ABP Neonatal-Perinatal Medicine key terms

Administration of betamethasone or dexamethasone to a pregnant woman at risk of preterm delivery between roughly 24 and 34 weeks, accelerating fetal lung maturation and reducing respiratory distress syndrome, intraventricular hemorrhage, and neonatal death.

Birth before 37 completed weeks of gestation, classified as extremely, very, or moderate-to-late preterm; it is the leading cause of neonatal mortality and morbidity, including respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis.

A fetus that fails to reach its genetically determined growth potential, usually identified by estimated fetal weight below the 10th percentile for gestational age, often with abnormal umbilical artery Doppler findings and increased perinatal morbidity.

Intrapartum intravenous penicillin or ampicillin given to women colonized with group B Streptococcus, or with risk factors, to prevent early-onset neonatal sepsis and meningitis; adequate prophylaxis requires at least four hours before delivery.

Waiting at least 30 to 60 seconds after birth before clamping the umbilical cord, allowing placental transfusion that increases neonatal blood volume and iron stores and reduces intraventricular hemorrhage, while occasionally delaying resuscitation in depressed infants.

Assisted breathing delivered by bag-mask, T-piece resuscitator, or mechanical device to a newborn who is apneic or has ineffective respirations, using initial peak inspiratory pressures around 20 to 25 cm H2O and blended oxygen guided by pulse oximetry.

A 0-to-10 score assigned at one and five minutes after birth based on heart rate, respiratory effort, muscle tone, reflex irritability, and color; it documents newborn condition and response to resuscitation but does not define asphyxia.

Passage of fetal stool before birth, which may signal fetal stress; if the infant is depressed, tracheal suctioning before ventilation is no longer routinely recommended, and management focuses on airway clearance and resuscitation.

A disorder of preterm infants caused by surfactant deficiency, producing grunting, retractions, tachypnea, and hypoxemia soon after birth, with chest radiographs showing low lung volumes and a ground-glass pattern; surfactant replacement and respiratory support are mainstays.

Instillation of natural or synthetic surfactant into the trachea of an infant with respiratory distress syndrome, reducing surface tension, improving lung compliance, and decreasing pneumothorax and mortality; earlier administration is generally more effective.

Chronic lung disease of prematurity defined by ongoing need for respiratory support or supplemental oxygen at 36 weeks' postmenstrual age, resulting from injury to an immature lung exposed to ventilation, oxygen, infection, and inflammation.

Respiratory distress in a newborn born through meconium-stained fluid, caused by airway obstruction, chemical pneumonitis, surfactant inactivation, and persistent pulmonary hypertension; severe cases may require mechanical ventilation, surfactant, or extracorporeal membrane oxygenation.

Persistence of the fetal connection between the pulmonary artery and aorta after birth, causing a left-to-right shunt with a systolic murmur, bounding pulses, and pulmonary overcirculation; treatment options include observation, cyclooxygenase inhibitors, or catheter closure.

Failure of pulmonary vascular resistance to fall after birth, causing right-to-left shunting and severe hypoxemia that is often out of proportion to lung disease; management includes inhaled nitric oxide, oxygen, and treatment of underlying disorders.

Structural heart lesions in which pulmonary or systemic blood flow depends on a patent ductus arteriosus, such as pulmonary atresia or coarctation; closure causes rapid deterioration, so prostaglandin E1 is infused to keep the ductus open.

Continuous intravenous alprostadil used to maintain ductal patency in newborns with ductal-dependent congenital heart disease; apnea, hypotension, and fever are common adverse effects, so airway and blood pressure monitoring are required.

Neurologic dysfunction in a newborn after a peripartum hypoxic-ischemic event, staged by severity, with encephalopathy, seizures, and multiorgan injury; therapeutic hypothermia improves outcomes when started promptly in eligible infants.

Controlled cooling of a newborn with moderate-to-severe hypoxic-ischemic encephalopathy to 33.5 to 34.5 degrees Celsius for 72 hours, started within six hours of birth, which reduces death and severe neurodevelopmental disability.

