Article on MSNBC about 22 weekers

Specialties NICU

Published

Has anyone else seen this article? Its about British guidelines to not resuscitate less than 22 weeks. Report: Don't save extreme preemies - Children's Health - MSNBC.com

Check out the message boards where people can respond with their opinions.

I don't know if anyone has seen "Born without a face", on Discovery Health with the baby that has Treacher Collins Syndrome. That baby is only 2 1/2 and all she has known her entire life is pain and surgery and recovery and she is looking at several more years of it. She is so deformed she couldn't even breathe out of her nose and had to be fed through a tub in her stomach. Pain medications don't work on her as well as they should. Surgeries include inserting rods in her face that are left in, they are brutal, invasive procedures.

The parents were like, "She's our little miracle, she is so brave"

There is nothing miraculous or brave about torturing a baby endlessly. What choice does that little girl have? None, no choice at all. She is being forced to endure whatever evil someone carries her to.

There is a REASON why alot of these babies with horrible deformities died at birth. There is just no way I could sit and let a baby go through that. I couldn't even watch it on TV with someone else's child, and considering I want a career in the NICU, really makes you question that move as well, as you know you are going to see things like that.

I saw that. They thought she was only going to be born with a cleft palate.

The thing is, she has a correctable deformity. Invasive and painful, yes. But she has quality of life. You can't correct a Grade IV bleed or PVL or severe BPD.

If she had been born anacephalic, as they were thinking at first. I would totally agree with you.

I was flabbergasted by the ignorance of the people on that message board. I, too, only made it to about page 3. The "born at 22 weeks weighing just under 3 pounds" and born at 20 weeks 49 years ago.... just couldn't read any more.

I really liked the reply by the neonatologist trying to explain why these little ones just can't be resucitated for the most part. It's pure anatomy. I wonder if we haven't come close to reaching the cusp of when we can help and when we can't. I know over time our advances have been amazing but most of those had to do wtih providing some ventilation when baby's lungs just weren't quite ready or providing surfactant or steroids to help baby's lungs mature a little sooner. This is anatomy here. Pretty hard to grow things before they're ready. :confused:

I, too, just got sick of all the "my friends baby was born at 21 weeks and now he's a doctor" lines. I just think of all the babies and even families who see one baby who survived from an early age and then have to go through thinking their baby will survive as well. Just the hope and disappointemnt have to be so devastating, above and beyond the fact that they've lost their child.

I think the television shows really do a disservice showing the "miracles" sometimes. It gives people an unreal expectation of what can truly be done. :(

Specializes in Looking for a career in NICU.
Do you mean that the doctors wouldn't save a baby because it's too much trouble? Because usually we see the opposite happening - doctors with God complexes that think they can save anything. They'll bring up a 22-23 weeker and try like the dickens to save it. It's very rare in neonatalogy these days, at least in the US, to have a doctor NOT try to save a baby so long as it's over 24 weeks gestation, and often only 23 weeks...

Thing is, if you talk to a lot of NICU nurses, we wouldn't want our babies saved at that gestation. I think that is pretty significant since we're the ones caring for these babies day in and day out. We even had a post on it not too long ago...

https://allnurses.com/forums/f33/what-gestation-would-you-want-your-baby-saved-63977.html?highlight=gestation

No, I am thinking of the doctors (in the minority) that are more likely to do what is convenient for them rather than what is convenient for the patient.

Reading through these boards (and when I'm a nurse, I'm sure I'll see more) I'm shocked at some calls the doctors make.

I would never say that all doctors would do that, or even most. I would like to think that Neonatologists are a different breed of doctor. I fear that if there was a blanket policy, some doctors may use that as an excuse not to save one that could possibly be saved.

Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

I actually got to about page 4. The subject is one that will naturally attract some people who wouldn't weigh in on a different topic.

To the huddled masses the concept of weeks of gestation doesn't make much of an impact......I can see people glazing over the number of weeks and only focusing in on......premature, baby, doctor, die.

My niece was a 36 weeker, her son was a 35.....both "premies" right? And I can say they are both fine. My niece is a L&D nurse in a university medical center. She sees the micropremies and what she tells me is nothing like what these people want to believe. Twenty two weeks and 36 weeks are equal aren't they?

