Abstract
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.
Keywords
fetal center - neonatology - anomalies - fetal intervention - maternal–fetal medicine
- multidisciplinary
