The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
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Recent progresses in fetal surgery have raised concern on fetal pain, its long-term consequences and the risks of sudden fetal movements induced by pain. In several studies, surgeons have directly administered opioids to the fetus, while others have considered sufficient the maternally administered analgesics. We performed a review of the literature to assess the state of the art. ⋯ Fetal direct analgesia is performed only in a minority of cases and no study gives details about fetal reactions to pain. More research is needed to assess or exclude its possible long-term drawbacks, as well as the actual consequences of pain during surgery.
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J. Matern. Fetal. Neonatal. Med. · Jan 2013
Management of term newborns following maternal intrapartum fever.
To evaluate the diagnostic and therapeutic approach to full term neonates born to mothers with intrapartum fever. ⋯ In low-risk women with asymptomatic intrapartum fever, neonatal infection is uncommon, so that aggressive evaluation and management of these infants may not be necessary and should be balanced against the low risk of neonatal sepsis.
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J. Matern. Fetal. Neonatal. Med. · Dec 2012
Controlled Clinical TrialIntraoperative aorta balloon occlusion: fertility preservation in patients with placenta previa accreta/increta.
To evaluate whether aorta balloon occlusion decreases the rate of hysterectomies and maternal morbidity during extirpative surgery of placenta previa accreta or increta. ⋯ During scheduled caesarean section for placenta previa multifocally accreta or increta, IABO can prevent hysterectomy in many cases and improves perioperative outcome as it gives the operator time to achieve the haemostasis via curettage and oversewing of the implantation site with acceptable blood loss.
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J. Matern. Fetal. Neonatal. Med. · Dec 2012
Do all deliveries with elective caesarean section need paediatrician attendance?
To determine whether paediatrician attendance to deliveries with elective caesarean section (CS) is really needed for term and also for preterm babies with 35-37 weeks gestational age. ⋯ There is not increased risk for chest compression and entubation for infants ≥ 35 gestation weeks without antenatally identified risk factors born with elective CS either under regional or general anesthesia and only 4.2% of the babies needed bag-mask ventilation, so a health care personel who knows basic NRP may be sufficient in the clinics where it is easy to achieve an advanced skilled health care personel when needed.
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J. Matern. Fetal. Neonatal. Med. · Dec 2012
Adrenomedullin alterations related to cardiopulmonary bypass in infants with low cardiac output syndrome.
Low cardiac output syndrome (LCOS) remains a major perioperative complications in infants subjected to open-heart surgery with cardiopulmonary bypass (CPB). The present study investigated whether perioperative blood assessment of a potent vasoactive peptide namely adrenomedullin (AM) can predict the risk of LCOS. ⋯ This study suggests that AM can constitute, alone or combined with standard parameters, a promising predictor of LCOS in infants subjected to open-heart surgery with CPB.