Advances in Perinatal Medicine : Volume 5 PDF

The state of health care is reflected by perinatal and neonatal morbidity and mortality as well as by the frequencies of long-term neurologic and developmental disorders.

Many factors, some without immediately rec- ognizable significance to childbearing and many still unknown, undoubt- edly contribute beneficially or adversely to the outcome of pregnancy.

Knowledge concerning the impact of such factors on the fetus and sur- viving infant is critical.

Confounding analyses of pregnancy outcome, especially these past two or three decades, are the effects of newly un- dertaken invasive or inactive therapeutic approaches coupled with the advent of high technology.

Many innovations have been introduced with- out serious efforts to evaluate their impact prospectively and objectively.

The consequences of therapeutic misadventures characterized the past; it seems they have been replaced to a degree by some of the complications of applied technology.

Examples abound: after overuse of oxygen was recognized to cause retrolental fibroplasia, its restriction led to an in- crease in both neonatal death rates and neurologic damage in surviving infants.

Administration of vitamin K to prevent neonatal hemorrhagic disease, particularly when given in what we now know as excessive dos- age, occasionally resulted in kernicterus.

Prophylactic sulfonamide use had a similar end result.

More recent is the observation of bronchopul- monary dysplasia as a complication of respirator therapy for hyaline membrane disease.