Top

Tip

Swipe om te navigeren naar een ander hoofdstuk

Gepubliceerd in:

2019 | OriginalPaper | Hoofdstuk

8. Birth and the neonatal period

Auteurs : Dr Rob (H. R.) Taal, Professor Irwin K. M. Reiss, Professor Enrico Lopriore, MD, PhD Professor Vincent W. V. Jaddoe

Gepubliceerd in: Textbook of Obstetrics and Gynaecology

Uitgeverij: Bohn Stafleu van Loghum

Summary

Foetal-to-neonatal transition during labour and just after birth is an intricate phenomenon in which many processes are involved. It is a vulnerable period for the newborn and perinatal mortality remains an important contributor to overall mortality and morbidity, despite improvements in foetal and neonatal care. In this chapter, the physiology of transition and potential diseases of the neonate are discussed. Important hallmarks of cardiopulmonary transition are the switch from foetal to postnatal circulation and aeration of the lungs, which also interact with each other. As perinatal asphyxia is an important risk factor for perinatal mortality and morbidity, neonatal resuscitation and pathophysiology of perinatal asphyxia are extensively discussed. The preterm born infant can encounter problems as a consequence of immaturity, such as respiratory distress syndrome and intraventricular haemorrhage. Insight into the physiology of transition at birth and the pathophysiology of common neonatal diseases is essential to improve neonatal and long-term outcome.

vorige hoofdstuk Embryonic, placental and foetal growth and development

volgende hoofdstuk Paediatric and adolescent gynaecology

Alleen toegankelijk voor geautoriseerde gebruikers

Perinatal mortality

Mortality in the first 28 days after birth

Right-left/left-right shunt

Indicates the direction of a shunt in blood flow from the right side of the heart or pulmonary circulation to the left side of the heart or systemic circulation, or vice versa. Effects mostly differ in foetal and postnatal life

Hypothermia

Hypothermia is defined as a temperature of < 36.5 ^oC. Neonates have a high risk of developing hypothermia. It is important to be aware of the causes and consequences of hypothermia; preventing hypothermia is essential for neonatal transition

Neonatal resuscitation

The aim of neonatal resuscitation is to support foetal to neonatal transition

Asphyxia

Asphyxia literally means ‘pulseless’ and indicates a poor clinical condition at birth. Perinatal asphyxia is defined as a condition including disturbed gas exchange which leads to progressive hypoxia, hypercapnia and acidosis

Pulmonary hypertension of the neonate

Increased pulmonary vascular resistance which supersedes systemic vascular resistance leading to right-to-left shunt of blood flow. As a consequence, oxygenation of peripheral tissues can be compromised

Cyanosis

Bluish discolouration of the skin can be seen when a certain concentration of deoxygenated haemoglobin level is reached ( ~ 2 g/dl). Patients with anaemia have a lower arterial oxygen saturation when cyanosis manifests, as compared with patients with high total haemoglobin levels

Growth restriction

Neonates born small for gestational age might not always be growth restricted during intrauterine growth. Measuring the length and head circumference is important to differentiate between proportional and disproportional growth restriction

Anderson JG, Baer RJ, Partridge JC, Kupperman M, Franck LS, Rand L, et al. Survival and major morbidity of extremely preterm infants: a population-based study. Pediatrics 2016;138. https://doi.org/10.1542/peds.2015-443.

Baird J, Fisher D, Lucas P, Kleijnen J, Roberts H, Law C. Being big or growing fast: systematic review of size and growth in infancy and later obesity. BMJ 2005;331:929. https://doi.org/10.1136/bmj.38586.411273.E0. CrossRef

Been JV, Nurmatov UB, Cox B, Nawrot TS, Schayk CP van, Sheikh A. Effect of smoke-free legislation on perinatal and child health: a systematic review and meta-analysis. Lancet 2014;383:1549–60. https://doi.org/10.1016/s0140-6736(14)60082-9. CrossRef

EXPRESS Group, Fellman V, Hellström-Westas L, Norman M, Westgren M, Kallen K, et al. One-year survival of extremely preterm infants after active perinatal care in Sweden. JAMA 2009;301:2225–33. https://doi.org/10.1001/jama.2009.771.

Gluckman PD, Hanson MA, Cooper C, Thornburg KL. Effect of in utero and early-life conditions on adult health and disease. N Engl J Med. 2008;359:61–73. https://doi.org/10.1056/NEJMra0708473. CrossRefPubMedPubMedCentral

Levene MI. The asphyxiated newborn infant. In: Levene MI, Lilford RJ, editors. Foetal and neonatal neurology and neuro-surgery. Edinburgh: Churchill Livingstone; 1995. pp. 405–426.

Shankaran S, Laptook AR, Ehrenkranz RA, Tyson JE, McDonald SA, Donovan EF, et al. Whole-body hypothermia for neonates with hypoxic-ischaemic encephalopathy. N Engl J Med. 2005;353:1574–84. https://doi.org/10.1056/NEJMcps050929. CrossRefPubMed

Stoll BJ, Hansen NI, Bell EF, Walsh MC, Carlo WA, Shankaran S, et al. Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993–2012. JAMA 2015;314:1039–51. https://doi.org/10.1001/jama.2015.10244. CrossRef

Timmermans S, Bonsel GJ, Steegers-Theunissen RP, Mackenbach JP, Steyerberg EW, et al. Individual accumulation of heterogeneous risks explains perinatal inequalities within deprived neighbourhoods. Eur J Epidemiol. 2011;26:165–80. https://doi.org/10.1007/s10654-010-9542-5. CrossRefPubMedPubMedCentral

10.

Wyllie J, Bruinenberg J, Roehrd CC, Rudiger M, Trevisanutoc D, Urlesberger B. European resuscitation council guidelines for resuscitation 2015: section 7. Resuscitation and support of transition of babies at birth. Resuscitation 2015;95:249–63. https://doi.org/10.1016/j.resuscitation.2015.07.029. CrossRef

Titel: Birth and the neonatal period
Auteurs: Dr Rob (H. R.) Taal
Professor Irwin K. M. Reiss
Professor Enrico Lopriore
MD, PhD Professor Vincent W. V. Jaddoe
Uitgeverij: Bohn Stafleu van Loghum
Boek: Textbook of Obstetrics and Gynaecology
Print ISBN: 978-90-368-2130-8

Elektronisch ISBN: 978-90-368-2131-5

Copyright: 2019
DOI: https://doi.org/10.1007/978-90-368-2131-5_8

Bohn Stafleu van Loghum

Tip

Swipe om te navigeren naar een ander hoofdstuk

Deel dit onderdeel of sectie (kopieer de link)

Summary

Log in om toegang te krijgen