Mestan Karen K, Leibel Sandra L, Sajti Eniko, Pham Betty, Hietalati Samantha, Laurent Louise, Parast Mana
Department of Pediatrics/Division of Neonatology, University of California, San Diego School of Medicine, La Jolla, CA, USA.
Department of Pediatrics/Division of Neonatology, Rady Children's Hospital of San Diego, San Diego, CA, USA.
Front Pediatr. 2023 May 15;11:1174174. doi: 10.3389/fped.2023.1174174. eCollection 2023.
The impact of placental dysfunction and placental injury on the fetus and newborn infant has become a topic of growing interest in neonatal disease research. However, the use of placental pathology in directing or influencing neonatal clinical management continues to be limited for a wide range of reasons, some of which are historical and thus easily overcome today. In this review, we summarize the most recent literature linking placental function to neonatal outcomes, focusing on clinical placental pathology findings and the most common neonatal diagnoses that have been associated with placental dysfunction. We discuss how recent technological advances in neonatal and perinatal medicine may allow us to make a paradigm shift, in which valuable information provided by the placenta could be used to guide neonatal management more effectively, and to ultimately enhance neonatal care in order to improve our patient outcomes. We propose new avenues of clinical management in which the placenta could serve as a diagnostic tool toward more personalized neonatal intensive care unit management.
胎盘功能障碍和胎盘损伤对胎儿及新生儿的影响已成为新生儿疾病研究中一个越来越受关注的话题。然而，由于多种原因，胎盘病理学在指导或影响新生儿临床管理方面的应用仍然有限，其中一些原因是历史性的，如今很容易克服。在本综述中，我们总结了将胎盘功能与新生儿结局联系起来的最新文献，重点关注临床胎盘病理学发现以及与胎盘功能障碍相关的最常见新生儿诊断。我们讨论了新生儿和围产医学领域最近的技术进步如何使我们能够实现范式转变，即利用胎盘提供的有价值信息更有效地指导新生儿管理，并最终加强新生儿护理以改善患者结局。我们提出了新的临床管理途径，其中胎盘可作为一种诊断工具，用于实现更个性化的新生儿重症监护病房管理。
