 | ||
| References | 45 | ||
| 3 The Organization of Perinatal Services | 46 | ||
| Historical Perspective | 46 | ||
| Philosophical Basis of Regionalization | 46 | ||
| Is Regionalization Still Relevant? | 48 | ||
| Impact on Neonatal Morbidity and Mortality | 48 | ||
| Impact on Maternal Morbidity and Mortality | 48 | ||
| Maternal and Neonatal Transport Services | 48 | ||
| Measurements of Effectiveness of Care Organization | 49 | ||
| References | 49 | ||
| 4 Medical Ethics in Neonatal Care | 50 | ||
| Principles in Medical Ethics | 51 | ||
| Autonomy | 51 | ||
| Beneficence | 51 | ||
| Nonmaleficence | 52 | ||
| Justice | 52 | ||
| Key Terms and Concepts | 53 | ||
| Communication with Parents | 53 | ||
| Teams and Communication | 54 | ||
| Family-Centered Neonatal Intensive Care | 54 | ||
| Consensual Decision Making | 55 | ||
| Team Consensus in Ethical Issues | 55 | ||
| Clinical Applications in Specific Moral Problems | 56 | ||
| Refusal of Treatment During Pregnancy | 56 | ||
| Prenatal Consultation at the Limits of Viability | 56 | ||
| To Provide Data on Which Decisions Can Be Based | 57 | ||
| To Explore the Values of the Pregnant Patient and Her Partner and Negotiate a Shared Decision Between Them and the Medical Team | 57 | ||
| Withholding and Withdrawing Life-Sustaining Medical Treatment in the Neonatal Intensive Care Unit | 59 | ||
| Collaborative, Procedural Framework for End-of-Life Decision Making | 59 | ||
| Specific Issues in End-of-Life Care | 60 | ||
| Brain Death, Donation After Cardiac Death, and Organ Donation | 60 | ||
| Brain Death | 60 | ||
| Donation After Cardiac Death | 60 | ||
| Use of Analgesic Agents at the Time of Withdrawing Life-Sustaining Medical Treatment | 61 | ||
| Palliative Care in the Neonatal Intensive Care Unit | 61 | ||
| Conflict Resolution When Consensus Cannot Be Reached | 62 | ||
| Ethics of Research in the Neonatal Intensive Care Unit | 63 | ||
| Ethical Responsibilities of Neonatal Physicians | 64 | ||
| Acknowledgment | 65 | ||
| References | 65 | ||
| 5 Legal Issues in Neonatal-Perinatal Medicine | 67 | ||
| Disclaimer | 67 | ||
| General Legal Principles | 68 | ||
| Legislative Law and Case Law | 68 | ||
| State Law and Federal Law | 68 | ||
| General Structure of the Federal and State Court Systems | 68 | ||
| Supervision of Others | 68 | ||
| Theories of Liability for Attending Physicians | 68 | ||
| Residents and Fellows | 69 | ||
| Physician Assistants | 70 | ||
| Advanced Practice Neonatal Nurses | 70 | ||
| Malpractice | 70 | ||
| Duty | 71 | ||
| Supervising Others | 71 | ||
| Telephone Advice | 71 | ||
| Telemedicine | 72 | ||
| Prenatal Consultation | 72 | ||
| Breach | 72 | ||
| Standard of Care | 72 | ||
| Role of the Expert Witness | 73 | ||
| Res Ipsa Loquitur | 73 | ||
| Causation | 74 | ||
| Damages | 74 | ||
| Burden of Proof | 74 | ||
| Protected (Nondiscoverable) Proceedings | 75 | ||
| Other Tort Actions | 75 | ||
| Wrongful Birth | 75 | ||
| Wrongful Life | 75 | ||
| Wrongful Death | 75 | ||
| Strategies for Avoiding Tort Litigation | 76 | ||
| Trends in Malpractice Legislation | 76 | ||
| Conclusions | 77 | ||
| Live Birth | 77 | ||
| Born-Alive Infants Protection Act | 78 | ||
| Handicapped Newborns | 78 | ||
| Baby Doe | 78 | ||
| Baby Jane Doe | 79 | ||
| Baby K | 79 | ||
| Sun Hudson | 80 | ||
| Conclusions | 80 | ||
| Providing Care Against Parents’ Wishes | 81 | ||
| Miller Case | 81 | ||
| Messenger Case | 82 | ||
| Montalvo Case | 82 | ||
| Conclusions | 82 | ||
| Summary | 83 | ||
| References | 84 | ||
| 6 Evaluating and Improving the Quality and Safety of Neonatal Intensive Care | 85 | ||
| The Case for Improvement | 85 | ||
| Brief History of Industrial Quality Improvement | 87 | ||
| Definition and Conceptual Frameworks for Quality | 90 | ||
| Definition | 90 | ||
| Conceptual Framework for Quality | 90 | ||
| Donabedian: Structure, Process, Outcomes | 90 | ||
| Pawson and Tilley: Realistic Evaluation | 90 | ||
| Batalden: Five Knowledge Systems | 90 | ||
| Complexity Theory | 91 | ||
| Translation of Frameworks into Action | 91 | ||
| Model for Improvement | 91 | ||
| Integrated Quality Management | 92 | ||
| Lean | 92 | ||
| Data and Methods for Quality Improvement | 92 | ||
| Data Elements for Assessment | 93 | ||
| Structure and Institutional Context | 93 | ||
| Processes | 93 | ||
| Outcomes | 94 | ||
| Balancing Measures | 94 | ||
| Assessing the Total Impact of a Quality Improvement Initiative | 94 | ||
| Risk Adjustment/Fair Comparisons | 95 | ||
| Data Sources | 98 | ||
| Administrative Data | 98 | ||
| Clinical Data | 100 | ||
| Qualitative Data | 100 | ||
| Quality Measurement and Improvement | 100 | ||
| Data for Selection | 101 | ||
| National Quality Measures | 102 | ||
| Data for Improvement | 102 | ||
| Global Assessments of Perinatal Quality: The Value Compass | 103 | ||
| Global Assessments of Perinatal Quality: The Baby-MONITOR | 105 | ||
| Quality and Safety Applied | 105 | ||
| Local Quality Improvement Applied: An Example | 106 | ||
| Quality Improvement Research | 108 | ||
| Quality and Safety in the International Context | 110 | ||
| Conclusion | 110 | ||
| Acknowledgment | 110 | ||
| References | 110 | ||
| 7 Simulation in Neonatal-Perinatal Medicine | 115 | ||
| Simulation-Based Learning | 115 | ||
| Simulation-Based Assessment | 120 | ||
| Simulation-Based Research | 120 | ||
| Simulation as the Basis of Clinical Care | 121 | ||
| The Future of Simulation in Neonatal-Perinatal Medicine | 121 | ||
| References | 122 | ||
| 8 Coding and Reimbursement: | 124 | ||
