The American corporation of Obstet...

The American corporation of Obstetricians and Gynecologists (ACOG) has issued guidelines forward perinatal care and counseling parents when an extremely preterm birth is anticipated. ACOG Practice Bulletin No. 38 appeared in the September 2002 issue of Obstetrics and Gynecology

Although early preterm births and births of extremely subdued birth weight (less than 1 kg [22 lb]) newborns make up les than 1 percent of all births, they account for nearly the same half of all cases of perinatal mortality. newly come information from large multicenter studies has made it possible to unfold an evidence-based approach to managing extremely preterm and extremely grave birth weight fetuses.

Parents of anticipated extremely preterm fetuses can be adviceed that the neonatal survival rate for newborns increases from cipher percent at 21 weeks' gestation to 75 percent at 25 weeks' gestation. The survival rate increases from 11 percent at 401 to 500 g (09 to 11 lb) to 75 percent at 701 to 800 g (15 to 18 lb) Girls generally have a better prognosis than boys

Parents also can be cautioned that infants delivered before 24 weeks' gestation are les likely to survive, and that those who do are likely to have disabilities. Disabilities in mental and psychomotor increase neuromotor function, or sensory and communication function are current in about one half of extremely preterm fetuses.

ACOG commends moving the mother to a tertiary care center before delivery when possible. Women at risk of delivery between 24 and 34 weeks' gestation also should be considered to receive a single course of corticosteroids. Whenever possible, data specific to the age, weight, and form relative to sex of the fetus should be used to aid management decisions, and each member of the health care team should strive for consistency in discussions with family members about the assessment, prognosis, and recommendations for care.

COPYRIGHT 2003 American Academy of Family Physicians

COPYRIGHT 2003 Gale Group