Straight from the Heart: IMA-IAP-NNF Policy on viability in India
As per the ILCOR / AAP / AHA 2015 Neonatal
Resuscitation Guidelines Subsection on Withholding Resuscitation we quote:
“There
is a no evidence to support the use of any particular delivery room prognostic
score presently available over gestational age assessment alone, in preterm
infants at less than 25 weeks gestation”.
As per the NRP Guidelines 3rd Edition
(India) “Neonatal Resuscitation: India
“Questions
about initiation of Resuscitation for extremely premature babies is a grey
area. Babies born between 24+ to 28 weeks has been increasing in the developed
countries, it may still not be true for most parts of our country. Non
initiation of Resuscitation may be considered appropriate in confirmed
gestation below 25 weeks (20 weeks to 24 completed weeks), anencephaly,
and confirmed lethal genetic malformation disorder”.
The most read textbook of community medicine
in India ‘Park’s Textbook of Preventive and Social Medicine’ states that “viability is a stage when foetus becomes
capable of living independently, this has been fixed administratively at 28
weeks, when the foetus weighs approximately 1000 g”.[1]
IMA-IAP-NNF
Policy
Viability
is defined as >28 weeks and more than 1000 grams. Anything less than
that level of treatment has to be decided on case to case basis based on
chances of intact survival, informed consent taking into consideration social
determinants of health. Basic care should not be compromised.
Reference
1. Park K.
Demography and Family Planning. In: Park K, editor. Park’s Textbook of
Preventive and Social Medicine. 24th ed. Jabalpur: Bhanot; 2017.p.539.
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