Abstract
Perinatal outcomes have improved steadily over time.1,2 Yet, in spite of overall lower neonatal and fetal mortality rates in Iowa, our outreach team continues to find unmet educational need in the community hospitals we visit. For example, in obstetrics: appropriate use of the vacuum extractor, the appropriateness of vaginal birth after cesarean delivery in community hospitals, proper use of tocolytics, and group B Streptococcus management. In newborn care, we note the failure to recognize the significance of neonatal respiratory distress and its relationship to sepsis, inappropriate management of significant jaundice, management of abdominal distention and vomiting in the early newborn period, and recognition of the early signs of sepsis.
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