| The Basis of Neonatal Coding and Reimbursement | 124 | ||
| Current Procedural Terminology Coding for Neonatology: The Process | 125 | ||
| Specific Neonatal Codes | 125 | ||
| Inpatient Consultation | 126 | ||
| Normal Newborn Care Codes | 126 | ||
| Intensive Care | 127 | ||
| Neonatal and Pediatric Critical Care | 127 | ||
| Hospital Discharge Services | 128 | ||
| International Coding | 128 | ||
| New Models of Physician Reimbursement | 129 | ||
| Acknowledgment | 130 | ||
| References | 130 | ||
| 9 Practicing Evidence-Based Neonatal-Perinatal Medicine | 131 | ||
| Asking a Focused Clinical Question | 131 | ||
| Finding Evidence | 132 | ||
| Sources of Evidence | 132 | ||
| Efficient Strategies for Searching for Evidence | 132 | ||
| Primary Reports | 132 | ||
| Reviews | 132 | ||
| Cochrane Systematic Reviews | 133 | ||
| Critically Appraising Evidence for Its Validity | 133 | ||
| Extracting the Data and Expressing the Effect of Treatment | 134 | ||
| Applying the Results to Patient Care | 134 | ||
| Promoting Evidence-Based Clinical Practice | 135 | ||
| References | 136 | ||
| 10 Perinatal and Neonatal Care in Developing Countries | 137 | ||
| Global Initiatives to Reduce Infant Mortality Rate and Neonatal Mortality Rate: From Alma-Ata to Millennium Development Goals | 137 | ||
| The Millennium Development Goals | 138 | ||
| Tracking the Global Progress of Millennium Development Goals | 139 | ||
| Global Burden of Maternal and Neonatal Deaths | 139 | ||
| Maternal Mortality | 139 | ||
| Neonatal Mortality | 140 | ||
| Causes of Global Neonatal Mortality | 141 | ||
| Socioeconomic and Cultural Factors | 141 | ||
| Influence of Political Instability, War, and Conflict | 142 | ||
| Medical Causes of Neonatal Mortality Rate | 142 | ||
| Postnatal Adaptation | 142 | ||
| Birth Asphyxia | 142 | ||
| Management of Post Asphyxial Syndrome | 146 | ||
| Hypothermia | 146 | ||
| Infections | 146 | ||
| Burden of Neonatal Sepsis | 147 | ||
| Diagnosis of Neonatal Sepsis | 147 | ||
| Evidence-Based Interventions to Reduce Maternal Mortality Rates, Infant Mortality Rates, and Neonatal Mortality Rates | 147 | ||
| The Impact of Progress | 149 | ||
| Emerging New Diseases | 149 | ||
| The Burden of the High Cost of Advanced Neonatal Care | 150 | ||
| Long-Term Neurodevelopmental Outcome | 150 | ||
| Ethical Dilemmas | 150 | ||
| Strategies to Improve Global Neonatal and Perinatal Outcome | 151 | ||
| Summary | 152 | ||
| References | 152 | ||
| 2 The Fetus | 155 | ||
| 11 Genetic Aspects of Perinatal Disease and Prenatal Diagnosis | 156 | ||
| Principles of Inheritance | 156 | ||
| Chromosomal Disorders | 156 | ||
| Maternal Age Considerations | 156 | ||
| Abnormalities of Chromosome Number | 156 | ||
| Triploidy and Tetraploidy. | 156 | ||
| Aneuploidy. | 156 | ||
| Abnormalities of Chromosome Structure | 157 | ||
| Single-Gene Disorders | 158 | ||
| Autosomal Dominant Disorders | 158 | ||
| Advanced Paternal Age. | 159 | ||
| Autosomal Recessive Disorders | 159 | ||
| Sex-Linked Disorders | 160 | ||
| Non-Mendelian Patterns of Inheritance | 160 | ||
| Mitochondrial Inheritance | 160 | ||
| Epigenetics and Uniparental Disomy | 161 | ||
| Trinucleotide Repeat Expansion | 162 | ||
| Multifactorial Inheritance | 162 | ||
| Teratogens | 162 | ||
| Diagnostic Imaging | 164 | ||
| Airline Flights | 164 | ||
| Congenital Anomalies and Ultrasonography | 164 | ||
| Screening Modalities | 165 | ||
| Screening for Aneuploidies | 165 | ||
| First-Trimester Screening | 165 | ||
| Second-Trimester Screening | 166 | ||
| Screening for Multifactorial Disorders | 166 | ||
| Serum α-Fetoprotein | 166 | ||
| Screening for Fetal Aneuploidy Using Cell-Free Fetal DNA from Maternal Serum | 166 | ||
| Screening for Mendelian Disorders | 166 | ||
| Screening for Hemoglobinopathies | 166 | ||
| Carrier Screening for Cystic Fibrosis | 167 | ||
| Jewish Carrier Screening | 167 | ||
| Carrier Screening for Spinal Muscular Atrophy | 167 | ||
| Diagnostic Modalities | 167 | ||
| Chorionic Villus Sampling | 167 | ||
| Amniocentesis | 169 | ||
| Cordocentesis | 169 | ||
| Preimplantation Genetic Diagnosis | 169 | ||
| Technical Advances in Molecular Cytogenetics | 169 | ||
| Assisted Reproductive Technologies | 170 | ||
| Genetic Evaluation and Counseling | 171 | ||
| Conclusion | 172 | ||
| References | 172 | ||
| 12 Perinatal Imaging | 173 | ||
| Fetal Imaging Techniques | 173 | ||
| Bioeffects and Safety | 175 | ||
| Ethical Considerations | 176 | ||
| Applications of Ultrasound | 177 | ||
| Genetic Screening | 177 | ||
| Assisted Reproduction | 179 | ||
| First-Trimester Studies | 180 | ||
| Multiple Gestations | 180 | ||
| Pregnancy Evaluation | 181 | ||
| Fetal Growth | 182 | ||
| Placental Abnormalities | 182 | ||
| Placental Location | 182 | ||
| Amniotic Fluid Volume | 183 | ||
| Cervical Length and Pelvic Structures | 184 | ||
| Second-Trimester Ultrasound Study of the Fetus | 185 | ||
| Doppler Ultrasound | 186 | ||
| Doppler Studies of the Growth-restricted Fetus | 187 | ||
| Procedures | 187 | ||
| Fetal Well-Being Assessment | 187 | ||
| Fetal Anomalies | 188 | ||
| Central Nervous System | 188 | ||
| Fetal Ventriculomegaly | 188 | ||
| Meningomyelocele and (Type II) Chiari Malformation | 189 | ||
| The Skull and Brain in Spina Bifida | 190 | ||
| Anencephaly | 190 | ||
| Encephalocele | 190 | ||
| Holoprosencephaly | 190 | ||
| Dandy-Walker Malformation | 192 | ||
| Choroid Plexus Cyst | 192 | ||
| Spine | 192 | ||
| Head and Neck | 193 | ||
| Heart | 194 | ||
| Gastrointestinal Tract | 195 | ||
