Clinics in perinatology
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Advances in monitoring technology, the availability of special skill, and training has resulted in the improved perioperative care of the newborn. With the coordinated efforts of pediatric anesthesiologists, pediatric surgeons, and neonatologists, safe anesthesia and surgery have become a reality even in a sick 500-gm premature infant. ⋯ With adequate preoperative preparation and intraoperative monitoring, safe anesthesia at present can be provided to most critically ill neonates, using the guidelines outlined above. In addition, the postoperative period also can be made pain free for them by a judicious selection of analgesic and local anesthetic drugs.
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Clinics in perinatology · Mar 1989
ReviewPersistent pulmonary hypertension of the newborn. Managing the unmanageable?
Persistent pulmonary hypertension of the newborn is a complex syndrome with multiple causes, which retains a high morbidity and mortality. This article presents pathophysiologic and diagnostic foundations and then focuses the discussion on management issues.
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Clinics in perinatology · Sep 1988
ReviewOpen repair of cardiac defects in neonates and young infants.
This article provides a general description of many aspects of the perioperative and operative management of neonates and young infants with congenital heart disease. Operative technique and results are described in more detail for the most important defects.
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The patient presenting for delivery with multiple gestation often produces extreme anxiety for those involved with her care. From the standpoint of anesthesia service, knowledge of what to expect, and better, the knowledge of what to do if and when the various potential problems present is paramount. ⋯ Lumbar epidural anesthesia is highly recommended for pain management when labor and vaginal delivery is anticipated. However, the knowledgeable obstetrician and the knowledgeable anesthesiologist must be present and prepared for all circumstances.
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Clinics in perinatology · Mar 1987
ReviewBreastfeeding and human milk: their association with jaundice in the neonate.
As demonstrated by this discussion, jaundice in breastfeeding infants appears to be related both to feeding-related issues and to an as-yet unidentified factor in the human milk of a small minority of women. In the case of feeding-related factors, how a mother breastfeeds; that is, how often she offers the breast and how well the baby suckles, as well as how often and how much the baby is offered complementary or supplementary feedings of water, glucose solutions, or a nonhuman mammal milk, influence serum bilirubin concentrations in the first week of postnatal life. We call this breastfeeding-related jaundice, recognizing that the feeding process is a key element in the condition. ⋯ The infant with breast-feeding jaundice has a larger bilirubin load at the time the abnormal milk is being ingested. The recycling of this increased load, because of exaggerated enterohepatic circulation, results in a further late rise in serum bilirubin. If the initial bilirubin pool is smaller, the effect of the abnormal milk might well be insignificant or at least markedly diminished.(ABSTRACT TRUNCATED AT 400 WORDS)