Tag Archives: Survival

What is happening for the most preterm deliveries.The Completed Week Heuristic.

Posted on 17 June 2022 by Keith Barrington

There are several recent publications about deliveries at 22 to 25 weeks gestation, evaluating the frequency of intensive care support of the babies, factors associated with support, and survival. The California Perinatal Quality Care Collaborative reports the proportion of “active … Continue reading →

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What do we tell families at 22 weeks?

Posted on 28 January 2022 by Keith Barrington

When we counsel families about the potential outcomes for infants born profoundly preterm, I think we would all agree that we should be honest, transparent and truthful. Which includes, I would suggest, truthfulness about our own local results, as well … Continue reading →

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Active intensive care at 22 weeks gestation

Posted on 27 January 2022 by Keith Barrington

Even the New England Journal are getting in on the act (Lee CD, et al. Neonatal Resuscitation in 22-Week Pregnancies. N Engl J Med. 2022;386(4):391-3), I guess that someone talked to the editors about the practice variation in resuscitation of … Continue reading →

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Survival and outcomes for the extremely preterm. The NICHD network results continue to improve: Can we do even better?

Posted on 20 January 2022 by Keith Barrington

A new publication from the NRN describes short term outcomes and care practices of babies from 22 to 28 weeks gestation born in recent years (2013 to 2018) and for those born in 2013-2016 results of evaluations of those followed … Continue reading →

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Cardiovascular support in the preterm, how to determine adequate perfusion?

Posted on 17 January 2022 by Keith Barrington

As many of you will know, I have advocated for many years for evaluation and management of very preterm babies based on their tissue perfusion rather than the blood pressure. There is little or no correlation between BP and perfusion, … Continue reading →

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Antenatal treatment of Diaphragmatic Hernia, indications for intervention.

Posted on 12 January 2022 by Keith Barrington

My previous post about the FETO trials noted that the published trials reported a clear benefit of antenatal treatment of the highest risk group, but the moderate risk group had an improved outcome which didn’t meet classic definitions of statistical … Continue reading →

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Caring for the most profoundly immature babies; what works?

Posted on 4 January 2022 by Keith Barrington

The upcoming issue of “Seminars in Perinatology” is about the controversies in caring for the babies <25 weeks gestation. Babies born at 24, 23, 22 or even now 21 weeks gestation are so physiologically immature that we can’t just assume … Continue reading →

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Plug the Lung Until it Grows: the FETO RCTs of antenatal diaphragmatic hernia intervention.

Posted on 18 August 2021 by Keith Barrington

What was at one time called PLUG, and, with the change from open to endoscopic intervention, is now called FETO (fetal endoscopic tracheal occlusion) is a way to harness the normal physiology of the lung in congential diaphragmatic hernia (CDH) … Continue reading →

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Two amazing trials, at the opposite ends of the spectrum. What a weird world.

Posted on 27 May 2021 by Keith Barrington

In the most recent NEJM two trials impacting newborn/paediatric care. One including 3,211 preterm infants, which shows that a very simple intervention could save, I estimate, tens of thousands of lives each year at almost no cost; the other with … Continue reading →

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The ACOG patient information page; what should it say about 22, 23, 24 weekers?

Posted on 16 April 2021 by Keith Barrington

I mentioned not so long ago that the web page of the US Obstetricians professional association has information for prospective parents of babies of less than 25 weeks gestation that is… questionable. They state, for example, the following : Medical … Continue reading →

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