Obstetric Anesthesiology as the Third Pillar of Perinatology

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control during labor, 3 and Ian Donald (Glasgow) introduced the ultrasound into the imaging methods of obstetrics. 4 The term "neonatology" was coined by Alexander Schaffer, whose book on the subject, "Diseases of the Newborn," was first published in 1960.5 This book, together with Clement Smith's "Physiology of the Newborn Infant" 6 formed cornerstones of the developing field.A body of specialized knowledge, a group of subspecialized professionals, the advent of technically advanced equipment, and the formation of special care units all contributed to the Over the course of the last 60 years, obstetrics, which had remained virtually unchanged for centuries, has progressively emerged from the past to become a scientific discipline and perinatal medicine has been born.It has evolved from the cultivation of an art to a science. 1 Perinatal medicine did not begin to take shape until the beginning of the 1960s.In 1961, the first direct examination of the human fetus was carried out by taking blood samples from its presenting part during labor.Late in the 1960s, further events brought essential breakthroughs, namely when cardiotocography and ultrasonography were introduced on a broad scale, and suitable equipment became available for the first time for routine use.Armed with these new resources, specialists began to realize, for the first time, that the fetus could be considered a patient; their efforts focused on monitoring it during both pregnancy and birth itself.Until the 1960s, the fetus remained a genuinely unknown entity to both obstetricians and the medical world in general.Besides studying in a rudimentary fashion, its position inside the maternal claustrum, its approximate growth, and the presence of a fetal heartbeat, doctors were incapable of obtaining any other kind of fetal information.During these years, three prestigious personalities in this field have defined the limits of the subspecialty and published the first protocols-Erich Saling (Berlin), responsible for the introduction of biochemical (acidbase balance) control of labor, 2 Roberto Caldeyro-Barcia (Montevideo), who introduced the biophysical (electronic)

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