Prof. Peter Dunn
Emeritus Professor Peter M. Dunn
MA, MD, FRCP, FRCOG, FRCPCH
23 June 1929 - 2 Feb 2021
Peter MacNaughton Dunn (PD) was born in Birmingham, UK, on June 23rd 1929, the fourth child with three older sisters. His father, Naughton Dunn, was a distinguished orthopaedic surgeon and his mother, Ethel (nee Jackson), was an ex-VAD nurse. His education was at West House School, Birmingham (1937-42), Marlborough College, Wiltshire (1942-47) and St. John's College, Cambridge (1947-50). He obtained an honours BA (Cantab, 1950, MA 1955). After clinical studies in Birmingham and Dublin, he qualified MB, ChB (Cantab) in 1953. Following pre-registration house jobs in Birmingham, he undertook National Service as a Captain in the RAMC. He served as medical officer (1955-57) to the 2nd KEO Goorkha Rifles during the Malayan Emergency.
As a student PD had observed the relative neglect of the unborn and newborn infant. So on returning to England in 1957, he determined to pioneer a new specialty for which he coined the term 'perinatal medicine'. After gaining more experience in obstetrics, paediatrics and general practice in Birmingham, he then spent the following decade (1959-68) as a paediatric registrar in maternity hospitals in Birmingham, South Warwickshire and Bristol, both as a clinician and research worker. The latter included a year as a senior research fellow in the Cardiovascular Research Institute in San Francisco (1966-67). During this decade, he acquired the London diplomas in obstetrics and child health and in 1968 the Cambridge MD for a thesis on congenital postural deformation, and in particular congenital dislocation of the hip (CDH). The ideas in his thesis were accepted internationally and by the World Health Organisation.
In 1968 PD was appointed consultant senior lecturer in perinatal medicine and child health, University of Bristol, the first such post in perinatal medicine in the UK. His first action was to found and organise the Bristol Perinatal Club which over the next 32 years organised some 700 distinguished guest lecturers on childbirth and related subjects. He also set up in 1970 the first university course on neonatal medicine in the UK for medical students. That same year, he introduced neonatal intensive care into Bristol. The neonatal mortality fell by 74% within three years, in 1979 he was promoted Reader and in 1987 given a personal Chair in perinatal medicine and child health.
Research interests during this period included studies on fetal adaptation to extrauterine life and the importance of an intact umbilical circulation at this time in order to prevent respiratory distress syndrome of the premature infant (RDS). For this work he was subsequently awarded the Dutch De Snoo-von't Hoogerhuigs Medal in 1983, the first time that this award had been made to a paediatrician or to someone in the UK. He was also the first in 1971 to introduce continuous positive airway pressure in the treatment of RDS into the UK. During these studies, he was one of the first to recognise in 1964 the importance and causation of neonatal polycythaemia and the need to treat it when appropriate by dilution exchange transfusion. Many other subjects were studied during this period included the thalidomide tragedy; liver damage suffered by infants with severe haemolytic disease of the newborn; neonatal jaundice; congenital malformation; neonatal intestinal obstruction; multiple pregnancy; chronic urinary tract infection in children; placement of the umbilical catheter; the infant of the diabetic mother; neonatai resuscitation; the importance of maternal posture and mobility during childbirth; management of the third stage of labour; protection of the normal physiology of childbirth; the causes and management of breech presentation; perinatal records; perinatal mortality and morbidity statistics; perinatal audit; the treatment of tongue tie; the significance of testicular birth trauma; imperforate hymen; the aetiology and management of necrotizing enterocolitis; and fetal growth. He also designed a flexible perinatal growth chart for international use. As a result of his research, the Royal College of Physicians (London) elected him MRCP in 1974 [FRCP, 1979).
In 1976 PD founded the British Association of Perinatal Medicine (BAPM) with the 20 paediatricians working mainly in major neonatal units around the UK and the Republic of Ireland. He became its first President and indeed filled all the offices of the Association during its early years. Later, he became the Honorary Archivist and recorded its early history. The aims of the BAPM were to improve the standard of perinatal care in the UK and also to bring together those responsible for that care as a team - the obstetricians, midwives, paediatricians, and neonatal nurses. The Association became affiliated to the British Paediatric Association and later to the RCOG. The Neonatal Nurses Association was founded on the lines of the BAPM in 1978. In 1981 the BAPM became a broad multi-disciplinary organisation. PD's contribution was acknowledged in two annual BAPM lectures, the Founders Lecture and the Peter Dunn Perinatal Lecture.
One of the first functions of the BAPM was to ascertain the resources available for newborn care and to determine what was required to provide a safe service. In 1978 Dunn prepared a report for the BPA/RCOG Joint Standing Committee of which he was Chairman, entitled: ‘Recommendations for the improvement of infant care during the perinatal period in the UK’. This was warmly welcomed by the BPA and RCOG who then forwarded it to the House of Commons Social Services Committee (Chairman, Mrs. R. Short) that was investigating the perinatal service (1978-80). Their report led to the formal recognition of perinatal medicine in the UK.
