Journal of Perinatology最新文献

{"title":"Diagnostic accuracy and short-term implications of prenatally diagnosed vascular rings: a single center study.","authors":"Nicolle M Ceneri, Michelle L Udine, Manan H Desai, Steven J Staffa, Wendy Ho, Leanne Buckels, Stephanie R Lacey, Mary T Donofrio","doi":"10.1038/s41372-025-02244-x","DOIUrl":"https://doi.org/10.1038/s41372-025-02244-x","url":null,"abstract":"<p><strong>Objective: </strong>To assess the diagnostic accuracy and postnatal outcomes of fetuses with a suspected vascular ring (VR).</p><p><strong>Study design: </strong>Single-center retrospective study of patients with suspected VR by fetal echocardiography. Postnatal evaluation included echocardiography +/- cross-sectional imaging. Outcomes, including symptomatology and surgery, were recorded and compared between VR types.</p><p><strong>Results: </strong>Of 68 suspected fetal VRs, 81% were confirmed postnatally. Concordance between fetal and postnatal anatomy was 76%. Five neonates required resuscitation unrelated to VR. Symptoms presented in 13 patients (median 45 days), independent of VR type. Surgical intervention was performed in 15 patients (median 99 days); 80% were symptomatic. At a median follow-up of 6 months, 4 patients were symptomatic including 3 postoperative.</p><p><strong>Conclusions: </strong>Fetal echocardiography accurately identifies and characterizes VR anatomy in most instances. Specialized delivery planning in uncomplicated cases is unnecessary given absence of symptoms at birth. Fetal diagnosis may not indicate surgical disease, as symptoms do not occur in all and early surgery does not guarantee symptom resolution.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Piloting the better research interactions for every family (BRIEF) researcher intervention to support recruitment for a neonatal clinical trial: parent experience and infant enrollment.","authors":"Elliott Mark Weiss, Devan M Duenas, Andrea Kelsh, Megan M Gray, Ellie Oslin, Devinae Mcneil, Sandra E Juul, Stephanie A Kraft","doi":"10.1038/s41372-025-02245-w","DOIUrl":"https://doi.org/10.1038/s41372-025-02245-w","url":null,"abstract":"<p><strong>Objective: </strong>Recruiting for neonatal clinical trials is difficult for families and participation rates are low. We partnered with the DIVI (Darbepoetin plus slow-release IntraVenous Iron) trial for pilot feasibility evaluation of the BRIEF (Better Research Interactions for Every Family) intervention.</p><p><strong>Study design: </strong>Pre/post design to compare infant data and parent surveys and interviews before and after the BRIEF intervention as well as comparing DIVI enrolled and DIVI not enrolled.</p><p><strong>Results: </strong>Enrollment rates and parental experiences were similar in pre- and post-BRIEF eras. Most respondents reported positive interactions with researchers. Parents who declined DIVI reported somewhat  worse experiences compared to those who enrolled. Interview respondents reported widely variable experiences. The narrow enrollment window emerged as particularly important to parents' recruitment experience.</p><p><strong>Conclusions: </strong>The BRIEF intervention was well received and is ready for larger scale testing to assess its impact on parental experience and enrollment rates. Future work should address short enrollment windows common in neonatal clinical trials.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary function tests in the neonatal intensive care unit and beyond: a clinical review.","authors":"Mitzi A Go, Kelvin D MacDonald, Manuel Durand, Cindy T McEvoy","doi":"10.1038/s41372-025-02243-y","DOIUrl":"https://doi.org/10.1038/s41372-025-02243-y","url":null,"abstract":"<p><p>Pulmonary function tests (PFTs) in the Neonatal Intensive Care Unit (NICU) have played a pivotal role in neonatal care. They have helped quantify the effects of therapeutic interventions, guide ventilator management, and serve as endpoints in clinical trials. Preterm delivery, the most common cause of altered lung development, establishes early lung function trajectories that persist into later life. Early PFTs in preterm infants can enhance our understanding of factors influencing these trajectories. This review summarizes techniques performed in the NICU and early infancy and the evolution of continuous lung function monitoring through the bedside ventilator. It provides examples incorporating PFTs in the NICU and early infancy to improve outcomes and identifies evolving technology in this area. This review does not include studies of control of breathing in newborn infants. Looking ahead, the field would greatly benefit from developing a sustainable, non-invasive PFT technique that can be applied across the lifespan.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and treatment analysis of neonatal testicular torsion.","authors":"Chengpin Tao, Yongsheng Cao, Zhikang Yu","doi":"10.1038/s41372-025-02249-6","DOIUrl":"https://doi.org/10.1038/s41372-025-02249-6","url":null,"abstract":"<p><strong>Background: </strong>Neonatal testicular torsion is a rare but critical condition that requires prompt diagnosis and treatment. While early surgical intervention may offer some benefit, in many prenatal cases, preventing testicular loss remains challenging, even with timely intervention. Early recognition remains challenging due to subtle clinical presentations in newborns.</p><p><strong>Objective: </strong>This study aims to analyze the clinical characteristics, diagnostic methods, and treatment outcomes of neonatal testicular torsion, providing a reference for early diagnosis and intervention of the disease.