MBRRACE-UK have released guidance on the 'Determination of signs of life following spontaneous births before 24+0 weeks of gestation where, following discussion with parents, active survival-focused care is not appropriate.'

This UK guidance was developed in collaboration with BAPM and is to support health care professionals in the assessment and documentation of signs of life in extremely preterm births. It aims to reduce the confusion and distress experienced by parents and increase the consistency of the registration of births and deaths.

Births included in this guidance

  • In-hospital spontaneous births <22+0 weeks
  • In-hospital spontaneous births at 22+0 to 23+6 weeks where, following discussion and agreement with parents, active survival-focused care is not appropriate
  • These principles may also apply to pre-hospital spontaneous births <20+0 weeks—for pre-hospital births at 22+0 to 23+6 weeks, see JRCALC Care for the newborn.

Births not included in this guidance

  • Medical terminations of pregnancy
  • Spontaneous births of uncertain gestation
  • Spontaneous births at 22+0 to 23+6 weeks of gestation where initiation of active survival-focused neonatal care is planned or uncertain

This guidance is only for births where, following discussion with the parents, active survival focused care is not appropriate. For decision making relating to perinatal care and preterm delivery see BAPM Framework for Practice on perinatal management of extreme preterm birth before 27 weeks of gestation.

Read MBRRACE-UK guidance

British Association of Perinatal Medicine (BAPM) is registered in England & Wales under charity number 285357 at 5-11 Theobalds Road, London, WC1X 8SH.
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