Key Points The key feature of neonatal physiology is rapid maturation, resulting in extensive variability in pharmacokinetics and pharmacodynamics, further aggravated by other covariates, like pharmacogenetics or unique disease characteristics. Variability is the essence of neonatal care and neonatal pharmacology.…
Key Points In the neonate, many pathologic states and/or their treatment are associated with disruptions in normal body fluid, electrolyte, and acid-base balance, which at times may in themselves become life-threatening. Conversely, many conditions may be negatively affected by disruptions…
Key Points Regionalization of neonatal critical care improves outcomes. Highly effective transport systems feature centralized and standardized communications, experienced medical oversight and skilled teams trained to care for sick neonates. Appropriate transport care depends on the training and competency of…
Key Points Newborn screening (NBS) provides an opportunity for early identification of newborns with disorders in which the clinical complications develop postnatally and may remain unrecognized prior to irreversible clinical damage. Since its inception nearly six decades ago, with screening…
Key Points Providing an appropriate and stable thermal environment is important for newborns regardless of size or gestational age. Neutral thermal environment (NTE) refers to the ambient temperature necessary to maintain normal metabolism. Newborn (admission) hypothermia continues to be a…
Key Points Prenatal ultrasonography can diagnose multiple newborn conditions early. However, the natural history of many common ultrasound findings is variable, and the findings may or may not represent markers of serious disease. The short-term and long-term benefits of breastfeeding…
Key Points Preparation prior to delivery helps ensure timely and effective newborn resuscitation. Delayed umbilical cord clamping following delivery may have a significant impact on newborn outcomes. Establishing adequate ventilation is key to the perinatal transition. The laryngeal mask airway…
Key Points Labor results in significant pain for many women that is individualized, dynamic, and unpredictable. Although the effects of obstetric analgesia and anesthesia on the fetus and neonate are typically benign, there is potential for adverse neonatal effects. During…
Key Points Cesarean section occurs in approximately one-third of all births in the United States, with substantial variation among hospitals that cannot be entirely accounted for by preexisting maternal or fetal comorbidities. Multidisciplinary team training can reduce infant morbidity after…
Key Points Fetal assessment demands a view into the somewhat inaccessible intrauterine environment; the primary tools are ultrasound and fetal heart rate monitoring. It is important to make the distinction between intrapartum (during labor) and antepartum (before labor) fetal assessment;…