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2022 | July-September | Volume 1 | Issue 3

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Rachana Singh

Coordinated Multispecialty Care: A Need for Critically Ill Newborn Infants

[Year:2022] [Month:July-September] [Volume:1] [Number:3] [Pages:1] [Pages No:00 - 00]

   DOI: 10.5005/newborn-1-3-iv  |  Open Access |  How to cite  | 



Neha Chaudhary, Romal Jassar, Rachana Singh

Neonatal Anemia

[Year:2022] [Month:July-September] [Volume:1] [Number:3] [Pages:8] [Pages No:263 - 270]

Keywords: Erythropoiesis, Hemoglobin, Hematocrit, Packed red blood cell transfusion

   DOI: 10.5005/jp-journals-11002-0027  |  Open Access |  How to cite  | 


Neonatal anemia is a public health problem of global concern and has significant associations with many short- and long-term morbidities. Many etiological factors ranging from perinatal physiologic transition, hematological maturation, illnesses, and iatrogenic reasons such as the phlebotomies necessary for laboratory evaluation may be involved, and there is a need for careful clinical decisions. In premature infants, the management of anemia also has to factor in the unique hematological transition seen during development, co-morbidities associated with preterm birth, the severity of illness severity, and all the iatrogenic factors. Untreated severe anemia is known to negatively impact long-term growth and neurodevelopment outcomes, making early diagnosis and treatment imperative. Additionally, there is a lack of consensus about the threshold and timing of packed red blood cell transfusions, and we need further consideration in view of various associated complications. Therefore, clinicians need to focus on preventable causes of anemia such as nutritional deficiencies, chronic illness, and excessive phlebotomy losses. In this article, we attempt to summarize the pathophysiology, etiologies, clinical management, and the opportunities in research in the field of neonatal anemia.



Use of Fresh-frozen Plasma in Newborn Infants

[Year:2022] [Month:July-September] [Volume:1] [Number:3] [Pages:7] [Pages No:271 - 277]

Keywords: Coagulation tests, Disseminated intravascular coagulation, Fresh-frozen plasma, Hemorrhages, Plasmapheresis, Relative risk, Whole-blood donor units

   DOI: 10.5005/jp-journals-11002-0039  |  Open Access |  How to cite  | 


Nearly 10% of premature and critically ill infants receive fresh-frozen plasma (FFP) transfusions to reduce their high risk of bleeding. The authors have only limited data to identify relevant clinical predictors of bleeding and to evaluate the efficacy of FFP administration. There is still no consensus on the optimal use of FFP in infants who have abnormal coagulation parameters but are not having active bleeding. The aims of this review are to present current evidence derived from clinical studies focused on the use of FFP in neonatology and then use these data to propose best practice recommendations for the safety of neonates receiving FFP.

Supplementary File



Akash Sharma, Mohammad Mozibur Rahman, Suresh B Boppana

Congenital and Perinatal Varicella Infections

[Year:2022] [Month:July-September] [Volume:1] [Number:3] [Pages:9] [Pages No:278 - 286]

Keywords: Congenital varicella syndrome, Herpes zoster, Neonatal varicella, Postexposure prophylaxis, Varicella–zoster virus, Vesicular rash, Varicella zoster immunoglobulin

   DOI: 10.5005/jp-journals-11002-0040  |  Open Access |  How to cite  | 


Varicella–zoster virus (VZV) is a human pathogen of the α-herpesvirus family. Some fetuses infected in utero around 8–20 weeks of pregnancy show signs of congenital varicella syndrome (CVS). Infants born to mothers who develop varicella within 5 days before and 2 days after delivery can experience severe disease with increased mortality. The best diagnostic modality is polymerase chain reaction (PCR), which can be done using vesicular swabs or scrapings, scabs from crusted lesions, tissue from biopsy samples, and cerebrospinal fluid. The prevention and management of varicella infections include vaccination, anti-VZV immunoglobulin, and specific antiviral drugs. In this article, we have reviewed the characteristics of VZV, clinical manifestations, management of perinatal infections, and short- and long-term prognosis.



