News & Comment

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.

The Accreditation Committee on Graduate Medical Education (ACGME) will host a second open comment period this summer to gather feedback on the proposed major changes to pediatric residency requirements. The proposed changes will have large-scale impacts on neonatal-perinatal medicine (NPM) practice, fellowship training, and the public health of newborns, and thus continued, vigorous advocacy from the NPM community will be required. Three of the originally proposed modifications: reduction in the minimum time allotted to critical care, removal of procedural requirements, and elimination of neonatologists from pediatric residency core faculty have the potential to impact readiness for NPM fellowship training, the neonatal workforce, and the delivery of newborn care. Analyzing and then preparing for these changes will allow NPM fellowship programs, neonatologists, and the profession to continue to ensure the health of the 3.6 million infants born each year [1].