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Books > Medicine > Clinical & internal medicine > Gynaecology & obstetrics > Materno-fetal medicine
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Advances in Perinatal Medicine - Volume 1 (Paperback, 1981 ed.)
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Advances in Perinatal Medicine - Volume 1 (Paperback, 1981 ed.)
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The state of health care isreflected by perinatal and neonatal
morbidity and mortality as weIl as by the frequencies of long-term
neurological and developmental disorders. Many factors, some
without immediately recognizable significance to childbearing and
many still unknown, undoubtedly contribute beneficially or
adversely to the outcome of pregnancy. Knowledge concerning the
impact of such factors on the fetus and survivinginfant iscritical.
Confounding analysesofpregnancy outcome, especially these past 2 or
3 decades, are the effects of newly undertaken invasive or inactive
therapeutic approaches coupled with the advent of high technology.
Many innovations have been introduced without serious efforts to
evaluate their impact prospectively and objectively. The
consequences of therapeutic misadventures character ized 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 increase 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 dosage, occasionally resulted in
kernicterus. Prophy lactic sulfonamide use had a similar end
result. More recent is the observation of bronchopulmonary
dysplasia as a complication of re spirator therapy for hyaline
membrane disease. The decade of the eighties opened with the
all-time highest rate of cesarean section in the United States.
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