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Re: Survey: Pre-viable But Living Newborns From: Garry E. Siegel, M.D. (garrys@mindspring.com) Fri May 29 23:08:12 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Garry E. Siegel, M.D.: "Re: OB: My case list..." Previous message: fseddon@interlog.com: "Re: My case list...TAH in 18yr" In reply to: perinatl@sprynet.com: "Survey: Pre-viable But Living Newborns" Next in thread: WashoeB@aol.com: "Re: Survey: Pre-viable But Living Newborns" >My questions: > >What is the policy in your hospital and what do you think the policy should >be concerning the birth of a live but pre-viable infant. i.e., an infant >incapable of sustained life outside the uterus because of severe prematurity? If there is any sign of life (ie any heartbeat, movement, or breathing, the infant irrespective of age, size, fused eyes, etc., is taken to the ICU to a warm bed. It is usually done slowly, and the baby stays with the Mom for a little while if she wishes. Obviously, if they're 19 weekers, it's really slow if the Mom wants; if it is 23, they move to the nursery quickly. The lawyers told us that the Ob has a stake in the outcome,a nd if we do things to hasten demise (ie keep it in the room with the Mom and *never* go to the ICU), then this could be interpreted as facilitating death to avoid a neurologically impaired baby (and the possible large lawsuit). > >- At delivery if the infant has a heart beat but is clearly pre-viable, is >it considered a livebirth or a stillbirth? If it might be considered a >stillbirth, under what criteria is the distinction made between stillbirth >and livebirth -- weight, estimated gestational age, head circumference or >other criteria? We call it a live birth and fill out those kind of papers, and a death certificate, if it is alive (see above). > >- Is the infant admitted to the hospital or not? Yes, I think, by the Neonatologist. Actually, at one hospital, I had to do the babies' (twins, 19 weeks) charts. > >- If admitted, who is the admitting physician or physician of record -- the >obstetrician or a pediatrician? > >- Is a livebirth certificate completed or is a stillbirth certificate (or >some other certificate) completed? How is the distinction made as to which >certificate to complete. Is a death certificate completed? Who signs these >certificates? > >- How is this birth counted on the hospital statistics? Don't know > >- Are there any other questions or comments on this issue? -- Garry E. Siegel, M.D., FACOG Private Practice Roswell, Ga. Next message: Garry E. Siegel, M.D.: "Re: OB: My case list..." Previous message: fseddon@interlog.com: "Re: My case list...TAH in 18yr" In reply to: perinatl@sprynet.com: "Survey: Pre-viable But Living Newborns" Next in thread: WashoeB@aol.com: "Re: Survey: Pre-viable But Living Newborns"

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