Newborn babies who do not spontaneously breathe at birth require support to safely make the transition to extra-uterine life. Over the past 20 years, guidelines for those providing care to these infants have been developed. However, the evidence available to…
The transition from fetus to neonate represents a series of rapid and dramatic physiologic changes during which the placenta is replaced by the lungs as the primary organ of gas exchange. Although this transition goes smoothly most of the time,…
Major anomalies are seen in about 2% of newborns, often prompting parental worry and urgent medical intervention soon after birth. In addition, they are a common cause of long-term illness and death. This chapter reviews some of the significant etiologic…
Birth injuries are those sustained during the birth process, which includes labor and delivery. They may be avoidable, or they may be unavoidable and occur despite skilled and competent obstetric care, as in an especially hard or prolonged labor or…
Immediately after a baby is born, all parents want to know, “Is my baby all right?” A quick initial physical examination of all newborns should be performed in the delivery room to ensure that there are no major anomalies or…
The goal of modern-day obstetric anesthesia practice is to provide the patient with analgesia as she requests it. That assumes her choice is appropriate to the labor process and to the current conditions as evaluated by her obstetric provider, and…
The placenta has two opposing functions. It is the sole source of sustenance for the fetus and its sole protection against noxious external influences. It can be argued that no evaluation of a sick neonate is complete without knowing the…
Definitions and Epidemiology Chorioamnionitis (or intra-amniotic infection) is a major cause of fetal, neonatal, and maternal morbidity and mortality. There are strong associations between chorioamnionitis and maternal morbidity, preterm birth, early-onset neonatal sepsis, bronchopulmonary dysplasia, retinopathy of prematurity, and diffuse…
Amniotic fluid surrounds the developing embryo throughout gestation, protecting the fetus and umbilical cord from trauma while allowing mobility to facilitate structural growth and development. The underlying forces that regulate amniotic fluid are exceedingly complex and dynamic, synchronizing volumes within…
Hydrops fetalis (HF) is defined as the presence of excessive fetal fluid in two or more of the following spaces: abdominal ascites, pleural effusion, pericardial effusion, skin edema, polyhydramnios, or placentomegaly. The diagnosis is made by ultrasound imaging evaluating body…