The NICU Side of Peri-Viable Birth

By on April 2, 2024

During the Healthful Woman podcast, host Dr. Fox and guest Annemarie Stroustrup, a neonatologist specializing in premature babies at the NICU, delve into the topic of peri-viable birth in the episode titled, “Peri-viable birth: The NICU Side.” Dr. Stroustrup shares insights drawn from her extensive experience in neonatal care.

About Peri-viable Birth

Peri-viable birth refers to the delicate stage between 23-24 weeks gestation. If a baby is born early, you may be faced with difficult decisions on their medical care. The decision to intervene involves complex considerations of fairness, medical possibility, and potential success.

Developmental Stages and Survival

If the lungs, intestines, congenital anomalies, and equipment are too small, it can be very difficult to resuscitate a baby. Dr. Stroustrup emphasizes, “If I can get oxygen in and carbon dioxide out and food in and growth to happen and all of those things, that’s really where we talk about it being ethically right to resuscitate.” These developments can happen around 25-27 weeks and are a critical period in development for the baby. Ethically a fetus without congenital anomalies at 25 weeks or beyond stands a high chance of survival with a normal life. Because of this critical developmental period, the ethical threshold for intervention occurs around 25 to 27 weeks.

Ethical Dilemmas

Navigating ethical dilemmas currently involves Doctors providing each family with comprehensive information and guiding them in framing their decisions.  Dr. Stroustrup states, “Families typically come in with some understanding of where they are on that spectrum, what they want, what they value, and if they haven’t thought about it, we hopefully can give them a little time to think about it.”

About NICU

The NICU provides comprehensive care for premature infants and offers round-the-clock visitation for parents. Many mothers pump breast milk to sustain their baby’s nutrition during this period. The NICU environment involves frequent blood testing and imaging to closely monitor the baby’s health. Each family is assigned a social worker and a case manager to provide support, ensure access to medical records, coordinate insurance matters, and facilitate discharge planning. Child-life specialists assist families in adjusting to the birth of a premature baby, including support for siblings.

Medical Advancements and Peri-viable Birth

Advancements in neonatal care have expanded the limits of viability, with improved nutrition, ventilator technology, neurodevelopmental care, and the availability of donor milk contributing to better outcomes for premature infants compared to previous decades.

Learn More

Listen to the Healthful Woman Podcast featuring Dr. Fox to learn more about women’s health. Remember that ongoing care from your regular physician and gynecologist is crucial in creating an effective treatment plan for your unique situation.

Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!