fetal/maternal

  • 文章类型: Journal Article
    新生儿低血糖(NH)被广泛地定义为引起低血糖诱导的脑功能受损的低血浆葡萄糖浓度。迄今为止,尚未公布新生儿血浆葡萄糖水平的普遍接受的阈值(参考范围),因为数据一致表明,在不同的血浆葡萄糖浓度下,对低血糖的神经系统反应不同。有NH风险的婴儿包括糖尿病母亲的婴儿,胎龄小或大,和早产儿。常见的表现包括抖动,喂养不良,烦躁,和脑病。与NH相关的神经发育障碍包括认知和运动延迟,脑瘫,视力和听力障碍,和糟糕的学校表现。本文及时讨论了NH的科学状况,并为新生儿提供者提供了有关早期识别和疾病预防的建议。
    Neonatal hypoglycemia (NH) is broadly defined as a low plasma glucose concentration that elicits hypoglycemia-induced impaired brain function. To date, no universally accepted threshold (reference range) for plasma glucose levels in newborns has been published, as data consistently indicate that neurologic responses to hypoglycemia differ at various plasma glucose concentrations. Infants at risk for NH include infants of diabetic mothers, small or large for gestational age, and premature infants. Common manifestations include jitteriness, poor feeding, irritability, and encephalopathy. Neurodevelopmental morbidities associated with NH include cognitive and motor delays, cerebral palsy, vision and hearing impairment, and poor school performance. This article offers a timely discussion of the state of the science of NH and recommendations for neonatal providers focused on early identification and disease prevention.
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  • 文章类型: Case Reports
    有或没有食管闭锁(EA)的气管食管瘘(TEF)是由于原始前肠成熟过程中气管和食道的发育不良所致。EA/TEF通常在出生后不久出现,因为口腔分泌物增加,并且无法将鼻胃管或口胃管推进到适当的深度。鉴于产前诊断并不常见,早期干预对降低发病率和死亡风险很重要,早期识别和诊断势在必行.我们介绍了两个被诊断为EA/TEF的新生儿的病例系列,键入\"C\"并键入\"E,“出生在低视力中心,他们需要运送到三级手术支持中心。TEF的病理生理学以及类型,症状学,稳定目标,纠正治疗,并将研究长期影响。最后,将讨论父母和照顾者的教育需求。
    Tracheoesophageal fistula (TEF) with or without esophageal atresia (EA) results from maldevelopment of the trachea and esophagus during maturation of the primitive foregut. EA/TEF commonly presents shortly after birth because of increased oral secretions and the inability to advance a nasogastric or orogastric tube to the proper depth. Given that prenatal diagnosis is uncommon and early intervention is important to reduce morbidity and mortality risk, early recognition and diagnosis are imperative. We present a case series of two neonates diagnosed with EA/TEF, type \"C\" and type \"E,\" born at low-acuity centers, who required transport to a tertiary center for surgical support. The pathophysiology as well as types of TEFs, symptomology, stabilization goals, corrective treatment, and long-term implications will be examined. Finally, the educational needs of parents and caregivers will be discussed.
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  • 文章类型: Journal Article
    在过去的一个世纪中,新生儿结局和婴儿死亡率显着改善。然而,与种族和族裔差异相关的结果差异持续存在,实际上有所增加。多年来,随着护理提供者努力改善对我们所有最脆弱和最年轻个人的护理,这些结果的差异得到了承认。总结了新生儿结局的趋势。
    Neonatal outcomes and infant mortality rates have improved significantly in the past century. However, the disparities in outcomes linked to racial and ethnic variations have persisted and actually increased. Those differences in outcomes have been acknowledged for years as care providers strive to improve care for all of our most vulnerable and youngest individuals. Trends in neonatal outcomes are summarized.
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