Seminars in perinatology最新文献

Overuse of reflux medications in Neonates. 新生儿过度使用反流药物

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2025-10-10 DOI: 10.1016/j.semperi.2025.152160

Kevin Ratnasamy, Shikib Mostamand

{"title":"Overuse of reflux medications in Neonates.","authors":"Kevin Ratnasamy, Shikib Mostamand","doi":"10.1016/j.semperi.2025.152160","DOIUrl":"https://doi.org/10.1016/j.semperi.2025.152160","url":null,"abstract":"Introduction: The diagnosis, management and differentiating of gastroesophageal reflux (GER) and pathologic gastroesophageal reflux disease (GERD) in infants remains a clinical challenge. There is significant clinical and economic burden attributed to GERD in the NICU leading to longer length of stays, higher financial costs, and overuse of medications.Current clinical practice: Current guidelines promote reduced reliance on acid suppression medication with shorter empiric trials (4 to 8 weeks) for the treatment of GERD, not attributing respiratory or laryngeal symptoms to GER due to a lack of diagnostic evidence, and a recommendation for trial of hydrolyzed formula before initiation of acid suppression. Few studies are demonstrating overall decrease use in all classes of medication for GERD, however, use of medications in infants remains high.Diagnostic challenges and drivers of overuse: Diagnostic challenges remain in pediatrics including interchangeable use of GER and GERD amongst clinicians, non-specific symptoms attributed to GERD, and lack of gold-standard diagnostic testing. Multichannel intraluminal impedance-pH monitoring (pH/MII) probes allow for an objective assessment of reflux episodes, reflux content, acidity, distance of reflux column or bolus direction, and symptom correlation.Conclusion: For any infant with a suspicion of GERD, priority should be made to take a thoughtful and complete history and physical exam, review of growth charts, and not only reviewing charted intake and output but observing feeding and episodes of reflux. A stepwise approach emphasizing non-pharmacological care, shared decision-making, and institutional-level stewardship remains essential to providing high-value care.","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":" ","pages":"152160"},"PeriodicalIF":3.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275634","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}

引用次数: 0

Transformative trials in cesarean delivery: Antibiotic prophylaxis, tranexamic acid, and uterine closure. 剖宫产的变革性试验：抗生素预防、氨甲环酸和子宫闭合。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2025-10-10 DOI: 10.1016/j.semperi.2025.152145

Ellen M Murrin, Scott A Sullivan, George Larry Maxwell, Antonio F Saad

{"title":"Transformative trials in cesarean delivery: Antibiotic prophylaxis, tranexamic acid, and uterine closure.","authors":"Ellen M Murrin, Scott A Sullivan, George Larry Maxwell, Antonio F Saad","doi":"10.1016/j.semperi.2025.152145","DOIUrl":"https://doi.org/10.1016/j.semperi.2025.152145","url":null,"abstract":"Cesarean delivery (CD), performed in nearly one in three U.S. births, is the most common surgical procedure. As utilization has increased, advances in surgical technique and perioperative management, guided by landmark trials, have refined the procedure and improved outcomes. Some of the most significant trials have focused on antibiotic prophylaxis, prevention of postpartum hemorrhage, and standardization of surgical techniques. For example, pre-incision prophylactic cefazolin has reduced the risk of postoperative infectious morbidity up to 60% compared to administration at the time of cord clamping. Additionally, the introduction of TXA to the treatment of obstetric hemorrhage has been shown to reduce maternal mortality related to hemorrhage. Future research should prioritize continuing reduction of maternal morbidity as CD still incurs increased risk of infectious and bleeding morbidity. Another important focus in the era of increased CD rates is research into the optimal closure of the hysterotomy. Identification of patients at risk of uterine rupture in future pregnancies can improve the safety of trial of labor after cesarean delivery (TOLAC); further investigation into how hysterotomy closure may contribute to the development of placenta accreta spectrum can significantly decrease maternal morbidity from an increasingly common and life-threatening placental disorder.","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":" ","pages":"152145"},"PeriodicalIF":3.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275692","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}

