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Obstetricians and pediatricians in daily practice will find here
the answersand explanations they need concerning the major problem
of perinatal asphyxia. Leading experts in pediatrics, obstetrics
and neurophysiology havecome together to produce a single
sourcebook covering all aspects of thesubject. Biochemical
mechanisms and clinical aspects of perinatal asphyxia, fetal and
neonatal assessment, and perinatal management are thoroughly
discussed. Neurodevelopmental outcome is another important issue
addressed. In light of newer technologies, the prognosis of infants
suffering from asphyxia is examined. Many figures and typicalcases
are provided, making the book easy to use and providing quick
access to solutions. The reader can easily identify a problem in
the fetus and its subsequent development. With such knowledge, the
improved managementof perinatal asphyxia is made possible.
There has been increasing interest in neonatal neurology,
especially since imaging techniques were introduced in the neonatal
ward. Looking at the natural history of imaging techniques, we can
identify three main axes of its development. Logically, it was
first essential to image the brain morphologically. For this
purpose, computed tomography was initially used, followed by ultra
sound. However, to improve the quality of the images, magnetic
resonance imaging was introduced. Major features of ultrasound and
magnetic reso nance imaging are their safety and lack of
ionization. Morphological imaging techniques have proved to be
insufficient to ex plain the mechanisms underlying CNS injuries.
Thus, it was essential to develop functional techniques to assess
cerebral hemodynamics and oxy genation. The use of Doppler
ultrasound, PET scanning, SPECT scanning and, more recently, NIRS
have widened our knowledge of general neurolog ical problems.
Finally, to achieve our goal of attaining a better understanding of
CNS injuries, it is important to assess cerebral cellular
metabolism. Magnetic resonance spectroscopy was introduced to
achieve this goal. We hope that this book links these different
techniques in order to widen our horizon. The future is promising
and bound to provide further develop ments, which however can only
be understood if we grasp the present level of development.
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