Fanaroff and Martin's Neonatal-Perinatal Medicine E-Book: Diseases of the Fetus and Infant (Current Therapy in Neonatal-Perinatal Medicine)

Trusted by physicians and advanced practice providers through ten standard-setting editions, Fanaroff and Martin's Neonatal-Perinatal Medicine, 11th Edition, remains the reference of choice for expert, multidisciplinary guidance on the management and evidence-based treatment of problems in the mother, fetus, and neonate. An expanded team of international authors, led by Drs. Richard J. Martin, Avroy A. Fanaroff, and Michele C. Walsh of Rainbow Babies and Children's Hospital, brings you up to date with advances in the control of nosocomial infections in preterm infants, genetic disorders and birth defects, the fetal origins of adult disease, the late preterm infants, and much more - all designed to help you improve the quality of life and long-term outcomes of your patients. Key Features Helps you make informed clinical choices for each patient - from diagnosis and treatment selection through post-treatment strategies and management of complications - with a dual focus on neonatology and perinatology. Includes a new chapter on Social and Economic Contributors to Neonatal Outcome. Features extensive updates and reorganization throughout, with new Key Points at the end of each chapter Provides up-to-date, evidence-based content, with more information on precision medicine and genetics. Uses detailed, full-color illustrations that depict disorders in the clinical setting and explain complex information. Offers indexing in both volumes that provides quick access to specific guidance. Remains the most comprehensive, multidisciplinary text in the field - an excellent source of information for every stage of your practice. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices. Author Information By Richard J. Martin, MBBS, FRACP, Professor, Pediatrics, Reproductive Biology, and Physiology and Biophysics, Case Western Reserve University School of Medicine; Drusinsky/Fanaroff Chair in Neonatology, Rainbow Babies and Children's Hospital, Cleveland, Ohio; Avroy A. Fanaroff, MB, FRCPE, FRCPCH, Emeritus Professor, Pediatrics and Reproductive Biology, Case Western Reserve University School of Medicine; Emeritus Eliza Henry Barnes Chair in Neonatology, Rainbow Babies and Children's Hospital, Cleveland, Ohio and Michele C. Walsh, MD, MSE, Professor, Pediatrics, Case Western Reserve University School of Medicine; William and Lois Briggs Chair in Neonatology, Chief, Divisions of Neonatology, Rainbow Babies and Children's Hospital, Cleveland, Ohio cover......Page 1 Fanaroff and Martin's Neonatal-Perinatal Medicine, 2-Volume Set......Page 2 Copyright Page......Page 4 Dedication......Page 5 content......Page 6 Contributors......Page 7 Preface......Page 20 The High-Risk Fetus and Perinatal Obstetrics......Page 21 Keywords......Page 22 Midwives and Perinatal Care......Page 24 An Ingenious Contrivance, the Couveuse, and Premature Baby Stations......Page 26 Incubators, Baby Shows, and Origins of Neonatal Intensive Care Units......Page 27 Supportive Care and Oxygen Therapy......Page 28 Supportive Care: Intravenous Fluid and Blood Transfusions......Page 30 Medical Errors and “Patient Safety” as a New Discipline......Page 32 Some Famous High-Risk Infants......Page 33 Acknowledgment......Page 34 References......Page 35 Health Statistics and Data Sources......Page 38 Keywords......Page 39 Birth Data......Page 40 Infant Deaths......Page 41 Prematurity and Low Birth Weight......Page 42 References......Page 45 3 Medical Ethics in Neonatal Care......Page 46 Keywords......Page 47 Autonomy......Page 48 Nonmaleficence......Page 49 Communication With Parents......Page 50 Family-Centered Neonatal Intensive Care......Page 52 Refusal of Treatment During Pregnancy......Page 53 Prenatal Consultation at the Limits of Viability......Page 54 Withholding and Withdrawing Life-Sustaining Medical Treatment in the Neonatal