Management of Extreme Preterm Infants (22+0 to 23+6 weeks) (1293)

Network Principles Underpinning this Consensus Framework

Recommendations

• Perinatal Care for pregnancies and babies applicable to this framework will be delivered by NICU centres as described within the Best Start Model. (A)

• In-utero and/or ex-utero transfers will be to NICU centres. (A) ^2,3,5

• NICUs must prioritise capacity for such high-risk extreme premature babies and ensure a process to mitigate against transferring out women or babies at this gestation to alternative units. (A)

• NICU centres will provide perinatal support including shared decision making to LNUs and SCUs. (A) ^1,4

• NICUs will provide care in line with the recommendations detailed within this framework facilitating a consistency of practice across Scotland. (A)

• NICUs will participate in audit and case reviews on an annual basis to review outcomes and share learning to inform future planning of care delivery for this population of babies. (A)

(A) Practices that should virtually always be practiced.
(B) Evidence of benefit unclear – variation in practice likely.
(C) Unknown efficacy and safety - items that still need evidence and may be practiced as part of extended practice from infants born more mature or part of ethically approved research.