HISTORY, PRESENT AND FUTURE OF NEONATOLOGY

Abstract

This paper deals with the history, present situation and future of neonatology. In the mid- the 20th century many pediatricans showed their interest in newborns. Several units for prematurely born infants already existed in the USA during the 1930's and 1940's, as well as written books about care of premature infants. The term ‘neonatology’ was introduced by Alexander Schaffer in 1960 in the introduction to the first edition of his book. The most important factors that will improve the care of newborns were: the miniaturization of blood samples  to determine blood gases,  different serum biochemistry tests; the ability to provide parenteral nutrition, and thermoregulation techniques. Management of respiratory distress syndrome was improved with intravenous glucose and correction of metabolic acidosis, accompanied by assisted ventilation, continuous positive air pressure, antenatal corticosteroids administration, and the introduction of exogenous surfactants. A significant influence on the cardiopulmonary management and treatment of neonates had pharmacological manipulation of the ductus arteriosus, maintaining blood pressure, echocardiography, and changes in the management of the treatment of persistent pulmonary hypertension, including the use of nitrogen oxides and extracorporeal membrane oxygenation. The regionalization of neonatal care; changes in parent-infant interaction; introducing technical changes such as phototherapy, monitoring oxygen saturation, brain imaging techniques, are considered the most important advances. Most importantly, infant born in 1960, who weighted hardly 1 kg had a mortality risk of 95%, and by 2000 the probability of survival increased to 95%. However, errors in neonatology are recognized and made the potential guidelines for the future.
Key words: neonatology, past, neonatal care