At what gestation would YOU want YOUR baby saved? - page 2
I have a good friend with a former 24 weeker (540g) who is doing WONDERFULLY. She is now 16 months and is developmentally normal in all areas. I was talking to her the other day, and she was saying... Read More
Jun 11, '04Occupation: Bedside RN at level 3 NICU Joined: May '04; Posts: 14Quote from annasmomrntobein az if the infant is >24 weeks and makes any attemt to breathe we have to resusitate. which then leaves the parents the terrible decision of withdrawing support if the damage we have done is great. i wouldn't want to go to the hospital under 26 weeks. but i luckily will not have to make that decision, i had 3 healthy full term kids! and i don't plan on anymore.just a question, is there a gestational age where you are required to do everything you can, no matter what the parent says? for example, if the child was born at 38 weeks and needed a ventilator? could the parent say no?
Jun 11, '04Joined: Jun '04; Posts: 7I was born at 24-25 weeks at 1.10 lbs, in 1987 in Baltimore, MD; and i turned out perfectly normal and healthy. And the fact that i was born so early is one of the reasons i'd like to work in NICU.Last edit by NICUhopeful87 on Jun 11, '04 : Reason: spelling error.
Jun 18, '04Occupation: ICU Nurse Specialty: 21 year(s) of experience in Newborn ICU, Trauma ICU, Burn ICU, Peds ; From: US ; Joined: Jun '04; Posts: 265; Likes: 32What a tough question. NICUhopeful87 you are a rare case, indeed. But a great success story to hear! I am going to guess that you are female? Makes a huge difference. Boys are generally wimpier. EGA save for me? Likely not below 29-30wks. Not with Gr II or above, certainly not with CDH (and premie), Left Hypoplast, Gastroschesis. I am sure there are others. It is so painful to watch and to do what we do every day to some of the poor babies.
Jun 19, '04Joined: Mar '04; Posts: 5,926; Likes: 15It won't ever be an issue with me since I am done having babies, but I have to say 28 weeks, unless one born sooner was doing EXCEPTIONALLY well....
I am of the mind that God has His reasons for everything and would put it firmly in His hands.
Jun 19, '04Joined: Jun '04; Posts: 107; Likes: 7I don't think you ever know what you'd do until you are in the situation. I didn't think I'd want heroic measures done to save a 23 weeker but when I was faced with it with my own child, the thought to not save her never crossed my mind and I'd been working NICU long enough to know what the odds were. Also factor in how your husband/family feels and it's not cut and dry about what to do. I wouldn't change a thing about our decision to save our daughters life.
Jun 19, '04Joined: May '02; Posts: 154; Likes: 3I don't think that anyone really knows until they are in that situation. And you have to remember that term or closer to it does not mean the baby is not at risk. I have a 37 week IUGR that is developmentally delayed. They knew I had a grade 3 placenta from 29 week. Over the next 8 weeks she only gained 2 pounds. I was never given a choice and I didn't know what the out come could be. A baby can regrow lung tissue, brain damage lasts a lifetime!
My friends daughter was a healthy term baby, at a year she started to limp...she has CP!
You just never know!
Jun 21, '06Joined: Jun '06; Posts: 8It would really depend on the situation....
My cousin just had a baby boy at 24 weeks, and he is doing OUTSTANDING.... no vent.... and looks great! So... I think it really depends on the situation. :angel2: :angel2:
Jun 21, '06Occupation: RN Clinician-United Biosource Specialty: 30 year(s) of experience in Pediatrics, Geriatrics ; From: US ; Joined: Feb '03; Posts: 1,237; Likes: 16Quote from fergus51Depends on the situation (how long was I ruptured, did I get steroids, what were the apgars...). I would probably say 26 weeks.
DEFINITELY not 22-23 weeks. It should be a criminal offense to torture those children the way we do. I work on them when the parents choose it, because it is their choice and not mine, but I would NEVER let my child be treated at that gestation.
This makes me very sad. I had a 23w/480gm daughter. They did give me the choice of what to do. They also told me the possible outcomes. She is not a happily ever after story, but she is a joy. She has CP, she had bleeds, and got NEC. I watched her code twice, they did it right in front of me. I wouldn't take it back either. She has a lot of challenges and so does our family. But she has brought my husband and myself closer together. She is progressing along her own curve. Since I have a preemie, I have met a lot of people who have preemies. There are a lot of 24 weekers who do just fine. For this reason I have chosen to want to be in the NICU. I want to support the parents in their decision whichever it may be and care for that 23-24 weeker. I believe that the choice to go all out on these little ones should be on a case by case basis. There should not be a black and white. JMHO
Jun 21, '06Joined: Jul '00; Posts: 11,351; Likes: 387I'm sorry my comment made you sad and I am glad your daughter has been a blessing in your life RNNow. I have looked after plenty of those babies and I do support the parents in their choice because like I said in that old post, it is THEIR choice and not mine. I even became the primary nurse for a family with a 23 weeker who insisted on treatment despite the docs telling them it was a lost cause (she did survive and her parents love her to bits). I agree with you that the decision to rescucitate should be black and white for someone else's baby, but the question was what would I want. I've been in the NICU for a few years and I still would never want MY baby treated at 22 or 23 weeks. I've seen too much and it breaks my heart.
Jun 21, '06Occupation: BSN RN Joined: Jan '02; Posts: 163; Likes: 8Anyone know how the George Bush Born Alive Protection Act works into this? Thanks!
Jun 21, '06Occupation: Med/Surg RN Specialty: 3 year(s) of experience in Med/Surg ; Joined: Jun '06; Posts: 12As the mother of a 27 weeker, now a healthy and beautiful 10 yr old, I can't really give a number, but I know that my husband and I were very blessed to have our daughter grow up with very little effects from her rocky start.
Jun 21, '06Occupation: Stay at home mom (for now) Joined: Jan '06; Posts: 165; Likes: 9My DH and I had to really think about this when I was pregnant with #2. I started having contractions at just under 21 wks. I was hospitalized and treated to stop the PTL. We were prepared for another rough pregnancy (I went into labor w/ #1 at 32 wks and delivered at 35 wk) but not for me having problems so early.
After a long and difficult discussion w/ my OB, family and each other we had made the decision not to do anything if I delivered before 24 wks unless the baby was doing really great by the doctor. I had to live with the fear of delivering a baby that was less than 24 wks for almost 3 wks. From 21 wks until 24 wks I wouldn't accept that I was pregnant and going to have a healthy baby, I had already planned on what I was going to do if something happened.
Thank God I could keep him in until he was 35 wks 2 days and he didn't need any special treatments (except bili lights for jaundice). It was a very scary time for my family and I, but we got through it. If it wasn't for the wonderful nurses and doctors I think that all my worst fears would have come true, but in fact all of my greatest dreams came true.
Jun 21, '06Occupation: RN-Retired Specialty: 27 year(s) of experience in NICU ; From: US ; Joined: Jul '02; Posts: 1,400; Likes: 163I hate to see 24 weekers resuscitated, chances are they will have problems. You never know, though. I had a 34 weeker as a patient, on a vent for a couple of days, extubated and doing well. The parents had 10 y/o twin girls, born at 24 weeks. I asked dad how they were doing. He told me their only problem is asthma! I suggested that he bring the girls in to see the sibling, because WE want to see how THEY are doing!
We don't keep micropremies, they all head on down the road. Some of the ones we get back as growing premies have had grade 3-4 bleeds, or NEC. They may be growing, but will have lifelong problems. Maybe 26 weeks would be a better place to start, unless the baby is vigorous. At least they have lungs, even if they need to be intubated. It would be a hard decision.