-- Mary Elizabeth Dallas
FRIDAY, March 2 (HealthDay News) -- When making decisions or
counseling families on how to manage very premature deliveries,
obstetricians are strongly influenced by parents' wishes,
especially when the parents want everything done to save their
baby's life, a new study finds.
Almost 50 percent of babies born between 22 weeks and 26 weeks
gestation (also known as a "periviable" delivery) do not survive,
University of Pennsylvania researchers explained. About half of the
babies who do survive will have moderate to severe neurologic
The researchers asked 21 obstetricians at academic medical
centers in Philadelphia to describe how they would typically deal
with a periviable delivery, the factors that influence their
decisions and challenges they face in counseling their
The study, published in the March issue of the
American Journal of Obstetrics and Gynecology, found that since there often is no formal policy on how to manage very early deliveries, obstetricians' decisions can vary significantly -- even among doctors working at the same hospital.
"While most participants said their first consideration was balancing maternal and child well-being, and the need to weigh the questionable benefits of Cesarean delivery for neonatal survival against the known risks of maternal morbidity, many described a 'do-everything default,'" study author Dr. Brownsyne Tucker Edmonds said in a journal news release.
That "default" means "interventions to prolong the pregnancy
[are] universally pursued unless patients actively opted out," said
Tucker Edmonds, an assistant professor of obstetrics and gynecology
at Indiana University who completed the research during a
University of Pennsylvania fellowship.
Although some obstetricians felt it was their job only to offer
information and not sway patients' decisions, others felt it was
necessary to provide guidance since the complexity and emotionality
of these situations may render patients incapable of making sound
decisions regarding the care of their babies.
These differences among obstetricians, the researchers said,
make it more difficult to manage patients' expectations. Study
participants said their greatest challenge was talking to patients
about the uncertainty of the situation and its effects on the baby,
particularly when parents had less education or faced a language
The U.S. National Institutes of Health provides more information
preterm delivery and birth.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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