Clinical report - Antenatal counseling regarding resuscitation at an extremely low gestational age

Daniel G. Batton, Ann R. Stark, David H. Adamkin, Edward F. Bell, Vinod K. Bhutani, Susan E. Denson, Gilbert I. Martin, Kristi L. Watterberg, Keith J. Barrington, Gary Hankins, Tonse N K Raju, Kay M. Tomashek, Carol Wallman, Jim Couto

Research output: Contribution to journalArticle

141 Citations (Scopus)

Abstract

The anticipated delivery of an extremely low gestational age infant raises difficult questions for all involved, including whether to initiate resuscitation after delivery. Each institution caring for women at risk of delivering extremely preterm infants should provide comprehensive and consistent guidelines for antenatal counseling. Parents should be provided the most accurate prognosis possible on the basis of all the factors known to affect outcome for a particular case. Although it is not feasible to have specific criteria for when the initiation of resuscitation should or should not be offered, the following general guidelines are suggested. If the physicians involved believe there is no chance for survival, resuscitation is not indicated and should not be initiated. When a good outcome is considered very unlikely, the parents should be given the choice of whether resuscitation should be initiated, and clinicians should respect their preference. Finally, if a good outcome is considered reasonably likely, clinicians should initiate resuscitation and, together with the parents, continually reevaluate whether intensive care should be continued. Whenever resuscitation is considered an option, a qualified individual, preferably a neonatologist, should be involved and should be present in the delivery room to manage this complex situation. Comfort care should be provided for all infants for whom resuscitation is not initiated or is not successful.

Original languageEnglish (US)
Pages (from-to)422-427
Number of pages6
JournalPediatrics
Volume124
Issue number1
DOIs
StatePublished - Jul 2009
Externally publishedYes

Fingerprint

Resuscitation
Gestational Age
Counseling
Parents
Extremely Premature Infants
Guidelines
Delivery Rooms
Critical Care
Physicians
Survival

Keywords

  • Antenatal counseling
  • Ethics
  • Prematurity
  • Resuscitation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Batton, D. G., Stark, A. R., Adamkin, D. H., Bell, E. F., Bhutani, V. K., Denson, S. E., ... Couto, J. (2009). Clinical report - Antenatal counseling regarding resuscitation at an extremely low gestational age. Pediatrics, 124(1), 422-427. https://doi.org/10.1542/peds.2009-1060

Clinical report - Antenatal counseling regarding resuscitation at an extremely low gestational age. / Batton, Daniel G.; Stark, Ann R.; Adamkin, David H.; Bell, Edward F.; Bhutani, Vinod K.; Denson, Susan E.; Martin, Gilbert I.; Watterberg, Kristi L.; Barrington, Keith J.; Hankins, Gary; Raju, Tonse N K; Tomashek, Kay M.; Wallman, Carol; Couto, Jim.

In: Pediatrics, Vol. 124, No. 1, 07.2009, p. 422-427.

Research output: Contribution to journalArticle

Batton, DG, Stark, AR, Adamkin, DH, Bell, EF, Bhutani, VK, Denson, SE, Martin, GI, Watterberg, KL, Barrington, KJ, Hankins, G, Raju, TNK, Tomashek, KM, Wallman, C & Couto, J 2009, 'Clinical report - Antenatal counseling regarding resuscitation at an extremely low gestational age', Pediatrics, vol. 124, no. 1, pp. 422-427. https://doi.org/10.1542/peds.2009-1060
Batton DG, Stark AR, Adamkin DH, Bell EF, Bhutani VK, Denson SE et al. Clinical report - Antenatal counseling regarding resuscitation at an extremely low gestational age. Pediatrics. 2009 Jul;124(1):422-427. https://doi.org/10.1542/peds.2009-1060
Batton, Daniel G. ; Stark, Ann R. ; Adamkin, David H. ; Bell, Edward F. ; Bhutani, Vinod K. ; Denson, Susan E. ; Martin, Gilbert I. ; Watterberg, Kristi L. ; Barrington, Keith J. ; Hankins, Gary ; Raju, Tonse N K ; Tomashek, Kay M. ; Wallman, Carol ; Couto, Jim. / Clinical report - Antenatal counseling regarding resuscitation at an extremely low gestational age. In: Pediatrics. 2009 ; Vol. 124, No. 1. pp. 422-427.
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