Category Archives: Clinical Practice Guidelines

Neonatal Sepsis after Chorioamnionitis, what to do about healthy appearing newborns

In 2007, when I was chair of the CPS Fetus and Newborn Committee, we published a guideline regarding the approach to term and late preterm infants with perinatal risk factors for sepsis. Obviously any infant with clinical signs consistent with … Continue reading

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Re-evaluating what is really friendly to babies

Many hospitals are very proud of being “baby friendly” or are trying to achieve “baby friendly hospital” certification, under the WHO initiative. Unfortunately many parts of that program are not evidence-based, such as (as one example) the ban on soothers … Continue reading

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The best outcome variable for very preterm newborns?

Death or ‘neurodevelopmental impairment’ (NDI) as a combined outcome has become a sort of de facto standard as the primary outcome for neonatal clinical trials. Because many very preterm infants have developmental delay, intellectual and learning difficulties, and some have … Continue reading

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Also, still no parents!

My previous post was long enough without addressing another serious deficiency in these guidelines. It is worth its own post. The guidelines are written by doctors. And only doctors (actually only Obstetricians). There is no input mentioned from any other … Continue reading

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Another extremely flawed guideline on periviable deliveries

Oh Dear, here we go again… This is a joint statement from ACOG and the SMFM. There is some good in here, but you’d think they could at least get the facts right. “Delivery before 23 weeks of gestation typically … Continue reading

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The new AAP position statement concerning extremely preterm birth decision making. A great leap… sideways.

To me, this new ‘clinical report’ was a major disappointment. Even though there are some good parts to this statement, there is one huge, major failing: there is absolutely no evidence that parents were consulted or included in the process of … Continue reading

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Writing Clinical Practice Guidelines, who should be involved?

Clinical Practice Guidelines are important for improving quality of care and uniformity of practice. Or at least they should be. There have been studies of the impact of guidelines, and it is variable, and sometimes negligible. Why is that? Why … Continue reading

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