Neonatology at a Glance

Tom Lissauer, Avroy A. Fanaroff, Lawrence Miall, Jonathan Fanaroff, Tom Lissauer, Avroy A. Fanaroff, Lawrence Miall, Jonathan Fanaroff

• Publisher: Wiley-Blackwell
• Year: 2020
• Print ISBN: 9781119513193
• eBook ISBN: 9781119513223
• Edition: 4
• Topic: Medicine
• Subtopic: Perinatology & Neonatology

Written by a team of leading international experts, Neonatology at a Glance provides a concise and easy-to-read overview of neonatal medicine. Each topic is clearly explained over a two-page spread, aided by numerous diagrams and illustrations. It has been extensively updated to include recent advances in perinatal medicine, genetics, respiratory support, therapeutic hypothermia, antimicrobial stewardship, and family integrated care. The book covers the wide range of problems encountered in looking after newborn babies, from normal newborn infants to the complexities of neonatal intensive care.

Neonatology at a Glance:

• Provides up-to-date coverage of the important conditions you will encounter, including neonatal resuscitation and care of preterm infants
• Covers challenging topics including pain, ethical issues, patient safety, evidence-based medicine, and palliative and end of life care
• Includes details of a wide range of practical procedures, including less invasive surfactant administration, cranial ultrasound, brain monitoring and neuroimaging, and neonatal transport

Neonatology at a Glance is the perfect guide for all health professionals looking after newborn infants, including pediatric trainees, medical students, neonatal nurse practitioners and neonatal nurses, therapists, and midwives. For neonatologists, pediatricians, and neonatal lecturers, it is a valuable resource to assist with teaching.

1 Milestones in neonatology

The care of newborn infants has evolved over the last century from simple and empirical care to modern, evidence‐based, high‐tech medicine. Neonatal mortality has correspondingly declined dramatically from 40/1000 live births in 1900 to <4/1000 in the US and UK. Improved obstetric care and maternal health and nutrition have also contributed. It was only in the 1950s that medical care of healthy and sick newborn infants was transferred from obstetricians to pediatricians. The specialty of neonatology developed only in the 1960s, and the first certifying examination for physicians in the US was held in 1975.

Thermal regulation

• • 1890s: Tarnier in France showed that a warm, controlled environment reduced mortality of infants <2 kg from 66% to 38% (Figure 1.1).
• • 1893: Budin, Tarnier's student, established the first unit for premature babies in Paris, emphasizing thermal regulation and breast‐feeding.
• • Early 1900s: Premature babies in incubators were exhibited in fairs around Europe and the US (Figure 1.2).
• • 1950s: Silverman in the US conducted elegant randomized controlled trials to confirm the beneficial effects of thermal control (including humidity) on mortality.
• • 2000s: Heat loss at delivery of extremely preterm babies minimized by plastic wrapping.

Figure 1.1 The Tarnier incubator. The water was heated by the oil flame. Heated air circulating around the incubator kept baby warm.

Figure 1.2 Incubators with premature babies at the Pan‐American Exposition, Buffalo, New York in 1901.

Source: Silverman WA. Incubator‐baby side shows. Pediatrics 1979; 64: 127. Courtesy of the American Academy of Pediatrics.

Nutrition

• • 1880s: Tarnier and Budin recommend early feeding and intragastric “gavage” feeding via a rubber tube inserted through the mouth.
• • 1907: Rotch in US introduces infant formula. Breast‐feeding declines as some believed formula was superior.
• • 1940s: Gavage feeding via a nasogastric tube used in neonatal units.
• • 1940s: Feeding of preterm infants delayed up to four days to avoid aspiration. Adverse effects (hypoglycemia, increased bilirubin and impaired development) recognized only in the 1960s, and early feeding reintroduced.
• • 1960s: Parenteral nutrition (PN) introduced by central venous catheter, then via peripherally inserted central catheters (PICC) lines.
• • 1960s: Infant formula associated with neonatal tetany from hypocalcemia and hemolysis from vitamin E deficiency.
• • 1980s: Development of special formulas for very low birth‐weight infants.
• • 1980s: Resurgence of use of breast milk. Human milk fortifiers developed for preterm infants.
• • 2000s: Addition of long‐chain polyunsaturated fatty acids (LCPUFA) to formula.