| Normal Bowel Appearance | 195 | ||
| Esophageal Atresia and Tracheoesophageal Fistula | 196 | ||
| Small Bowel Obstruction | 196 | ||
| Anterior Abdominal Wall Defects | 196 | ||
| Diaphragmatic Hernia and Thoracic Lesions | 196 | ||
| Gallbladder and Bile Ducts | 198 | ||
| Genitourinary Tract | 199 | ||
| Musculoskeletal System | 202 | ||
| Two-Vessel Umbilical Cord | 203 | ||
| Summary | 204 | ||
| References | 204 | ||
| 13 Estimation of Fetal Well-Being | 207 | ||
| Antepartum Fetal Surveillance | 207 | ||
| Indications for Surveillance | 207 | ||
| Physiologic Basis for Antenatal Surveillance | 207 | ||
| Patient Assessment of Fetal Movement | 208 | ||
| Nonstress Test | 208 | ||
| Contraction Stress Test | 209 | ||
| Biophysical Profile | 209 | ||
| Amniotic Fluid Volume Assessment | 209 | ||
| Doppler Flow Velocimetry | 210 | ||
| Interpretation of Test Results | 212 | ||
| Evaluation of the Intrapartum Fetus | 212 | ||
| Intrapartum Oxygenation and Neurologic Morbidity | 213 | ||
| Continuous Versus Intermittent Fetal Heart Rate Monitoring | 213 | ||
| Interpretation of Continuous FHR Recordings | 214 | ||
| Baseline Fetal Heart Rate | 214 | ||
| Fetal Heart Rate Variability | 214 | ||
| Accelerations | 215 | ||
| Decelerations | 215 | ||
| Interpretative Systems for Classification of Fetal Heart Rate Patterns | 218 | ||
| Category I | 218 | ||
| Category II | 218 | ||
| Category III | 218 | ||
| Management of Non–Category I FHR Patterns During Labor | 218 | ||
| Summary | 219 | ||
| Acknowledgement | 220 | ||
| References | 220 | ||
| 14 Surgical Treatment of the Fetus | 222 | ||
| Fetal Access | 222 | ||
| Percutaneous | 222 | ||
| Fetoscopic | 222 | ||
| Open Hysterotomy | 222 | ||
| Exit Procedure | 223 | ||
| Anesthetic Considerations | 223 | ||
| Anomalies Amenable to Fetal Surgery | 224 | ||
| Congenital Diaphragmatic Hernia | 224 | ||
| Prognostic Criteria | 224 | ||
| Fetal Interventions | 224 | ||
| Neoplasms | 226 | ||
| Congenital Pulmonary Airway Malformations | 226 | ||
| Sacrococcygeal Teratoma | 226 | ||
| Fetal Neck Mass | 228 | ||
| Myelomeningocele | 229 | ||
| Urinary Tract Abnormalities | 230 | ||
| Hydronephrosis | 230 | ||
| Lower Urinary Tract Obstruction | 230 | ||
| Primary Fetal Hydrothorax | 231 | ||
| Abnormalities of Twin Gestations | 231 | ||
| Twin-Twin Transfusion Syndrome | 231 | ||
| Twin Reversed Arterial Perfusion Sequence | 233 | ||
| Polyhydramnios Affecting Runt Twin | 233 | ||
| Congenital Heart Disease | 233 | ||
| Amniotic Bands | 234 | ||
| Summary | 234 | ||
| References | 234 | ||
| 15 Adverse Exposures to the Fetus | 237 | ||
| Exposures Not Concurrent with Pregnancy | 237 | ||
| Preconceptional Effects | 237 | ||
| Exposures Affecting the Epigenome | 237 | ||
| Exposures Affecting the Ovum | 238 | ||
| Paternal Effects | 239 | ||
| Secondary Fetal Exposure: Maternal Body Burden | 240 | ||
| Polychlorinated Biphenyls | 240 | ||
| Lead. | 240 | ||
| Mercury. | 240 | ||
| Maternal Exposures Concurrent with Pregnancy | 240 | ||
| Occupation and Paraoccupation | 240 | ||
| Air | 241 | ||
| Water | 242 | ||
| Diet | 242 | ||
| Pathways of Fetal Exposure | 242 | ||
| Placenta-Dependent Pathways | 242 | ||
| Placenta-Independent Pathways | 242 | ||
| Radiation | 242 | ||
| Heat | 243 | ||
| Noise | 243 | ||
| Fetal Pharmacokinetics | 243 | ||
| Fetal Distribution | 243 | ||
| Fetal Metabolism | 243 | ||
| Specific Exposures | 244 | ||
| Cigarette Smoke | 244 | ||
| e9780323295376v2 | 932 | ||
| Front cover | 932 | ||
| Fanaroff and Martin’s Neonatal-Perinatal Medicine | 933 | ||
| Copyright page | 934 | ||
| Dedication | 935 | ||
| Contributors | 937 | ||
| Preface | 949 | ||
| Table of Contents | 951 | ||
| 11 The Central Nervous System | 957 | ||
| 58 Normal and Abnormal Brain Development | 958 | ||
| Mechanisms of Brain Development | 958 | ||
| Neural Induction and Neurulation | 958 | ||
| Neuronal Proliferation | 959 | ||
| Neuronal Migration and Cortical Lamination | 962 | ||
| Central Nervous System Organization | 965 | ||
| Subplate Neurons | 965 | ||
| Axonal and Dendritic Growth | 966 | ||
| Synaptogenesis | 970 | ||
| Programmed Cell Death | 970 | ||
| Glial Proliferation and Differentiation, and Myelination | 972 | ||
| Astrocytes. | 972 | ||
| Oligodendrocytes and Myelination. | 973 | ||
| Imaging Characteristics of Myelination. | 974 | ||
| Microglia and Brain Macrophages. | 975 | ||
| Brain Vascular Development | 975 | ||
| Abnormal Brain Development and Disorders | 976 | ||
| Disorders of Neural Tube Formation and Prosencephalic Development | 976 | ||
| Craniorachischisis Totalis, Anencephaly, Myeloschisis, Encephalocele, Myelomeningocele, and Occult Dysraphic States | 976 | ||
| Holoprosencephaly and Agenesis of the Corpus Callosum | 977 | ||
| Dandy-Walker Malformation | 979 | ||
| Abnormalities of Neuronal Proliferation | 979 | ||
| Microcephaly | 979 | ||
| Primary Microcephalies. | 980 | ||
| Microcephaly with Simplified Gyral Pattern. | 980 | ||
| Microlissencephaly | 980 | ||
| Megalencephaly | 981 | ||
| Disorders of Neuronal Migration | 981 | ||
| Classic Lissencephalies (Type I Lissencephalies) | 981 | ||
| LIS1 Mutations (Isolated Lissencephaly and Miller-Dieker Syndrome). | 981 | ||
| DCX Mutations. | 981 | ||
| Tubulin Mutations. | 982 | ||
| ARX Mutations. | 982 | ||
| Lissencephaly with Cerebellar Hypoplasia. | 982 | ||
| Syndromic Lissencephaly. | 983 | ||
| Cobblestone Lissencephalies (Type II Lissencephalies) | 983 | ||
| Type III Lissencephaly | 983 | ||
| X-Linked Periventricular Heterotopia | 983 | ||
