News & Comment

In this article, we describe our experience in developing couplet care in our level 4 academic neonatal intensive care unit. We discuss the steps for implementation and optimization of couplet care as part of the renovation and reconstruction of a previous unit. Preliminary data from our couplet care population when compared to historical controls revealed significantly higher rates of any breastfeeding and shorter length of stay for our couplet care neonates. We also discuss the challenges and opportunities in undergoing such an undertaking. Many minds and hands worked together to make this reality possible.

Managing high-risk newborns with critical congenital heart disease (CCHD) in the delivery room is a unique challenge, characterized by complex physiology, heightened urgency, the coordinated efforts of multiple medical teams, and depending on the facility, the infrequent occurrence of such cases. Currently, there is a lack of unified guidance for resuscitation of these newborns in the delivery room. In this commentary, we advocate for an integrated approach involving maternal-fetal medicine specialists, fetal cardiologists, neonatologists, and cardiac intensivists. The proposed approach emphasizes collaborative pre-delivery planning, focusing on anticipated risk factors, postnatal physiology, and clinical management plans. We stress the importance of simulation-based education specifically addressing CCHD scenarios and advocate for research collaborations to establish evidence-based guidelines and track outcomes. Ultimately, a comprehensive, collaborative, and standardized approach, involving prenatal coordination, communication, and education, is essential for optimizing the delivery room management of neonates with CCHD.