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Re: Ob: Late Preterm DeliveryFrom: DoctorJoe@aol.comTue Apr 22 09:45:46 2008
In a message dated 4/22/08 8:35:42 AM, garrys@mindspring.com writes:
> Well, there was a sentiment floating around that if a preterm pregnancy, say at 24 weeks, was starting to "give trouble" (you define "give trouble" however you like) then you need to strongly think about "letting nature take her course" so as not to deliver, say, a 27 weeker who will have lasting deficits. I got the distinct impression that the relatively recent (say, last 20 years?) strategy of "let's try to get them to at least 28 weeks so we can save them in the nursery" was somehow being warped to "don't do anything UNTIL 28 weeks so we don't have lots of long-term morbidity." It all had to do with a couple of studies showing a fairly high rate of long term neurologic and physical morbidity in extreme prematures who lived. The philosphy was being advanced that you need to give STRONG "informed" consent to the parents about the wisdom of "letting nature take her course." So maybe they're trying to put that back in the box. Joe P.
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