Advances In Perinatal Medicine

The state of health care isreflected by perinatal and neonatal morbidity and mortality as weIl as by the frequencies of long-term neurological and developmental disorders. Many factors, some without immediately recognizable significance to childbearing and many still unknown, undoubtedly contribute beneficially or adversely to the outcome of pregnancy. Knowledge concerning the impact of such factors on the fetus and survivinginfant iscritical. Confounding analysesofpregnancy outcome, especially these past 2 or 3 decades, are the effects of newly undertaken invasive or inactive therapeutic approaches coupled with the advent of high technology. Many innovations have been introduced without serious efforts to evaluate their impact prospectively and objectively. The consequences of therapeutic misadventures character ized the past; it seems they have been replaced to a degree by some of the complications of applied technology. Examples abound: after overuse of oxygen was recognized to cause retrolental fibroplasia, its restriction led to an increase in both neonatal death rates and neurologic damage in surviving infants. Administration of vitamin K to prevent neonatal hemorrhagic disease, particularly when given in what we now know as excessive dosage, occasionally resulted in kernicterus. Prophy lactic sulfonamide use had a similar end result. More recent is the observation of bronchopulmonary dysplasia as a complication of re spirator therapy for hyaline membrane disease. The decade of the eighties opened with the all-time highest rate of cesarean section in the United States.

The state of health care is reflected by perinatal and neonatal morbidity and mortality as well as by the frequencies of long-term neurologic and developmental disorders. Many factors, some without immediately rec ognizable significance to childbearing and many still unknown, undoubt edly contribute beneficially or adversely to the outcome of pregnancy. Knowledge concerning the impact of such factors on the fetus and sur viving infant is critical. Confounding analyses of pregnancy outcome, especially these past two or three decades, are the effects of newly un dertaken invasive or inactive therapeutic approaches coupled with the advent of high technology. Many innovations have been introduced with out serious efforts to evaluate their impact prospectively and objectively. The consequences of therapeutic misadventures characterized the past; it seems they have been replaced to a degree by some of the complications of applied technology. Examples abound: after overuse of oxygen was recognized to cause retrolental fibroplasia, its restriction led to an in crease in both neonatal death rates and neurologic damage in surviving infants. Administration of vitamin K to prevent neonatal hemorrhagic disease, particularly when given in what we now know as excessive dos age, occasionally resulted in kernicterus. Prophylactic sulfonamide use had a similar end result. More recent is the observation of bronchopul monary dysplasia as a complication of respirator therapy for hyaline membrane disease.

This is a large, all-inclusive reference volume of 67 chapters documenting the very latest experimental and clinical advances in perinatal medicine by world-class experts in the field. It covers fetal anomalies, intrauterine growth and parturition, maternal and infant nutrition, the very low birthweight infant, ultrasound for fetal and neonatal assessment, environmental influences on the embryo and fetus, maternal disease and pregnancy outcome, pre- and perinatal diagnosis and management of inherited metabolic diseases, protection of the fetal/infant brain, investigation and treatment and outcome for fetal abnormalities, perinatal nursing care and perinatal transport, perinatal medicine and professional education in Europe, perinatal cardiorespiratory support, ethics and audit and medicolegal aspects of perinatal practice in Europe, prevention of preterm deliveries, fetal and in-fant learning and behavior, biotechnology and perinatal research, surfactant replacement therapy, and matters of special controversy. Includes bibliographic references and index.

The state of health care isreflected by perinatal and neonatal morbidity and mortality as weIl as by the frequencies of long-term neurological and developmental disorders. Many factors, some without immediately recognizable significance to childbearing and many still unknown, undoubtedly contribute beneficially or adversely to the outcome of pregnancy. Knowledge concerning the impact of such factors on the fetus and survivinginfant iscritical. Confounding analysesofpregnancy outcome, especially these past 2 or 3 decades, are the effects of newly undertaken invasive or inactive therapeutic approaches coupled with the advent of high technology. Many innovations have been introduced without serious efforts to evaluate their impact prospectively and objectively. The consequences of therapeutic misadventures character ized the past; it seems they have been replaced to a degree by some of the complications of applied technology. Examples abound: after overuse of oxygen was recognized to cause retrolental fibroplasia, its restriction led to an increase in both neonatal death rates and neurologic damage in surviving infants. Administration of vitamin K to prevent neonatal hemorrhagic disease, particularly when given in what we now know as excessive dosage, occasionally resulted in kernicterus. Prophy lactic sulfonamide use had a similar end result. More recent is the observation of bronchopulmonary dysplasia as a complication of re spirator therapy for hyaline membrane disease. The decade of the eighties opened with the all-time highest rate of cesarean section in the United States.