Tuesday, September 11, 2007

Clarification

I just wanted to say that I do not necessarily disagree with our NICU's policy on resuscitation. 21 weekers are almost never resuscitated anywhere in the world, and although Keiry was breathing when she was born, it does not then follow that she would have been able to survive had she been intubated. There is much growth and lung development between 21 and 23 weeks. Even Keiry's tiny fingers were still partially webbed. I have done some reading on the age of viability and although there are some variations, I have not read about 21 weekers surviving on a regular basis if at all. I also don't know if my sister-in-law was closer to 21.0 or 21.6. Either way, our NICU has its policy based on research of survival statistics and outcomes. It is terrible to know that if Keiry had remained in utero for only 2 more weeks she would have had a chance at life, but unfortunately this was not the case.
When my other brother-in-law said "if she was breathing why didn't they at least try" I reminded him of my Edwin. As you know my 2 were 23 and barely 5 days gestation (born at 3am on the 5th day.) My son barely had the lung capacity to survive. I'm not a biologist and do not pretend to know a whole lot about fetal development, but I do know the degree of lung disease my son has, and I watched as he failed on the highest settings on the osciallator time and time again. I reminded my family of this and told them that at 23 weeks we were told for every day I remained pregnant through the end of 24 weeks, the percentage of survival increased by 4%. That's a 4% increase EVERY day, and in this case we needed weeks for Keiry's survival.
I just wanted to clarify this based upon a comment I received. 21 weeks is drastically different from 26 weeks, and in all reality, 23 weeks is significantly different than 26 weeks. I am not advocating for pushing viability back too far. As 23 weekers my kids had an extremely difficult NICU course and the affects will probably last a lifetime. Don't get me wrong, I would do nothing different and I am sooo thankful for S&E; I'm just saying, I would need more evidence that at 21 weeks a baby has a decent shot at survival before I would begin to advocate for resuscitation at that gestation. And unfortunately, there is just no evidence to show a baby is viable at only 21 weeks even though they can make initial respiratory effort.

2 comments:

Sarah said...

Please forgive me. I didn't mean to suggest the baby should have been resuscitated, only that my 26-weeker was more like a 23-weeker at assessment because he stopped growing. He wasn't what one would normally expect for a 26-weeker.
Sometimes (because it's all I know) I assume that my son's situation is normal.

23wktwinsmommy said...

It's no problem, I just reread my posts and wanted to clarifiy...especially too for people who read this without micropreemies who don't know as much about gestational age. I just thought my posts might have confused some...thanks for commenting.