Intensive Care Unit......Page 57 Collaborative, Procedural Framework for End-of-Life Decision Making......Page 58 Donation After Cardiac Death......Page 59 Palliative Care in the Neonatal Intensive Care Unit......Page 60 Conflict Resolution When Consensus Cannot Be Reached......Page 61 Ethics of Research in the Neonatal Intensive Care Unit......Page 62 References......Page 64 Disclaimer......Page 69 Keywords......Page 70 State Law and Federal Law......Page 71 Residents and Fellows......Page 72 Malpractice......Page 73 Telephone Advice......Page 74 Standard of Care......Page 75 Role of the Expert Witness......Page 76 Damages......Page 77 Wrongful Birth......Page 78 Strategies for Avoiding Tort Litigation......Page 79 Trends in Malpractice Legislation......Page 80 Born-Alive Infants Protection Act......Page 81 Baby Doe......Page 82 Baby K......Page 83 Conclusions......Page 84 Miller Case......Page 85 Conclusions......Page 86 Summary......Page 87 References......Page 88 The Case for Improvement......Page 90 Keywords......Page 91 Brief History of Industrial Quality Improvement......Page 94 Batalden: Five Knowledge Systems......Page 97 Model for Improvement......Page 98 Lean......Page 99 Structure and Institutional Context......Page 100 Processes......Page 101 Assessing the Total Impact of a Quality Improvement Initiative......Page 102 Risk Adjustment/Fair Comparisons......Page 103 Data Sources......Page 105 Administrative Data......Page 106 Clinical Data......Page 107 Quality Measurement and Improvement......Page 108 Data for Selection......Page 109 Data for Improvement......Page 110 Global Assessments of Perinatal Quality: The Baby-MONITOR......Page 113 Local Quality Improvement Applied: An Example......Page 115 Sustainability......Page 116 Quality Improvement Research......Page 118 Conclusion......Page 120 References......Page 121 Introduction......Page 126 Keywords......Page 127 Simulation-Based Training in Health Care......Page 128 Simulation-Based Training in Neonatal-Perinatal Medicine......Page 130 Debriefing Simulated Events......Page 132 Simulation-Based Assessment......Page 133 Simulation as the Basis of Clinical Care......Page 134 References......Page 135 Asking a Focused Clinical Question......Page 138 Keywords......Page 139 Primary Reports......Page 140 Critically Appraising Evidence for Its Validity......Page 141 Applying the Results to Patient Care......Page 142 Promoting Evidence-Based Clinical Practice......Page 143 References......Page 144 Historical Perspective......Page 146 Keywords......Page 147 Tracking the Global Progress of the Sustainable Development Goals......Page 149 Neonatal and Infant Mortality......Page 150 Causes of Global Maternal and Neonatal Mortality......Page 151 Socioeconomic and Cultural Factors......Page 153 Medical Causes of Neonatal Mortality Rate......Page 154 Birth Asphyxia......Page 155 Hypothermia......Page 156 Burden of Neonatal Sepsis......Page 157 Evidence-Based Interventions to Reduce Maternal Mortality Rates, Neonatal Mortality Rates, and Infant Mortality Rates......Page 158 The Burden of the High Cost of Advanced Neonatal Care......Page 160 Ethical Dilemmas......Page 161 Summary......Page 162 References......Page 163 Infant Mortality......Page 167 Keywords......Page 168 Determinants of Prematurity and Adverse Outcomes......Page 171 Social Determinants of Health......Page 172 Interventions to Reduce Neonatal Health Outcome Disparities......Page 174 References......Page 177 Abnormalities of Chromosome Number......Page 180 Keywords......Page 181 Aneuploidy......Page 182 Single-Gene Disorders......Page 183 Autosomal Dominant Disorders......Page 184 Sex-Linked Disorders......Page 185 Epigenetics and Uniparental Disomy......Page 186 Multifactorial Inheritance......Page 187 Congenital Anomalies and Ultrasonography......Page 188 Cell Free DNA Screening......Page 191 Microdeletions......Page 192 Carrier Screening for Cystic Fibrosis......Page 193 Diagnostic Modalities......Page 