| Zellweger Syndrome | 984 | ||
| Effects of Environmental Factors on Neuronal Migration | 984 | ||
| Disorders of Central Nervous System Organization and Maturation | 985 | ||
| References | 985 | ||
| 59 White Matter Damage and Encephalopathy of Prematurity | 988 | ||
| Neuropathology of White Matter Injury | 988 | ||
| Historical View | 988 | ||
| Periventricular Leukomalacia | 988 | ||
| Macroscopic Neuropathology | 988 | ||
| Microscopic Neuropathology | 988 | ||
| New Neuropathologic Insights | 989 | ||
| Vulnerability of Oligodendroglia Cell Line. | 990 | ||
| Microglial Activity. | 990 | ||
| Neuronal/Axonal Damage. | 990 | ||
| Subplate Damage. | 990 | ||
| Models of Encephalopathy of Prematurity: Implications for Pathogenesis | 991 | ||
| Hypoperfusion and Hypoxia-Ischemia | 991 | ||
| Infection and Inflammation | 992 | ||
| Excitotoxicity and Oxidative Stress | 993 | ||
| Combined Insults | 994 | ||
| Neuroimaging of White Matter Injury | 995 | ||
| Neonatal Sonography | 995 | ||
| Conventional Magnetic Resonance Imaging | 996 | ||
| Diffusion Magnetic Resonance Imaging | 997 | ||
| Magnetic Resonance Spectroscopy | 1000 | ||
| Impairment of Brain Growth and Long-Term Development | 1001 | ||
| References | 1003 | ||
| 60 Intracranial Hemorrhage and Vascular Lesions in the Neonate | 1008 | ||
| Intracranial Hemorrhage | 1008 | ||
| Incidence | 1008 | ||
| Timing of the Hemorrhage | 1008 | ||
| Neuropathology | 1008 | ||
| Germinal Matrix Hemorrhage | 1009 | ||
| Intraventricular Hemorrhage | 1009 | ||
| Parenchymal Hemorrhage | 1009 | ||
| Intracerebellar Hemorrhage | 1010 | ||
| Pathogenesis | 1011 | ||
| Prenatal Factors | 1011 | ||
| Intrapartum Factors | 1011 | ||
| Neonatal Factors | 1012 | ||
| Cardiovascular Factors | 1012 | ||
| Genetic Factors | 1012 | ||
| Diagnosis | 1013 | ||
| Management | 1013 | ||
| Neurodevelopmental Outcome | 1015 | ||
| Prevention | 1015 | ||
| Other Hemorrhages | 1017 | ||
| Cerebral Artery Infarction | 1017 | ||
| Sinovenous Thrombosis | 1017 | ||
| Perinatal Arterial Ischemic Stroke | 1019 | ||
| Incidence | 1019 | ||
| Diagnosis | 1019 | ||
| Risk Factors | 1021 | ||
| Prognosis | 1021 | ||
| References | 1022 | ||
| 61 Hypoxic-Ischemic Encephalopathy | 1026 | ||
| Definitions | 1026 | ||
| Hypoxic-Ischemic Encephalopathy | 1026 | ||
| Hypoxia or Anoxia | 1026 | ||
| Ischemia | 1026 | ||
| Perinatal Asphyxia | 1026 | ||
| Pathophysiology | 1026 | ||
| Systemic Adaptation to Hypoxic-Ischemic Insult | 1026 | ||
| Preconditioning | 1028 | ||
| Perinatal Hypoxic-Ischemic Brain Damage | 1029 | ||
| Secondary Neuronal Death | 1029 | ||
| Glutamate Injury (Excitotoxicity) | 1029 | ||
| Free Radical Formation | 1029 | ||
| Apoptosis | 1031 | ||
| Cytokines | 1031 | ||
| Human Studies | 1031 | ||
| Selective Vulnerability | 1031 | ||
| Cellular Susceptibility | 1031 | ||
| Maturity | 1031 | ||
| Vascular Territories | 1032 | ||
| Regional Susceptibility | 1032 | ||
| Types of Hypoxic-Ischemic Insult | 1032 | ||
| Others | 1032 | ||
| Neuropathology | 1032 | ||
| Cerebral Edema | 1032 | ||
| Cellular Responses | 1033 | ||
| Calcification | 1033 | ||
| Chronic Lesions | 1033 | ||
| Assessment Tools | 1033 | ||
| Clinical Examination | 1033 | ||
| Neurophysiology | 1033 | ||
| EEG | 1033 | ||
| Evoked Potentials | 1037 | ||
| Neuroimaging | 1038 | ||
| Chemical Biomarkers | 1039 | ||
| Management | 1040 | ||
| Primary Prevention | 1040 | ||
| Resuscitation | 1040 | ||
| Systemic Management | 1040 | ||
| Renal System | 1041 | ||
| Cardiovascular System | 1041 | ||
| Hepatic and Gastrointestinal Systems | 1041 | ||
| Hematologic System | 1041 | ||
| Brain-Oriented Management | 1041 | ||
| Glucose | 1041 | ||
| Seizures | 1042 | ||
| Cerebral Edema | 1043 | ||
| Corticosteroids | 1043 | ||
| Specific Neuroprotective Strategies | 1043 | ||
| Hypothermia | 1043 | ||
| Other Strategies | 1043 | ||
| Prognostic Factors | 1045 | ||
| Apgar Scores and Condition at Birth | 1045 | ||
| Acidosis | 1045 | ||
| Severity of Encephalopathy | 1045 | ||
| Hypoxic-Ischemic Encephalopathy and Less Severe Neurodisability | 1046 | ||
| Acknowledgment | 1046 | ||
| References | 1046 | ||
| 62 Seizures in Neonates | 1049 | ||
| Diagnosis: Clinical Versus Electroencephalographic | 1049 | ||
| Clinical Seizure Criteria | 1049 | ||
| Subtle Seizure Activity | 1049 | ||
| Clonic Seizures | 1050 | ||
| Multifocal (Fragmentary) Clonic Seizures | 1052 | ||
| Tonic Seizures | 1052 | ||
| Myoclonic Seizures | 1052 | ||
| Nonepileptic Behaviors of Neonates | 1052 | ||
| Tremulousness or Jitteriness Without Electrographic Correlates | 1052 | ||
| Neonatal Myoclonus Without Electrographic Seizures | 1053 | ||
| Neonatal Dystonia/Dyskinesia Without Electrographic Seizures | 1055 | ||
| Electrographic Seizure Criteria | 1055 | ||
| Ictal Electroencephalographic Patterns: A More Reliable Marker for Seizure Onset, Duration, and Severity | 1055 | ||
| Seizure Duration and Topography | 1055 | ||
| Brainstem Release Phenomena | 1056 | ||
| Subcortical Seizures and Electroclinical Dissociation | 1057 | ||
| Incidence of Neonatal Seizures | 1057 | ||
| Interictal Electroencephalographic Pattern Abnormalities | 1057 | ||
| Major Etiologies for Seizures | 1058 | ||
| Asphyxia-Related Events | 1058 | ||
| Metabolic Derangements | 1060 | ||
| Hypoglycemia | 1060 | ||
| Hypocalcemia | 1060 | ||
| Hyponatremia and Hypernatremia | 1060 | ||
| Cerebrovascular Lesions | 1060 | ||
| Infection | 1061 | ||
| Central Nervous System Malformations | 1061 | ||
| Inborn Errors of Metabolism | 1064 | ||
