First name
Felix
Middle name
R
Last name
De Bie

Title

Neonatal and fetal therapy of congenital diaphragmatic hernia-related pulmonary hypertension.

Year of Publication

2022

Number of Pages

458-466

Date Published

09/2022

ISSN Number

1468-2052

Abstract

Congenital diaphragmatic hernia (CDH) is a complex malformation characterised by a triad of pulmonary hypoplasia, pulmonary hypertension (PH) and cardiac ventricular dysfunction. Much of the mortality and morbidity in CDH is largely accounted for by PH, especially when persistent beyond the neonatal period and refractory to available treatment. Gentle ventilation, haemodynamic optimisation and pulmonary vasodilation constitute the foundations of neonatal treatment of CDH-related PH (CDH-PH). Moreover, early prenatal diagnosis, the ability to assess severity and the developmental nature of the condition generate the perfect rationale for fetal therapy. Shortcomings of currently available clinical therapies in combination with increased understanding of CDH pathophysiology have spurred experimental drug trials, exploring new therapeutic mechanisms to tackle CDH-PH. We herein discuss clinically available neonatal and fetal therapies specifically targeting CDH-PH and review the most promising experimental treatments and future research avenues.

DOI

10.1136/archdischild-2021-322617

Alternate Title

Arch Dis Child Fetal Neonatal Ed

PMID

34952853

Title

Ethics Considerations Regarding Artificial Womb Technology for the Fetonate.

Year of Publication

2022

Number of Pages

1-12

Date Published

2022 Apr 01

ISSN Number

1536-0075

Abstract

<p>Since the early 1980's, with the clinical advent of in&nbsp;vitro fertilization resulting in so-called "test tube babies," a wide array of ethical considerations and concerns regarding artificial womb technology (AWT) have been described. Recent breakthroughs in the development of extracorporeal neonatal life support by means of AWT have reinitiated ethical interest about this topic with a sense of urgency. Most of the recent ethical literature on the topic, however, pertains not to the more imminent scenario of a physiologically improved method of neonatal care through AWT, but instead to the remote scenario of "complete ectogenesis" that imagines human gestation occurring entirely outside of the womb. This scoping review of the ethical literature on AWT spans from more abstract concerns about complete ectogenesis to more immediate concerns about the soon-to-be-expected clinical life support of what we term the fetal neonate or fetonate. Within an organizing framework of different stages of human gestational development, from conception to the viable premature infant, we discuss both already identified and newly emerging ethical considerations and concerns regarding AWT and the care of the fetonate.</p>

DOI

10.1080/15265161.2022.2048738

Alternate Title

Am J Bioeth

PMID

35362359

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