Rhesus hemolytic disease

Kernicterus, from bilirubin deposition in the brain in rhesus disease, was first described in 1938. Exchange transfusions became a common procedure in neonatal units and saved an estimated 8000 lives/year in the US alone.

• • 1925: Hart describes first exchange transfusion – blood given via saphenous vein, removed from anterior fontanelle.
• • 1940: Landsteiner discovers rhesus factor.
• • 1945: Coombs develops Coombs test (direct antiglobulin test [DAT]) to detect rhesus agglutinins.
• • 1947: Diamond describes exchange transfusion via umbilical vein with rubber catheter.
• • 1...

Table of contents

• Table of Contents
• Preface
• Contributors
• Acknowledgments
• 1 Milestones in neonatology
• 2 Epidemiology
• 3 Perinatal medicine overview
• 4 Prepregnancy care, prenatal screening, and fetal medicine
• 5 Maternal medical conditions
• 6 Intrauterine growth restriction
• 7 Multiple births
• 8 Preterm delivery
• 9 Maternal drugs affecting the fetus and newborn infant
• 10 Congenital infection
• 11 Genetics
• 12 Adaption to extra‐uterine life
• 13 Neonatal resuscitation and post‐resuscitation care
• 14 Birth injuries
• 15 Routine care of the newborn infant
• 16 Routine examination of the newborn infant
• 17 Neurology examination
• 18 Feeding
• 19 Parental attachment
• 20 Minor abnormalities in the first few days
• 21 Overview of common problems of term infants
• 22 Admission to the neonatal unit
• 23 Stabilizing the sick newborn infant
• 24 Respiratory support
• 25 Developmental care
• 26 Family integrated care
• 27 Preterm infants and their complications
• 28 Lung development and surfactant
• 29 Respiratory distress syndrome
• 30 Temperature control
• 31 Growth and nutrition
• 32 Intraventricular hemorrhage and periventricular leukomalacia
• 33 Patent ductus arteriosus (PDA)
• 34 Apnea, infection, anemia, and jaundice
• 35 Retinopathy of prematurity
• 36 Necrotizing enterocolitis
• 37 Bronchopulmonary dysplasia
• 38 Discharge of preterm infants from hospital
• 39 Outcome of preterm infants
• 40 Respiratory distress in term infants
• 41 Upper airway disorders
• 42 Jaundice
• 43 Neonatal infection
• 44 Antimicrobial stewardship
• 45 Specific bacterial infections
• 46 Viral infections
• 47 Hypoglycemia and hyperglycemia
• 48 Gastrointestinal disorders
• 49 Gastrointestinal obstruction
• 50 Cardiac disorders
• 51 Hypoxic–ischemic encephalopathy
• 52 Seizures and perinatal strokes
• 53 Neural tube defects and hydrocephalus
• 54 The hypotonic infant
• 55 Renal and urinary tract anomalies diagnosed prenatally
• 56 Renal and urinary tract disorders
• 57 Genital disorders
• 58 Disorders of sex development
• 59 Anemia and polycythemia
• 60 White cell disorders
• 61 Coagulation and thrombotic disorders
• 62 Dermatological disorders
• 63 Bone and joint disorders
• 64 Inborn errors of metabolism
• 65 Hearing and vision
• 66 Pain
• 67 Pharmacology
• 68 Quality improvement
• 69 Patient safety
• 70 Evidence‐based practice
• 71 Ethics
• 72 Research and consent
• 73 Palliative and end‐of‐life care
• 74 Follow‐up of high‐risk infants
• 75 Global neonatology
• 76 Transport of the sick newborn infant
• 77 Intubation
• 78 Chest tubes
• 79 Common practical procedures
• 80 Umbilical catheters and intraosseous cannulation
• 81 Central venous catheters and exchange transfusions
• 82 Cranial ultrasound
• 83 Brain monitoring
• 84 Perinatal neuroimaging with MRI
• 85 Echocardiography for the neonatologist
• AppendixAppendixGestational age assessment, BP, Newborn Early Warning Trigger and Track (NEWTT) chart, Jaundice, Hypoglycemia, Growth chartsGestational age assessment, BP, Newborn Early Warning Trigger and Track (NEWTT) chart, Jaundice, Hypoglycemia, Growth charts
• Further reading
• Index
• End User License Agreement