194 Amniocentesis......Page 195 Microarray Technology......Page 196 Future Directions for Prenatal Diagnostic Testing......Page 197 Genetic Evaluation and Counseling......Page 198 References......Page 199 Fetal Imaging Techniques......Page 201 Keywords......Page 202 Bioeffects and Safety......Page 204 Ethical Considerations......Page 205 A. First-Trimester Examination......Page 206 Genetic Screening......Page 207 Assisted Reproduction......Page 209 Multiple Gestations......Page 210 Pregnancy Evaluation......Page 212 Placental Abnormalities......Page 213 Placental Location......Page 214 Amniotic Fluid Volume......Page 215 Cervical Length and Pelvic Structures......Page 216 Second-Trimester Ultrasound Study of the Fetus......Page 217 Doppler Ultrasound......Page 218 Fetal Well-Being Assessment......Page 219 Fetal Ventriculomegaly......Page 220 Meningomyelocele and (Type II) Chiari Malformation......Page 221 Anencephaly......Page 222 Dandy-Walker Malformation......Page 223 Spine......Page 224 Head and Neck......Page 225 Heart......Page 226 Normal Bowel Appearance......Page 227 Diaphragmatic Hernia and Thoracic Lesions......Page 228 Gallbladder and Bile Ducts......Page 230 Genitourinary Tract......Page 231 Musculoskeletal System......Page 234 Two-Vessel Umbilical Cord......Page 235 References......Page 236 Indications for Surveillance......Page 238 Keywords......Page 239 Non-Stress Test......Page 240 Biophysical Profile......Page 241 Interpretation of Test Results......Page 242 Intrapartum Oxygenation and Neurologic Morbidity......Page 243 Continuous Versus Intermittent Fetal Heart Rate Monitoring......Page 244 Fetal Heart Rate Variability......Page 245 Decelerations......Page 246 Interpretative Systems for Classification of Fetal Heart Rate Patterns......Page 248 Management of Non–Category I FHR Patterns During Labor......Page 249 References......Page 251 Fetoscopic Surgery......Page 252 Keywords......Page 253 Anesthetic Considerations......Page 254 Congenital Diaphragmatic Hernia......Page 255 Fetal Hydrothorax......Page 257 Amniotic Bands......Page 258 Sacrococcygeal Teratoma......Page 259 Fetal Neck Mass......Page 260 Hydronephrosis......Page 261 Twin–Twin Transfusion Syndrome......Page 262 Selective Fetal Reduction......Page 263 Key Points......Page 264 References......Page 265 The Epigenome......Page 269 Keywords......Page 270 Paternal Exposures......Page 273 Secondary Fetal Exposure: Maternal Body Burden......Page 274 Occupation and Paraoccupation......Page 275 Diet......Page 276 Heat......Page 277 Metabolism......Page 278 Toxic Effects......Page 279 Toxic Effects......Page 280 Pesticides......Page 281 Prevention Strategies......Page 282 Toxic Effects......Page 283 Sources of Exposure......Page 284 Toxic Effects......Page 285 Key Points......Page 286 References......Page 287 Classification of IUGR......Page 291 Keywords......Page 292 Etiology of IUGR......Page 293 Maternal Etiologies......Page 294 Pathophysiology......Page 295 Antenatal Screening and Prenatal Management......Page 296 Postnatal Diagnosis of IUGR......Page 298 Hypoglycemia......Page 299 Necrotizing Enterocolitis......Page 300 Seizures, Intraventricular Hemorrhage......Page 301 Conclusions......Page 302 References......Page 303 Influences on the Early Embryo......Page 306 Keywords......Page 307 Postnatal Growth and Nutrition......Page 308 Mismatch Concept......Page 309 Fetal Origins of Vascular Structural Abnormalities and Dysfunction in Adult Cardiometabolic Disease......Page 310 Psychosocial Aspects......Page 313 Epigenetics......Page 314 Key Points......Page 316 References......Page 317 Preeclampsia......Page 319 Keywords......Page 320 Short Term......Page 322 Pregnancy-Specific Characteristics......Page 323 Angiogenic Factors......Page 324 Endothelial Dysfunction......Page 325 Initial Evaluation......Page 326 Antihypertensive Therapy......Page 327 Timing of Delivery......Page 328 Mode of Delivery......Page 329 Chronic Hypertension......Page 