The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
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Clinical and laboratory investigations of neonatal pain suggest that preterm neonates are more vulnerable to stress and painful procedures and have heightened responses to successive stimuli. Preterm infants receiving intensive care are subjected to frequent invasive and stressful procedures as well as more chronic environmental influences. Acute episodic pain may cause early neurologic injury. ⋯ Several pain measures exist to assess pain in full-term and preterm neonates, including behavioral indicators and physiological indicators of pain. Therapeutic interventions can provide comfort and analgesia in preterm neonates. Guidelines for preventing or treating neonatal pain and its adverse consequences include recognition of the sources of pain and routine assessments of neonatal pain, avoidance of recurrent painful stimuli and the use of specific non-pharmacological and pharmacological interventions.
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J. Matern. Fetal. Neonatal. Med. · Aug 2009
Anaesthetic management of patients with pre-eclampsia/eclampsia and perinatal outcome.
This study examined risk factors for perinatal mortality associated with anaesthesia for caesarean delivery in patients with pre-eclampsia/eclampsia. The study is apt because perinatal mortality rate is one of the indicators of health status of pregnant women, new mothers and their newborns. The information obtained may help to assess changes in public health policy and practise amongst women of child-bearing age. ⋯ Pre-eclampsia/eclampsia continues to be a cause of foetal loss in the developing world even where essential obstetric services are available. Early onset management of severe pre-eclampsia with maintenance of adequate placental perfusion during anaesthesia may result in lower perinatal deaths.
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J. Matern. Fetal. Neonatal. Med. · Aug 2009
ReviewImplementing safe obstetric anesthesia in Eastern Europe.
The position of woman in any civilization is an index of the advancement of that civilization; the position of woman is gauged best by the care given her at the birth of her child. Obstetric anesthesia, by definition, is a subspecialty of anesthesia devoted to peripartum, perioperative, pain and anesthetic management of women during pregnancy and the puerperium. ⋯ Perhaps, no other subspecialty of anesthesiology provides more personal gratification than the practice of obstetric anesthesia. This article reviews the challenges associated with implementing safe obstetric anesthesia practice in Eastern Europe.
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J. Matern. Fetal. Neonatal. Med. · Jun 2009
Randomized Controlled TrialThe effects of the tocolytics atosiban and nifedipine on fetal movements, heart rate and blood flow.
The choice of first-line tocolytic agent is a topic of worldwide debate. The oxytocin receptor antagonist atosiban and the calcium antagonist nifedipine appear to be effective in postponing delivery. However, information is lacking on their possible effects on the fetal biophysical profile. ⋯ This study demonstrates for the first time the direct effects of atosiban on fetal movement, heart rate and blood flow. Tocolysis with either atosiban or nifedipine combined with betamethasone administration appears to have no direct fetal adverse effects.
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J. Matern. Fetal. Neonatal. Med. · Mar 2009
Maternal and perinatal outcome in obese pregnant patients.
Obesity represents a rapidly emerging epidemic amongst pregnant patients in South Australia, in particular in Adelaide's Northern suburbs, one of the poorest urban areas in Australia. The aim of the current study was to prepare a comprehensive overview of maternal and perinatal outcome in overweight, obese and morbidly obese pregnant patients. ⋯ These South Australian data from a socio-economically deprived area in Adelaide's Northern suburbs confirm that obesity during pregnancy represents a major risk for adverse outcome for patients with a whole spectrum of adverse pregnancy outcomes; obesity represents a major challenge for health care providers.