引用次数: 0

The diagnosis of gastroesophageal reflux in the Neonate. 新生儿胃食管反流的诊断。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2025-10-08 DOI: 10.1016/j.semperi.2025.152161

Maheen Hassan, Hayat Mousa

引用次数: 0

Transforming preterm care: The power of small baby guidelines in enhancing outcomes. 改变早产儿护理：小婴儿指南在提高结果方面的力量。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2025-10-07 DOI: 10.1016/j.semperi.2025.152155

Leeann Pavlek, Debra Armbruster, Cecilie Halling, Kaitlyn Hipp, Maria Jebbia, Susan Lopata, Matthew Rysavy, Rebecca Saliga, Sheria Wilson, Claire Beaullieu

引用次数: 0

Medical and surgical treatment of gastroesophageal reflux in the neonate. 新生儿胃食管反流的内科和外科治疗。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2025-09-30 DOI: 10.1016/j.semperi.2025.152159

Suzanna Hirsch

引用次数: 0

Using media to transform education and public health messaging in the neonatal intensive care unit. 利用媒体改变新生儿重症监护病房的教育和公共卫生信息。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2025-09-26 DOI: 10.1016/j.semperi.2025.152150

Joanna Parga-Belinkie, Benjamin Courchia, Daphna Yasova Barbeau

引用次数: 0

Bronchopulmonary dysplasia, pulmonary hypertension, and neonatal gastroesophageal reflux: Association, causation, or neither? 支气管肺发育不良、肺动脉高压和新生儿胃食管反流：相关性、因果关系还是两者都没有？

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2025-09-25 DOI: 10.1016/j.semperi.2025.152158

Erik A Jensen

{"title":"Bronchopulmonary dysplasia, pulmonary hypertension, and neonatal gastroesophageal reflux: Association, causation, or neither?","authors":"Erik A Jensen","doi":"10.1016/j.semperi.2025.152158","DOIUrl":"https://doi.org/10.1016/j.semperi.2025.152158","url":null,"abstract":"Bronchopulmonary dysplasia (BPD) is among the most common and serious complications of prematurity. The pathobiology of BPD and BPD associated pulmonary arterial hypertension (BPD-PH) is multifactorial and not yet fully defined. Gastroesophageal reflux (GER), a physiologic process that occurs in most preterm infants and is typically benign, has been proposed as a potential contributor to the development or worsening of BPD and BPD-PH. Infants who develop BPD compared to those who do not are more frequently diagnosed with symptomatic GER and undergo therapeutic interventions to treat GER. However, current evidence does not support a direct causal relationship between GER and the onset or progression of BPD or BPD-PH in preterm infants. While GER may contribute to respiratory morbidity in individual cases, population-level data do not implicate it as a major driver of BPD pathogenesis. Moreover, the limited available data from clinical trials and observational studies does not consistently demonstrate improved outcomes in patients with BPD who are treated for GER. This narrative review summarizes the current literature evaluating the relationship between GER, BPD, and BPD-PH.","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":" ","pages":"152158"},"PeriodicalIF":3.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145178282","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}

引用次数: 0

Adjunctive technologies to electronic fetal monitoring: Promise, pitfalls, and lessons learned. 电子胎儿监护的辅助技术：前景、缺陷和经验教训。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2025-09-25 DOI: 10.1016/j.semperi.2025.152157

Rebecca Horgan, George Saade

引用次数: 0

Measuring family-important outcomes in large neonatal networks: where we are and where we need to go. 在大型新生儿网络中衡量家庭重要结果：我们在哪里，我们需要去哪里。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2025-09-24 DOI: 10.1016/j.semperi.2025.152149

Catherine Demers, Thuy Mai Luu, Stephanie Glegg, Jehier Afifi, Rebecca Pearce, Émilie Thivierge, Annie Janvier

引用次数: 0

Quality improvement collaboratives: A neonatal perspective. 质量改进协作：新生儿视角。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2025-09-24 DOI: 10.1016/j.semperi.2025.152152

Eugenia K Pallotto, Michelle-Marie Peña, C Briana Bertoni, Beverly S Brozanski, Laurel B Moyer, Anthony Piazza

引用次数: 0