NeoReviews最新文献

Elevation of depressed skull fractures in pediatric patients is indicated when the depression extends below the level of the inner table. Although open surgical reduction is an option for treatment, closed vacuum-assisted elevation has been found to have a high success rate and low complication rates when employed in children less than 6 months of age without disruption of the cortex. In this article, we describe two recent cases from our institution and summarize the reported cases in the literature including information about fracture specifics, device used, technical approach, and success rate of the procedure.

Robin sequence (RS) is defined by the clinical triad of micrognathia, glossoptosis, and airway obstruction. The presence of glossoptosis can also obstruct fusion of the palatal shelves during development, resulting in the characteristic wide U-shaped cleft palate. RS can present in isolation (isolated RS) or in association with a congenital syndrome or other abnormalities (syndromic RS or RS plus). Diagnosis is primarily clinical but can be identified prenatally on ultrasonography or magnetic resonance imaging. Management of RS focuses on improving glossoptosis and relieving airway obstruction. Conservative management includes positioning, nasopharyngeal airway, orthodontic appliances, and respiratory support strategies. Surgical interventions include tracheostomy, tongue-lip adhesion, and mandibular distraction osteogenesis. All management strategies can be effective in the appropriately selected patient. Future areas of research include understanding the genetics of RS, improving surgical outcomes with preoperative planning and advanced biomaterials, and improving prenatal identification of children with clinically significant RS.

Critical congenital heart defects (CHDs) are life-threatening cardiac lesions requiring cardiac surgery or transcatheter intervention or result in death within 28 days after birth. In infants with critical CHDs, delayed diagnosis and inappropriate management are associated with higher mortality and comorbidities. Antenatal anomaly screening and fetal echocardiography has improved the detection of fetal CHDs, which helps in perinatal management planning with multidisciplinary teams. Even with precision delivery planning, postnatal transition may affect each infant with CHDs differently depending on the variants and severity of the defect. Therefore, it is important to have a thorough understanding of the hemodynamic physiology in infants with a critical CHD during the transition from intrauterine to extrauterine life and alter management accordingly. This review summarizes the care of infants with critical CHDs in the immediate transition period with a focus on cases with distinctive physiology.

Congenital anomalies present significant health challenges globally, affecting millions of children and contributing to mortality, morbidity, and disability. The immediate health needs of a fetus/neonate diagnosed with a congenital anomaly can overshadow discussions about future reproductive risks. This review explores the broad landscape of recurrence risks in common congenital anomalies and summarizes the implications for parental counseling.

La centralización de los partos de alto riesgo en los hospitales con el más alto nivel de atención es fundamental para ampliar el margen de seguridad materno-neonatal y mejorar los desenlaces. Por lo tanto, es altamente recomendable trasladar oportunamente a las pacientes gestantes portadoras de embarazos de alto riesgo y/o con amenazas de parto pretérmino a centros de atención terciaria, sin embargo, no siempre es posible anticipar los riesgos antenatalmente, lo cual resulta en la necesidad de trasladar a neonatos en estado crítico. Lamentablemente, la movilización de los recién nacidos compromete aún más su estado de salud, especialmente en los países latinoamericanos. El presente trabajo resume los resultados del XIII Consenso Clínico de SIBEN de Traslado Neonatal, en el cual colaboraron 65 miembros de SIBEN, neonatólogos y licensiados en enfermería de 14 países de Iberoamérica, que participaron activamente durante el 2022, antes, durante y después de la reunión presencial que se llevó a cabo en Mérida, Yucatán, México el 12 de noviembre del 2022. En esta reunión se consensuaron las recomendaciones aquí vertidas.

The coagulation and thrombotic systems of an infant are fundamentally different from those of adults and older children. Hemostatic factors have inherently lower circulation levels in infants and are also affected prenatally by conditions of pregnancy. The unique physiology of neonates can contribute to a procoagulant state, which can result in a high level of morbidity and mortality. This review outlines the epidemiology, clinical characteristics, diagnosis and management, and etiologies of congenital and acquired forms of thrombotic disorders, with a discussion of the evaluation for hypercoagulation.

The coagulation system in newborns varies from that of children and adults, with many circulating hemostatic factors being lower in the newborn. Infants are also susceptible to diseases and conditions in the pregnant person affecting their coagulation system, which can make it difficult to rapidly identify the cause behind coagulopathy in a neonate. Coagulation disorders can result in high levels of infant morbidity and mortality, which makes early diagnosis and prompt treatment critical. This review outlines the clinical characteristics, diagnosis and management, epidemiology, and etiologies of both common and uncommon congenital and acquired forms of neonatal coagulopathy.