Literature DB >> 19633753

Treatment of preterm infants at the lower margin of viability--a comparison of guidelines in German speaking countries.

Roland Hentschel1, Stella Reiter-Theil.   

Abstract

INTRODUCTION: The treatment of preterm infants at the lower margin of viability is carried out amid growing tension between increasing survival rates, uncertain clinical outcomes, and financial and ethical considerations. The three German speaking countries have released guidelines on this issue, based on a previous common guideline. That is why the differences in national guidelines between the three countries is of peculiar interest in respect of medical ethics.
METHODS: Current guidelines from Germany, Switzerland, and Austria were compared and similarities and differences discussed.
RESULTS: The three countries' guidelines follow broadly similar principles, with almost identical intellectual underpinnings and formulations. Some national differences are apparent, nevertheless. DISCUSSION: All three guidelines call for a pragmatic approach. National guidelines can only predetermine the framework, with long-term collection of sound local data on morbidity and mortality forming a prerequisite for decision-making, and also in discussions with parents.

Entities:  

Keywords:  ethics; guidelines; palliative care; preterm infant; viability

Year:  2008        PMID: 19633753      PMCID: PMC2696678          DOI: 10.3238/arztebl.2008.0047

Source DB:  PubMed          Journal:  Dtsch Arztebl Int        ISSN: 1866-0452            Impact factor:   5.594


  10 in total

1.  Obtaining informed consent to neonatal randomised controlled trials: interviews with parents and clinicians in the Euricon study.

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2.  End-of-life decisions in neonatal intensive care: physicians' self-reported practices in seven European countries. EURONIC Study Group.

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3.  Medical staff guidelines for periviability pregnancy counseling and medical treatment of extremely premature infants.

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Journal:  Pediatrics       Date:  2006-01       Impact factor: 7.124

4.  Delivery room decision-making for extremely preterm infants in Sweden.

Authors:  Jehanna M Peerzada; Jens Schollin; Stellan Håkansson
Journal:  Pediatrics       Date:  2006-06       Impact factor: 7.124

5.  Survival and major neonatal complications in infants born between 22 0/7 and 24 6/7 weeks of gestation (1999-2003).

Authors:  Jean-Claude Fauchère; Hans Ulrich Bucher; Guy Moriette; Arnold Pollak
Journal:  Am J Obstet Gynecol       Date:  2007-05       Impact factor: 8.661

6.  28-day survival rates of 6676 neonates with birth weights of 1250 grams or less.

Authors:  D L Phelps; D R Brown; B Tung; G Cassady; R E McClead; D M Purohit; E A Palmer
Journal:  Pediatrics       Date:  1991-01       Impact factor: 7.124

7.  Perinatal care at the threshold of viability.

Authors:  Hugh MacDonald
Journal:  Pediatrics       Date:  2002-11       Impact factor: 7.124

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Authors:  Roland Hentschel; Katharina Lindner; Markus Krueger; Stella Reiter-Theil
Journal:  Pediatrics       Date:  2006-08       Impact factor: 7.124

9.  Perinatal care at the borderlines of viability: a consensus statement based on a NSW and ACT consensus workshop.

Authors:  Kei Lui; Barbara Bajuk; Kirsty Foster; Arnolda Gaston; Alison Kent; John Sinn; Kaye Spence; Wendy Fischer; David Henderson-Smart
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  10 in total
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Review 1.  [Interdisciplinary stratification of patients with myoma-related symptoms].

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Review 2.  Shall parent / patient wishes be fulfilled in any case? A series of 32 ethics consultations: from reproductive medicine to neonatology.

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  2 in total

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