Roya Huseynova Arif, Latifa Bin Mahmoud, Abdel Basit El Syed Ali, Adli Abdelrahim, Oktay Huseynov Ilham, Fazal Nouman Wahid, Mohammad Mozibur Rahman, Nalinikanta Panigrahy, Devendra Panwar, Kamlesh Jha

Gastroschisis: Anatomic Defects, Etiopathogenesis, Treatment, and Prognosis

[Year:2022] [Month:July-September] [Volume:1] [Number:3] [Pages:10] [Pages No:287 - 296]

Keywords: Abdominal wall defect, Amniotic fluid, Atresia, Chronic hypertension, Congenital, Gastroschisis, Neonatal intensive care unit, Pulmonary

   DOI: 10.5005/jp-journals-11002-0041  |  Open Access |  How to cite  | 


Gastroschisis is a congenital defect in the abdominal wall that is typically located to the right of the umbilicus. The intestines, and sometimes parts of the liver and the stomach, also protrude into the amniotic space. Unlike in omphaloceles, these visceral organs do not have a covering sac and are directly exposed to the amniotic fluid. The organs show variable degrees of inflammatory changes and scarring. In this review, we have summarized currently available information on the anatomical changes in the intestine directly exposed to the amniotic fluid, the etiopathogenesis, treatment, and prognosis.



Sushant Satish Mane, Sofia Cartaya, Mohd Mujibur Rahman, Pradeep Dudeja

Enteroviral Infections in Infants

[Year:2022] [Month:July-September] [Volume:1] [Number:3] [Pages:9] [Pages No:297 - 305]

Keywords: Coxsackie virus, Enteroviruses, Neonate, Newborn

   DOI: 10.5005/jp-journals-11002-0036  |  Open Access |  How to cite  | 


Enteroviruses (EVs) are major pathogens in young infants. These viruses were traditionally classified into the following four subgenera: polio, coxsackie A and B, and echoviruses. Now that poliomyelitis seems to be controlled in most parts of the world, coxsackie and echoviruses are gaining more attention because (i) the structural and pathophysiological similarities and (ii) the consequent possibilities in translational medicine. Enteroviruses are transmitted mainly by oral and fecal–oral routes; the clinical manifestations include a viral prodrome including fever, feeding intolerance, and lethargy, which may be followed by exanthema; aseptic meningitis and encephalitis; pleurodynia; myopericarditis; and multi-system organ failure. Laboratory diagnosis is largely based on reverse transcriptase–polymerase chain reaction, cell culture, and serology. Prevention and treatment can be achieved using vaccination, and administration of immunoglobulins and antiviral drugs. In this article, we have reviewed the properties of these viruses, their clinical manifestations, and currently available methods of detection, treatment, and prognosis.



Krystle Perez, Gregory Charles Valentine, Sushma Nangia, Douglas G Burrin, Mahlet Abayneh, Redeat Workneh, Maggie Jerome, N Alejandro Dinerstein, Ariel Salas

Advancement of Enteral Feeding in Very-low-birth-weight Infants: Global Issues and Challenges

[Year:2022] [Month:July-September] [Volume:1] [Number:3] [Pages:8] [Pages No:306 - 313]

