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Neonatology Review: Q & A

Editors, Dr. Brodsky and Dr. Martin, have granted us permission to reproduce these questions.

A term infant is born by cesarean section and transferred to the NICU at one hour of life with respiratory distress.  The infant is intermittently tachypneic and has some mild subcostal retractions and nasal flaring.  The infant has a room air oxygen saturation of 100%.  A chest radiograph reveals a pneumomediastinum.
What is the most appropriate NEXT step?

A. Administer supplemental oxygen
B. Initiate continuous positive airway pressure
C. Intubate the infant
D. Observe the infant
E. Obtain an arterial blood gas

Briefly Legal

Gastric Perforation in the Neonate

Maureen E. Sims, M.D.
Professor Emeritus, University of California, Los Angeles

Gastric perforation is a rare complication in neonates, but it is more common in preterm than term babies.  The causes are numerous, and the associated signs and symptoms are non-specific.  Gastric perforation can present with any combination of abdominal distention feeding intolerance, respiratory distress, poor activity, gastrointestinal bleeding, abdominal erythema, or shock. The mortality is high if there is a delay in recognition and surgical repair.

Gastric Perforation »
Hemologic Disease »

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Necrotizing enterocolitis: a clinical review on diagnostic biomarkers and the role of the intestinal microbiota

In this manuscript, the authors review the role of the intestinal microbiome-related factors in the pathogenesis, diagnosis, and treatment of NEC. Clinical prediction models and the potential utility of noninvasive biomarkers for early detection of NEC are also described.

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Section on Perinatal Pediatrics

The Section on Perinatal Pediatrics is the home organization for specialists in Neonatal-Perinatal Medicine and also welcomes affiliate members working in related disciplines. At a membership of nearly 3,500, the Section is the largest specialty group of the American Academy of Pediatrics. The Section's highest priority is to ensure optimal health and well-being of babies and mothers and this is accomplished through the Section's core activities in the realms of advocacy, education, outreach and support of clinicians and researchers.

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