Article on MSNBC about 22 weekers

  1. 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.
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  2. 32 Comments

  3. by   dawngloves
    I had to stop on page 3 because if I read one more, "My neighbor's niece's friend was born at 19 weeks and is now CEO of Avon" type post I was going to eat my monitor.
  4. by   walkingrock
    Wow! I can't even read through all those, not only because of the amount of posts, but the ignorance and vehement emotion by people who don't know enough to be commenting on this...plus those who believe they or someone they know was a microrpremie 30-50 yrs ago, I'm sorry, they just didn't have enough info back then to determine the age accurately enough, they is just no way that someone that premie would be just fine later, back then, let alone now. Personally, with what I've seen in NICU over the last 27-28 yrs I've been in it, I would NOT want my own child to be resuscitated under 28 wks, even then, it would be very scary...
  5. by   Imafloat
    I tried to read the messages also, but there were too many and most made no sense. A neonatologist stated that there are no alveoli at 20 weeks and somene jumped all over them saying, you can't tell her what her child did and didn't have. That is when I stopped reading, too much emotion, not enough facts.
  6. by   Gompers
    I also had to stop reading those posts. You guys are right, way too emotional and these people were not believing actual doctors that were posting. What they don't understand is that while they might know ONE micropreemie, neonatalogists have known thousands. Plus, dates are often wrong. Many women STILL count from the day they believe they conceived, not from the date of the last mentral period. So that explains some of the supposed 20-22 weekers that were really 22-24 weekers. But geez, I really don't think a 22 weeker could have survived 40 years ago like some of those posts are stating!!! We couldn't even save the President's baby at 34 weeks back then!

    I'm sure pre-eclampsia has been around for far longer than we've known about it. IUGR babies have been born since the beginning of time. Yes, I can totally see a 30-week IUGR baby being born at 1-2 pounds and surviving back then, bundled up in a shoebox by the stove, fed with an eyedropper. Rare, yes, but believable. But come on, no one's grandmother had a 20-anything weeker back then that survived...

    I am still wary of the fact that our new guidelines for viability include 23 weekers. I've been working in the NICU for over 8 years. I have never once seen a 22-23 weeker survive that didn't suffer for months in the NICU, only to end up with life-long medical problems so severe that independent living will never be an option. I know I'm not supposed to decide what quality of life is for anybody, but it's just very upsetting because usually the parents don't understand until later what the reality of the situation is. They come back and say that no one warned them, when in fact we did but they kept insisting that their baby would be different. We actually just had an inservice from one of our attendings about the ethics of saving babies under 23 weeks and 400 grams...our studies have shown that 99% of those babies will have some degree of damage, with well over 50% of that being severe. Again, quality of life is in the eyes of the beholder, but you can't ignore statistics...
  7. by   Jolie
    Quote from Gompers
    I'm sure pre-eclampsia has been around for far longer than we've known about it. IUGR babies have been born since the beginning of time. Yes, I can totally see a 30-week IUGR baby being born at 1-2 pounds and surviving back then, bundled up in a shoebox by the stove, fed with an eyedropper. Rare, yes, but believable. But come on, no one's grandmother had a 20-anything weeker back then that survived...
    This part of your post reminds me of my OB and Peds instructors back in the mid-1980's pounding into our heads that the size of a baby may have nothing to do with length of gestation. The definition of prematurity used to be any baby born weighing less than 5 lbs. No thought given to pregnancy complications that can effect weight gain, or physical indications of maturity in the neonate.

    Of course, we now know about SGA, LGA, term and pre-term babies, but no one in the 1950's did, when these supposed "miracle" babies were born.
  8. by   Imafloat
    Quote from Jolie
    This part of your post reminds me of my OB and Peds instructors back in the mid-1980's pounding into our heads that the size of a baby may have nothing to do with length of gestation. The definition of prematurity used to be any baby born weighing less than 5 lbs. No thought given to pregnancy complications that can effect weight gain, or physical indications of maturity in the neonate.

    Of course, we now know about SGA, LGA, term and pre-term babies, but no one in the 1950's did, when these supposed "miracle" babies were born.
    I would have been considered a preemie for weighing less than 5 lbs at birth. I was only 2 weeks early though. My mom smoked a lot while pregnant with me. In the 60's, when I was born, women were encouraged to smoke to keep their weight down, and have a cocktail or two a night to help with their nerves.
  9. by   BSNtobe2009
    I don't believe in a blanket policy, due dates gets missed all the time, and one week could be crucial. There are too many doctor's walking around with God complexes that would just write off a baby because it's too much trouble.

    The choice needs to rest with the parents, and I don't think it should be liimited to preemies, there are full term infants that need to be let go.

    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.
  10. by   MegNeoNurse
    Yes it's a controversial issue, and unfortunately these people do not see what we see with these micropreemies. There are miracles that happen, but rarely, especially with kids born at <22 wks gestation.

    I read down to a post where a "gentleman" had this to say:
    Ron WMessage #24
    11/15/06 03:44 PM

    Apparently you was born perfect. So Was Adolf HItler. I have twin grand babies that were "preemies", and are doing just fine. I just hope you choke on your dinner tonight & no one gets there in time to help you.



    ::GASP!:: Excuse me, but what an ass.
  11. by   Gompers
    Quote from BSNtobe2009
    I don't believe in a blanket policy, due dates gets missed all the time, and one week could be crucial. There are too many doctor's walking around with God complexes that would just write off a baby because it's too much trouble.

    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...

    http://allnurses.com/forums/f33/what...ight=gestation
  12. by   dawngloves
    Quote from CSM08MMS
    Yes it's a controversial issue, and unfortunately these people do not see what we see with these micropreemies. There are miracles that happen, but rarely, especially with kids born at <22 wks gestation.

    I read down to a post where a "gentleman" had this to say:
    Ron WMessage #24
    11/15/06 03:44 PM

    Apparently you was born perfect. So Was Adolf HItler. I have twin grand babies that were "preemies", and are doing just fine. I just hope you choke on your dinner tonight & no one gets there in time to help you.



    ::GASP!:: Excuse me, but what an ass.

    Ironically, I'm pretty sure Hitler was a preemie! :roll
  13. by   dawngloves
    Quote from BSNtobe2009
    I don't believe in a blanket policy, due dates gets missed all the time, and one week could be crucial. There are too many doctor's walking around with God complexes that would just write off a baby because it's too much trouble.

    I have to disagree with you on that. It is taken very seriously at my facility when we go to a delivery of a 23-24 weeker.There are consultations with OB where both teams look at ultrasounds to confim gestation. Lengthy talks with parents about what ifs and their wishes. And even still, if the the kid comes out and is very active and looks more 25 weeks, everyone goes whole hog.In medicine there is no black and white and every doctor I have worked with knows that and takes it to heart.Even on the opposite end, if we are expecting a 24 weeker and it looks more 22-ish, we won't do a thing. What could we do? Smash up it's trachea with a 2.0 ?
    Last edit by dawngloves on Nov 19, '06
  14. by   dawngloves
    Quote from BSNtobe2009
    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.

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