To the general populace this bit of news-which is really not "new news"-means nothing scientific only emotic. I can actually understand their pain.

Specializes in NICU- now learning OR!.

wow....125 pages worth of discussion....99% of it ignorance!!

I love the posts..."I was a 3 lb. 21 weeker and now I'm fine" Hmm....

Or the posts "My twins were 32 1/2 weeks....blah blah blah....and now they are perfect.." Uhhh...yea, of course!

Or how about the "Why would you use age as a factor for saving a person? Not before 22 weeks and not over 85??" Umm....you are NOT even comparing the same things...and 85 year old ACTUALLY has lungs!

The first time I saw a 22 weeker (22 6/7) I had trouble sleeping for days....some of the things that I have seen in just the last year are things I never dreamed I would see in my life...sitting at a bedside with a baby getting blood....vented, had been satting 20 on 100% for over 10 hours, massive brain bleed, seizures...ugh...I never want to see a baby have seizures again (although I know that I will....) Parents wanted "everything" done....

Jenny

Specializes in NICU- now learning OR!.
No, I am thinking of the doctors (in the minority) that are more likely to do what is convenient for them rather than what is convenient for the patient.

Reading through these boards (and when I'm a nurse, I'm sure I'll see more) I'm shocked at some calls the doctors make.

I would never say that all doctors would do that, or even most. I would like to think that Neonatologists are a different breed of doctor. I fear that if there was a blanket policy, some doctors may use that as an excuse not to save one that could possibly be saved.

We DO have a blanket policy at our hospital. Resuscitate 23+ weeks...22 weeks is a loooong discussion between the Neo and parents about the 10% chance of survival and everything that this child will require for care. Then the decision is made by the parents whether to try or not. If they say "do everything" once that kid comes out they will do what the parents ask, but NRP has limits for resuscitation as well and those guidelines are followed.

There are no "excuses" when you are talking about saving these babies...read my above post. When you are a nurse, you may not be so shocked when the Docs make a certain call...someday you may actually be relieved.....

Jenny

Specializes in ER, NICU, NSY and some other stuff.

Alveoli do not form before 23-24 weeks. fetal development

Infants born before this gestation are essentially born with a not compatible with life diagnosis.

This article is written in an extremely biased manner. It is not about playing God, it is about being realistic.

We are talking about humane treatment of these tiny fragile fetuses.

If you have ever watched the gelatinious layer of skin slough off where you attached your leads and watched these little guys ooze and crack it is painful just to look at. I can only imagine how excruciating how it actually feels.

This is such an emotional issue, without a doubt. Obviously NO ONE wants babies to die. The thing to remember is that we cannot fix everything. We can be compassionate and caring to them and their parents.

Specializes in NICU,PICU.

If I had a dime for each parent that said they wish they knew what was going to happen, I'd be darn near retirement by now.

We all cringe when we hear the beepers going off for 22 weeks....we just know that it is coming back unless it is near dead over there. Most parents don't have a clue....oh my neighbor's baby was 22 weeks and is fine...okay, right. They don't get the concept of WEEKS...only MONTHS. When they say they are 6 months along, they are really about 28 weeks.

I bet a lot of those "early" babies were actually the results of a hurried marriage (the 3 lb 22 weeker!?!).

Specializes in ICU, PICC Nurse, Nursing Supervisor.

Ok one of these women on the message board posted she had a 3 lb 22 week baby. I guess I am just behind cause with my last sono about 2 weeks ago (21 wks) this baby was just shy of 1 lb. I have not read all of the thread just throwing in my 2 cents...

Specializes in NICU.
I bet a lot of those "early" babies were actually the results of a hurried marriage (the 3 lb 22 weeker!?!).

That's actually a really good point. "Oh, the baby was premature" was used at times "way back when" if the mom was already pregnant when she got married. I'm sure there were a lot of 8 pound "preemies" once upon a time!

Oh, they still try and use it today. I go to many "32 weeker" deliveries that turn into a fat term baby. I love to see granma's face when she looks at her 8 pound preemie grandchild.

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