Neonatology at a Glance, Third by Lissauer, Tom -- Read -- Imperial Library of Trantor

Index

Cover Title page Table of Contents Preface Contributors How to use this textbook About the companion website 1 Milestones in neonatology

Thermal regulation Nutrition Rhesus hemolytic disease Antibiotics Respiratory distress syndrome (RDS) Development of neonatal intensive care Challenges for the future

2 Epidemiology

Births Maternal mortality Perinatal mortality Neonatal mortality Epidemiologic data collection Infant mortality

3 Perinatal medicine

Neonatal involvement in perinatal care Neonatal Networks

4 Prepregnancy care, prenatal screening and fetal medicine

Fetal medicine

5 Maternal medical conditions

Diabetes mellitus Type 2 and gestational diabetes Maternal red blood cell alloimmunization Perinatal alloimmune thrombocytopenia

6 Intrauterine growth restriction

Definition Etiology Pathophysiology Management

7 Multiple births

Pregnancy complications Neonatal complications

8 Preterm delivery

Causes Epidemiological risk factors Prevention Management Delivery

9 Birth defects and genetic disorders

Chromosomal disorders

10 Maternal drugs affecting the fetus and newborn infant

Neonatal withdrawal (abstinence) syndrome Medicines

11 Congenital infection

Clinical features Congenital cytomegalovirus (CMV) infection Congenital toxoplasmosis Rubella Congenital syphilis Varicella: chickenpox, varicella zoster virus (VZV) infection Parvovirus B19

12 Adaptation to extrauterine life

Physiologic changes in fetal–neonatal transition Abnormal transition from fetal to extrauterine life The Apgar score Asphyxia

13 Neonatal resuscitation and post-resuscitation care

Preparation Cord clamping Temperature control Initial assessment at birth A – Airway B – Breathing Endotracheal intubation (see Chapter 74) C – Circulation Drugs (Table 13.1) Withholding and discontinuing resuscitation Post-resuscitation care in the delivery room

14 Hypoxic–ischemic encephalopathy

Pathogenic mechanisms Compensatory mechanisms Primary and delayed injury Clinical manifestations Clinical staging of hypoxic–ischemic encephalopathy Outcome

15 Birth injuries

Common or important birth injuries

16 Routine care of the newborn infant

Screening Health promotion Discharge

17 Routine examination of the newborn infant

Preparation The infant Routine examination of newborn infants

18 Neurologic examination

States of alertness Visual fixing and following Hearing Consolability Head circumference Face (cranial nerves) Posture and spontaneous motor activity

19 Care and support for parents

Communicating with parents

20 Feeding

Nutritional characteristics of human milk compared with unmodified cow’s milk Formula

21 Minor abnormalities in the first few days 22 Common problems of term infants

Anticipation Overview of common medical problems

23 Admission to the neonatal unit

Welcoming parents and families Open access Explanation and facilitating communication Assisting attachment Providing a family-friendly environment

24 Developmental care

Observing newborn behavior The nursery environment Adapting care

25 Stabilizing the sick newborn infant

Heart rate Circulation

26 Respiratory support

Forms of respiratory support Supplemental oxygen therapy Continuous positive airway pressure (CPAP) Positive-pressure ventilation (PPV) High-frequency oscillatory ventilation (HFOV) Inhaled nitric oxide (iNO) Respiratory failure Extracorporeal membrane oxygenation (ECMO)

27 Preterm infants and their complications

Morbidity Mortality

28 Lung development and surfactant

Structural development Surfactant Clinical implications of surfactant deficiency Surfactant therapy

29 Respiratory distress syndrome

Risk factors Pathology Pathogenesis Clinical features Management Complications

30 Temperature control

Hypothermia Evaporative heat loss in preterm infants Keeping neonates warm

31 Growth and nutrition

Growth Nutrition

32 Intraventricular hemorrhage and periventricular leukomalacia

Diagnosis Clinical features Laboratory findings Management Prognosis Prevention

33 Patent ductus arteriosus (PDA)

Ductal closure Risk factors Clinical features Investigations Management

34 Infection, jaundice, anemia, osteopenia of prematurity

Infection Jaundice Anemia Osteopenia of prematurity

35 Apnea, bradycardia and desaturations, retinopathy of prematurity

Apnea, bradycardia and desaturations Retinopathy of prematurity (ROP)

36 Necrotizing enterocolitis

Risk factors Clinical features Laboratory findings Radiologic abnormalities Management (Table 36.2) Sequelae Prevention

37 Bronchopulmonary dysplasia

Definition Predisposing factors Clinical features Investigations Management Long-term consequences of severe BPD Strategies for prevention

38 Outcome of preterm infants

Growth Medical complications Disability and impairment Cognitive impairment Behavioral outcomes School performance

39 Respiratory distress in term infants

Common causes Less common causes Rare causes

40 Upper airway disorders

Cleft lip and palate Choanal atresia Pierre Robin sequence

41 Jaundice

Significance of severe hyperbilrubinemia Causes of early-onset jaundice (<24 hours) (Table 41.1) Causes of jaundice 24 hours to 2 weeks Clinical examination and assessment Investigations Management Prolonged jaundice (>14 days)

42 Neonatal infection

Bacterial sepsis Risk factors Clinical presentation Investigations Interpretation of laboratory investigations

