Jefferies Ann L, Kirpalani Haresh M
Paediatr Child Health. 2012 Oct;17(8):443-6. doi: 10.1093/pch/17.8.443.
Extremely preterm birth (birth between 22(0/7) and 25(6/7) weeks' gestational age [GA]) often requires parents to make complex choices about the care of their infant. Health professionals have a significant role in providing information, guidance and support. Parents facing the birth of an extremely preterm infant should have the chance to meet with both obstetrical and paediatric/neonatal care providers to receive accurate information about their infant's prognosis, provided with clarity and compassion. Decision making between parents and health professionals should be an informed and shared process, with documentation of all management decisions. Consultation with and transfer to tertiary perinatal centres are important for the care of both mother and fetus. As the survival of infants born before or at 22 completed weeks' GA remains uncommon, a noninterventional approach is recommended, whereas at 23, 24 and 25 weeks' GA, counselling about outcomes and decision making should be individualized for each infant and family, using factors which influence prognosis. All extremely preterm infants who are not resuscitated, or for whom resuscitation is not successful, must receive compassionate palliative care.
极早早产（孕龄在22(0/7)至25(6/7)周之间出生）通常需要父母就其婴儿的护理做出复杂的选择。卫生专业人员在提供信息、指导和支持方面发挥着重要作用。面临极早早产儿出生的父母应有机会与产科和儿科/新生儿护理人员会面，以获得有关其婴儿预后的准确信息，且信息应清晰明了并富有同情心。父母与卫生专业人员之间的决策应是一个明智且共同参与的过程，所有管理决策都应记录在案。咨询三级围产期中心并转诊至该中心对于母亲和胎儿的护理都很重要。由于孕龄在22足周之前或之时出生的婴儿存活情况仍不常见，因此建议采取非干预性方法，而对于孕龄在23、24和25周的婴儿，应根据影响预后的因素，为每个婴儿及其家庭提供个性化的预后咨询和决策指导。所有未进行复苏或复苏未成功的极早早产儿都必须接受富有同情心的姑息治疗。
