Neonatal Network
September/Ocotber 2007
Vol. 26, No. 5

ABSTRACTS

Caput Succedaneum and Cephalohematoma: The Cs that Leave Bumps on the Head
Lisa Hicholson, RNC, MSN, NNP

Caput succedaneum and cephalohematoma are conditions that rarely evoke much concern in the NICU but deserve more attention. This article examines the two conditions, reviews the literature, discusses possible complications, and leaves the reader with a heightened awareness of these seemingly benign lesions.

Infants of Diabetic Mothers: The Effects of Hyperglycemia on the Fetus and Neonate
Laura L. Barnes-Powell, RNC, MS, NNP

News that a woman with diabetes is about to deliver brings up images of a macrosomic infant. This infant may experience birth injuries, asphyxia, respiratory distress, hypoglycemia, hypocalcemia, hyperbilirubinemia, polycythemia/hyperviscosity syndrome, asymmetric septal hypertrophy, and other congenital malformations. Uncontrolled diabetes has profound effects on embryogenesis, organogenesis, and fetal and neonatal growth, and evidence increasingly indicates that some of these effects are lifelong and may contribute to adult obesity. Preconception control of diabetes and monitoring throughout pregnancy are important in reducing the impact of diabetes on the fetus and newborn.

Postnatal Corticosteroids in the Treatment of Chronic Lung Disease in the Preterm Infant: Past, Present, Future
Julie Nye, MSN, NNP, PNP

Over the past 20 years, corticosteroid use in the preterm infant has fallen in and out of favor. Steroids were introduced in the 1980s as a mode of preventing and treating chronic lung disease (CLD) in the preterm infant population. This use has been targeted toward low birth weight infants who are unable to wean off the ventilator. Dose, duration, and timing of treatment with dexamethasone, the steroid typically used in NICUs, has varied. This article examines why the medication has fallen out of favor and whether postnatal corticosteroids still have a place in preventing and treating CLD.

Neonatal Back Transport: Perspectives from Parents of Medicaid-Insured Infants and Providers
Krystal Hanrahan, MSPH
Molly Gates, RN
Mohammad-Ali Attar, MD
Sylvia W. Lang, PhD
Alice Frohna, PhD
Sarah J. Clark, MPH

Purpose: to examine parents' and health care providers' perceptions of back transport from a tertiary care neonatal intensive care unit to a community hospital.

Design: Qualitative, hypothesis-generating, cross-sectional study utilizing focus group methodology.

Sample: Participants included 12 parents of back-transported infants insured by Medicaid, 6 regional nicu health care providers, and 17 community hospital special care nursery health care providers.

Main Outcome Measures: Participant perceptions of factors that support or impede successful back transport.

Results: data from the focus groups were analyzed to identify five main themes: early communication about back transport, preparing parents for back transport, communication between hospitals at the time of back transport, follow-up and information exchange after back transport, and improving the back-transport experience for parents.