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The Progress of Perinatal Medicine in Italy

Perinatal Medicine in Italy became a national entity with the foundation in Rome in 1984 of the Italian Society of Perinatal Medicine. Some pioneering works from late 60s have been done previously mainly by groups of investigators based at the Universities of Parma (Bruno Salvadori), Florence (Corrado Vecchi) and Rome (Emilio Imparato), followed in the 70s by groups in Modena (Giorgio Montanari), Rome (Antonio Pachi’, Ermelando Cosmi, Giovanni Bucci) Milan (Giorgio Pardi), and others. It is through the foundation and implementation of the Italian Society that the development of perinatal medicine in Italy has taken a big step forward. In particular, the Society produced two sets of Guidelines on the “Organisation and management of perinatal medicine” which marked the organisation, homogenisation and advancement of perinatal centers in Italy, and the systematic audit of perinatal medicine statistics bringing Italy among the countries in the world which have the best perinatal organisation, and the best perinatal statistics in term of maternal and fetal-neonatal mortality and morbidity [1,2] (Table 1).


Introduction
Perinatal Medicine in Italy became a national entity with the foundation in Rome in 1984 of the Italian Society of Perinatal Medicine. Some pioneering works from late 60s have been done previously mainly by groups of investigators based at the Universities of Parma (Bruno Salvadori), Florence (Corrado Vecchi) and Rome (Emilio Imparato), followed in the 70s by groups in Modena (Giorgio Montanari), Rome (Antonio Pachi' , Ermelando Cosmi, Giovanni Bucci) Milan (Giorgio Pardi), and others. It is through the foundation and implementation of the Italian Society that the development of perinatal medicine in Italy has taken a big step forward. In particular, the Society produced two sets of Guidelines on the "Organisation and management of perinatal medicine" which marked the organisation, homogenisation and advancement of perinatal centers in Italy, and the systematic audit of perinatal medicine statistics bringing Italy among the countries in the world which have the best perinatal organisation, and the best perinatal statistics in term of maternal and fetal-neonatal mortality and morbidity [1,2] (Table 1).

Essence
The Società Italiana of Medicina Perinatale (SIMP-Italian Society of Perinatal Medicine) is defined as an active and permanent workshop for creating "cultural products", aimed at defining the themes relating to the life of man, his birth and future, while at the same time promoting actions designed to guarantee the health of the pregnant woman, the foetus and the newborn. The Society is composed of various professional figures, including gynaecologists, neonatologists, obstetricians, anaesthetists, midwives, professional nurses, surgeons, geneticists, psychologists, and so forth. This, therefore, enables it to have a holistic vision of health and disease, declining this complex area of medicine from various perspectives and deciphering phenomena which, while appearing to be strictly medical-biological in their final determinism, are also of a social and environmental nature [3,4]. The SIMP directs observations and activities concerning concepts that are able to give new vigour to the culture of mother, foetus and newborn. Within the context of care, training and research, it is involved not only in strictly scientific topics, but also in others, in which the SIMP places its political ideals, namely, the defence of the rights of the woman and the newborn, especially when they belong to society's most vulnerable outsiders. These words must to be declined in the light of what is happening in today's society, and placed inside cultural policy think-tanks, which form the driving force behind the SIMP.
Perinatal care has to deal with increasingly more complex situations, for which it must provide research capable of producing knowledge, the translational effectiveness of which is decided not merely via scientific production, but also the impact it has on the health of the population. Those who judge the goodness of said research will be colleagues, and more importantly, also the users. The SIMP is constituted in this sense as an authority for perinatal research, organising and coordinating the perfected resources and stabilising the relationships among related cultures, while opening the way for collaboration with other public and private scientific societies. The SIMP has also taken root with authority in the European scientific, cultural and social spheres, considered increasingly more as a privileged contact and interlocution instrument with European partners.

