Perinatal Management of Extreme Preterm Birth Before 27 Weeks of Gestation

The purpose of this Framework for Practice is to assist decision-making prior to and/or at the time of birth relating to perinatal care and preterm birth at 26 weeks and 6 days of gestation or less in the United Kingdom. 

While this update retains the core elements of the 2019 Framework, we have made revisions to provide clearer language, support and guidance around appropriate decisions for babies assessed to be at extremely high risk of dying. It emphasises that for such babies, comfort care should be provided. 

This framework also includes updated survival and neurodevelopmental outcome figures and a revised infographic including information on the proportion of babies liveborn.

We welcome your comments on this DRAFT document ahead of a final version being published later this year.

Consultation closes: 30 September 2025

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Infographics

We have revised the infographics to additionally provide the proportion of livebirths. There are two options and we would welcome feedback as part of this consultation.

Infographic 1: For each gestational age 22-26 weeks, provides the proportion of livebirths, survival for babies given intensive care, and severe disability (3 columns).

OR

Infographic 2 and 3 together

Some feedback suggested that 3 columns for each GA may be too much, and that information for counselling could be more detailed and distinct for babies born 22-23 weeks GA, given that for 24-26 weeks, these data are mainly for information provision rather than informing decision making for survival focused care.

• Infographic 2
  All GA: survival and severe disability for 22-26 weeks (i.e. no column for proportion of livebirths).
• Infographic 3
  For 22-23 weeks – more detail, including proportion of livebirths (with dots illustration), survival and severe disability.