Babies born at 22 weeks WILL now be resuscitated – after docs change ‘viability’ guidelines
DOCTORS should attempt to save the lives of babies born as early as 22 weeks, new guidelines say.
The premature tots are so under-developed it was previously thought best not to treat them.
Medical advances
But a review by the British Association of Perinatal Medicine found medical advances mean many can now be saved.
It has prompted them to issue new guidance and reignited a row over the abortion time limit, which stands at 24 weeks.
Four in ten babies born at 23 weeks and receiving treatment in UK neonatal units survive.
This is double the two in ten that survived when the BAPM last issued guidance in 2008.
Even 35 per cent of babies born at 22 weeks, when they are four months premature and weigh the same as a tin of beans, now survive if treated.
Old recommendations said it was “in the best interests of the baby, and standard practice, for resuscitation not to be carried out”.
Experts credit the gains to improved nutrition, better infection control, greater use of steroids and more advanced medical staff.
Case-by-case basis
Association president Dr Helen Mactier said: “We’ve got better at keeping extremely premature babies alive.
“Clinicians are increasingly willing to consider survival-focused care for the most extremely premature babies.”
It is possible, in 2019, to save babies who could not previously have survived. But the very high risks mean that it is not always the right thing to do to provide intensive medical treatment
Prof Dominic Wilkinson, of the University of Oxford
The new guidelines say life-saving treatment should be considered at 22 weeks if the baby has “favourable risk factors”.
This may mean they are towards the end of the 22nd week, of normal weight, female or a singleton, rather than a twin or more.
The others will be given palliative care, which aims to keep them as comfortable as possible until they die.
Warning over disability risks
Figures show there were 183 live births at 22 weeks in the UK in 2016. Some 23 per cent received active care, of which 35 per cent survived.
Prof Dominic Wilkinson, of the University of Oxford, warned some of these will develop disabilities as a result of their premature delivery.
He added: “It is possible, in 2019, to save babies who could not previously have survived.
“That is fantastic news. But the very high risks mean that it is not always the right thing to do to provide intensive medical treatment.
“Sometimes the best and wisest path is to take a palliative approach to the baby’s care, focused on the baby’s comfort and avoiding invasive medical treatment.”
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Abortion debate
John Deighan, of the Society for the Protection of Unborn Children, said it was wrong to allow abortions at 24 weeks.
He said: “The effort now to be made to save the lives of premature babies, born before the standard abortion time limit, exposes a shocking contradiction at the heart of our health service.
“We rightly recognise the value of tiny premature lives in these new policies, so how can we continue to permit laws which allow the killing of babies at the same age through elective abortion?”