Sunday, April 20, 2008

New Tool for Doctors and Parents

The NIH (National Institutes of Health) has created a new tool to help parents and physicians make decisions regarding the extent of care that will be given to a newborn premature infant (22-25 weeks gestation).

4 key bits of information are entered (weight or estimated weight based on US, sex, gestation and whether or not the mother received steroids before birth) and then a chart is displayed with statistics showing survival rates and the percentage of those with mild to profound disabilities.

Directly from the NIH website...

"Every day, physicians and new parents must struggle with the type of care to provide to extremely low birth weight infants, the smallest, most frail category of preterm infants. These infants are born in the 22nd through the 25th week of pregnancy—far earlier than the 40 weeks of a full term pregnancy. Many die soon after birth, despite the best attempts to save them, including the most sophisticated newborn intensive care available. Some survive and reach adulthood, relatively unaffected. The rest will experience some degree of life long disability, ranging from minor hearing loss to blindness, to cerebral palsy, to profound intellectual disability.

The study authors referred to the issue of providing intensive care for extremely low birth weight infants. For example, physicians and family members may be reluctant to expose an infant to painful life support procedures if the infant is unlikely to survive. In such cases, they may opt for “comfort care,” which provides for an infant’s basic needs, but foregoes painful medical procedures. In deciding the kind of care to provide, specialists at intensive care facilities traditionally have relied heavily on an infant’s gestational age—the week of pregnancy a premature infant is born. Gestational age is known to play a large role in the infant’s survival. For this reason, in many facilities, intensive care is likely to be routinely given to infants born in the 25th week of pregnancy, whereas infants born in the 22nd week may be more likely to receive comfort care."

Although I am encouraged to see that parents will be given a choice and hopefully some useful information, I wonder how many docs are aware of this information or will even use it.

It is a start nonetheless.

Saturday, April 5, 2008


First off, thank you to all who contributed to Chris' ethical discussion. I have been fascinated with all of the responses and different view points. I enjoy being challenged and medical ethics has done just that for me.

I have received a few emails wondering why I have not commented. It would take too long to explain at this time, but in short, I am not in a place in my life that I can take a step back and be objective. Things have been on the rough side here and I am not able to sort out my thoughts or emotions. I have read every comment though and feel very thankful that most all have refrained from being less than polite. I honestly believe that we learn a lot about each other with each challenging topic.

On a another note... we are headed out of town to have some fun. Much deserved fun. Although I will have my laptop, I am going to try very hard to spend some time away from it.

Lastly, thank you to all who have continued to visit The Preemie Experiment. I've been somewhat absent but I assure you, I am not going anywhere. I still feel that together, with all of our various viewpoints, we can make the future brighter for the new crop of preemies being born each day.

I want to leave you all with a video that I found very interesting. Although not directly related to prematurity, I think Jill Bolte Tayler's experience will open some doors into the world of the human brain.