Clinics in perinatology
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Clinics in perinatology · Jun 1992
Review Randomized Controlled Trial Clinical TrialNeonatal management of the very low birth weight infant: the use of surfactant.
The use of surfactant in the low birth weight infant with respiratory distress syndrome has undergone multicenter randomized clinical trials. This article addresses the properties of surfactant, the clinical aspects of surfactant replacement therapy and the implications for future research.
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Fluid requirements in the newborn are related to net fluid expenditures, normal changes in body water composition, and the integrity of renal regulatory functions. A variety of clinical conditions and therapeutic modalities also have an important effect on fluid requirements. Fluid therapy must be individualized to meet the specific needs of the infant. Appropriate fluid therapy will facilitate physiologic changes of body water composition and decrease neonatal morbidity.
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Narcotic use in pregnancy remains a critical problem in 1990. Maternal and neonatal morbidity and mortality are increased significantly in pregnancies complicated by opioid addiction. ⋯ The helpless fetus does not get the opportunity to just say no to drugs. As a society, we must just say no to continuing to ignore this problem.
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Neonatal stress responses have been investigated only in recent years. Term neonates mount substantial hormonal and metabolic responses, which are distinct from those of adult patients. These responses can be altered significantly by the effects of prematurity, the effects of graded surgical stress, and the anesthetic techniques used during surgery. In addition, neonatal stress responses may have important implications for the clinical outcome following surgery in neonates.
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Clinics in perinatology · Dec 1989
ReviewParental adjustment to intrapartum and delivery room loss. The role of a hospital-based support program.
Perinatal loss prompts a unique bereavement for parents and their families that is unlike the mourning process experienced at the death of other loved ones. The Support Center For Perinatal and Childhood Death has developed a comprehensive program to provide support, counseling, and information to families who experience miscarriage, stillbirth, fetal anomalies, and therapeutic abortion for genetic or congenital abnormalities. The impact of perinatal loss is felt not only in the real loss of the wished-for child but also in the loss of self-esteem, the role of parent, and the loss of confidence in the ability to produce a healthy child. ⋯ Stein expresses the essence of grief work and resolve: Mourning is not just feeling sad. It is the specific psychological process by which human beings become able to give up some of the feelings they have invested in a person who no longer exists, and extend their love to the living. Mourning is hard, emotional work.(ABSTRACT TRUNCATED AT 400 WORDS)