PD served on many national committees. As Chairman of the BPA Health Statistics Committee, 1975-1980, he helped to organise and was a member of the Paediatric Diagnostic Classification Working Party which revised the BPA paediatric and perinatal classifications (1979). Between 1975-1980 he was a member of the RCOG Scientific and Pathology Committee and also of the Antenatal and Intrapartum Working Party that made important recommendations on the management of childbirth (1979-81). During this period he helped to organise and take part in many national scientific obstetric meetings. In 1983 the Royal College of Obstetrics and Gynaecology made him a Fellow ad eundem. PD also served on many NHS/DHSS committees including the Medical Research Council. In 1985-6 he was a member of the National SMAC Working Party on Congenital Dislocation of the Hip and rapporteur of its report. The British Orthopaedic Association awarded him their Gold Medal in 1986.
In 1981-82 PD organised and acted as rapporteur to the SW Regional Perinatal Working Party that undertook a survey of the organisation and facilities available for perinatal care throughout the Region. The two volume report with recommendations for improvement was warmly welcomed. The perinatal mortality in the South West, from being the highest for any region in the country in 1980, became the lowest in 1983.
Between 1970 and 2000, PD acted on many occasions as a consultant to the World Health Organisation. He played a major role in preparing the obstetric, congenital anomalies and paediatric sections of both the 9th (1977) and 10th (1992) revisions of the International Classification of Diseases. He was also a member of the Task Force on Appropriate Technology for Maternal and Child Health. On behalf of the WHO, he visited many countries abroad including Uruguay, Brazil, India and China.
Between 1976 and 2000 he was a member of four committees of the International Federation of Gynecologists and Obstetricians (FIGO): Standardisation of Reports and Terms; Perinatal Mortality and Morbidity;
Perinatal Epidemiology and Health Statistics (Chairman); and Ethics in Human Reproduction. As the only paediatrician on the Ethics Committee, he introduced many guidelines relating to the care of the fetus and newborn infant. In 1991 he was invited to become a member of the Ethics Committee of the World Association of Perinatal Medicine.
Between 1977 and 1983 Dunn was co-ordinator of the International Pediatric Association's (IPA) Expert Advisory Panel on Perinatology/Neonatology. He was also British paediatric representative to the International Association of Maternal and Neonatal Health (IAMANEH) (1977-83) and a member of the Board of the European Association of Allied Specialists in Maternal and Neonatal Care (1989-94).
As a member of the European Association of Perinatal Medicine (EAPM) since its foundation in 1968, he was a member of its Scientific Committee on many occasions between 1972 and 1996. In 1990-96 he was Chairman of the Association's Working Party on Perinatal Audit and co-author of its report (1996). In 2000, he was made an Honorary member of the EAPM. At the same time he became an Honorary member of many other national and international scientific associations.
In 1984 PD became involved in the future of the British Paediatric Association. He worked hard to promote the creation of a Royal College of Paediatrics and Child Health which was finally achieved in 1996. The new College made him an Honorary FRCPCH the same year.
In 1981 PD was invited to act as an expert witness in the defence of Dr. Leonard Arthur who had been accused of the murder of an infant with Down's Syndrome. Dr. Arthur was acquitted. This was followed by the successful defence of Dr. Wendy Savage in 1985. He also defended the unjustly accused Bristol paediatric heart surgeons in 1995-2000. During this period, he became very interested in the ethics of human reproduction and the neonatal period. As a member of the FIGO Ethics Committee (1985-2001) he helped to prepare many guidelines in this field including that of the birthrights of the newborn infant.
PD retired from clinical practice at the age of 60 but continued to undertake perinatal research and publish over the next 30 years. His output was considerable with over 500 publications, as well as a number of books, including co-authorship of the Bristol Neonatal Vade-Mecum (1985). He also made a significant input into 158 national and international reports on perinatal matters. As a lecturer he was in demand giving over 1,000 invited lectures in 55 countries around the world including 73 in North America.
During retirement PD served as president of the South West Paediatric Club (1988-90), the Bristol Medico Chirurgical Society (1993-94) and the Bristol Medico Historical Society (1999-2003). Between 1989 and 2009 he prepared 108 articles on doctors and others who had made significant contributions to the development of perinatal medicine. All were published in the Archives of Disease in Childhood under the title 'Perinatal lessons from the past. He also wrote about the history of perinatal medicine and of the BAPM. In 2002 he founded the British Society for the History of Paediatrics and Child Health and became its first President. The Society was affiliated with the RCPCH. In 1999 PD presented his perinatal library to the BAPM. In 2001 the RCPCH awarded Dunn with the James Spence Medal for distinguished contributions to paediatrics, their highest award.
In 1961 Peter Dunn married Judy (nee Lunt), a nurse from Great Ormond Street and they had three children, Robert, John and Sara. He owed a great debt to his wife for her support. His non-medical interests included archaeology/history, chess, golf, sailing, skiing, fly-fishing, hill walking and the sports of squash, badminton and tennis.