| Drug Withdrawal and Intoxication | 1064 | ||
| Progressive Neonatal Epileptic Syndromes | 1064 | ||
| Benign Familial Neonatal Seizures | 1064 | ||
| Diagnostic Algorithm | 1065 | ||
| Treatment | 1065 | ||
| Novel Drug Approaches | 1066 | ||
| Single/Synergistic Treatments for General Neonatal Disease States | 1066 | ||
| Treatments That Alter Neurotransmission | 1067 | ||
| Selective Alteration of a Specific Receptor | 1068 | ||
| Efficacy of Treatment | 1068 | ||
| Discontinuation of Drug Use | 1068 | ||
| Consequences of Neonatal Seizures | 1068 | ||
| Prognosis | 1069 | ||
| References | 1070 | ||
| 63 Hypotonia and Neuromuscular Disease in the Neonate | 1072 | ||
| Diagnosis | 1072 | ||
| Neonatal Neuromuscular Disorders | 1073 | ||
| Spinal Muscular Atrophies | 1073 | ||
| Hereditary Motor and Sensory Neuropathies | 1075 | ||
| Hereditary Sensory and Autonomic Neuropathies | 1075 | ||
| Neuromuscular Junction Disorders | 1076 | ||
| Congenital Muscular Dystrophy | 1078 | ||
| Congenital Myotonic Dystrophy | 1080 | ||
| Other Muscular Dystrophies | 1081 | ||
| Congenital Myopathies | 1081 | ||
| Nemaline Myopathy | 1081 | ||
| Central Core Disease | 1082 | ||
| Multi-Minicore Myopathy | 1082 | ||
| Myotubular Myopathy | 1082 | ||
| Metabolic and Multisystem Disorders | 1083 | ||
| Mitochondrial Myopathies | 1083 | ||
| Disorders of Glycogen Metabolism | 1083 | ||
| Pompe Disease (Type II Glycogen Storage Disease) | 1083 | ||
| Debrancher Enzyme Deficiency (Type III Glycogen Storage Disease) | 1083 | ||
| McArdle Disease (Type V Glycogen Storage Disease) | 1084 | ||
| Phosphofructokinase Deficiency (Type VII Glycogen Storage Disease) | 1084 | ||
| Primary Carnitine Deficiency | 1084 | ||
| Peroxisomal Disorders | 1084 | ||
| References | 1084 | ||
| 64 Disorders in Head Shape and Size | 1086 | ||
| Examination of the Head | 1086 | ||
| The Small Head | 1086 | ||
| Primary Microcephaly | 1087 | ||
| Genetic Defects | 1087 | ||
| Neurulation and Cleavage Anomalies | 1087 | ||
| Migrational Anomalies | 1088 | ||
| Congenital Infections | 1090 | ||
| Biochemical Disorders | 1090 | ||
| Radial Microbrain and Micrencephaly Vera | 1090 | ||
| Secondary Microcephaly | 1091 | ||
| Craniosynostosis | 1091 | ||
| Evaluation and Treatment of the Small Head | 1091 | ||
| The Large Head | 1092 | ||
| Macrencephaly | 1092 | ||
| Isolated Macrencephaly | 1092 | ||
| Macrencephaly and Growth Disorders | 1092 | ||
| Neurocutaneous Syndromes | 1093 | ||
| Chromosomal Disorders | 1093 | ||
| Degenerative Disorders | 1094 | ||
| Metabolic Disorders | 1094 | ||
| Enlargement of the Cerebrospinal Fluid Spaces | 1094 | ||
| Background | 1094 | ||
| Aqueductal Stenosis | 1095 | ||
| Dandy-Walker Malformation | 1096 | ||
| Chiari II Malformation | 1096 | ||
| Posthemorrhagic Hydrocephalus | 1097 | ||
| External Hydrocephalus | 1098 | ||
| Hydranencephaly | 1099 | ||
| Intracranial Cysts | 1100 | ||
| Presence or Enlargement of Other Structures | 1100 | ||
| Neoplasms | 1100 | ||
| Vascular Lesions | 1100 | ||
| Trauma | 1101 | ||
| Infection | 1101 | ||
| The Abnormally Shaped Head | 1102 | ||
| Craniosynostosis | 1102 | ||
| Nonsyndromic Craniosynostosis | 1102 | ||
| Sagittal Craniosynostosis. | 1102 | ||
| Unilateral Coronal Craniosynostosis. | 1104 | ||
| Bilateral Coronal Craniosynostosis. | 1104 | ||
| Metopic Craniosynostosis. | 1105 | ||
| Syndromic Craniosynostosis | 1105 | ||
| Crouzon Syndrome. | 1106 | ||
| Apert Syndrome. | 1106 | ||
| Pfeiffer Syndrome. | 1107 | ||
| Saethre-Chotzen Syndrome. | 1108 | ||
| Deformational Plagiocephaly | 1108 | ||
| Diagnosis | 1108 | ||
| Treatment | 1109 | ||
| References | 1109 | ||
| 65 Myelomeningocele and Related Neural Tube Defects | 1112 | ||
| Defining Anatomy | 1112 | ||
| Embryology and Pathogenesis | 1112 | ||
| Specific Types | 1112 | ||
| Clinical Expression | 1112 | ||
| Treatment | 1113 | ||
| References | 1113 | ||
| 66 Hearing Loss in the Newborn Infant | 1115 | ||
| Background | 1115 | ||
| Normal Hearing and Hearing Loss | 1115 | ||
| Tests for Hearing Loss | 1115 | ||
| Early Intervention Services | 1117 | ||
| Etiology of Hearing Loss | 1117 | ||
| Risk Factors | 1118 | ||
| Medical Workup for Hearing Loss and Care Coordination | 1119 | ||
| Middle Ear Disease | 1119 | ||
| Communication Options | 1119 | ||
| Audiologic Devices | 1119 | ||
| Hearing Aids | 1119 | ||
| Frequency Modulated Systems | 1120 | ||
| Cochlear Implants | 1120 | ||
| Continued Surveillance | 1120 | ||
| Stress and Impact on the Family | 1120 | ||
| References | 1121 | ||
| 67 Assessment and Optimization of Neurobehavioral Development in Preterm Infants | 1123 | ||
| Neurobehavioral Maturation | 1123 | ||
| Behavioral States | 1123 | ||
| Sensory Functions and Interaction | 1125 | ||
| Sensory Function and Pain | 1126 | ||
| Muscle Tone, Movements, and Reflexes | 1126 | ||
| Sucking and Swallowing | 1126 | ||
| Neurobehavioral Assessment Tools | 1126 | ||
| The Neonatal Behavioral Assessment Scale and Related Methods | 1128 | ||
| General Movements | 1128 | ||
| The Dubowitz Neurological Assessment | 1128 | ||
| Methods to Assess Sucking and Swallowing | 1130 | ||
| Techniques for Optimizing Neurodevelopment | 1130 | ||
| Antenatal Care | 1130 | ||
| Neonatal Medical Care | 1130 | ||
| Developmental Care | 1134 | ||
| NIDCAP | 1134 | ||
| Skin-to-Skin Care | 1134 | ||
| Parenting Interventions | 1135 | ||
| Acknowledgement | 1137 | ||
| References | 1137 | ||
| 68 Early Childhood Neurodevelopmental Outcomes of High-Risk Neonates | 1140 | ||
