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Neurodevelopmental outcomes following very preterm birth: What clinicians need to know
Introduction The vast majority of children born very preterm (<32 weeks’ gestation) now survive, with survival rates increasing significantly over the past three decades due to advances in obstetric and neonatal care. While important, survival is only one outcome, and…
Congenital heart disease: An important cause of brain injury and dysmaturation
Key points Although there have been significant improvements in the survival of infants with congenital heart disease (CHD), they remain at high risk for neurodevelopmental impairments. Brain dysmaturation and brain injury are key brain changes contributing to adverse neurodevelopmental outcomes…
Magnetic resonance imaging—newer techniques and overall value in diagnosis and predicting long-term outcome
Introduction Despite marked improvements in antenatal and perinatal care, perinatal brain injury remains one of the most important medical complications in the newborn resulting in significant handicap later in life. Experimental advances have helped to understand many of the cellular…
Amplitude-integrated EEG and its potential role in improving neonatal care within the NICU
Case description ( Fig. 14.1 ) The patient was born at 40 weeks’ gestation and weighed 3150 g at birth. An emergency cesarean section was performed for suspected fetal compromise with bradycardia on the cardiotocogram because of a nuchal cord.…
Neonatal hypotonia and neuromuscular disorders
Gaps in knowledge 1. The severe hypotonia and hyporeflexia in Prader-Willi syndrome (PWS) may lead to unnecessary invasive tests such as electromyography, muscle biopsy, and/or genetic testing for spinal muscular atrophy (SMA). Genetic testing for PWS is not well understood…
Neonatal herpes simplex virus, congenital cytomegalovirus, congenital Zika, and congenital and neonatal SARS-CoV-2 virus infections
Key points After reading this chapter, readers will be familiar with the epidemiology of congenital infections such as CMV, HSV, Zika, and SARS-CoV-2 virus. Risk factors for acquiring these infections are discussed. Clinical manifestations, diagnosis, treatment, and clinical outcomes are…
Neonatal meningitis: Current treatment options—an update
Summary As many as 40% of infants with meningitis do not have a positive blood culture at the time of their diagnosis. Infants with uncomplicated meningitis due to group B streptococcus should receive a 14-day course of antimicrobial therapy. A…
Glucose and perinatal brain injury: Questions and controversies
Introduction Neonatal hypoglycemia is the most common biochemical abnormality of the newborn, affecting 5%–15% of all infants and 50% of those with risk factors. Although severe hypoglycemia has been incontrovertibly linked with brain injury and impairment, the glucose thresholds below…
Diagnosis and management of acute symptomatic seizures in neonates
Neonatal seizures—introduction Seizures occur during the neonatal period in approximately 2 to 4 per 1000 live births. Seizures are a neurologic emergency: they are often caused by acute brain injury or treatable underlying conditions and rapid, appropriate treatment can improve…