Clinics in perinatology
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Clinics in perinatology · Dec 2011
ReviewEarly visual development: implications for the neonatal intensive care unit and care.
Much of the early development of the human visual system occurs while the preterm infant is in the neonatal intensive care unit (NICU). Critical events and processes happen between 20 and 40 weeks' gestational age, before the onset of vision at term birth. Knowledge of the development of the visual system and the timing of the processes involved is essential to adapting NICU care to support all neurosensory development including visual development.
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Prematurity is one of the leading causes of infant morbidity and mortality globally. Over the years, however, advances in medicine and technology have enhanced the ability to care for babies at very early gestations. ⋯ These changes have added to the burden of premature births. The focus of this article is to present both sides of the story, one that highlights the many problems and morbidities faced by this subgroup of premature infants and the other that justifies their early delivery.
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Clinics in perinatology · Sep 2011
ReviewQuality improvement opportunities to prevent preterm births.
Quality improvement initiatives have been successfully employed in many areas of medicine, but few have been implemented in preventing prematurity (or preterm birth), which continues to be one of the most common complications in obstetrics, and the leading cause of perinatal morbidity and mortality in the United States. Due to the complex nature of the causes of prematurity, developing and instituting a quality improvement program to prevent prematurity can be challenging. However, using proven quality improvement principles and techniques, along with institutional will and commitment, are invaluable in rapidly implementing evidence-based initiatives for the prevention of preterm births.
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Clinics in perinatology · Jun 2011
Nonclinical factors affecting women's access to trial of labor after cesarean delivery.
The use of trial of labor after cesarean (TOLAC) has declined in the last decade, and the clinical risks of TOLAC remain low. Nonclinical factors continue to affect women's access to TOLAC. ⋯ An evidence base and strategies to provide guidance to create a safe environment for vaginal birth after cesarean are needed. Obstetric information systems are critical to this effort.