43 Specific bacterial infections

Group B streptococcal (GBS) infection Listeria monocytogenes Gram-negative infection Conjunctivitis Skin

44 Viral infections

Herpes simplex virus (HSV) Hepatitis B (HBV) Hepatitis C HIV

45 Hypoglycemia and hyperglycemia

Hypoglycemia Hyperglycemia

46 Inborn errors of metabolism

Age of presentation When to suspect an inborn error of metabolism Management

47 Gastrointestinal disorders

Vomiting Gastroesophageal reflux Esophageal atresia Abdominal masses Abdominal wall defects Imperforate anus

48 Gastrointestinal obstruction

Causes – see Fig. 48.1 Diagnostic clues Clinical presentation Diagnosis Management Some specific conditions

49 Cardiac disorders

Risk factors Presentation Antenatal diagnosis Heart Murmur Heart failure Cyanosis Selected causes of cyanotic congenital heart disease (Table 49.1) Oxygen saturation screening for critical congenital heart disease Investigations Management of congenital heart disease

50 Renal and urinary tract anomalies diagnosed prenatally

Embryology Structural abnormalities of the kidneys

51 Renal and urinary tract disorders

Electrolyte problems Urinary tract infection (UTI) Acute kidney injury, AKI (acute renal failure)

52 Genital disorders

Inguinal hernia Hydrocele Undescended testis Torsion of the testis Hypospadias Circumcision

53 Disorders of sex development

Sex development Congenital adrenal hyperplasia

54 Anemia and polycythemia

Anemia Polycythemia

55 Neutrophil and thrombotic disorders

Thrombotic disorders (thrombophilia)

56 Coagulation disorders

Thrombocytopenia Abnormal coagulation

57 Dermatological disorders

Goals of neonatal skin care Diaper (nappy) dermatitis Infection Vascular skin lesions

58 Seizures and perinatal strokes 59 Neural tube defects and hydrocephalus

Neural tube defects Anencephaly Encephalocele Spina bifida Hydrocephalus

60 The hypotonic infant

Clues from the history Causes and clinical features (Table 60.1) Investigations Some specific conditions

61 Bone and joint disorders

Congenital abnormalities of the hip and feet Infection Skeletal dysplasias

62 Hearing and vision

Hearing Vision

63 Pain

Development of pain pathways in the fetus and preterm infant Factors that modify pain responses Assessment of pain Pain assessment scales Minimizing pain

64 Pharmacology

Drug prescription and administration Drug monitoring Drugs in breast milk Drug licensing and neonatalogy

65 Quality improvement

Quality assurance Clinical audit Simulation Critical incident reporting (Table 65.2)

66 Critical incidents

Extravasation of intravenous infusions (Figs 66.2 and 66.3) Excessive fluid volume infused Giving wrong breast milk to wrong patient Complications of umbilical arterial catheters (UAC) Blood loss from arterial catheters Ischemic damage from peripheral artery catheters Portal vein thrombosis from umbilical venous catheters Extravasation of parenteral nutrition (PN) from central venous lines Burns and scalds Scarring of skin Nasal damage from tracheal tube Nasal damage from nasal CPAP Tracheal stenosis Infection Aspiration pneumonia from misplaced gavage (nasogastric) feeding tubes

67 Evidence-based medicine

What is evidence-based medicine (EBM)? Steps in the practice of evidence-based medicine Examples of evidence-based medicine in neonatology

68 Ethics

The withholding or withdrawal of life-saving medical treatment

69 Research and consent

Research Consent in clinical practice

70 Palliative and end-of-life care

Care Plans Place of care Support for the parents, siblings and family Care after death Caring for staff Organ donation Autopsy

71 Discharge from hospital

Discharge planning

72 Follow-up of high-risk infants

Goals Criteria Organization and timing Who should conduct neonatal follow-up? Components Outcome measures

73 Global neonatology

Geography of newborn deaths Causes of newborn deaths Timing of newborn deaths Maternal health and obstetric care Newborn care in low-resource settings – what works?

74 Transport of the sick newborn infant

Infrastructure Why transfer? Equipment Documentation

75 Intubation and chest tubes

Endotracheal intubation Chest tubes (chest drain) Needle thoracotomy (chest needling) Pleural tap

76 Common practical procedures 77 Umbilical catheters and intraosseous cannulation

Umbilical catheters Intraosseous cannulation

78 Central venous catheters and exchange transfusions

Central venous catheters (CVC) Exchange transfusion

79 Cranial ultrasound

Indications Lesions that can be identified Color Doppler flow velocity measurements Additional windows Limitations of ultrasound Practical issues

80 Amplitude-integrated electroencephalography (aEEG)

Use of aEEG in neonates Cerebral function monitor Seizure detection and response to anticonvulsants Artifacts on an aEEG trace aEEG as a prognostic tool in HIE Use of aEEG in preterm infants

81 Perinatal neuroimaging 82 Echocardiography for the neonatologist

Views (see videos) Assessment of left ventricular function in critically ill neonates Assessment of PPHN

83 Gestational age assessment, BP, severity of illness scores, jaundice treatment chart

Blood pressure charts (Fig. 83.2) Severity of illness scores Jaundice treatment chart

Index End User License Agreement

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