The area of fetal medicine is a crossroads for modern medicine. The past 2 decades have seen the emergence of the fetus as a patient. It is incumbent upon both obstetricians and pediatricians to be knowledgeable about advances that affect the fetus and neonate. Although fetal medicine is fruitful ground for discussions of medical ethics and medical economics,this review will focus on recent advances in prevention of preterm labor and low birthweight, prenatal diagnosis, molecular biology, and congenital infection, including perinatal transmission of human immunodeficiency virus (HIV). Exclusion of other equally relevant topics, such as group B Streptococcus screening and prophylaxis,ultrasonography, Doppler studies, and antiphospholipid antibody syndromes, does not reflect their lack of importance.

Approximately 75% to 85% of neonatal deaths of normally formed infants are related to preterm delivery, although only about 10%of births in the United States are preterm (<37 wk gestational age). This rate of prematurity has...

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