By Gordon B Avery; Mhairi G MacDonald; Mary M K Seshia; Martha D Mullett
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Extra info for Avery's neonatology : pathophysiology & management of the newborn
We will need new types of statistics to aid in benchmarking interventions and studies of the impact of benchmarking practices. Large, computer-supported databases will help with hypothesis generation. 7 versus the specific interventions we intend to study. And some of our interventions will be outside the nursery, in programs of education and/or pre- and post-NICU care. The years ahead will be as fast paced and challenging as those that have gone before. TABLE 1-1 NEONATOLOGY—PAST, PRESENT, AND FUTURE.
In obstetrics, these same elements came together approximately 10 years later and resulted in the specialty of maternofetal medicine. Perinatologists developed high-risk prenatal clinics and special delivery facilities for unstable patients. A steadily growing body of literature from animal and clinical investigations allowed improved management of pregnancy complications and monitoring of fetal status. Ultrasonography detected fetal abnormalities and determined fetal size, anatomy, activity, breathing, and response to stress.
A sturdy trunk has developed in the intensive care nurseries (ICNs) scattered across the United States and around the world. The branches have spread so widely that it is difficult for a single person to be expert in all the areas of activity required for a tertiary neonatology service. Important interactions have gone beyond allied disciplines such as obstetrics, anesthesiology, cardiology, radiology, and surgery. Neonatologists today struggle with hospital administrators, pediatric training program directors, legislatures, Congress, the courts, the federal government, malpractice lawyers, right-to-life groups, and ethicists in an effort to determine their proper roles and limits.