Seminars in neonatology : SN
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Birthmarks are commonly seen in neonates. Most are insignificant incidental findings and straightforward in their diagnosis and management. ⋯ This chapter will focus on the diagnosis and management of large vascular and pigmented birthmarks. A multidisciplinary team approach involving paediatricians, dermatologists, plastic surgeons and other specialists is often required in the management of these children.
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The use of tobacco products by pregnant women is associated with placenta previa, abruptio placentae, premature rupture of the membranes, preterm birth, intrauterine growth restriction and sudden infant death syndrome. Approximately 15-20% of women smoke during pregnancy. It has been suggested that smoking is responsible for 15% of all preterm births, 20-30% of all infants of low birthweight, and a 150% increase in overall perinatal mortality. Cigarette smoking is one of the most important and modifiable risk factors associated with adverse perinatal outcomes.
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Review
Cooling the newborn after asphyxia - physiological and experimental background and its clinical use.
Many years of experimental work on hypoxic-ischaemic injury have supported the hypothesis that cooling the body and brain after the primary injury offers permanent neuroprotection. Clinically, the question of how late cooling can start after the insult and still have a protective effect is important and not fully investigated. Pilot studies in human adults initiated cooling after 10-18 h (trauma, stroke), however animal data suggest cooling is not effective if started later than 6 h. ⋯ Hypothermia must be administered with understanding of the extensive physiological effects. Different enzymes have different sensitivity to changes in temperature, hence some effects may be beneficial and some deleterious. Hypothermia and cardiovascular responses and coagulation needs careful monitoring.