330 Superimposed Preeclampsia......Page 331 Prediction......Page 332 Key Points......Page 333 References......Page 334 Screening and Diagnosis......Page 336 Keywords......Page 337 Antenatal Management......Page 338 Screening for Congenital Anomalies......Page 339 Assessment of Fetal Weight......Page 340 Implications for the Neonate......Page 341 References......Page 343 Prematurity......Page 345 Keywords......Page 346 Pathogenesis......Page 349 Demographics......Page 351 Bleeding......Page 352 Infection......Page 353 Predicting Preterm Labor......Page 354 Biochemical Predictors......Page 355 Prevention......Page 356 Bed Rest......Page 357 Progesterone......Page 358 Cerclage......Page 359 Ritodrine......Page 361 Terbutaline......Page 362 Magnesium Sulfate......Page 363 Prostaglandin Synthetase Inhibitors......Page 364 Indomethacin......Page 365 Calcium Channel Blockers......Page 366 Oxytocin Antagonists......Page 367 Nitric Oxide Donors......Page 368 Antibiotics......Page 369 Corticosteroids......Page 370 Additional Interventions......Page 372 Key Points......Page 373 References......Page 374 Immune Thrombocytopenic Purpura......Page 380 Keywords......Page 381 Management of a Subsequent Pregnancy......Page 383 Fetal-Neonatal Consequences of Maternal Antinuclear Antibodies......Page 385 Fetal-Neonatal Consequences of Maternal Antiphospholipid Antibodies......Page 386 Herpes Gestationis......Page 387 References......Page 388 Biology......Page 390 Keywords......Page 391 Maternal Consequences......Page 392 Malformations......Page 393 Complications of the Monochorionic Placenta......Page 394 Fetal Growth......Page 395 Mortality......Page 396 Outcome......Page 397 References......Page 398 Risks of Post-Term Pregnancy......Page 400 Keywords......Page 401 Dysmaturity......Page 402 Should Labor Be Induced Before 42 Weeks?......Page 403 How Should Labor Be Induced?......Page 404 Post-Term Twin Pregnancies......Page 405 References......Page 406 Genetics of the Rh System......Page 408 Keywords......Page 409 Pathophysiology of Rh-D Isoimmunization......Page 410 Prevention......Page 411 Rh Alloimmunization......Page 412 Prediction of Anemia......Page 413 Intravascular Transfusion......Page 414 Timing of Delivery......Page 415 Atypical Antigens......Page 416 Differential Diagnosis/Etiology......Page 417 Antepartum Evaluation......Page 418 Management......Page 419 Prognosis......Page 420 References......Page 421 Production and Regulation......Page 424 Keywords......Page 425 Measurement of Amniotic Fluid Volume......Page 426 Amniotic Fluid Index Measurement......Page 427 Normal Volume and the Singleton Pregnancy......Page 428 Twins and Amniotic Fluid......Page 429 Oligohydramnios......Page 431 Etiology......Page 432 Assess Fetal Anatomy......Page 433 Assess Fetal Pulmonary Status......Page 434 Treatment......Page 435 Tissue Sealants......Page 436 Assess Fetal Anatomy......Page 437 Amnioreduction......Page 438 Key Points......Page 439 References......Page 440 Risk Factors......Page 443 Keywords......Page 444 Diagnosis......Page 446 Obstetric Management......Page 449 Outcomes......Page 450 Areas for Future Investigation......Page 451 References......Page 452 Overview......Page 455 Keywords......Page 456 Inflammatory and Infectious Lesions......Page 459 Developmental and Structural Lesions......Page 460 Clinical Correlation......Page 461 References......Page 462 Techniques That Modify Pain......Page 464 Keywords......Page 465 Water Birth......Page 466 Pharmacokinetics, Pharmacodynamics, and the Fetus......Page 467 Sedatives......Page 468 Opioid Agonists......Page 469 Nitrous Oxide......Page 470 Techniques......Page 471 Combined Spinal-Epidurals (CSE)......Page 472 Maternal Risks......Page 473 Maternal Temperature Elevation......Page 474 Fetal Heart Rate......Page 475 Cesarean Section......Page 476 General Anesthesia......Page 477 References......Page 478 Measurements......Page 481 Keywords......Page 482 Syndromes......Page 483 