| Medical Problems | 1142 | ||
| Physical Growth | 1142 | ||
| Neurodevelopmental Outcome | 1143 | ||
| Transient Neurologic Problems | 1143 | ||
| Major Neurologic Sequelae | 1143 | ||
| Assessment of Functional Outcomes | 1145 | ||
| Timing of Follow-up Visits | 1146 | ||
| Developmental and Neurologic Testing | 1146 | ||
| Methodologic Considerations in Neurodevelopmental Outcome Studies | 1147 | ||
| School-Age Outcome | 1147 | ||
| School-Age Behavioral Problems | 1148 | ||
| Young Adult Outcomes | 1148 | ||
| Children Born at the Threshold of Viability | 1149 | ||
| Early Intervention | 1150 | ||
| References | 1150 | ||
| 69 Role of Imaging in Neurodevelopmental Outcomes of High-Risk Neonates | 1154 | ||
| Cranial Ultrasound | 1154 | ||
| Intraventricular Hemorrhage, Periventricular Hemorrhagic Infarction, and White Matter Injury | 1154 | ||
| Normal Cranial Ultrasound and Outcomes | 1155 | ||
| Potential Limitations to Interpretation: Reliability, Accuracy, and Imaging Protocols | 1155 | ||
| Magnetic Resonance Imaging | 1156 | ||
| White Matter Injury | 1156 | ||
| Areas of the Brain and Findings of Interest | 1156 | ||
| Neonatal Magnetic Resonance Imaging to Predict Early Childhood Neurodevelopmental Outcomes | 1158 | ||
| Later Childhood Outcomes and Need for Further Study | 1158 | ||
| References | 1159 | ||
| 12 The Respiratory System | 1163 | ||
| 70 Lung Development and Maturation | 1164 | ||
| A Brief History | 1164 | ||
| Lung Structural Development | 1164 | ||
| Embryonic Period | 1164 | ||
| Pseudoglandular Stage | 1164 | ||
| Canalicular Stage | 1165 | ||
| Saccular and Alveolar Stages | 1167 | ||
| Fetal Lung Fluid | 1169 | ||
| Pulmonary Hypoplasia | 1169 | ||
| Alveolar Macrophages | 1170 | ||
| Surfactant Metabolism | 1170 | ||
| Composition | 1170 | ||
| Synthesis and Secretion | 1171 | ||
| Surfactant Pool Sizes | 1172 | ||
| Alveolar Life Cycle of Surfactant | 1174 | ||
| Pulmonary Alveolar Proteinosis | 1174 | ||
| Physiologic Effects of Surfactant in the Preterm Lung | 1174 | ||
| Alveolar Stability | 1174 | ||
| Pressure-Volume Curves | 1175 | ||
| Lung Maturation and Lung Maturity Testing | 1175 | ||
| Surfactant Appearance with Development | 1175 | ||
| Induced Lung Maturation | 1177 | ||
| Glucocorticoids and Lung Maturation | 1178 | ||
| Intrauterine Infection and Lung Maturation | 1179 | ||
| References | 1180 | ||
| 71 Assessment of Neonatal Pulmonary Function | 1182 | ||
| Clinical Observations | 1182 | ||
| Respiratory Rate | 1182 | ||
| Retractions | 1182 | ||
| Nasal Flaring | 1182 | ||
| Grunting | 1182 | ||
| Cyanosis | 1183 | ||
| Cardiovascular Assessment | 1183 | ||
| Blood Gas Measurements | 1183 | ||
| Invasive Blood Gas Measurements | 1183 | ||
| Partial Pressure of Alveolar Oxygen and Carbon Dioxide | 1183 | ||
| Partial Pressure of Arterial Oxygen | 1184 | ||
| Partial Pressure of Arterial Carbon Dioxide | 1185 | ||
| Noninvasive Blood Gas Measurements | 1185 | ||
| Carbon Dioxide | 1185 | ||
| Oxygen | 1185 | ||
| Pulse Oximetry: Optimal Oxygen Saturation Target Range. | 1185 | ||
| Pulse Oximetry: Screening for Critical Congenital Heart Disease. | 1186 | ||
| Pulse Oximetry: Perfusion Index. | 1186 | ||
| Hyperoxia-Hyperventilation Test | 1186 | ||
| Evaluation of Shunting | 1186 | ||
| Respiratory Function | 1186 | ||
| Physiologic Measurements | 1187 | ||
| Airflow | 1187 | ||
| Lung Volume | 1187 | ||
| Pressure | 1188 | ||
| Respiratory Mechanics | 1188 | ||
| Compliance | 1188 | ||
| Resistance | 1190 | ||
| Time Constant | 1191 | ||
| Forced Expiratory Maneuvers | 1191 | ||
| Work of Breathing | 1192 | ||
| Limitations | 1192 | ||
| Clinical Applications | 1193 | ||
| References | 1194 | ||
| 72 Respiratory Distress Syndrome in the Neonate | 1196 | ||
| Incidence | 1196 | ||
| Pathophysiology | 1196 | ||
| Heritability of Respiratory Distress Syndrome | 1197 | ||
| Prevention: Pharmacologic Acceleration of Pulmonary Maturation | 1198 | ||
| Clinical Features | 1199 | ||
| Radiographic Findings | 1200 | ||
| Treatment | 1200 | ||
| Positive-Pressure Ventilation | 1200 | ||
| Surfactant Therapy | 1201 | ||
| Inhaled Nitric Oxide Therapy | 1203 | ||
| Assessment of Blood Gas Status | 1203 | ||
| Arterial Sampling | 1203 | ||
| Noninvasive Monitoring: Pulse Oximetry | 1204 | ||
| Noninvasive Carbon Dioxide Monitoring | 1204 | ||
| Acid-Base Therapy | 1204 | ||
| Cardiovascular Management | 1205 | ||
| Antibiotics | 1205 | ||
| Blood Transfusion | 1205 | ||
| References | 1205 | ||
| 73 Assisted Ventilation and Its Complications | 1209 | ||
| Continuous Positive Airway Pressure and Noninvasive Ventilation | 1209 | ||
| Physiology of CPAP | 1209 | ||
| Nasal Continuous Positive Airway Pressure | 1209 | ||
| Methods of Generating Continuous Positive Airway Pressure | 1210 | ||
| Flow-Driven CPAP. | 1210 | ||
| Bubble CPAP. | 1210 | ||
| Ventilator-Derived CPAP. | 1210 | ||
| Clinical Indications for CPAP in Newborns | 1210 | ||
| Practical Problems of NCPAP | 1211 | ||
| Complications of CPAP | 1211 | ||
| High-Flow Nasal Cannula | 1211 | ||
| Noninvasive Nasal Ventilation | 1211 | ||
| Clinical Indications for NIPPV | 1211 | ||
| Indications for Assisted Ventilation | 1212 | ||
| General Principles of Assisted Ventilation | 1212 | ||
| Oxygenation | 1212 | ||
| Ventilation | 1213 | ||
| Time Constant | 1213 | ||
| Classification of Mechanical Ventilators | 1214 | ||
| Control Variables (Ventilatory Modalities) | 1214 | ||
| Phase Variables (Ventilatory Modes) | 1214 | ||
| Modes of Ventilation | 1215 | ||