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on cases of neonatal testicular torsion admitted to Anhui Provincial Children's Hospital from August 2014 to June 2024. Information collected included the infants' age, at diagnosis onset time, clinical manifestations, diagnostic methods, surgical treatment, and postoperative follow-up results.</p><p><strong>Results: </strong>This study included 21 cases of neonatal testicular torsion. Among them, 1 case involved bilateral testicular torsion, and the remaining 20 cases involved unilateral torsion, with 11 cases on the right side and 9 on the left. The median age at diagnosis of the patients was 1 day (IQR: 1-3), and the median onset time was 24 h (IQR: 10-60). All patients underwent surgical exploration, revealing a median torsion angle of 720 degrees (IQR: 360-720). The average surgery duration was 57.9 min (SD: 25.9). In the case of bilateral testicular torsion, the blood supply was restored after detorsion, and the testicles were preserved. However, in the 20 cases of unilateral torsion, necrotic testicles were removed. Postoperative follow-up over an average period of 31.3 months (SD: 11.5) showed no atrophy in the preserved testicles, with good development of the contralateral testicles and no recurrence of torsion.</p><p><strong>Conclusion: </strong>Neonatal testicular torsion is rare and urgent, often prenatally occurring with high testicular necrosis risk. Ultrasound is crucial for diagnosing cryptorchid testicular torsion. Clinical uncertainty requires prompt surgical exploration to save the testicle.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the refineR algorithm to generate indirect reference intervals for newborn infants for the parameters \"Micro-R\" and \"HYPO-He\".","authors":"Timothy M Bahr, Kelly Doyle, Robin K Ohls, Robert D Christensen","doi":"10.1038/s41372-025-02251-y","DOIUrl":"https://doi.org/10.1038/s41372-025-02251-y","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A quality improvement project improving post-operative transitions of care in a level IV NICU.","authors":"Hannah Fischer, Diane Buckley, Jessica Ford, John Juneau, Daniel Kahn, Carrie Moore, Julia Springate Spalding, Tamina Singh","doi":"10.1038/s41372-025-02228-x","DOIUrl":"https://doi.org/10.1038/s41372-025-02228-x","url":null,"abstract":"<p><strong>Objective: </strong>Transitions of care are critical periods when NICU patients are at risk for miscommunication leading to patient harm. This quality improvement project aimed to decrease post-operative hand-off-related failures and improve communication in a level IV NICU.</p><p><strong>Project design: </strong>The Vermont Oxford Network transitions of care framework was used to develop a safe surgical hand-off definition; (1) all team members present, (2) a structured hand-off format utilized, and (3) an environment conducive for hand-off. Interventions included using standardization for process improvement, scripting ideal communication, and simulation to establish behavioral norms of effective communication.</p><p><strong>Results: </strong>Post-surgical hand-off-related care failures decreased from 75% pre-implementation to 6% post-implementation (p < 0.00001) by increasing the percentage of hand-offs meeting pre-defined criteria.</p><p><strong>Conclusion: </strong>Using quality improvement methods to implement process and behavioral changes to improve communication, our team reached our goal of decreasing post-operative hand-off-related care failures.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"End-tidal carbon monoxide for routine monitoring of significant hemolysis in the management of newborn hyperbilirubinemia.","authors":"Shanice Wells, Ramya Balasubramanian, Khang Nguyen, David L Schutzman","doi":"10.1038/s41372-025-02242-z","DOIUrl":"https://doi.org/10.1038/s41372-025-02242-z","url":null,"abstract":"<p><strong>Objective: </strong>Assess the efficacy of routine ETCOc for all newborns in managing neonatal hyperbilirubinemia.</p><p><strong>Study design: </strong>Retrospective chart review of 1029 consecutive well-baby nursery admissions following the 2022 AAP hyperbilirubinemia guidelines. Only ETCOc, not type, Rh, and DAT, was used to determine if significant hemolysis was present in sufficient degree to affect bilirubin management. A cost-benefit analysis comparing the two methods was conducted.</p><p><strong>Result: </strong>2.8% of infants required phototherapy, and 1.1% were readmitted for hyperbilirubinemia. The closer an infant's bilirubin level was to the phototherapy threshold, the higher the ETCOc. 12 of 29 DAT negative infants with ETCOc ≥ 2.5 PPM who received phototherapy would have gone home with significant hemolysis at risk for readmission or kernicterus if not for the use of ETCOc.</p><p><strong>Conclusion: </strong>ETCOc is preferable for assessing significant hemolysis in the newborn, can be used to safely manage newborn hyperbilirubinemia, and results in cost savings.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caveats when interpreting meta-analyses of randomized controlled trials for patent ductus arteriosus in preterm infants.","authors":"Takashi Shima","doi":"10.1038/s41372-025-02248-7","DOIUrl":"https://doi.org/10.1038/s41372-025-02248-7","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of video review to enhance recognition of intubation attempt duration and success in fetal care center delivery room resuscitations.","authors":"Morgan E Hill, Jae H Kim, Stefanie Riddle","doi":"10.1038/s41372-025-02240-1","DOIUrl":"https://doi.org/10.1038/s41372-025-02240-1","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transfer validity testing of a virtual reality simulation for umbilical venous catheter placement.","authors":"Harris Nisar, Nicole M Rau, Taylor Gohman, M Jawad Javed, Avinash Gupta","doi":"10.1038/s41372-025-02246-9","DOIUrl":"https://doi.org/10.1038/s41372-025-02246-9","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}