Skin......Page 484 Eyes......Page 485 Breathing and Chest......Page 486 Abdomen......Page 487 Limbs and Hands and Feet......Page 488 Hips......Page 489 Detailed Neurologic Assessment......Page 490 Cranial Nerves......Page 491 Motor Function......Page 492 Behavioral Evaluation......Page 493 The Premature Infant......Page 494 Congenital Heart Disease......Page 496 Discharge......Page 497 References......Page 498 Petechiae......Page 500 Keywords......Page 501 Pathology......Page 502 Etiology......Page 503 Treatment......Page 504 Mechanism of Injury......Page 505 Etiology......Page 506 Intracranial Hemorrhage......Page 507 Fractures and Dislocations of Facial Bones......Page 508 Eyelids......Page 509 Optic Nerve......Page 510 Lacerations......Page 511 Fracture of the Clavicle......Page 512 Prognosis......Page 513 Clinical Manifestations......Page 514 Treatment......Page 515 Radiographic Manifestations......Page 516 Prognosis......Page 517 Treatment......Page 518 Clinical Manifestations......Page 519 Treatment......Page 520 Differential Diagnosis......Page 521 Radiographic Manifestations......Page 522 Clinical Manifestations......Page 523 Prognosis......Page 524 Dislocations......Page 525 Management......Page 526 Scrotum and Labia Majora......Page 527 Injuries Related to Trauma During Pregnancy......Page 528 References......Page 529 General Clinical Approach......Page 532 Keywords......Page 533 Complex or Multifactorial......Page 534 Chromosomal......Page 535 Environmental Exposure and Teratogens......Page 536 Anomalies in Aborted Fetuses......Page 537 Racial and Ethnic Differences......Page 538 Patient and Family History......Page 539 Head......Page 540 Face......Page 541 Eyes......Page 542 Ears......Page 543 Nose......Page 544 Mouth......Page 545 Chest......Page 546 Extremities......Page 547 Evaluation of the Stillborn......Page 550 Genetic Laboratory Studies......Page 551 Educational Resources and Support Organizations......Page 554 References......Page 555 Fetus......Page 558 Keywords......Page 559 Transition at Birth......Page 560 Causes of Depression and Asphyxia......Page 562 Response to Asphyxia......Page 563 Preparation for Resuscitation......Page 564 Adequate Personnel......Page 565 Elements of a Resuscitation......Page 566 Initial Quick Overview......Page 567 Initial Steps......Page 568 Free-Flow Oxygen......Page 569 References......Page 570 Delayed Transition and Need for Respiratory Support......Page 573 Keywords......Page 574 Basics of Positive Pressure Support......Page 575 Self-Inflating Bags (SIB)......Page 576 Other Options for Providing Positive Pressure......Page 577 Single Nasal Tube and Bi-Nasal Prongs......Page 578 Endotracheal Tube......Page 579 Intubation Procedure......Page 580 Applying Positive Pressure Support......Page 581 Positive End Expiratory Pressure......Page 582 References......Page 583 Oxidative Stress: Pathophysiologic Background......Page 587 Keywords......Page 588 Room Air versus Pure Oxygen for Resuscitation of the Newborn......Page 590 Clinical Data......Page 591 Oxygen Supplementation in the Delivery Room in Extremely Low Gestational Age Neonates......Page 592 Room Air versus 100% Oxygen— or Something Else......Page 593 References......Page 594 Importance of Effective Ventilation......Page 597 Keywords......Page 598 Chest Compressions......Page 599 Volume......Page 601 When to Discontinue Resuscitation Efforts......Page 602 Sodium Bicarbonate......Page 603 Fluids......Page 604 Meconium Aspiration......Page 605 Erythroblastosis and Hydrops Fetalis......Page 606 Key Points......Page 607 References......Page 608 Evaporative Heat Loss Is Related to Infant Maturity and Ambient Humidity......Page 611 Keywords......Page 612 The Fetal Thermal Equilibrium......Page 613 Neonatal Thermoregulation......Page 614 Thermoneutrality......Page 615 What Temperature Should Be Aimed for?......Page 616 Incubator Humidification......Page 617 Phototherapy......Page 618 Very (28-31 Weeks) and Extremely (