| Intermittent Mandatory Ventilation | 1215 | ||
| Synchronized Intermittent Mandatory Ventilation | 1215 | ||
| Assist/Control Ventilation | 1215 | ||
| Pressure Support Ventilation | 1215 | ||
| Proportional Assist Ventilation | 1216 | ||
| Pressure-Targeted Modalities | 1216 | ||
| Volume-Targeted Modalities | 1217 | ||
| Volume-Controlled Ventilation. | 1217 | ||
| Hybrid Volume-Targeted Ventilation. | 1218 | ||
| Volume Guarantee Ventilation. | 1218 | ||
| Pressure-Regulated Volume Control Ventilation. | 1219 | ||
| Volume-Assured Pressure Support Ventilation. | 1219 | ||
| Volume Support Ventilation. | 1219 | ||
| Pressure Augmentation. | 1219 | ||
| Suggested Ventilatory Management Guidelines | 1219 | ||
| Weaning Infants from Assisted Ventilation | 1220 | ||
| Weaning Strategies | 1221 | ||
| Weaning and Ventilator Modes | 1221 | ||
| SIMV and PSV | 1221 | ||
| Assessment for Extubation | 1222 | ||
| Postextubation Care | 1222 | ||
| High-Frequency Ventilation | 1222 | ||
| High-Frequency Jet Ventilation | 1222 | ||
| High-Frequency Oscillatory Ventilation | 1223 | ||
| Monitoring of Ventilated Infants | 1223 | ||
| Clinical Evaluation | 1223 | ||
| Assessment of Gas Exchange | 1223 | ||
| Blood Gases and Acid-Base Balance. | 1223 | ||
| Base Deficit. | 1224 | ||
| Capnometry or End-Tidal Carbon Dioxide Monitoring. | 1224 | ||
| Radiography and Other Chest Imaging | 1224 | ||
| Real-Time Pulmonary Graphic Monitoring | 1225 | ||
| Volume and Pressure Waveforms. | 1225 | ||
| Flow Waveform. | 1225 | ||
| Pulmonary Mechanics (Loops). | 1226 | ||
| Complications of Assisted Ventilation | 1227 | ||
| Airway | 1227 | ||
| Upper Airway | 1228 | ||
| Trachea | 1228 | ||
| Lungs | 1228 | ||
| Ventilator-Associated Pneumonia | 1228 | ||
| Air Leaks | 1229 | ||
| Ventilator-Induced Lung Injury | 1230 | ||
| Bronchopulmonary Dysplasia (Chronic Lung Disease) | 1230 | ||
| Miscellaneous Complications | 1231 | ||
| Imposed Work of Breathing | 1231 | ||
| Patent Ductus Arteriosus | 1231 | ||
| Neurologic Complications | 1231 | ||
| Intraventricular Hemorrhage and Periventricular Leukomalacia. | 1231 | ||
| Retinopathy of Prematurity | 1232 | ||
| References | 1232 | ||
| 74 Neonatal Respiratory Disorders | 1235 | ||
| Developmental Diseases | 1235 | ||
| Pulmonary Underdevelopment: Pulmonary Agenesis, Aplasia, and Hypoplasia | 1235 | ||
| Congenital Diaphragmatic Hernia | 1237 | ||
| Capillary Alveolar Dysplasia | 1239 | ||
| Congenital Pulmonary Lymphangiectasia | 1239 | ||
| Chylothorax | 1240 | ||
| Congenital Cystic Pulmonary Malformations | 1240 | ||
| Congenital Cystic Adenomatoid Malformation | 1240 | ||
| Bronchopulmonary Sequestration | 1242 | ||
| Bronchogenic Cyst | 1243 | ||
| Congenital Lobar Emphysema | 1243 | ||
| Pulmonary Arteriovenous Malformation | 1244 | ||
| Acquired Neonatal Pulmonary Diseases | 1244 | ||
| Meconium Aspiration Syndrome | 1244 | ||
| Pathophysiology | 1244 | ||
| Clinical Features | 1245 | ||
| Management | 1246 | ||
| In the Delivery Room. | 1246 | ||
| In the Neonatal Intensive Care Unit. | 1247 | ||
| Other Aspiration Syndromes | 1247 | ||
| Neonatal Pneumonia | 1248 | ||
| Etiology | 1248 | ||
| Clinical Presentation | 1248 | ||
| Management | 1249 | ||
| Transient Tachypnea of the Newborn | 1249 | ||
| Pulmonary Hemorrhage | 1250 | ||
| Pulmonary Air Leak Syndromes | 1251 | ||
| Pathophysiology | 1251 | ||
| Clinical Presentation | 1251 | ||
| Diagnosis | 1252 | ||
| Management | 1253 | ||
| Rib Cage Abnormalities | 1254 | ||
| Asphyxiating Thoracic Dystrophy (Jeune Syndrome) | 1254 | ||
| Thanatophoric Dwarfism | 1254 | ||
| Phrenic Nerve Injury | 1255 | ||
| Acknowledgment | 1255 | ||
| References | 1255 | ||
| 75 Neonatal Apnea and the Foundation of Respiratory Control | 1259 | ||
| Fetal Breathing | 1259 | ||
| Postnatal Development of Respiratory Control | 1259 | ||
| Neonatal Breathing Pattern | 1259 | ||
| Hypercapnia and Acidosis | 1260 | ||
| Hypoxia | 1260 | ||
| Laryngeal and Pulmonary Afferent Reflexes | 1260 | ||
| Neurotransmitters and Neuromodulators | 1261 | ||
| Neonatal Apnea | 1262 | ||
| Definition and Epidemiology | 1262 | ||
| Pathogenesis | 1262 | ||
| Clinical Associations | 1264 | ||
| Gastroesophageal Reflux and Neonatal Apnea | 1265 | ||
| Treatment | 1265 | ||
| Continuous Positive Airway Pressure | 1265 | ||
| Xanthine Therapy | 1266 | ||
| Other Therapeutic Approaches | 1266 | ||
| Resolution and Consequences of Apnea of Prematurity | 1266 | ||
| Apnea and Sudden Infant Death Syndrome | 1267 | ||
| Acknowledgment | 1268 | ||
| References | 1268 | ||
| 76 Upper Airway Lesions in the Neonate | 1269 | ||
| Nasal and Nasopharyngeal Lesions | 1269 | ||
| Pyriform Aperture Stenosis | 1269 | ||
| Nasolacrimal Duct Cysts | 1269 | ||
| Choanal Atresia | 1269 | ||
| Intranasal Tumors | 1270 | ||
| Mucosal Obstruction | 1270 | ||
| Continuous Positive Airway Pressure Trauma | 1270 | ||
| Oral and Oropharyngeal Lesions | 1270 | ||
| Lymphatic Malformations | 1271 | ||
| Tongue Cysts | 1271 | ||
| Laryngeal Lesions | 1272 | ||
| Laryngomalacia | 1273 | ||
| Bifid or Absent Epiglottis | 1273 | ||
| Laryngeal Cysts | 1273 | ||
| Vocal Cord Paralysis | 1274 | ||
| Laryngeal Web | 1275 | ||
| Congenital Subglottic Stenosis | 1275 | ||
| Subglottic Hemangioma | 1275 | ||
| Laryngeal Cleft | 1276 | ||
| Congenital High Airway Obstruction Syndrome | 1276 | ||
| Intubation Trauma | 1276 | ||
| Conclusion | 1277 | ||
| References | 1277 | ||
| 77 Bronchopulmonary Dysplasia in the Neonate | 1279 | ||
| Clinical Presentation | 1279 | ||
| Pathology | 1281 | ||