Dialogue
In its optimisation, the SIMP website possesses ample guarantees for expanding traffic and giving visibility to the SIMP, and the services it offers. In this regard, the editorial activities, communication and promotion lines, link popularity, and management and monitoring of the contents become strategic.
All training activities are deemed authentic experiments within the context of a general strategy for evaluating the SIMP's training offer.
In this way, a shared work area is defined, that allows for the interchange of information and the activation of interactive dynamics between members and SIMP supporters, as well as between the latter and other external national and international subjects. The international projections is a privileged objective pursued by the SIMP via the creation of an interactive network of subjects interested in training enhancement in perinatal sciences, for the purpose of generating a dynamic archive of educational initiatives offering innovation in terms both of contents and methods.

The Difficult Choices
The SIMP is constantly seeking to substantiate UNESCO's invitation, extended to 191 countries and all the scientific societies and cultural associations, to perform actions for ensuring that the rights of the woman and the newborn are always respected everywhere. The most significant moments of human experience, life and death are often addressed and represented as abstract moments, far removed from the factual reality of things. Dogmatic and ideological disputes rage around these issues, thus, preventing the creation of a fertile space, where man, woman and newborn are able to express their real entity and individuality, and the way in which these are lived.
Wherever possible, the SIMP creates "spaces and actors" for shared bioethics as an alternative to the prejudicial attitude, often assumed by various parties in dealing with the sensitive issues of perinatal medicine [5,6].
Shared bioethics reclaim a more authentic scientific method, subtracting from politics, often approximate and ideological, a role, which at least during the early stages of analysis and in-depth assessment, is the responsibility of the scientific societies, and namely, the SIMP, in the case of sensitive issues falling under its competence.

The Alliances
The SIMP creates informal and formal moments, during which partnership agreements are entered into with other national and international scientific societies, foundations and associations in this field, as well as the interchange of cultural and project information.
Cultural and programming alliances are established with scientific societies of disciplines, which interact extensively in the perinatal care and research activities.

Funding
The acquisition of financial resources for the development of the SIMP represents a priority in many interventions.
This topic calls for a synergic action by the entire society. Fundraising activities are immediately conceived and implemented for acquiring a minimal base of financial resources, indispensable for reaching (even only partially), the goals of the three-year tenure. Fundraising is not a means adopted by the SIMP merely for economic purposes, rather, it represents a tool for providing visibility and aggregating consensus, not only material, but also moral, for its own actions, which as per the articles of association, are always non-profit.

Agorà
The SIMP embodies its synthesis of identity and culture in Agorà. Agorà is the name given to its national conference, in the sense of being a "place for the free exchange of ideas and issues". A translational Agorà of Perinatal Medicine is created to provide answers to the professional complexities, thus producing culture, regarding the sensitive issues faced daily for promoting the health of mother and newborn, and creating perinatal thinking boxes, containers to be filled with the multiplicities of our knowledge. An active form of experiencing a conference is created with Agorà, in which interaction allows for overcoming the passivating method of listening: from "who speaks and who listens" to "discussing together", in order to become a synergically ideational scientific community. Real time and space is given to young colleagues, so that they may add their contributions and acquire a wealth of creative knowledge to be transferred into their daily clinical practice and research. Learning by thinking: we address the complexities of the perinatal sciences, building a shared pathway: "you pinpoint the problems and communicate them; we all analyse and resolve them together". Learning by doing: through a cultural pathway that targets "the work of Perinatal Medicine", with the enhancement of subjectivity, and multiple leadership of the professional identities. Learning by living: learning through the passion to know everything about the mission, practice and values of belonging to our scientific community [7].

Conclusion
From here, the SIMP is projecting itself towards objectives that are in line with its mission, while taking care to render them increasingly more appropriate and compliant with the specific situations. Future progress of perinatal medicine in Italy should cover the three following strategic areas: i. Care: The adapting of quality standards for all the perinatal care services, especially in the southern regions ii. Training: The standardising of perinatal medicine training processes in all the universities iii. Research: The promotion of multi-center randomized controlled trials, especially for the prevention and treatment of prematurity [8].