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Perinatal network consensus guidelines on the resuscitation of extremely preterm infants born at <27 weeks' gestation
Ujwal Kariholu1, Sunit Godambe, Richa Ajitsaria
1Imperial College Healthcare NHS Trust, London, UK.
Insights
Resuscitation practices for extremely preterm infants lack consensus. A survey of clinicians led to new guidelines for infants born before 27 weeks gestation, aiming to improve care and establish consistent protocols.
Area of Science:
- Neonatal Medicine
- Perinatal Care
- Pediatric Resuscitation
Background:
- Despite advances, consensus on resuscitating extremely preterm infants (<27 weeks gestation) is lacking.
- Varied clinical opinions exist globally regarding resuscitation practices for these vulnerable infants.
Framework:
- A survey explored UK Perinatal Network clinicians' and nurses' opinions on resuscitation for infants <27 weeks gestation.
- The survey aimed to identify areas of consensus and divergence in current practices.
Implementation:
- Responses revealed significant differences in opinion but also some areas of agreement.
- Consensus guidelines for practical resuscitation of infants <27 weeks gestation were developed by the North West London Perinatal Network (NWLPN).
Implications:
- The NWLPN implemented these specific guidelines for their network.
- Future audits and parent information leaflets are planned to support guideline adoption and understanding.
Abstract:
In spite of recent advances in perinatal care and an increase in survival of extremely preterm infants over the last few years, there remains a lack of consensus about practical aspects of resuscitation of extremely preterm infants born before 27 weeks' gestation. With this in the background, the working group of one of the Perinatal Networks in London, UK, set out to conduct a survey to explore the opinions of the doctors and nurses on resuscitation practices of infants born before 27 weeks' gestation, with the aim of developing consensus guidelines. The working group emailed a questionnaire to all neonatal units within the Perinatal Network to seek the views of paediatric medical and nursing staff on resuscitation of infants born at <27 weeks' gestation. The questionnaire was returned anonymously by post. The responses highlighted the difference of opinion that currently exists amongst the clinicians and nurses across the world around the resuscitation practices of extremely preterm infants; yet at the same time, there seemed to be some consensus on certain issues. Based on the survey (questionnaire) results and already existing literature, the working group of the North West London Perinatal Network (NWLPN) produced and implemented specific consensus guidelines on practical aspects of resuscitation for infants born before 27 weeks' gestation for the network. The network plans to audit these guidelines in future and also produce a parent information leaflet explaining the relevance of these guidelines.