Keywords: Enteral nutrition, Necrotizing enterocolitis, Prematurity

   DOI: 10.5005/jp-journals-11002-0038  |  Open Access |  How to cite  | 


In very-low-birth-weight (VLBW) infants, the initiation of enteral feedings is frequently delayed and the feeding volumes are advanced very slowly. Clinicians often express concerns about gut immaturity and consequent increased risk of feeding intolerance, spontaneous intestinal perforation (SIP), and necrotizing enterocolitis (NEC). Late initiation and ultracautious advancement of enteral feedings are seen all over the world, despite known associations with a prolonged need for central venous access and increased risk of sepsis, which is one of the leading causes of neonatal mortality. Promoting early establishment of full enteral feeding, particularly when maternal or donor milk is available, can improve neonatal outcomes, particularly the incidence of central-line-associated bacterial infections, the length of hospital stay, and survival. This review highlights current evidence for maximizing enteral feeding strategies for VLBW infants in various settings. Specifically, we will outline the physiologic evidence for early and continued enteral feedings in VLBW infants, discuss considerations for the initiation and advancement of enteral feedings, and highlight future areas of research focused on these issues. Consideration for the evidence from low- as well as high-resource settings is critical to inform optimal feeding strategies of VLBW infants globally.



Mona Khalaf, Haider Nadhim, Fares Chedid, Yaser Al Sayed, Rola AlAzi, Ahmad Mohd Haider Al Amad, Suad Hannawi, Mahmoud Hamouri, Majeed Jawad, Abdulrahman Al Nemri, Alok Sharma, Yusra Swaidat, Rola Al Thawbti

Neonatal Intensive Care Unit Care of Newborn Infants born to Mothers with Suspected or Confirmed COVID-19 Infection

[Year:2022] [Month:July-September] [Volume:1] [Number:3] [Pages:6] [Pages No:314 - 319]

Keywords: Acute respiratory syndrome-coronavirus 2, Coronavirus disease-19, Neonatal intensive care unit, Personal protection equipment, Ribonucleic acid reverse transcription-polymerase chain reaction, Reverse transcription-polymerase chain reaction, Severe acute respiratory syndrome-coronavirus 2

   DOI: 10.5005/jp-journals-11002-0042  |  Open Access |  How to cite  | 


The virus severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), which was later termed Coronavirus disease-19 (COVID-19), was first identified as a cause of atypical respiratory diseases in the Hubei Province of Wuhan, China, December 2019, and was then officially declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Severe acute respiratory syndrome coronavirus 2 contains a single-stranded, positive-sense ribonucleic acid (RNA) genome surrounded by an extracellular membrane containing a series of spike glycoproteins resembling a crown. In this article, we have reviewed the perinatal clinical implications of SARS-CoV-2 infections and their management in birthing and neonatal intensive care units (NICUs). Increasing evidence suggest that strict hospital protocols are needed, but we may not need to separate the mothers and their infants or discourage breastfeeding. We have included information from our infection-control protocols in our hospitals and from an extensive literature search in the databases PubMed, EMBASE, and Scopus. To avoid bias in the identification of studies, keywords were shortlisted a priori from anecdotal experience and PubMed's Medical Subject Heading (MeSH) thesaurus.


Clinicopathological Conference Report

Shabih Manzar, Ramachandra Bhat, Sheila Asghar, Rosario Riel–Romero, Nitin Walyat, Octavio Arevalo–Espejo, Maroun Mhanna

Hypoxic–Ischemic Encephalopathy: To Cool, or Not to Cool, That Is the Question

[Year:2022] [Month:July-September] [Volume:1] [Number:3] [Pages:7] [Pages No:320 - 326]

Keywords: Apgar, Bradypnea, Electroencephalogram, Gag reflex, Gestation, Infant, Neonatal, Newborn

   DOI: 10.5005/jp-journals-11002-0037  |  Open Access |  How to cite  | 


An infant was born at 38 weeks’ gestation. The assigned Apgar scores were 2, 3, and 5 at 1, 5, and 10 minutes, respectively. The physical examination showed hypotonia, absent gag reflex, and poor response to pain. At 9 hours after birth, the infant was noted to have a subtle seizure and bradypnea. The infant was intubated and started on anticonvulsant therapy. A brain magnetic resonance imaging (MRI) and an electroencephalogram (EEG) were obtained. This report presents the clinical and diagnostic dilemma that is typically associated with decisions needed for treatment with therapeutic hypothermia (TH).


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