http://neoreviews.aappublications.org Pediatrics RSS feed -- current issue 1526-9906 Aug 1 2008 12:00:00:000AM NeoReviews http://neoreviews.aappublications.org/icons/banner/title.gif http://neoreviews.aappublications.org http://neoreviews.aappublications.org/cgi/content/abstract/9/8/e321?rss=1 The ability to communicate effectively with families in the neonatal intensive care unit (NICU) is an essential skill for clinicians. Parental satisfaction and trust depend on the perception of open communication that reflects compassion, honesty, and caring. Families struggling with difficult situations in the NICU derive great benefit from discussions in which information is provided clearly and with empathy. Strategies for delivering bad news have been developed within the medical community and can be adapted for difficult discussions in the NICU. Such strategies can be integrated within an interactive curriculum that emphasizes simulation and role play to promote competency in communication skills.

]]> 2008-08-01 info:doi/10.1542/neo.9-8-e321 American Academy of Pediatrics 8 9 e325 2008-08-01 e321 Articles http://neoreviews.aappublications.org/cgi/content/abstract/9/8/e326?rss=1 Neonates are potent incentive stimuli who regulate the mother's ability and motivation to engage in costly care-taking activities during a most vulnerable period of their early life. Laboratory animal studies as well as functional neuroimaging in human mothers have shown that the medial preoptic area of the hypothalamus and its projections to the mesocorticolimbic dopaminergic system regulate the motivational aspects of maternal behavior. Peripartum hormonal changes acting in these brain areas enhance the reinforcing value of the newborns and promote in the mother the highly motivated behavior observed immediately after parturition. A better understanding of the neural mechanisms that regulate the motivational aspects of maternal behavior can help to increase awareness of the importance of the early maternal/parental-infant interaction as well as to identify possible biological factors that underlie anomalies in human maternal behavior.

]]> 2008-08-01 info:doi/10.1542/neo.9-8-e326 American Academy of Pediatrics 8 9 e331 2008-08-01 e326 Articles http://neoreviews.aappublications.org/cgi/content/abstract/9/8/e332?rss=1 Since the discovery of cell-free fetal DNA (cffDNA) in peripheral maternal blood a decade ago, advances have been made in the identification and clinical application of these segments. Most studies of cffDNA have focused on using the segments for sex determination and fetal Rh genotyping, employing differences in genomic DNA between mother and fetus. Research has shifted toward targeting cffDNA for noninvasive aneuploidy detection. Over the last decade, a tremendous volume of research has focused on advancing the understanding of cffDNA structure, function, and detection. Despite this growing body of evidence, gaps in understanding of the biology of cffDNA and challenges in its isolation, enrichment, and processing have limited clinical applications in noninvasive prenatal diagnosis.

]]> 2008-08-01 info:doi/10.1542/neo.9-8-e332 American Academy of Pediatrics 8 9 e337 2008-08-01 e332 Articles http://neoreviews.aappublications.org/cgi/content/abstract/9/8/e338?rss=1 Advances in the diagnosis of congenital defects have led to the development of a multidisciplinary approach to prenatal counseling and postnatal management. New techniques in fetal imaging, including magnetic resonance imaging (MRI), provide clinicians with better anatomic detail of such anomalies. This added information facilitates frank prenatal discussions with families, anticipating challenges in delivery room resuscitation and planning of postnatal care. In this report, we review three cases of giant omphalocele (GO) at our institution, highlighting the changes in practice management for prenatal diagnosis and consultation. We discuss controversies regarding mode of delivery and describe the evolution toward an initial nonsurgical approach to GO.

]]> 2008-08-01 info:doi/10.1542/neo.9-8-e338 American Academy of Pediatrics 8 9 e347 2008-08-01 e338 Articles http://neoreviews.aappublications.org/cgi/content/abstract/9/8/e348?rss=1 Increasing use of antenatal screening and genetic testing has created the circumstance of a woman who finds herself pregnant with a fetus that is known to be unsound. Some practitioners have become so concerned about the prospect of the less-than-perfect fetus that they have projected their personal desires into the care that they provide, thereby eliminating the possibility of following the natural history of the pregnancy. To serve the needs of these patients, a perinatal hospice service has been created.

]]> 2008-08-01 info:doi/10.1542/neo.9-8-e348 American Academy of Pediatrics 8 9 e352 2008-08-01 e348 Articles http://neoreviews.aappublications.org/cgi/content/full/9/8/e353?rss=1 2008-08-01 info:doi/10.1542/neo.9-8-e353 American Academy of Pediatrics 8 9 e354 2008-08-01 e353 Articles http://neoreviews.aappublications.org/cgi/content/full/9/8/e355?rss=1 2008-08-01 info:doi/10.1542/neo.9-8-e355 American Academy of Pediatrics 8 9 e360 2008-08-01 e355 Articles http://neoreviews.aappublications.org/cgi/content/short/9/8/e361?rss=1 2008-08-01 info:doi/10.1542/neo.9-8-e361 American Academy of Pediatrics 8 9 e361 2008-08-01 e361 Visual Diagnosis