| Pathogenesis | 1282 | ||
| Prematurity | 1282 | ||
| Mechanical Trauma | 1282 | ||
| Oxygen Toxicity | 1282 | ||
| Infection and Inflammation | 1283 | ||
| Pulmonary Edema and Patent Ductus Arteriosus | 1283 | ||
| Airway Damage | 1284 | ||
| Other Factors | 1284 | ||
| Prediction of Bronchopulmonary Dysplasia | 1284 | ||
| Pulmonary Function | 1284 | ||
| Management | 1285 | ||
| Respiratory Support | 1285 | ||
| Fluid Management | 1286 | ||
| Bronchodilator Therapy | 1286 | ||
| Nutrition | 1286 | ||
| Control of Infection | 1287 | ||
| Corticosteroids | 1287 | ||
| Pulmonary Vasodilators | 1288 | ||
| Infant Stimulation | 1288 | ||
| Parental Support | 1288 | ||
| Outcome | 1288 | ||
| Prevention | 1289 | ||
| References | 1289 | ||
| 78 Therapy for Cardiorespiratory Failure in the Neonate | 1292 | ||
| Extracorporeal Membrane Oxygenation | 1292 | ||
| Basic Techniques | 1292 | ||
| Venovenous Extracorporeal Membrane Oxygenation | 1294 | ||
| Personnel Needs | 1294 | ||
| Criteria for Patient Selection | 1294 | ||
| Gestational Age of 34 Weeks or Older | 1294 | ||
| No Major Intracranial Hemorrhage | 1295 | ||
| Absence of Complex Congenital Heart Disease | 1295 | ||
| Less than 10 to 14 Days of Assisted Ventilation | 1295 | ||
| Reversible Lung Disease | 1295 | ||
| The Dilemma of Congenital Diaphragmatic Hernia | 1295 | ||
| Failure of Maximal Medical Therapy | 1298 | ||
| Extracorporeal Membrane Oxygenation Referral | 1299 | ||
| Extracorporeal Membrane Oxygenation Follow-Up | 1300 | ||
| Cost Analysis | 1301 | ||
| Alternative Uses for Extracorporeal Membrane Oxygenation | 1301 | ||
| Extracorporeal Membrane Oxygenation Present and Future | 1301 | ||
| Nitric Oxide Therapy | 1301 | ||
| Physiology and Pharmacology | 1302 | ||
| Nitric Oxide Toxicity | 1303 | ||
| Neonatal Studies of Inhaled Nitric Oxide | 1303 | ||
| Term Infants | 1303 | ||
| Premature Infants | 1304 | ||
| Alternative Treatments and Avenues for Future Research | 1305 | ||
| References | 1306 | ||
| 13 The Cardiovascular System | 1309 | ||
| 79 Cardiac Embryology | 1310 | ||
| Overview of Normal Heart Development | 1310 | ||
| Scientific Basis of Cardiogenesis | 1313 | ||
| Precardiac to Cardiac Tissues: Commitment and Formation of Primary Axes | 1313 | ||
| The Tubular and Looping Heart | 1313 | ||
| Septation | 1314 | ||
| Endocardial Development: Formation of Cushion Tissue | 1314 | ||
| Neural Crest Contribution to Cardiogenesis | 1314 | ||
| Development of the Cardiac Conduction System | 1315 | ||
| Epicardium | 1316 | ||
| Lymphatics | 1316 | ||
| Cell Division and Cell Death | 1317 | ||
| Human Genetics | 1317 | ||
| Therapy | 1317 | ||
| References | 1318 | ||
| 80 Pulmonary Vascular Development | 1320 | ||
| Fetal Pulmonary Vascular Development | 1320 | ||
| Structural Development | 1320 | ||
| Mediators of Fetal Pulmonary Vascular Tone | 1321 | ||
| Pulmonary Vascular Transition | 1321 | ||
| Vasoactive Mediators of the Pulmonary Vascular Transition | 1322 | ||
| Abnormalities of Pulmonary Vascular Development | 1323 | ||
| Persistent Pulmonary Hypertension of the Newborn | 1323 | ||
| Congenital Diaphragmatic Hernia | 1325 | ||
| Alveolar Capillary Dysplasia | 1325 | ||
| Bronchopulmonary Dysplasia | 1326 | ||
| Clinical Therapy of Persistent Pulmonary Hypertension of the Newborn | 1327 | ||
| General Care | 1327 | ||
| Pulmonary Vasodilator Therapy | 1327 | ||
| Prostanoids | 1328 | ||
| Milrinone | 1328 | ||
| Endothelin Receptor Antagonists | 1328 | ||
| Outcome and Follow-Up | 1328 | ||
| Neurodevelopmental Sequelae | 1328 | ||
| References | 1328 | ||
| 81 Genetic and Environmental Contributions to Congenital Heart Disease | 1332 | ||
| Chromosomal Defects | 1332 | ||
| Genomic Defects | 1332 | ||
| Single Gene Defects | 1333 | ||
| Environmental Toxins | 1334 | ||
| Maternal Diseases | 1334 | ||
| Influence of Genetics, Gender, and Race | 1334 | ||
| Major Associated Noncardiac Defects | 1335 | ||
| Acknowledgment | 1335 | ||
| References | 1335 | ||
| 82 Prenatal Diagnosis of Congenital Heart Disease | 1337 | ||
| Historical Perspective | 1337 | ||
| Overview of Fetal Circulation and Cardiac Adaptation at Birth | 1337 | ||
| Indications for Fetal Echocardiogram | 1338 | ||
| Performance of a Fetal Echocardiogram | 1338 | ||
| Fetal Pathology | 1341 | ||
| Impact of Prenatal Diagnosis | 1342 | ||
| Fetal Therapies | 1342 | ||
| Novel Approaches to Prenatal Diagnosis of Congenital Heart Disease | 1343 | ||
| References | 1343 | ||
| 83 Patent Ductus Arteriosus | 1345 | ||
| Pathogenesis | 1345 | ||
| Pathophysiology | 1346 | ||
| Clinical Presentation | 1346 | ||
| Diagnostic Evaluation | 1347 | ||
| Management | 1347 | ||
| References | 1349 | ||
| 84 Congenital Defects of the Cardiovascular System | 1352 | ||
| Cyanotic Heart Defects: Poor Mixing | 1352 | ||
| d-Transposition of the Great Arteries | 1352 | ||
| Anatomy and Pathophysiology | 1352 | ||
| Associated Defects | 1352 | ||
| Clinical Presentation | 1352 | ||
| Laboratory Evaluation | 1352 | ||
| Management and Prognosis | 1352 | ||
| History. | 1353 | ||
| Arterial Switch Operation. | 1353 | ||
| Cyanotic Defects: Restricted Pulmonary Blood Flow | 1353 | ||
| Tetralogy of Fallot | 1353 | ||
| Anatomy and Pathophysiology | 1353 | ||
| Associated Defects | 1353 | ||
| Clinical Presentation | 1353 | ||
| Laboratory Evaluation | 1354 | ||
| Management and Prognosis | 1354 | ||
| Tricuspid Atresia | 1354 | ||
| Anatomy and Pathophysiology | 1354 | ||
| Associated Defects | 1354 | ||
| Clinical Presentation | 1354 |