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Fetal centers and the role of the neonatologist in complex fetal care.

CPQCC Publication
TitleFetal centers and the role of the neonatologist in complex fetal care.
Publication TypeJournal Article
Year of Publication2014
AuthorsDavis AS, Chock VY, Hintz SR
JournalAm J Perinatol
Date Published2014 Aug
KeywordsFemale, Fetal Diseases, Fetal Therapies, Health Facilities, Humans, Neonatology, Patient Care Team, Physician's Role, Pregnancy, Prenatal Care, Prenatal Diagnosis

As prenatal imaging and genetic diagnostic techniques developed, clinicians knew earlier and with greater accuracy of the extent and severity of fetal anomalies. This, coupled with an acute awareness of high rates of death or devastating neonatal morbidities in some cases, drove efforts to create innovative fetal interventions. However, with advances in neonatal quaternary care, infants with even the most complex congenital anomalies now have a substantially greater chance of survival. But many still require highly coordinated intensive care from the moment of delivery, have lengthy and complicated hospitalizations, and need ongoing complex care and services. Therefore, a new vision of complex fetal medicine must evolve, actively integrating robust multidisciplinary involvement in collaborative counseling, planning, and management. The clinical arc visualized for complex fetal patients should shift toward a comprehensive continuum of care concept-extending from fetal life, through neonatal intensive care, to childhood. The neonatologist plays a critical role in bridging this trajectory, coordinating complex processes to a smooth delivery and neonatal plan, counseling and preparing expectant mothers, and integrating many components of subspecialty input for families and other fetal team members. Neonatologists' engagement and perspective can substantively inform the clinical and strategic direction for fetal centers.

Alternate JournalAm J Perinatol
PubMed ID24705973