Bleeding into the germinal matrix and ventricles, primarily in very preterm infants, graded I to IV by ultrasound; severe grades cause hydrocephalus and neurodevelopmental impairment, and prevention includes antenatal steroids and careful hemodynamic management.

Abnormal electrical or clinical events in the first month of life, most often caused by hypoxic-ischemic encephalopathy, intracranial hemorrhage, infection, or metabolic disturbances; most are subtle or electrographic only, so video-EEG monitoring is often needed.

An inflammatory bowel disease of preterm infants, often after enteral feeding, causing feeding intolerance, abdominal distension, bloody stools, and pneumatosis intestinalis; severe cases progress to perforation and require bowel resection.

Intravenous delivery of amino acids, dextrose, lipids, electrolytes, vitamins, and trace minerals when the gastrointestinal tract cannot be used; in preterm infants it supports growth and is advanced while enteral feeding is established.

Addition of protein, minerals, and vitamins to human milk fed to preterm infants to meet higher nutritional needs for growth and bone mineralization; fortification typically begins once enteral feeding reaches a threshold volume.

Bacterial infection presenting within the first 72 hours after birth, usually acquired vertically from maternal genital flora, especially group B Streptococcus and Escherichia coli; signs are nonspecific, so empiric ampicillin and gentamicin are started while cultures are pending.

Infection occurring after 72 hours of life, often hospital-acquired through central catheters or the gastrointestinal tract, with organisms such as coagulase-negative staphylococci, Staphylococcus aureus, and gram-negative bacilli; prevention relies on hand hygiene and catheter care.

Transplacental cytomegalovirus infection, the leading nonhereditary cause of sensorineural hearing loss; most infants are asymptomatic, but symptomatic cases may have growth restriction, hepatosplenomegaly, jaundice, thrombocytopenia, and neurodevelopmental sequelae.

Low blood glucose in the newborn, commonly defined as below 45 mg/dL in the first hours, caused by inadequate glycogen stores, hyperinsulinism, or increased utilization; persistent or severe cases require evaluation for endocrine and metabolic disorders.

Elevation of serum bilirubin in the newborn, arising from increased bilirubin production and immature conjugation; severe untreated levels risk kernicterus, so treatment uses phototherapy and, in extreme cases, exchange transfusion.

Treatment of neonatal jaundice with blue-green light that converts bilirubin into water-soluble isomers excreted without conjugation; intensity and duration depend on bilirubin level, gestational age, and risk factors for neurotoxicity.

Thyroid hormone deficiency present at birth, often from thyroid dysgenesis or dyshormonogenesis; newborn screening enables early levothyroxine treatment, which prevents irreversible intellectual disability if started within the first weeks.

Presence of an extra copy of chromosome 21, causing Down syndrome with hypotonia, characteristic facial features, congenital heart defects, duodenal atresia, and increased risk of leukemia and hypothyroidism; diagnosis is confirmed by karyotype or chromosomal microarray.

A genome-wide test that detects submicroscopic deletions and duplications, used as a first-tier evaluation for congenital anomalies and developmental delay; it identifies copy-number variants but does not detect balanced rearrangements or point mutations.

Population-based testing of dried blood spots and other measurements shortly after birth to detect treatable disorders such as congenital hypothyroidism, phenylketonuria, sickle cell disease, and cystic fibrosis, enabling early intervention before symptoms appear.

A collaborative process in which clinicians and parents exchange information about benefits, risks, and family values before agreeing on care, especially for premature infants at the border of viability or with uncertain long-term outcomes.

A structured, team-based review after a serious safety event that maps contributing factors across systems, equipment, communication, and policy, then recommends changes to prevent recurrence rather than assigning individual blame.

An organizational approach that distinguishes honest human error from reckless behavior, encouraging error reporting and learning while still holding staff accountable for unsafe choices; it supports patient safety and quality improvement in neonatal units.