Periviability

Online Outcome Calculator

Information needed

• GA
• BW/EFW
• Sex
• Number of gestation (singleton vs. multiple)
• Any antenatal steroids

Link

NICHD Extremely Preterm Birth Outcomes Tool

Antenatal Consult

<GA22w0d

DO NOT OFFER or recommend resuscitation. Please refer to the NICHD Extremely Preterm Birth Outcomes Tool

GA22w0d-22w6d

Counsel parents regarding NICHD statistics AND KPSD NICU/region statistics. In general discourage against resuscitation/intervention, but after counseling with NICU, if parents opt for it, then perinatology team will administer steroids and discuss other interventions such as tocolysis, mag for neuroprotection, fetal monitoring and c/s (also classical) if clinically indicated and write plan in chart for OB MD providers. perinatology team will offer everything if patients elect for resuscitation.

GA23w0d-23w6d

Counsel parents regarding NICHD statistics AND KPSD NICU/region statistics. After counseling with NICU, if parents opt for it, then perinatology team will administer steroids and discuss other interventions such as tocolysis, mag for neuroprotection, fetal monitoring and c/s (also classical) if indicated and write plan in chart for OB MD providers. perinatology team will offer everything if patients elect for resuscitation. Parents may elect to NOT intervene/resuscitate until 24 weeks.

≥GA24w0d

Counsel parents regarding NICHD statistics AND KPSD NICU/region statistics. In general, the NICU team 100% of the time will resuscitate any infant born at or after 24w0d regardless of parents’ desires.

Risks of Autism Spectrum Disorder by GA

ASD prevalences by gestational age at birth:

Preterm: overall 1 in 48 or 2.1% for all preterm (<37 weeks)

• 1 in 16 or 6.1% for extremely preterm (22–27 weeks)
• 1 in 38 or 2.6% for very to moderate preterm (28–33 weeks)
• 1 in 53 or 1.9% for late preterm (34–36 weeks)

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Term:

• 1 in 62 or 1.6% for early term (37–38 weeks)
• 1 in 71 or 1.4% for full-term (39–41 weeks)

Neonatologists’ Role

Updated: April 18, 2024

< 22 0/7 weeks’ GA (≤ 21 6/7 weeks)

• No involvement regardless of whether the newborn has a heartbeat or not. If called, defer to the OB physician in charge.

• Do NOT resuscitate any newborn with a GA of < 22 0/7 weeks.

≥ 22 0/7 weeks’ GA

• If the newborn is born WITH a heartbeat but comfort care is already planned, the neonatologist on call is responsible for the following:
  • Admission H&P
  • Discharge summary
  • Death certificate
• If the newborn is born WITHOUT a heartbeat, it is considered fetal demise; defer all paperwork to the OB physician in charge.